§205 Sixth edition
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,* 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 symptoms# 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 disease 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.

*I cannot therefore advise, for instance, the local extirpation of the so-called cancer of the lips and face (the product of highly developed psora, not infrequently in conjunction with syphilis) by means of the arsenical remedy of Frere Cosme, not only because it is excessively painful and often fails, but more for this reason, because, if this dynamic remedy should indeed succeed in freeing the affected part of the body from the malignant ulcer locally, the basic malady is thereby not diminished in the slightest, the preserving vital force is therefore necessitated to transfer the field of operation of the great internal malady to some more important part (as it does in every case of metastasis), and the consequence is blindness, deafness, insanity, suffocative asthma, dropsy, apoplexy, etc. But this ambiguous local liberation of the part from the malignant ulcer by the topical arsenical remedy only succeeds, after all, in those cases where the ulcer has not yet attained any great size, and when the vital force is still very energetic; but it is just in such a state of things that the complete internal cure of the whole original disease is also still practicable.

* The result is the same without previous cure of the inner miasm when cancer of the face or breast is removed by the knife alone and when encysted tumors are enucleated; something worse ensues, or at any rate death is hastened. This has been the case times without number, but the old school still goes blindly on in the same way in every new case, with the same disastrous results.

# Itch eruption, chancre (bubo), condylomata.