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Organon by Hahnemann, aphorisms 231 - 235
"Intermittent and alternating diseases"

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Organon aphorism §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.

Organon aphorism §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.

Organon aphorism §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.

Organon aphorism §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.

Organon aphorism §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 homeopathic 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 homeopathic remedy.(129)

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Organon notes and explanatory remarks

--- 232 Organon aphorism ---

[127] Two or three states may alternate with one another. Thus, for instance, in the case of double alternating diseases, certain pains may occur persistently in the legs, etc., immediately on the disappearance of a kind of ophthalmia, which latter again appears as soon as the pain in the limbs has gone off for the time— convulsions and spasms may alternate immediately with any other affection of the body or some part of it—in a case of threefold alternating states in a common indisposition, periods of apparent increase of health and unusual exaltation of the corporeal and mental powers (extravagant gaiety, extraordinary activity of the body, excess of comfortable feeling, inordinate appetite, etc.) may occur, after which, and quite unexpectedly, gloomy, melancholy humor, intolerable hypochondriacal derangement of the disposition, with disorder of several of the vital operations, the digestion, sleep, etc., appear, which again, and just as suddenly, give place to the habitual moderate ill-health; and so also several and very various alternating states. When the new state makes its appearance, there is often no perceptible trace of the former one. In other cases only slight traces of the former alternating state remain when the new one occurs; few of the symptoms of the first state remain on the appearance and during the continuance of the second. Sometimes the morbid alternating states are quite of opposite natures, as for instance, melancholy periodically alternating with gay insanity or frenzy.

--- 235 Organon aphorism ---

[128] The pathology hitherto in vogue, which is still in the stage of irrational infancy, recognizes but one single INTERMITTENT FEVER, which it likewise termed AGUE, and admits of no varieties but such as are constituted by the different intervals at which the paroxysms recur, quotidian, tertian, quartan, etc. But there are much more important differences among them than what are marked by the periods of their recurrence; there are innumerable varieties of these fevers, some of which cannot even be denominated AGUE, as their fits consist solely of heat; others, again, are characterised by cold alone, with or without subsequent perspiration; yet others which exhibit general coldness of the surface, with a sensation of heat on the patient's part, or whilst the body feels externally hot, the patient feels cold; others, again, in which one paroxysm consists entirely of a rigor or simple chilliness, followed by an interval of health, while the next consists of heat alone, followed or not by perspiration; others, again, in which the heat comes first, and the cold stage not till that is gone; others, again, wherein after a cold or hot stage apyrexia ensues, and then perspiration comes on like a second fit, often many hours subsequently; others, again, in which no perspiration at all comes on, and yet others in which the whole attack consists of perspiration alone, without any cold or hot stage, or in which the perspiration is only present during the heat; and there are innumerable other differences, especially in regard to the accessory symptoms, such as headache of a peculiar kind, bad taste in the mouth, nausea, vomiting, diarrhoea, want of or excessive thirst, peculiar pains in the body or limbs, disturbed sleep, deliria, alterations of temper, spasms, etc., before, during or after the cold stage, before, during or after the hot stage, before, during, or after the sweating stage, and countless other varieties. All these are manifestly intermittent fevers of very different kinds, each of which, as might naturally be supposed, requires a special (homeopathic) treatment. It must be confessed that they can almost all be suppressed (as is often done) by enormous doses of bark and of its pharmaceutical preparation, the SULPHATE OF QUININE; that is to say, their periodical recur-rence (their typus) may be extinguished by it, but the patients who suffered from intermittent fevers for which cinchona bark is not suitable, as is the case with all those epidemic intermittent fevers that traverse whole countries and even mountainous districts, are not restored to health by the extinction of the typus; on the contrary, they now remain ill in another manner, and worse, often much worse, than before; they are affected by peculiar, chronic bark dyscrasias, and can scarcely be restored to health even by a prolonged treatment by the true system of medicine—and yet that is what is called CURING, forsooth!

[129] Dr. von Bonninghausen, who has rendered more services to our beneficent system of medicine than any other of my disciples, has best elucidated this subject, which demands so much care, and has facilitated the choice of the efficient remedy for the various epidemics of fever, in his work entitled VERSUCH EINER HOMOOPATHISCHEN THERAPIE DER WECHSELFIEBER, 1833, Miinster bei Regensberg.


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