118     I cannot therefore advise, for instance, the local extirpation of the so-called cancer of the lips and face (the product of highly developed psora, not infrequently in conjunction with syphilis) by means of the arsenical remedy of Frère Cosme, not only because it is excessively painful and often fails, but more for this reason, because, if this dynamic remedy should indeed succeed in freeing the affected part of the body from the malignant ulcer locally, the basic malady is thereby not diminished in the slightest, the preserving vital force is therefore necessitated to transfer the field of operation of the great internal malady to some more important part (as it does in every case of metastasis), and the consequence is blindness, deafness, insanity, suffocative asthma, dropsy, apoplexy, etc. But this ambiguous local liberation of the part from the malignant ulcer by the topical arsenical remedy only succeeds, after all, in those cases where the ulcer has not yet attained any great size, and when the vital force is still very energetic; but it is just in such a state of things that the complete internal cure of the whole original disease is also still practicable.      The result is the same without previous cure of the inner miasm when cancer of the face or breast is removed by the knife alone and when encysted tumors are enucleated; something worse ensues, or at any rate death is hastened. This has been the case times without number, but the old school still goes blindly on in the same way in every new case, with the same disastrous results.