Homoeopath’s Attitude towards External Application

Abstract 

External application in homoeopathy is controversial. According to Dr. Samuel Hahnemann, outward manifestations without treating internal derangement is not a holistic approach of treatment. But in today’s practice physicians come across cases which require external application. What should we do in such cases? This article deals with the concept of external application in homoeopathic practice as per Dr.samuel Hahnemann and other stalwarts of homeopathy.

• Keywords: external application, local application, suppression, homoeopathic medicines, Dr. Samuel Hahnemann, location affection, local manifestations, external manifestations
• Introduction 

External application – this method of treatment was based on teaching and general belief that if the outward manifestations were removed, the disease was cured, that outward manifestation was the disease itself and that the individual would be cured when the manifestations were removed. This doctrine was taught from the earliest times until Dr. Samuel Hahnemann proclaimed to the world a new doctrine that local manifestations were but an outward expression of the inward and spiritual force, which when disturbed expressed itself in external signs; that if these external manifestations were removed by external application, the disease was not cured, but driven in to some more centrally located organ, there to express itself in some graver form. Thus, removal of external manifestation by external application leads to suppression of primary signs which were thrown externally by disturbed vital force, which then turns inward damaging more vital organs. 

Let’s understand it with the following example.

Example 1: indiscriminate and persistent use of astringent sprays, which are usually permeated with medicinal ingredients.

Nasal sprays and douches are suppressive of natural discharges of the body whenever such treatment is used, and so clogs and shuts off the natural outlets of the sinuses in the nose and face. When natural discharges are once suppressed and shut in, we have the ideal circumstances for abscess formation, for we have heat, moisture and bacilli. 

Example 2: another field where much harm is done is in gynecological work. Leucorrhoea discharges are exceedingly troublesome to many patients, and astringent douches are frequently ordered by specialists in this field. Lotions and astringent douches can and do suppress the quantity of these secretions, oftentimes changing their character entirely. This treatment appeals to the patient because it speedily reduces the offensiveness of the symptom. The temptation would be to do this very thing, if we did not know the fundamental law of vital energy – will express itself, & in the kindliest way to the future health of the patient; when we attempt to alter by physiological means, we are bound to disturb that vital force and cause it to express itself in some other channel than that which nature chooses.

Example 3: use of local applications, deodorants to suppress or change the character of perspiration. This is exceedingly objectionable, because it leaves pent up in the system that is poisonous and injurious to the health of the individual. This condition is not often observed by the doctor unless he by chance runs across it, or is on the alert for such suppression.

1. Disadvantages of External Application. 

• Indicated homoeopathic medicine given internally and externally.

The cure of local affections by employing the medicinal substance which is known to be truly homeopathic to the totality of the symptoms, not only internally but also externally is quite inadmissible, not only for the local symptoms arising from the miasm psora, but also and especially for those originating in the miasm of the syphilis or sycosis, for the simultaneous local applications along with the internal employment of the remedy in the disease whose chief symptoms is a constant local affection, has this great disadvantage that, by such a external application this chief symptoms (local affection) will usually be annihilated sooner than then internal disease, & we shall now be deceived by semblance of a perfect cure, or at least it will be difficult, & in some cases impossible, to determine, from the premature disappearance of the local symptoms, if general disease is destroyed by the simultaneous employment of the internal medicine.

• Indicated homoeopathic medicine given externally. 

The mere topical employment of the medicines, that are powerful for cure when given internally, to the local symptoms of chronic miasmatic disease is for the same reason, quite inadmissible; for if the local affection of the chronic disease by only removed locally & in a one sided manner, the internal treatment indispensable for the complete restoration of the health remains in dubious obscurity; the chief symptom (local affection) is gone, and less constant and less persistent than the local affection and frequently not sufficiently peculiar and too slightly characteristic to display after that, a picture of the disease in clear and peculiar outlines.  

• Local affection removed by external application.

If the remedy perfectly homeopathic to the disease had not yet been discovered at the time when the local symptoms were destroyed by a corrosive or dessicative external remedy or by the knife, then the case becomes much more difficult on account of the too indefinite (uncharacteristic) & in constant appearance of the remaining symptoms for what might have contributed most to determine the selection of the most suitable remedy, and its internal employment until the disease should have been completely annihilated namely the external principal symptoms, has been removed from our observation. 

If the local symptoms are destroyed by external application of external remedies, under the belief that it thereby cures the whole disease, nature makes up for its loss by rousing the internal malady and the other symptoms that previously existed in a latent state side by side with the local affection; that is to say, she increase the internal disease. When this occurs it is usual to say, though incorrectly, that the local affection has been driven back into the system or upon the nerves by the external remedy. 

2. Attitude of Dr. Samuel Hahnemann in regard to external application.

• In the fifth edition of organon of medicine Dr. Hahnemann mostly criticized external application as seen in aphorism 196-203, but in the sixth edition he mostly preferred external application as seen in aphorism 284-285. 
• Dr. Dudgeon in his lectures mentioned two exceptions as made by Hahnemann to his general rejection of topical applications. These were the use of Arnica, Rhus tox, Arsenicum and heated alcohol for bruises and burns respectively and of Thuja for old condylomata. 

Bruises, sprains, wounds, stings and burns are local injuries which may occur in an otherwise healthy person.

“old and stubborn” fig warts are as well-high extra vital things, remaining behind after the whole internal malady-“the entire sycosis”-had been cured. They were dead results of a past process, withered fruits of a germination which had reached from within, were, therefore, best dealt with by local application of the remedy-the application of Thuja to condylomata. 

• If by external application we mean something that will thwart the expression of the disease, this certainly should not be considered beneficial according to Dr. hahnemann’s teaching; but if we base our use of local applications upon physical principles, we may consider it. 

For instance in cases of psoriasis and like disease, the scale that is thrown off by the cuticle tears the cornium. This is the cause of the intense itching and is purely a mechanical disturbance. This can be removed very easily and properly by olive oil followed by a bathing of the part, for cleansing purposes.

In erysipelas, where there is great tension and dryness, may be temporarily relieved without violating hahnemannian principles by laying on for a few minutes a soft cloth which has been dipped in a normal salt solution, such treatments are not external applications in the sense that Dr. Hahnemann referred to in his derogation of the practice.

• External application in relation to thermal reaction of the body.

For instance, it would be very objectionable to put cold applications on a patient whose symptomatology calls for Rhus tox. It would be equally inconsistent and aggravating to put a local hot application on a pulsatilla patient, and one should guard against using a hot water bottle at the feet of sulphur patients. When using any adjuvants, the thermic reactions of the patient should be considered. This brings out the necessity of having a keen observation and a very thorough knowledge of the aggravations and ameliorations of our remedies, so as to avoid doing anything locally that would aggravate the general discomfort of the patient. 

• There is only one condition where external application of the indicated potentized remedy may be used to advantage, and that is in cases where it is impossible to administer it by mouth. This statement is based on Dr. Hahnemann’s observations that mucous surfaces and denuded surfaces are receptive to the indicated remedy, but to a more limited degree than through the alimentary canal. Besides the stomach, the tongue and mouth are the parts most susceptible to medicinal impressions; but the lining membrane of the nose possesses this susceptibility to a high degree. Also the rectum, genitals, and all sensitive organs of our body are almost equally susceptible to medicinal effects. For this reason, parts denuded of cuticle, wounded and ulcerated surfaces, will allow the effects of medicines to penetrate quite as readily as if they had been administered by mouth, and therefore olfaction or inhalation must be still more efficacious.

Parts of the body are deprived of their natural sense. Example: in the absence of the sense of taste or smell, the tongue, palate, and nose will impart impressions made primarily on these organs, with a considerable degree of perfection to all other organs of the body. 

Also the external surface of the body, covered by cutis and cuticle, is capable of receiving the action particularly of liquid medicines; and the most sensitive parts of the surface are, at the same time, the most susceptible.

• Conclusion.

External application of medicine for any topical affection is not advisable if it is with intent to remove topical affection only and underlying disturbed vital force which is solely responsible for these remains as it is. Such practice leads to suppression, thus making cases more complex and difficult to cure. Dr.hahnemann’s attitude towards external application is different from other schools of medicine. Dr. Hahnemann considers external application when it is impossible to administer medicine by mouth; In diseases where the external manifestations remain after the cure of internal disorders and in conditions in which miasms have no role in the origin of disease such as injury, burns, fracture, bruises, sprains etc where external medicine can be advised as a part of supportive therapy. Local affections which occur because of internal disorders are a very good guide to physicians to check whether the deranged vital force is gaining its equilibrium back to normal with homoeopathic medicines. Removing these local affections with any means of external application is not a holistic approach of treatment and it has been the most prolific source of all the innumerable named or unnamed chronic maladies under which mankind groans.

• References

1. B.k.sarkar, organon of medicine, 16th edition, Birla publication Pvt.Ltd.
2. Herbert A. Roberts, The principles and art of cure by homoeopathy, 15th edition, B. Jain publication Pvt. Ltd.
3. Samuel Hahnemann, organon of medicine, 6^th edition, B. Jain publishers Pvt. Ltd. Reprint: 2004, 2005.
4. Samuel Hahnemann, organon of medicine, 5^th & 6^th edition, B. Jain publishers Pvt. Lmt. Reprint 1986.
5. https://ijrpr.com/uploads/V3ISSUE10/IJRPR7465.pdf
6. https://www.scribd.com/document/249727521/Uses-of-External-applications-in-Homoeopathy-Justify