The Aphorisms of Hippocrates by von Boenninghausen - Book V

Selected Aphorisms Of Hippocrates
With Comments By Dr. von Boenninghausen

From The Homoeopathic Recorder, Vol. LVIII, No. 10, 11, 12, (April, May, June) 1943.

translated by S.W.S.

BOOK V.

APHORISM 4. Convulsions or hiccup supervening during excessive purging are a bad sign.

COMMENT: Excessive purging is similar in its effect on the organism to severe bleeding, perspiration, or loss of body fluids generally. But if strong purging was caused by large doses of Veratrum, which in the days of Hippocrates was the purgative, then the results were bad.

In this connection we must mention that also in homoeopathic circles the abuse of China in cases of loss of body fluids has crept in. This proves Hahnemann's admonition correct as stated in his introductory remarks to this remedy in his Materia Medica Pura: "Aside from Opium I know no remedy which is more abused than China." Even though this remedy has the top ranking in so many ailments resulting from loss of body fluids, and can hardly be neglected as an intercurrent remedy, yet it would denote a total lack of understanding of our therapy, if we should consider it the remedy generally at all times, and the only indicated medicine in such cases. Indeed we have a large list of remedies at our disposal belonging in this group among which the most important are: Calcarea carbonica, Carbo vegetabilis, Phosphoric acid, Pulsatilla, Sepia, and Staphisagria, and they are just as important, not to mention many others which under certain conditions even supersede those mentioned, according to the individual indications. Hence it is absolutely unhomoeopathic if the remedy choice is prompted only by the general anamnesis: loss of body fluids (from hemorrhage, diarrhea, nursing, frequent seminal emissions, masturbation, excessive perspiration, etc.) if only China were considered regardless of the special kind of condition following. Such abuse is equal to the blind use of this remedy in intermittent fevers.

APHORISM 5. If the drunken man suddenly becomes dumb, he dies under convulsions unless he falls into a fever, or lives till sober and then regains his speech.

COMMENT: Here we see a drunken man briefly sketched, and we find his symptoms more completely under Opium. His face is dark red, frequently perspiring, staring eyes, jerky motions of mouth, loud snoring, and other symptoms as seen in the totally intoxicated, which may end in apoplexy. Only frequently given small doses of Opium (every quarter to half an hour) can prevent the debacle. The fever following, which the aphorism mentions as a saving expedient, is usually of such nature that Aconite or Belladonna, or perhaps Stramonium, can bring normalcy.

APHORISM 8. Pleurisy, which does not clear up in fourteen days, ends in empyema.

COMMENT: Nowadays a physician is not an idle observer, necessary to prove the truth of this aphorism. While the old school has its antiphlogistic method, we use our dynamic, highly potentized remedies which act quickly and infallibly: Aconite, Bryonia, Dulcamara, Kali carbonicum, Phosphorus and Squilla, and we do not delay using them immediately we find symptoms enough to make the correct choice.

APHORISM 19. Heat parts which are chilled, except where hemorrhage is present or threatened.

COMMENT: Allopaths have hailed this aphorism as proof for contraria contrariis. A commentator in one place calls it "an axiom which is fully correct." And yet, the experience of every physician, and even of the laity, proves the opposite, for when the cold has reached a severe degree, a handful of snow is applied (no rubbing) to a frozen nose or ear. The patient who may not be aware that parts are white, frozen, will be grateful. Suddenly applied heat might cause a loss of such members.
The approved preventive against coldness or freezing of parts is application of Spirits of Camphor, which in the primary action produces a high degree of cold, but in the lasting secondary action develops warmth. In the often following painful heat as from burns, the best remedy is diluted Tincture of Cantharis.
The resuscitation of stiff frozen patients is said to have been accomplished in some cases when they were treated according to the homoeopathic principle: packing in snow, or a bath made cold by ice lumps; in both cases the patient remains till the flesh has become soft, and the member can be carefully bent. Then the body is rubbed carefully with snow till the skin becomes red; later dry rub with dry woolen cloth. The resuscitated should not get near a fire or hot stove for some time.
How can the thousandfold experiences be harmonized with the above axiom: contraria contraries? It seems that this aphorism is only an introduction to:

APHORISM 20. In ulcers cold causes a sensation of biting, thickening of the skin, painful stopping of suppuration, blackens the skin, causes feverish rigors, convulsions, and tetanus.

COMMENT: Also these results are not the same in all ulcers, for there are many which do not tolerate warmth, and which are less painful and heal quicker when kept cool. We here mention only the ulcers which demand: Acidum fluoricum, Lycopodium, Pulsatilla, and Sabina which do not tolerate warmth; those which are better from warmth and warm covering are: Arsenicum, Clematis, Conium, Hepar, Lachesis, Rhus, and Silica.

APHORISM 22. Heat does not always expedite suppuration though it is an aid, it softens the skin and makes it thin, removes pain and soothes rigors, convulsion, and tetanus, and relieves heaviness of head. It is especially useful in bone fractures, compound especially, but above all in fractured skulls; also in necrosis, and sore from cold; corroding herpes around anus, pudenda, vagina and in the urinary bladder. In all these cases heat is beneficial, while cold is harmful and tends to a fatal issue.

COMMENT: Homoeopathy does not approve of external medicated applications, but chooses only such internal remedies which are indicated by their symptomatology, like: Arsenicum, Belladonna, Calcarea, Hepar, Kreosotum, Lachesis, Lycopodium, Mercurius, Silica, or others. Thus the desired result is obtained safely and surely.

APHORISM 24. Cold things, such as snow or ice are harmful to the chest, and provoke coughing, catarrh and haemoptysis.

COMMENT: This aphorism must be accepted only with due reserve. It will suffice to call attention to the peculiarity indicated remedies: Antimonium crudum, Drosera, Iodum, Laurocerasus, Pulsatilla, Senega, Veratrum, Verbascum. But one must not confound the symptoms from taking cold in some way, with those which through cold temperatures are aggravated. Sickness from any cause usually continues long after the cause is removed. Often complaints are caused from unknown conditions which cannot be ascertained. In such cases only the presenting symptoms can help out, especially those of aggravation, amelioration, and other modalities, which always supersede the causative factors, without neglecting the latter in the remedy choice. There are, e.g., troubles caused originally by cold temperatures, but later on are aggravated by warm applications, and it would be a mistake to select a remedy rather for the cause than for the effect.

APHORISM 27. It is a good symptom when patients with nocturnal thirst can go to sleep in spite of it.

COMMENT: It is difficult to know how to evaluate this isolated rule. If a patient after taking a medicine can go to sleep even if thirst is tormenting, that surely would be a favorable sign for a good prognosis. But it is difficult to understand why this should apply especially to nocturnal thirst. This observation was possibly made in individual cases, perhaps during a particular epidemic in which nocturnal thirst was a prominent symptom, as we have met in several acute fevers, which pointed to: Aconitum, Antimonium crudum, Belladonna, Bryonia, Chamomilla, or Rhus toxicodendron. But to select a remedy or make a prognosis on the basis of such a single symptom might be absolutely impossible and unreliable.

APHORISM 32. When a woman vomits blood, menstruation will cure it.

COMMENT: According to Galen (in his Commentary) and Celsus it is probable that this applies to vomiting of blood only; yet this aphorism can just as appropriately include haemoptysis, which in this connection is much more frequent. But neither symptom is innocent nor without danger, and even if menstruation temporarily overcomes the trouble, it is no cure and does not prevent recurrence. Every homoeopathist will pay earnest attention to this symptom, especially in young girls, as it may lead to grave conditions, and may lay the germ to desperate chronic diseases, but he will attack immediately before it is too late, as often consumption follows, which may then be curable.
Fortunately he has at his disposal the best approved remedies: Belladonna, Cuprum, Phosphorus, Pulsatilla, Sulphur, and Veratrum, the one or the other properly selected will not fail to give the expected result.

APHORISM 33. It is well if a woman has epistaxis when menses are suppressed.

COMMENT: According to Celsus it is probable that Hippocrates here refers to the sometimes dangerous and always troublesome congestion to the upper part of the body and to head, following suppression of the menstrual flow. In such conditions epistaxis gives temporary relief, but seldom lasting help, for it is, in a sense, only palliative, never a real cure. Hence there is no sufficient reason for waiting, but the homoeopathic physician will rather act promptly by applying the well chosen remedy according to the symptoms, for which purpose he has: Aconitum, Apis, Belladonna, Bryonia, Calcarea carbonica, Carbo animalis, Chamomilla, Conium, Dulcamara, Ferrum metallicum, Graphites, Lachesis, Lycopodium, Mercurius, Phosphorus, Pulsatilla, Sepia, Silica, Sulphur, and Veratrum.

APHORISM 34. Frequent diarrhea during pregnancy is a danger sign of miscarriage.

COMMENT: This aphorism is in connection with Aphorism 1 of Book IV which treats of diarrhea of pregnancy. But in this particular case the danger is greater, because every severe diarrhea is caused by a real abdominal disease. That is why homoeopathy dreads every kind of diarrhea, rejects all kinds of laxatives, and hastens to cure every diarrhea quickly. Frequently diarrhea during pregnancy are mild and these remedies will cure them: Antimonium crudum, China, Dulcamara, Pulsatilla, or Rheum. But when a chronic disease is at the bottom of it, which may call for Lycopodium, Mercurius, Petroleum, Phosphorus, Sepia, Sulphur, or Thuja, then these remedies will cure slowly but lastingly.

APHORISM 37: If the breasts become suddenly small during pregnancy, abortion is imminent.

COMMENT: In this condition often the foetus is already dead, but where there is still life, help is usually possible by remedy selection with care according to symptoms, and the following remedies given in high potency: Chamomilla, China, Conium, Ferrum metallicum, Iodum, Nitric acid, Nux moschata, Secale cornutum, and Silica are to be consulted. In our own practice we have had a number of such fortunate cases even in women who have had previous abortions.

APHORISM 39. When milk is in breasts of a woman who is not pregnant, nor has been, her menstruation is suppressed.

COMMENT: Experience verifies this only partially, for some women have milk, though they never bore a child, nor did their menses cease. In such cases, especially when menses are suppressed, consult: Belladonna, Bryonia, Calcarea carbonica, Lycopodium, Phosphorus, Pulsatilla, Rhus toxicodendron, Sabina, and Stramonium, letting the other symptoms be the deciding factors; however, Belladonna and Stramonium are most prominent, especially if the following aphorism applies:

APHORISM 40. It indicates mental disturbance when there is congestion in the female breast.

COMMENT: Here are also cases in which an inflammatory condition demands: Aconitum, Apis, Ferrum metallicum, Phosphorus, or other remedies, and they will act quickest if given before mental disturbance is present, provided the accompanying symptoms indicate any of them.

APHORISM 43. It is fatal when during pregnancy inflammation of the uterus takes place.

COMMENT: This surely is an extremely dangerous sickness, but not necessarily fatal, which attacks after birth more often than in the pregnant. In the hands of an experienced and prudent homoeopathic physician the result is usually favorable. But this quickly fatal fever demands very strict individualization, for the number of possibly indicated remedies is very large, the accompanying and deciding symptoms very manifold, while quickly and exactly chosen remedies alone can be relied upon to turn the imminent danger. In most cases the choice will be between: Aconitum, Belladonna, Chamomilla, Colocynthis, Nux vomica, Platina, Pulsatilla, Rhus, Sabina, Secale, and Sepia, but others may also be indicated like: Apis, Arnica, Arsenicum, Calcarea carbonica, Carbo animalis, Coffea, Cocculus, Ferrum metallicum, Hyoscyamus, Ipecacuanha, Kali carbonicum, Stramonium, or Sulphur, without excluding entirely: Antimonium crudum, China, Cocculus, Conium, Ignatia, Kreosotum, Moschus, Natrum muriaticum, Opium, Phosphorus, Veratrum, and Zincum. It is clear that in the treatment of this sickness procrastination and guessing are out of the question, that its treatment is very difficult, which can only be handled efficiently by a physician who knows well the peculiarities of all these remedies and who has a sharp eye for all the symptoms present, and who does not try to accomplish his aim violently which only can be reached by smallest doses of the simillimum in dynamic form.

APHORISM 49. To expel the placenta, cause sneezing while nose and mouth are closed.

COMMENT: The result is reached much better and safer by giving small doses of Colchicum.

APHORISM 54. If the cervix uteri is hard, it must of necessity also be closed.

COMMENT: This does not apply to the closed os uteri of pregnancy which is soft, but to actual hardening and swelling, which is always dangerous and may easily end in cancer uteri. Only in the beginning can one prognosticate a favorable result by selecting a remedy for the recognized totality of symptoms, not only for the local but, what is more important, the concomitant symptoms. But when the condition is fully developed with foetid suppuration, then there IS very little or no hope. Hence it is mandatory that from the start the greatest care be exercised to select the indicated remedy, which may be especially one of these: Arsenicum, Aurum, Belladonna, Carbo animalis, China, Clematis, Ferrum, Iodum, Kreosotum, Lachesis, Magnesia muriatica, Mercurius, Platina, Pulsatilla, Sabina, Sarsaparilla, Secale, Sepia, and Thuja. Thus we, and some of our friends, have been able every time to ward off the imminent danger before the disease had reached its incurable height.

APHORISM 56. Convulsions and fainting during menstruation are bad symptoms.

COMMENT: Some commentators opine that here Hippocrates refers to metrorrhagia, especially postpartum hemorrhages, but we are not of that opinion. Such menstrual convulsions and faintings usually happen before (Cuprum, Kali carbonicum, Natrum muriaticum, Phosphorus, Phosphoric acid, Platina, Pulsatilla, Sepia, Sulphur), or during (Aconitum, Bryonia, Calcarea carb., Causticum, Chamomilla, China, Cocculus, Coffea, Cuprum, Ferrum, Hyoscyamus, Ignatia, Ipecacuanha, Lycopodium, Magnesia muriatica, Mercurius, Natrum muriaticum, Nux vomica, Pulsatilla, Sulphur), but rarely or perhaps never following menstruation (China, Cuprum, Pulsatilla). Hence it follows that such convulsions and syncopes are not the result of loss of blood, though that may happen, when China, Kreosotum, etc., may be indicated. A strong proof of our view might be the fact that several of the quoted remedies point especially to a weak or late menstruation, in which case a severe hemorrhage and its consequences are excluded.

APHORISM 60. If a pregnant woman continues to menstruate, it is impossible for the foetus to be healthy.

COMMENT: It is evident that this aphorism does not refer only to the first months (in which such a condition is also suspicious), but more to later periods. In these cases experience emphasizes it, and abortion is usually the end of gestation. Many homoeopathic physicians have seen what our indicated remedies here can accomplish, viz., Asarum, Chamomilla, Cocculus, Crocus, Ipecacuanha, Kali carb., Lycopodium, Phosphorus, Rhus, Sabina, and Secale.

APHORISM 64. Milk is not suitable for patients with headache, in fever, or in patients with swollen hypochondria in which rumbling is heard, nor for thirsty patients with bilious diarrhea, acute fevers, or after severe hemorrhages. It is beneficial in consumption without high fever, in protracted low fevers when none of the mentioned symptoms are present, but when there is excessive emaciation.

COMMENT: With great pleasure one here again meets pure experience from life, free from all explanations, and in its simple exactitude worthy of the penetrating observer who has left it to us. Indeed, it would have been of great value to science, if the outstanding patriarch had left us many more such gold nuggets which he gathered from the votive tablets of his own practice, stripped of philosophic-theoretic opinions. One commentator says that milk is always harmful in headaches from gastric conditions, as we all know, in which case Bryonia and Veratrum are a great help. In burning fevers milk is not always a disadvantage, and those cases which are indicating our great antiphlogisticum: Aconitum, hardly ever are aggravated by milk. That milk is harmful after severe hemorrhages tallies with our experience and with our remedy provings, according to which our chief remedy for such conditions China, as also the second line remedies: Arsenicum, Calcarea carbonica, Carbo vegetabilis, Conium, Kali carbonicum, Lachesis, Lycopodium, Nux vomica, Phosphorus, Pulsatilla, Sepia, and Sulphur have aggravation from milk. But here, as always, we find exceptions to the rule in that two remedies which are here often indicated: Phosphoric acid and Staphisagria, and also China, Ferrum metallicum, Iodum, Mercurius, Squilla and Veratrum tolerate milk very well.

Of course, the choice of the simillimum must always be strictly homoeopathic, combining all the symptoms into one picture of the complaint, and search for the one remedy which has the symptoms, or which is at least not antagonistic to them. Therefore, taking the anti-milk symptoms of the first part of this aphorism together, then all the remedies are dropped except China, which corresponds to everything, and Pulsatilla, which has the next most symptoms, but the thirst contraindicates it, for Pulsatilla is one of the thirstless remedies.

May we be pardoned when in this connection we mention that we have found the milk diet very effective in freeing drunkards of their hard-to-cure vice. After a few small doses of Opium have removed the main symptoms of the drink sickness, the persistent use of milk, both as food and drink, taken several times during the day, will in a short time cause a real disgust toward alcoholic drinks.

APHORISM 67. Soft swellings are harmless. Hardness is bad.

COMMENT: It is bad when a swelling disappears suddenly, or where no swelling takes place in wounds or ulcers. But a hard swelling usually denotes a severe degree of inflammation, which must first be remedied, perhaps by: Arsenicum, Belladonna, Hepar, Lachesis, Mercurius, Pulsatilla, or Silica according to accompanying symptoms, and the pus will be discharged, which, if "laudable," is the best salve for all ulcers. When swelling of injured parts is lacking entirely it means lack of reactive power, which first must be remedied (without much consideration of the damaged parts), usually by Arsenicum, Camphora, Carbo vegetabilis, Conium, Laurocerasus, Opium, Phosphoric acid, and Sulphur, which remedy must be selected strictly in accordance with homoeopathic tenets, and given in the smallest dose. Through such exclusively internal treatment it is frequently possible to restore the vanished swelling especially through Arsenicum, Calcarea carb., Hepar, Kreosotum, Lachesis, Lycopodium, Mercurius, Sepia, and Silica, which could hardly be accomplished by external means, since the cause is not in the injured parts, but only in the internal organism. What can be accomplished by the exclusive internal treatment of external injuries, e.g., by Arnica in crushed wounds, Arsenicum in burns, and Symphytum in fractures, etc., that is known in wider circles of physicians than many other things of which Homoeopathy boasts.

APHORISM 68. Pains in the back of the head are relieved by opening the straight frontal vein.

COMMENT: This must refer to the amelioration of fleeting congestive occipital pain, which usually can be cured lastingly by: Aconitum, Apis, Belladonna, Borax, Ignatia, Mezereum, Nux vomica, Petroleum, Sepia, Silica, Staphisagria, or Sulphur. All other nervous, rheumatic or other pains in the occiput can hardly be relieved by venesection, which might even aggravate the pain. However, the indicated homoeopathic remedy will cure them all. Consult especially: Alumina, Ambra, Carbo animalis or vegetabilis, Chelidonium, Colchicum, Magnesia muriatica, Mezereum, Natrum carbonicum, Nitric acidum, Sabina, Senega, Thuja, Zincum, etc. In no case can a phlebotomy be any kind of a cure.

APHORISM 72. Jaundiced patients seldom suffer from flatulency.

COMMENT: Book V contains much of value, but also some half truths, questionable and erroneous statements. This aphorism also suffers many exceptions, which, however, are of little importance to science. We only shall, in a general way, point to cases of jaundice for which suitable remedies are: Carbo vegetabilis, Chamomilla, China, Ignatia, Lycopodium, Nux, and Plumbum, and in which considerable flatulency is often present.

APHORISM 70. Patients suffering from quartan fevers usually do not get convulsions, but were cured of the fevers when convulsions were present.

COMMENT: Our attentive and astute observer could not miss seeing that never two diseases of different nature existed at the same time in a patient. This important observation is the first basis on which the doctrine of Homoeopathy foots, which was fixed by experiments, observations, and experience. Thus it was shown that only similar diseases can blot out each other, while dissimilar diseases can only temporarily suppress each other. Thus under the dominance of the stronger disease the weaker only slumbers and remains uncured when the super-disease subsides or is cured. That may be the reason why Hippocrates in this aphorism does not claim a lasting cure of quartan fevers when convulsions also appear. Only such remedies, which have in their proving symptomatology both the quartan (or any other intermittent) fever in addition to convulsions are indicated, viz.: Antimonium crudum, Arnica, Arsenicum, Belladonna, Calcarea carb., Causticum, China, Cina, Cocculus, Cuprum, Hyoscyamus, Ignatia, Lachesis, Nux, Rhus, Sepia, Stannum, Sulphur, or Veratrum. Hence, if epileptic patients get quartan fever demanding a remedy which lacks real convulsions, then the fever may temporarily cease, but returns inevitably later. From our numerous experiences just in these two conditions, we must conclude this to be the only interpretation of this aphorism.

END OF BOOK V.