§ 201     It is evident that man's vital force, when encumbered with a chronic disease which it is unable to overcome by its own powers instinctively, adopts the plan of developing a local malady on some external part, solely for this object, that by making and keeping in a diseased state this part which is not indispensable to human life, it may thereby silence the internal disease, which otherwise threatens to destroy the vital organs (and to deprive the patient of life), and that it may thereby, so to speak, transfer the internal disease to the vicarious local affection and, as it were, draw it thither. The presence of the local affection thus silences, for a time, the internal disease, though without being able either to cure it or to diminish it materially.¹¹⁶ The local affection, however, is never anything else than a part of the general disease, but a part of it increased all in one direction by the organic vital force, and transferred to a less dangerous (external) part of the body, in order to allay the internal ailment. But (as has been said) by this local symptom that silences the internal disease, so far from anything being gained by the vital force towards diminishing or curing the whole malady, the internal disease, on the contrary, continues, in spite of it, gradually to increase and Nature is constrained to enlarge and aggravate the local symptom always more and more, in order that it may still suffice as a substitute for the increased internal disease and may still keep it under. Old ulcers on the legs get worse as long as the internal psora is uncured, the chancre enlarges as long as the internal syphilis remains uncured, the fig warts increased and grow while the sycosis is not cured whereby the latter is rendered more and more difficult to cure, just as the general internal disease continues to increase as time goes on.

§ 202     If the old-school physician should now destroy the local symptom by the topical application of external remedies, under the belief that he thereby cures the whole disease, Nature makes up for its loss by rousing the internal malady and the other symptoms that previously existed in a latent state side by side with the local affection; that is to say, she increases the internal disease. When this occurs it is usual to say, though incorrectly that the local affection has been driven back into the system or upon the nerves by the external remedies.

§ 203     Every external treatment of such local symptoms, the object of which is to remove them from the surface of the body, whilst the internal miasmatic disease is left uncured, as, for instance, driving off the skin the psoric eruption by all sorts of ointments, burning away the chancre by caustics and destroying the condylomata on their seat by the knife, the ligature or the actual cautery; this pernicious external mode of treatment, hitherto so universally practised, has been the most prolific source of all the innumerable named or unnamed chronic maladies under which mankind groans; it is one of the most criminal procedures the medical world can be guilty of, and yet it has hitherto been the one generally adopted, and taught from the professional chairs as the only one.¹¹⁷

§ 204     If we deduct all chronic affections, ailments and diseases that depend on a persistent unhealthy mode of living (§ 77), as also those innumerable medicinal maladies (v. § 74) caused by the irrational, persistent, harassing and pernicious treatment of diseases often only of trivial character by physicians of the old school, most the remainder of chronic diseases result from the development of these three chronic miasms, internal syphilis, internal sycosis, but chiefly and in infinitely greater proportion, internal psora. Each of these infections was already in possession of the whole organism, and had penetrated it in all directions before the appearance of the primary, vicarious local symptom of each of them (in the case of psora the scabious eruption, in syphilis the chancre or the bubo, and in sycosis the condylomata) that prevented their outburst; and these chronic miasmatic diseases, if deprived of their local symptom, are inevitably destined by mighty Nature sooner or later to become developed and to burst forth, and thereby propagate all the nameless misery, the incredible number of chronic diseases which have plagued mankind for hundreds and thousands of years, none of which would so frequently have come into existence had physicians striven in a rational manner to cure radically and to extinguish in the organism these three miasms without employing local remedies for their corresponding external symptoms, relying solely on the proper internal homœopathic medicines for each. (See note to § 282).

§ 205     The homœopathic physician never treats one of these primary symptoms of chronic miasms, nor yet one of their secondary affections that result from their further development, by local remedies (neither by those external agents that act dynamically,¹¹⁸ nor yet by those that act mechanically), but he cures, in cases where the one or the other appears, only the great miasm on which they depend, whereupon its primary, as also its secondary symptoms disappear spontaneously; but as this was not the mode pursued by the old-school practitioners who preceded him in the treatment of the case, the homœopathic physician generally, alas! finds that the primary symptoms¹¹⁹ have already been destroyed by them by means of external remedies, and that he has now to do more with the secondary ones, i.e., the affections resulting from the breaking forth and development of these inherent miasms, but especially with the chronic diseases evolved from internal psora, the internal treatment of which, as far as a single physician can elucidate it by many years of reflection, observation and experience, I have endeavored to point out in my work on Chronic Diseases, to which I must refer the reader.

§ 206     Before commencing the treatment of a chronic disease, it is necessary to make the most careful investigation¹²⁰ as to whether the patient has had a venereal infection (or an infection with condylomatous gonorrhœa); for then the treatment must be directed towards this alone, when only the signs of syphilis (or of the rarer condylomatous disease) are present, but this disease is very seldom met with alone nowadays. If such infection has previously occurred, this must also be borne in mind in the treatment of those cases in which psora is present, because in them the latter is complicated with the former, as is always the case when the symptoms are not those of pure syphilis; for when the physician thinks he has a case of old venereal disease before him, he has always, or almost always, to treat a syphilitic affection accompanied mostly by (complicated with) psora, for the internal itch dyscrasia (the psora) is far the most frequent fundamental cause of chronic diseases. At times, both miasms may be complicated also with sycosis in chronically diseased organisms, or, as is much more frequently the case, psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear, which are, moreover, so often bungled, increased and disfigured to a monstrous extent by allopathic unskillfulness.

§ 207     When the above information has been gained, it still remains for the homœopathic physician to ascertain what kinds of allopathic treatment had up to that date been adopted for the chronic disease, what perturbing medicines had been chiefly and most frequently employed, also what mineral baths had been used and what effects these had produced, in order to understand in some measure the degeneration of the disease from its original state, and, where possible, to correct in part these pernicious artificial operations, or to enable him to avoid the employment of medicines that have already been improperly used.

§ 208     The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relations and so forth must next be taken into consideration, in order to ascertain whether these things have tended to increase his malady, or in how far they may favor or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that presents any obstacle to the treatment, or requires to be directed, encouraged or modified.

§ 209     After this is done, the physician should endeavor in repeated conversations with the patient to trace the picture of his disease as completely as possible, according to the directions given above, in order to be able to elucidate the most striking and peculiar (characteristic) symptoms, in accordance with which he selects the first antipsoric or other remedy having the greatest symptomatic resemblance, for the commencement of the treatment, and so forth.

§ 210     Of psoric origin are almost all those diseases that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their other morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease sharply separated from all others, since in all other so-called corporeal diseases the condition of the disposition and mind is always altered;¹²¹ and in all cases of disease we are called on to cure the state of the patient's disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homœopathically with success.

§ 211     This holds good to such an extent, that the state of the disposition of the patient often chiefly determines the selection of the homœopathic remedy, as being a decidedly characteristic symptom which can least of all remain concealed from the accurately observing physician.

§ 212     The Creator of therapeutic agents has also had particular regard to this main feature of all diseases, the altered state of the disposition and mind, for there is no powerful medicinal substance in the world which does not very notably alter the state of the disposition and mind in the healthy individual who tests it, and every medicine does so in a different manner.

§ 213     We shall, therefore, never be able to cure conformably to nature—that is to say, homœopathically—if we do not, in every case of disease, even in such as are acute, observe, along with the other symptoms, those relating to the changes in the state of the mind and disposition, and if we do not select, for the patient's relief, from among the medicines a disease-force which in addition to the similarity of its other symptoms to those of the disease, is also capable of producing a similar state of the disposition and mind.¹²²

§ 214     The instructions I have to give relative to the cure of mental diseases may be confined to a very few remarks, as they are to be cured in the same way as all other diseases, namely, by a remedy which shows, by the symptoms it causes in the body and mind of a healthy individual, a power of producing a morbid state as similar as possible to the case of disease before us, and in no other way can they be cured.

§ 215     Almost all the so-called mental and emotional diseases are nothing more than corporeal diseases in which the symptom of derangement of the mind and disposition peculiar to each of them is increased, whilst the corporeal symptoms decline (more or less rapidly), till it a length attains the most striking one-sidedness, almost as though it were a local disease in the invisible subtle organ of the mind or disposition.

§ 216     The cases are not rare in which a so-called corporeal disease that threatens to be fatal—a suppuration of the lungs, or the deterioration of some other important viscus, or some other disease of acute character, e.g., in childbed, etc.—becomes transformed into insanity, into a kind of melancholia or into mania by a rapid increase of the psychical symptoms that were previously present, whereupon the corporeal symptoms lose all their danger; these latter improve almost to perfect health, or rather they decrease to such a degree that their obscured presence can only be detected by the observation of a physician gifted with perseverance and penetration. In this manner they become transformed into a one-sided and, as it were, a local disease, in which the symptom of the mental disturbance, which was at first but slight, increases so as to be the chief symptom, and in a great measure occupies the place of the other (corporeal) symptoms, whose intensity it subdues in a palliative manner, so that, in short, the affections of the grosser corporeal organs become, as it were, transferred and conducted to the almost spiritual, mental and emotional organs, which the anatomist has never yet and never will reach with his scalpel.

§ 217     In these diseases we must be very careful to make ourselves acquainted with the whole of the phenomena, both those belonging to the corporeal symptoms, and also, and indeed particularly, those appertaining to the accurate apprehension of the precise character of the chief symptom, of the peculiar and always predominating state of the mind and disposition, in order to discover, for the purpose of extinguishing the entire disease, among the remedies whose pure effects are known, a homœopathic medicinal pathogenetic force—that is to say, a remedy which in its list of symptoms displays, with the greatest possible similarity, not only the corporeal morbid symptoms present in the case of disease before us, but also especially this mental and emotional state.

§ 218     To this collection of symptoms belongs in the first place the accurate description of all the phenomena of the previous so-called corporeal disease, before it degenerated into a one-sided increase of the physical symptom, and became a disease of the mind and disposition. This may be learned from the report of the patient's friends.

§ 219     A comparison of these previous symptoms of the corporeal disease with the traces of them that still remain, though they have become less perceptible (but which even now sometimes become prominent, when a lucid interval and a transient alleviation of the psychical disease occurs), will serve to prove them to be still present, though obscured.

§ 220     By adding to this the state of the mind and disposition accurately observed by the patient's friends and by the physician himself, we have thus constructed the complete picture of the disease, for which, in order to effect the homœopathic cure of the disease, a medicine capable of producing strikingly similar symptoms, and especially an analogous disorder of the mind, must be sought for among the antipsoric remedies, if the psychical disease has already lasted some time.

§ 221     If, however, insanity or mania (caused by fright, vexation, the abuse of spirituous liquors, etc.) has suddenly broken out as an acute disease in the patient's ordinary calm state, although it almost always arises from internal psora, like a flame bursting forth from it, yet when it occurs in this acute manner it should not be immediately treated with antipsorics, but in the first place with remedies indicated for it out of the other class of proved medicaments (e.g., aconite, belladonna, stramonium, hyoscyamus, mercury, etc.) in highly potentized, minute, homœopathic doses, in order to subdue it so far that the psora shall for the time revert to its former latent state, wherein the patient appears as if quite well.

§ 222     But such a patient, who has recovered from an acute mental or emotional disease by the use of these non-antipsoric medicines, should never be regarded as cured; on the contrary, no time should be lost in attempting to free him completely,¹²³ by means of a prolonged antipsoric treatment, from the chronic miasm of the psora, which, it is true, has now become once more latent but is quite ready to break out anew; if this be done, there is no fear of another similar attack, if he attend faithfully to the diet and regimen prescribed for him.

§ 223     But if the antipsoric treatment be omitted, then we may almost assuredly expect, from a much slighter cause than brought on the first attack of the insanity, the speedy occurrence of a new and more lasting and severe fit, during which the psora usually develops itself completely, and passes into either a periodic or continued mental derangement, which is then more difficult to be cured by antipsorics.

§ 224     If the mental disease be not quite developed, and if it be still somewhat doubtful whether it really arose from a corporeal affection, or did not rather result from faults of education, bad practices, corrupt morals, neglect of the mind, superstition or ignorance; the mode of deciding this point will be, that if it proceed from one or other of the latter causes it will diminish and be improved by sensible friendly exhortations, consolatory arguments, serious representations and sensible advice; whereas a real moral or mental malady, depending on bodily disease, would be speedily aggravated by such a course, the melancholic would become still more dejected, querulous, inconsolable and reserved, the spiteful maniac would thereby become still more exasperated, and the chattering fool would become manifestly more foolish.¹²⁴

§ 225     There are, however, as has just been stated, certainly a few emotional diseases which have not merely been developed into that form out of corporeal diseases, but which, in an inverse manner, the body being but slightly indisposed, originate and are kept up by emotional causes, such as continued anxiety, worry, vexation, wrongs and the frequent occurrence of great fear and fright. This kind of emotional diseases in time destroys the corporeal health, often to a great degree.

§ 226     It is only such emotional diseases as these, which were first engendered and subsequently kept up by the mind itself, that, while they are yet recent and before they have made very great inroads on the corporeal state, may, by means of psychical remedies, such as a display of confidence, friendly exhortations, sensible advice, and often by a well-disguised deception, be rapidly changed into a healthy state of the mind (and with appropriate diet and regimen, seemingly into a healthy state of the body also).

§ 227     But the fundamental cause in these cases also is a psoric miasm, which was only not yet quite near its full development, and for security's sake, the seemingly cured patient should be subjected to a radical antipsoric treatment, in order that he may not again, as might easily occur, fall into a similar state of mental disease.

§ 228     In mental and emotional diseases resulting from corporeal maladies, which can only be cured by homœopathic antipsoric medicine conjoined with carefully regulated mode of life, an appropriate psychical behavior towards the patient on the part of those about him and of the physician must be scrupulously observed, by way of an auxiliary mental regimen. To furious mania we must oppose clam intrepidity and cool, firm resolution—to doleful, querulous lamentation, a mute display of commiseration in looks and gestures—to senseless chattering, a silence not wholly inattentive—to disgusting and abominable conduct and to conversation of a similar character, total inattention. We must merely endeavor to prevent the destruction and injury of surrounding objects, without reproaching the patient for his acts, and everything must be arranged in such a way that the necessity for any corporeal punishments and tortures¹²⁵ whatever may be avoided. This is so much the more easily effected, because in the administration of the medicine—the only circumstance in which the employment of coercion could be justified—in the homœopathic system the small doses of the appropriate medicine never offend the taste, and may consequently be given to the patient without his knowledge in his drink, so that all compulsion is unnecessary.

§ 229     On the other hand, contradiction, eager explanations, rude corrections and invectives, as also weak, timorous yielding, are quite out of place with such patients; they are equally pernicious modes of treating mental and emotional maladies. But such patients are most of all exasperated and their complaint aggravated by contumely, fraud, and deceptions that they can detect. The physician and keeper must always pretend to believe them to be possessed of reason.
     All kinds of external disturbing influences on their senses and disposition should be if possible removed; there are no amusements for their clouded spirit, no salutary distractions, no means of instruction, no soothing effects from conversation, books or other things for the soul that pines or frets in the chains of the diseased body, no invigoration for it, but the cure; it is only when the bodily health is changed for the better that tranquillity and comfort again beam upon their mind.¹²⁶

§ 230     If the antipsoric remedies selected for each particular case of mental or emotional disease (there are incredibly numerous varieties of them) be quite homœopathically suited for the faithfully traced picture of the morbid state, which, if there be a sufficient number of this kind of medicines known in respect of their pure effects, is ascertained by an indefatigable search for the most appropriate homœopathic remedy all the more easily, as the emotional and mental state, constituting the principal symptom of such a patient, is so unmistakably perceptible,—then the most striking improvement in no very long time, which could not be brought about by physicking the patient to death with the largest oft-repeated doses of all other unsuitable (allopathic) medicines. Indeed, I can confidently assert, from great experience, that the vast superiority of the homœopathic system over all other conceivable methods of the treatment is nowhere displayed in a more triumphant light than in mental and emotional diseases of long standing, which originally sprang from corporeal maladies or were developed simultaneously with them.

§ 231     The intermittent diseases deserve a special consideration, as well those that recur at certain periods—like the great number of intermittent fevers, and the apparently non-febrile affections that recur at intervals like intermittent fevers—as also those in which certain morbid states alternate at uncertain intervals with morbid states of a different kind.

§ 232     These latter, alternating diseases, are also very numerous,¹²⁷ but all belong to the class of chronic diseases; they are generally a manifestation of developed psora alone, sometimes, but seldom, complicated with a syphilitic miasm, and therefore in the former case may be cured by antipsoric medicines; in the latter, however, in alternation with antisyphilitics as taught in my work on the Chronic Diseases.

§ 233     The typical intermittent diseases are those where a morbid state of unvarying character returns at a tolerably fixed period, whilst the patient is apparently in good health, and takes its departure at an equally fixed period; this is observed in those apparently non-febrile morbid states that come and go in a periodical manner (at certain times), as well as in those of a febrile character, to wit, the numerous varieties of intermittent fevers.

§ 234     Those apparently non-febrile, typical, periodically recurring morbid states just alluded to observed in one single patient at a time (they do not usually appear sporadically or epidemically) always belong to the chronic diseases, mostly to those that are purely psoric, are but seldom complicated with syphilis, and are successfully treated by the same means; yet it is sometimes necessary to employ as an intermediate remedy a small dose of a potentized solution of cinchona bark, in order to extinguish completely their intermittent type.

§ 235     With regard to the intermittent fevers,¹²⁸ that prevail sporadically or epidemically (not those endemically located in marshy districts), we often find every paroxysm likewise composed of two opposite alternating states (cold, heat—heat, cold), more frequently still of three (cold, heat, sweat). Therefore the remedy selected for them from the general class of proved (common, not antipsoric) medicines must either (and remedies of this sort are the surest) be able likewise to produce in the healthy body two (or all three) similar alternating states, or else must correspond by similarity of symptoms, in the most homœopathic manner possible, to the strongest, best marked, and most peculiar alternating state (either to the cold stage, or to the hot stage, or to the sweating stage, each with its accessory symptoms, according as the one or other alternating state is the strongest and most peculiar); but the symptoms of the patient's health during the intervals when he is free from fever must be the chief guide to the most appropriate homœopathic remedy.¹²⁹

§ 236     The most appropriate and efficacious time for administering the medicine in these cases is immediately or very soon after the termination of the paroxysm, as soon as the patient has in some degree recovered from its effects; it has then time to effect all the changes in the organism requisite for the restoration of health, without any great disturbance or violent commotion; whereas the action of a medicine, be it ever so specifically appropriate, if given immediately before the paroxysm, coincides with the natural recurrence of the disease and causes such a reaction in the organism, such a violent contention, that an attack of that nature produces at the very least a great loss of strength, if it do not endanger life.¹³⁰ But if the medicine be given immediately after the termination of the fit, that is to say, at the period when the apyretic interval has commenced and a long time before there are any preparations for the next paroxysm, then the vital force of the organism is in the best possible condition to allow itself to be quietly altered by the remedy, and thus restored to the healthy state.

§ 237     But if the stage of apyrexia be very short, as happens in some very bad fevers, or if it be disturbed by some of the after sufferings of the previous paroxysm, the dose of the homœopathic medicine should be administered when the perspiration begins to abate, or the other subsequent phenomena of the expiring paroxysm begin to diminish.

§ 238     Not infrequently, the suitable medicine has with a single dose destroyed several attacks and brought about the return of health, but in the majority of cases, another dose must be administered after each attack. Better still, however, when the character of the symptoms has not changed, doses of the same medicine given according to the newer discovery of repetition of doses (see note to § 270), may be given without difficulty by dynamizing each successive dose with 10-12 succussions of the vial containing the medicinal substance. Nevertheless, there are at times cases, though seldom, where the intermittent fever returns after several days' well being. This return of the same fever after a healthy interval is only possible when the noxious principle that first caused the fever, is still acting upon the convalescent, as is the case in marshy regions. Here a permanent restoration can often take place only by getting away from this causative factor, as is possible by seeking a mountainous retreat, if the cause was a marshy fever.

§ 239     As almost every medicine causes in its pure action a special, peculiar fever, and even a kind of intermittent fever with its alternating states, differing from all other fevers that are caused by other medicines, homœopathic remedies may be found in the extensive domain of medicines for all the numerous varieties of natural intermittent fevers and, for a great many of such fevers, even in the moderate collection of medicines already proved on the healthy individual.

§ 240     But if the remedy found to be the homœopathic specific for a prevalent epidemic of intermittent fever do not effect a perfect cure in some one or other patient, if it be not the influence of a marshy district that prevents the cure, it must always be the psoric miasm in the background, in which case antipsoric medicines must be employed until complete relief is obtained.

§ 241     Epidemics of intermittent fever in situations where none are endemic, are of the nature of chronic diseases, composed of single acute paroxysms; each single epidemy is of a peculiar, uniform character common to all the individuals attacked, and when this character is found in the totality of the symptoms common to all, it guides us to the discovery of the homœopathic (specific) remedy suitable for all the cases, which is almost universally serviceable in those patients who enjoyed tolerable health before the occurrence of the epidemy, that is to say, who were not chronic sufferers from developed psora.

§ 242     If, however, in such an epidemic intermittent fever the first paroxysms have been left uncured, or if the patients have been weakened by improper allopathic treatment; then the inherent psora that exists, alas! in so many persons, although in a latent state, becomes developed, takes on the type of the intermittent fever, and to all appearances continues to play the part of the epidemic intermittent fever, so that the medicine, which would have been useful in the first paroxysms (rarely an antipsoric), is now no longer suitable and cannot be of any service. We have now to do with a psoric intermittent fever only, and this will generally be subdued by minute and rarely repeated doses of sulphur or hepar sulphuris in a high potency.

§ 243     In those often very pernicious intermittent fevers which attack a single person, not residing in a marshy district, we must also at first, as in the case of acute diseases generally, which they resemble in respect to their psoric origin, employ for some days, to render what service it may, a homœopathic remedy selected for the special case from the other class of proved (not antipsoric) medicines; but if, notwithstanding this procedure, the recovery is deferred, we know that we have to do with psora on the point of its development, and that in this case antipsoric medicines alone can effect a radical cure.

§ 244     The intermittent fevers endemic in marshy districts and tracts of country frequently exposed to inundations, give a great deal of work to physicians of the old school, and yet a healthy man may in his youth become habituated even to marshy districts and remain in good health, provided he preserves a faultless regimen and his system is not lowered by want, fatigue or pernicious passions. The intermittent fevers endemic there would at the most only attack him on his first arrival; but one or two very small doses of a highly potentized solution of cinchona bark would, conjointly with the well-regulated mode of living just alluded to, speedily free him from the disease. But persons who, while taking sufficient corporeal exercise and pursuing a healthy system of intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever by one or a few of such small doses of cinchona—in such persons psora, striving to develop itself, always lies at the root of their malady, and their intermittent fever cannot be cured in the marshy district without antipsoric treatment.¹³¹ It sometimes happens that when these patients exchange, without delay, the marshy district for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if they be not yet deeply sunk in disease, that is to say, if the psora was not completely developed in them and can consequently return to its latent state; but they will never regain perfect health without antipsoric treatment.

§ 245     Having thus seen what attention should, in the homœopathic treatment, be paid to the chief varieties of diseases and to the peculiar circumstances connected with them, we now pass on to what we have to say respecting the remedies and the mode of employing them, together with the regimen to be observed during their use.

§ 246     Every perceptibly progressive and strikingly increasing amelioration during treatment is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever, because all the good the medicine taken continues to effect is now hastening towards its completion. This is not infrequently the cause in acute diseases, but in more chronic diseases, on the other hand, a single dose of an appropriately selected homœopathic remedy will at times complete even with but slowly progressive improvement and give the help which such a remedy in such a case can accomplish naturally within 40, 50, 60, 100 days. This is, however, but rarely the case; and besides, it must be a matter of great importance to the physician as well as to the patient that were it possible, this period should be diminished to one-half, one-quarter, and even still less, so that a much more rapid cure might be obtained. And this may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions: firstly, if the medicine selected with the utmost care was perfectly homœopathic; secondly, if it is highly potentized, dissolved in water and given in proper small dose that experience has taught as the most suitable in definite intervals for the quickest accomplishment of the cure but with the precaution, that the degree of every dose deviate somewhat from the preceding and following in order that the vital principle which is to be altered to a similar medicinal disease be not aroused to untoward reactions and revolt as is always the case¹³² with unmodified and especially rapidly repeated doses.

§ 247     It is impractical to repeat the same unchanged dose of a remedy once, not to mention its frequent repetition (and at short intervals in order not to delay the cure). The vital principle does not accept such unchanged doses without resistance, that is, without other symptoms of the medicine to manifest themselves than those similar to the disease to be cured, because the former dose has already accomplished the expected change in the vital principle and a second dynamically wholly similar, unchanged dose of the same medicine no longer finds, therefore, the same conditions of the vital force. The patient may indeed be made sick in another way by receiving other such unchanged doses, even sicker than he was, for now only those symptoms of the given remedy remain active which were not homœopathic to the original disease, hence no step towards cure can follow, only a true aggravation of the condition of the patient. But if the succeeding dose is changed slightly every time, namely potentized somewhat higher (§§ 269-270) then the vital principle may be altered without difficulty by the same medicine (the sensation of natural disease diminishing) and thus the cure brought nearer.¹³³

§ 248     For this purpose, we potentize anew the medicinal solution¹³⁴ (with perhaps 8, 10, 12 succussions) from which we give the patient one or (increasingly) several teaspoonful doses, in long lasting diseases daily or every second day, in acute diseases every two to six hours and in very urgent cases every hour or oftener. Thus in chronic diseases, every correctly chosen homœopathic medicine, even those whose action is of long duration, may be repeated daily for months with ever increasing success. If the solution is used up (in seven to fifteen days) it is necessary to add to the next solution of the same medicine if still indicated one or (though rarely) several pellets of a higher potency with which we continue so long as the patient experiences continued improvement without encountering one or another complaint that he never had before in his life. For if this happens, if the balance of the disease appears in a group of altered symptoms then another, one more homœopathically related medicine must be chosen in place of the last and administered in the same repeated doses, mindful, however, of modifying the solution of every dose with thorough vigorous succussions, thus changing its degree of potency and increasing it somewhat. On the other hand, should there appear during almost daily repetition of the well indicated homœopathic remedy, towards the end of the treatment of a chronic disease, so-called (§ 161) homœopathic aggravations by which the balance of the morbid symptoms seem to again increase somewhat (the medicinal disease, similar to the original, now alone persistently manifests itself). The doses in that case must then be reduced still further and repeated in longer intervals and possibly stopped several days, in order to see if the convalescence need no further medicinal aid. The apparent symptoms (Schein-Symptome) caused by the excess of the homœopathic medicine will soon disappear and leave undisturbed health in its wake. If only a small vial say a dram of dilute alcohol is used in the treatment, in which is contained and dissolved through succussion one globule of the medicine which is to be used by olfaction every two, three or four days, this also must be thoroughly succussed eight to ten times before each olfaction.

§ 249     Every medicine prescribed for a case of disease which, in the course of its action, produces new and troublesome symptoms not appertaining to the disease to be cured, is not capable of effecting real improvement,¹³⁵ and cannot be considered as homœopathically selected; it must, therefore, either, if the aggravation be considerable, be first partially neutralized as soon as possible by an antidote before giving the next remedy chosen more accurately according to similarity of action; or if the troublesome symptoms be not very violent, the next remedy must be given immediately, in order to take the place of the improperly selected one.¹³⁶

§ 250     When, to the observant practitioner who accurately investigates the state of the disease, it is evident, in urgent cases after the lapse of only six, eight or twelve hours, that he has made a bad selection in the medicine last given, in that the patient's state is growing perceptibly, however slightly, worse from hour to hour, by the occurrence of new symptoms and sufferings, it is not only allowable for him, but it is his duty to remedy his mistake, by the selection and administration of a homœopathic medicine not merely tolerably suitable, but the most appropriate possible for the existing state of the disease (§ 167).