§ 81
The fact that this extremely ancient infecting agent has gradually passed, in some hundreds of generations, through many millions of human organisms and has thus attained an incredible development, renders it in some measure conceivable how it can now display such innumerable morbid forms in the great family of mankind, particularly when we consider what a number of circumstances1 contribute to the production of these great varieties of chronic diseases (secondary symptoms of psora), besides the indescribable diversity of men in respect of their congenital corporeal constitutions, so that it is no wonder if such a variety of injurious agencies, acting from within and from without and sometimes continually, on such a variety of organisms permeated with the psoric miasm, should produce an innumerable variety of defects, injuries, derangements and sufferings, which have hitherto been treated of in the old pathological works2, under a number of special names, as diseases of an independent character.
1 Some of these causes that exercise a modifying influence on the transformation of psora into chronic diseases manifestly depend sometimes on the climate and the peculiar physical character of the place of abode, sometimes on the very great varieties in the physical and mental training of youth, both of which may have been neglected, delayed or carried to excess, or on their abuse in the business or conditions of life, in the matter of diet and regimen, passions, manners, habits and customs of various kinds.
2 How many improper ambiguous names do not these works contain, under each of which are included excessively different morbid conditions, which often resemble each other in one single symptom only, as ague, jaundice, dropsy, consumption, leucorrhoea, haemorrhoids, rheumatism, apoplexy, convulsions, hysteria, hypochondriasis, melancholia, mania, quinsy, palsy, etc., which are represented as diseases of a fixed and unvarying character, and are treated, on account of their name, according to a determinate plan! How can the bestowal of such a name justify an identical medical treatment? And if the treatment is not always to be the same, why make use of an identical name which postulates an identity of treatment? Nihil sane in artem medicam pestiferum magis unquam irrepsit malum, quam generalia quaedam medicinam, says Huxham, a man as clear-sighted as he was estimable on account of his conscientiousness (Op. phys. med., tom. I.). And in like manner Frittze laments (Annalen, I, p.80) that essentially different diseases are designated by the same name. Even those epidemic diseases, which undoubtedly may be propagated in every separate epidemic by a peculiar contagious principle which remains unknown to us, are designated, in the old school of medicine by particular names, just as if they were well-known fixed diseases that invariably recurred under the same form, as hospital fever, goal fever, camp fever, putrid fever, bilious fever, nervous fever, mucous fever, although each epidemic of such roving fevers exhibits itself at every occurrence as another, a new disease, such as it has never before appeared in exactly the same form, differing very much, in every instance, in its course, as well as in many of its most striking symptoms and its whole appearance. Each is so for dissimilar to all previous epidemics, whatever names they may bear, that it would be dereliction of all logical accuracy in our ideas of things were we to give to these maladies, that differ so much among themselves, one of those names we meet with in pathological writings, and treat them all medicinally in conformity with this misused name. The candid Sydenham alone perceived this, when he (Obs. med., cap. ii, De morb, epid.) insists upon the necessity of not considering any epidemic disease as having occurred before and treating it in the same way as another, since all that occur successively, be they ever so numerous, differ from one another: Nihil quicquam (opinor,) animum universae qua patet medicinae pomoeria perlustrantem, tanta admiratione percellet, quam discolor illa et sui plane dissimilis morborum Epidemicorum facies; non tam qua varias ejusdem anni tempestates, quam qua discrepantes divewrsorum ab invicem annorum constitutiones referunt, ab iisque dependent. Quae tam aperta praedictorum morborum diversitas tum propriis ac sibi peculiaribus symptomatis, tum etiam medendi ratione, quam hi ab illis disparem prorsus sibi vendicant, satis illucescit. Ex quibus constat morbus hosce, ut ut externa quadantenus specie, er symptomatis aliquot utrisque pariter super venientibus, convenire paulo incautioribus videantur, re tamen ipsa (si bene adverteris animum), alienae admondum esse indolis, et distare ut aera lupinis.
From all this it is clear that these useless and misused names of diseases ought to have no influence on the practice of the true physician, who knows that he has to judge of and to cure diseases, not according to the similarity of the name of a single one of their symptoms, but according to the totality of the signs of the individual state of each particular patient, whose affection it is his duty carefully to investigate, but never to give a hypothetical guess at it.
If, however, it is deemed necessary sometimes to make use of names of diseases, in order, when talking about a patient to ordinary persons, to render ourselves intelligible in few words, we ought only to employ them as collective names, and tell them, eg., the patient has a kind of St. Vitus’s dance, a kind of dropsy, a kind of typhus, a kind of ague; but (in order to do away once and for all with the mistaken notions these names give rise to) we should never say he has the St. Vitus’s dance, the typhus, the dropsy, the ague, as there are certainly no disease of these and similar names of fixed unvarying character.