16. However, a trival cause, an ordinary vexation, a cold, an irregularity in the diet, etc., may, in a more advanced age, cause a violent though short attack of disease, out of proportion with the moderately exciting cause, especially during the fall, winter and early spring.

17. But whenever the vital power has been reduced by some mental ailments or by a bodily affection, the latent psora becomes aroused and develops a host of inveterate symptoms; some one of the psoric chronic diseases break forth, unless more favorable circumstances set in, diminishing the intensity of the disease and making its ulterior development more moderate. (Here follow the symptoms of the aroused psora, differing according to the individuality of the patient and the extent of the psoric intoxication).

18. Sycotic excrescences are often accompanied with a sort of gonorrhoea from the urethra, are sometimes dry and in the form of warts, but more frequently soft, spongy, emitting a fetid fluid, of a sweetish taste, bleeding readily and having the form of a coxcomb or a cauliflower. In man they appear upon the glans and around or beneath the prepuce; in woman they surround the pudenda. Surgery and mercury are still much abused in sycosis; the extirpation of the excrescences only lead to their appearance at some other place and the internal use of mercurials rouses a latent psora and we deal then with a combination of psora and sycosis. Our duty then is to annihilate the psoric miasm by the indicated antipsorics, and then we use the remedies indicated for sycosis (Thuja, Nitric acid), and for syphilitic complications Mercury remains the remedy.

19. The syphilitic contagion is much more general than the poison of sycosis. The treatment of syphilis is only difficult when complicated with the psoric poison. The former is rarely complicated with sycosis, but whenever it exists we meet psora as an additional complication.

20. Chancre and bubo are the original representatives of syphilis, and if not interfered with, they might remain during life and no secondary symptoms will appear. By considering the chancre a mere local ulcer and by removing it by external means, the disease is forced to manifest itself throughout the organism with all the secondary symptoms of a fully developed syphilis; hence it is that the internal disease is most permanently cured while the chancre or the bubo are yet existing as its vicarious types, especially in young persons of a cheerful temper, where often one single minute dose of Mercury suffices, and Hahnemann prefers that preparation which goes by his name. If more than one dose should be required, the lower potencies may then be employed.

21. The second stage sets in when the chancre has been speedily removed by external means, but even then, provided there is no latent psora, the secondary symptoms may be prevented by the soluble Mercury, and the original spot of the chancre can no more be traced, while without that internal treatment a reddish morbid-looking, red or bluish scar remains. Bubo, when not complicated with psora, only needs the same treatment.

22. In the third stage we find syphilis complicated with psora and the patient suffered already from psora when the syphilitic infection took place or false internal and external treatment caused a combination of the psoric with the syphilitic element and it take then more than one remedy to remove the evil consequences. It may be here observed that it is the nature of the psoric poison to break forth in consequence of great concussions of the system and violent inroads upon the general health.

23. In order to reach this marked syphilis (pseudo syphilis), we must remove from the patient all hurtful external influences and put him on an easily and vigorously nourishing diet and regulate his general mode of life. The most appropriate antipsoric must then be selected which may be followed by a second antipsoric according to the new symptoms, and when the latter has accomplished its action, the single dose of Mercury must be allowed to act as long as it is capable of exercising a curative influence.

24. In old difficult cases, ailments remain which are neither purely psoric or syphilitic. Here several courses of antipsorics are needed, until the last trace of all provocation has ceased. After this we give a lower potency of Mercury and allow it to act until the skin has recovered its healthy color at the spot where the venereal chancre stood.

25. A complication of the three chancre poisons must be treated on the same principles. Antipsoric first and then that poison whose symptoms are most prominent. Afterwards the remaining portion of the psoric symptoms must be removed and then the last traces of syphilis and sycosis by other adequate remedies. A return of a healthy color of the skin on places which had been affected, is the surest sign of a perfect restoration.

26. As long as the psora eruption is yet existing upon the skin, psora exhibits itself in its simple and most natural integrity, and may be cured in the easiest, quickest and safest manner; but when the internal disease is deprived of its vicarious symptoms, the psoric poison is forced to spread over the most delicate parts of the internal organism and to develop its secondary symptoms.

27. The psoric poison having pervaded millions of organisms for thousands of years, has gradually developed out of itself an endless number of symptoms, varied according to differences of constitution, climate, residence, education, habits, occupation, mode of life, diet, and various other bodily and mental influences; herein different antipsoric remedies will be required for the eradication of the psoric poison.

28. Only the recent itch, with the eruption still existing upon the skin, can be completely cured by one dose of sulphur; but such a speedy cure is not always possible, as the age of the patient has great influence upon the result of the treatment. In eruptions which have existed for some time on the skin, it ceases to be a vicarious symptom for the internal disease, and secondary psoric affections will manifest themselves; in such case sulphur does not suffice, and it requires several antipsorics for a cure.