The division of diseases into local and constitutional is without any practical value. Every physician knows that the so-called local diseases are much more speedily removed by internal remedies than by external applications; we need but remind the reader of syphilis, sycosis, plica polonica, etc. The fearful diseases which frequently break out after the pretended local affection had been suppressed by external means, show that this apparently local symptom was a sort of vicarious concentration of the internal constitutional disease which was held in a latent state as long as the local symptom continued upon the skin. How is it possible that a simple ulcer on the finger should not only remain uncured under the merely external surgical treatment, but that it should even assume the dangerous form of a phagedenic ulcer, if it were not the local vicarious expression for an internal dyscrasia. It is self-evident that an apparently local affection which does not owe its existence to an external cause, must depend upon a coexisting disturbance of various organs and tissues; the local affection, even if it had been produced by a merely local external cause, cannot exist for any length of time without affecting the whole organism, as we see in the case of a burn, a toothache proceeding from a carious tooth, etc.

The division of diseases into acute and chronic is of particular importance to us, for this reason, that we have made that division the basis of the arrangement which we have adopted in the present work. To each of those divisions we have devoted a special volume.

Acute diseases are sudden disturbances of the vital force, characterized by the greater rapidity with which they run through their course and by the powerful reaction which takes place in the vascular system. In treating such diseases, it is a matter of course that wherever we know the cause from which they arise we ought to remove it if we can.

Chronic maladies frequently arise from a disturbance of the vital force, which is seated in the vegetative system. A concealed dyscrasia affecting that system is frequently the cause of the obstinacy with which those diseases cling to the organism. According to Hahnemann, chronic diseases invade the organism, each in its own peculiar manner, the invasion being scarcely or not at all perceived, in the commencement and gradually overpowering the vital force, so that it is only able to offer an inadequate resistance, allowing the malady to increase, until it finally destroys the organism. Starting from the definitions which we have given of acute and chronic diseases, it will be found easy to draw a line of separation between them, especially if we admit Hahnemann's theory that all chronic diseases derive their existence from some miasm; a theory, which seems to be somewhat inconsistent with Hahnemann's previous condemnation and rejection of all theories and speculations about the essence of disease and the relation existing between it and the changes in the body. We have already stated above that a number of diseases may exist without depending upon a psoric miasm, and Hahnemann seems to have had a similar idea inasmuch as he designates them spurious or improper chronic diseases. He accepted three fundamental forms of chronic diseases: psora, syphilis and sycosis; from these three fundamental chronic miasms all chronic diseases derive their origin, seven-eighths from the former, and the remaining eighth from the two latter. It is neither our intention, nor is this the proper place to criticize Hahnemann's views; we may however remark that the merely palliative effect which he frequently obtained from his remedies in chronic diseases, led him to the belief that these diseases depended upon some latent chronic miasm; and it was indeed ascertained that many of them had been preceded by itch. Hahnemann was persuaded that the suppressed itch was the primary cause of those diseases. Observing that several of them had been cured by the use of mineral springs, his acute powers of penetration led him to suppose that the cure had been wrought by the medicinal substances which exist in those springs in minute and greatly divided quantities. He was confirmed in this view by farther observations and the successive results of his practice, and he therefore designated the medicines by means of which the cure of chronic diseases was effected, as antipsorics - that is, medicines directed against a chronic malady. It is now well known, however, that those antipsorics not only cure chronic, but also a host of acute diseases, and that they are employed for that purpose by all homoeopathic practitioners. Hahnemann be praised for having made us acquainted with such efficient means to relieve the sufferings of our fellow-beings.

It is an undoubted fact that the inveterate character of chronic diseases frequently depends upon some latent dyscrasia which has become rooted in the organism, and that those conditions have been removed by certain remedies which exercise a specific effect upon the organs invaded by a psoric miasm. It is for this reason that the general therapeutic rules remain the same for chronic as well as any other diseases. If such chronic diseases have already been treated with a variety of allopathic medicinal substances, it is advisable that the homoeopathic practitioner should let some time elapse before he gives any medicine to the patient, that the organism may free itself as much as possible from the various influences which those drugs have left and may become more susceptible to the action of our small doses.

According to Hahnemann, diseases of the mind likewise originate. These diseases do not constitute as distinct a class of diseases as those which have been indicated above. In almost every disease of the body the mind is affected more or less, on which account the state of the mind is to be regarded as an important feature in the image of the disease. We know from experience that the condition of the mind in health is frequently the contrary of what it was in disease. If a certain group of symptoms indicate two different remedies, the state of the mind is frequently the only symptom by which we can decide which of those remedies ought to be selected; Aconite, for instance, will never effect a rapid cure in a person with a calm, even temperament; Nux will be found very little adapted to a mild and phlegmatic, or Pulsatilla to a cheerful, bright and obstinate temper; Ignatia is counter-indicated by an unchangeable mind which is neither given to fright nor vehemence.

In all chronic diseases it is not only of the utmost importance to investigate all the physical symptoms, but the moral and mental condition of the patient would seem to require our especial attention.* The physician will have not only to inquire into all the previous bodily diseases of the patient, but he will have to make particular inquiries about the disease which preceded the mental disorder previous to its increasing to a complete derangement. This information can, of course, only be obtained from the family. If the mental derangement (mania, rage) set in of a sudden, in consequence of fright, chagrin, abuse of spirituous drinks, then Hahnemann teaches that it is to be treated as an acute disease with Aconite, Belladonna, Stramonium, Hyosciamus, Veratrum, Mercurius, etc., and that the antipsoric treatment, with a properly regulated diet, ought to be instituted only after the acute symptoms have been subdued; the antipsoric treatment is necessary to prevent a new outbreak of the disease which might easily become a permanent derangement.

Diseases of the mind which are not yet fully developed and do not arise from bodily affections but from bad habits, faulty education, immoral conduct, neglect, superstition or ignorance, may be improved by kind persuasion, consolations, romonstrance, reasoning; whereas those mental diseases which arise from bodily diseases, are made worse by such means, and become more inveterate. A physician ought never to lose patience or self-control, he ought never to indulge angry expressions or manners, lest he should lose the confidence and the affection of his patients, which are indispensable means of cure.

* See Organon, § 217 seq.

There is another class of mental diseases which we observe in men who have been frequently a prey to grief, chagrin, insults, attacks of fear and fright. Those diseases emanate primarily from the mind, and the bodily affection is a mere result of the mental disturbance. If these diseases be recent, they are most easily removed by spiritual means, such as: kind persuasion, reasoning, confiding manners, sometimes by a clever deception; the mode of life ought not to be neglected, of course. Such means are frequently sufficient to restore the normal state of the mind.

In all cases of mental derangement which can be cured by homoeopathic remedies it is essential not only to observe a rigorous diet, but to submit the patient to a proper treatment on the part of his relatives and physician. The raving maniac ought to meet a firm will and a bold and fearless expression of countenance; the lamenting and disconsolate ought to be surrounded with silent and sympathizing grief; senseless prattle ought to be met by silence expressing a slight degree of attention; disgusting and revolting conduct are to be left unheeded. The patients ought to be prevented from injuring or ruining the things around them, without rebuking, or, what would be still worse, punishing or torturing them. The only compulsion to which the patient is liable, is to take the homoeopathic medicine, but even that kind of compulsion can be avoided by mixing the medicine in the beverage of the patient without his knowing it.

It is a great mistake on the part of the physician or the attendants of the patients to contradict, censure, or scold them, or to treat them with yielding timidity; it would be just as indiscreet to irritate them by derision, and ill-disguised deception. On the contrary, those patients ought always to be treated like sane persons, and everything by which their senses or minds might be disturbed, ought to be carefully removed from their presence.