So there I was, working on an extremely erudite article on so-called aggravations, mildly and elegantly nuanced with subtle humour, sharp wit and penetrating wisdom…. And then I realized there was really not much point (actually I think I looked up and asked myself a question beginning with WT…). Because it has all been said before, by someone who knows the subject much better than I do (I think perhaps I win points on the subtle humour bit, but he has me beat on the sharp wit…)
So before we get into any discussion about aggravations, the importance of a good cup of coffee and the essential requirement of any homoeopath – to know when to send the patient swiftly into the waiting arms of the conventional system – I present some of Hahnemann’s words on the subject, taken from the 6th Organon. It’s not that I don’t think you’ll open your copies of the Organon to get into the material yourselves, it’s…well it is because… I don’t think you’ll open your copies – dog-eared or digital – of the Organon …or you’ll procrastinate… This of course is not intended to insult those of you who immediately fished the book out of your waist-wallets where it accompanies you always, night and day…. yes, all five of you…
I’ll leave you alone for a bit and give you some time to read this. In a future article, I’ll attempt to highlight and organize the ideas. I promise to stay away from peroration. And waist wallets. And further kangaroo nonsense… maybe… Read on, I’ve even added some bold and italic formatting for your reading pleasure … we’ll “talk” later…
from Hahnemann’s Organon, 6th Edition:
I say without any considerable disturbance. For in the employment of this most appropriate homoeopathic remedy it is only the symptoms of the medicine that correspond to the symptoms of the disease that are called into play, the former occupying the place of the latter (weaker) in the organism, i.e., in the sensation of the life principle, and thereby annihilating them by overpowering them; but the other symptoms of the homoeopathic medicine, which are often very numerous, being in no way applicable to the case of disease in question, are not called into play at all. The patient, growing hourly better, feels almost nothing of them at all, because the excessively minute dose requisite for homoeopathic use is much too weak to produce the other symptoms of the medicine that are not homoeopathic to the case, in those parts of the body that are free from disease, and consequently can allow only the homoeopathic symptoms to act on the parts of the organism that are already most irritated and excited by the similar symptoms of the disease, in order that the sick life principle may react only to a similar but stronger medicinal disease, whereby the original malady is extinguished.
There is, however, almost no homoeopathic medicine, be it ever so suitably chosen, that, especially if it should be given in an insufficiently minute dose, will not produce, in very irritable and sensitive patients, at least one trifling, unusual disturbance, some slight new symptom while its action lasts; for it is next to impossible that medicine and disease should cover one another symptomatically as exactly as two triangles with equal sides and equal angles. But this (in ordinary circumstances) unimportant difference will be easily done away with by the potential activity (energy) of the living organism, and is not perceptible by patients not excessively delicate; the restoration goes forward, notwithstanding, to the goal of perfect recovery, if it be not prevented by the action of heterogeneous medicinal influences upon the patient, by errors of regimen or by excitement of the passions. §
But though it is certain that a homoeopathically selected remedy does, by reason of its appropriateness and the minuteness of the dose, gently remove and annihilate the acute disease analogous to it, without manifesting its other unhomoeopathic symptoms, that is to say, without the production of new, serious disturbances, yet it usually, immediately after ingestion – for the first hour, or for a few hours – causes a kind of slight aggravation when the dose has not been sufficiently small and (where the dose has been somewhat too large, however, for a considerable number of hours), which has so much resemblance to the original disease that it seems to the patient to be an aggravation of his own disease. But it is, in reality, nothing more than an extremely similar medicinal disease, somewhat exceeding in strength the original affection.
This slight homoeopathic aggravation during the first hours – a very good prognostic that the acute disease will most probably yield to the first dose – is quite as it ought to be, as the medicinal disease must naturally be somewhat stronger than the malady to be cured if it is to overpower and extinguish the latter, just as a natural disease can remove and annihilate another one similar to it only when it is stronger than the latter (§§ 43-48).
The smaller the dose of the homoeopathic remedy is in the treatment of acute diseases so much the slighter and shorter is the apparent increase of the disease during the first hours.
But as the dose of a homoeopathic remedy can scarcely ever be made so small that it shall not be able to relieve, overpower, indeed completely cure and annihilate the uncomplicated natural disease of not long standing that is analogous to it (§ 249, note), we can understand why a dose of an appropriate homoeopathic medicine, not the very smallest possible, does always, during the first hour after its ingestion, produce a perceptible homoeopathic aggravation of this kind.
(1) This exaltation of the medicinal symptoms over those disease symptoms analogous to them, which looks like an aggravation, has been observed by other physicians also, when by accident they employed a homoeopathic remedy. When a patient suffering from itch complains of an increase of the eruption after sulphur, his physician who knows not the cause of this, consoles him with the assurance that the itch must first come out properly before it can be cured; he knows not, however, that this is a sulphur eruption, that assumes the appearance of an increase of the itch. “The facial eruption which the viola tricolor cured was aggravated by it at the commencement of its action,” Leroy tells us (Heilk, fur Mutter, p.406), but he knew not that the apparent aggravation was owing to the somewhat too large dose of the remedy, which in this instance was to a certain extent homoeopathic. Lysons says (Med. Transact., vol ii, London, 1772), “The bark of the elm cures most certainly those skin diseases which it increases at the beginning of its action.” Had he not given the bark in the monstrous doses usual in the allopathic system, but in the quite small doses requisite when the medicine shows similarity of symptoms, that is to say, when it is used homoeopathically, he would have effected a cure without, or almost without, seeing this apparent increase of the disease (homoeopathic aggravation).
When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase somewhat the symptoms of the original disease, to the first or few hours, this is certainly true with respect to diseases of a more acute character and of recent origin, but where medicines of long action have to combat a malady of, considerable or of very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper small, gradually higher doses, each somewhat modified with renewed dynamization (§ 247). Such increase of the original symptoms of a chronic disease can appear only at the end of treatment when the cure is almost or quite finished.
It sometimes happens, owing to the moderate number of medicines yet known with respect to their true, pure action , that but a portion of the symptoms of the disease under treatment are to be met with in the list of symptoms of the most appropriate medicine, consequently this imperfect medicinal morbific agent must be employed for lack of a more perfect one.
In this case we cannot indeed expect from this medicine a complete, untroubled cure; for during its use some symptoms appear which were not previously observable in the disease, accessory symptoms of the not perfectly appropriate remedy. This does by no means prevent a considerable part of the disease (the symptoms of the disease that resemble those of the medicine) from being eradicated by this medicine, thereby establishing a fair commencement of the cure, but still this does not take place without those accessory symptoms, which are, however, always moderate when the dose of the medicine is sufficiently minute.
The small number of homoeopathic symptoms present in the best selected medicine is no obstacle to the cure in cases where these few medicinal symptoms are chiefly of an uncommon kind and such as are peculiarly distinctive (characteristic) of the disease; the cure takes place under such circumstances without any particular disturbance.
If, however, among the symptoms of the remedy selected, there be none that accurately resemble the distinctive (characteristic), peculiar, uncommon symptoms of the case of disease, and if the remedy correspond to the disease only in the general, vaguely described, indefinite states (nausea, debility, headache, and so forth), and if there be among the known medicines none more homoeopathically appropriate, in that case the physician cannot promise himself any immediate favorable result from the employment of this unhomoeopathic medicine.
Such a case is, however, very rare, owing to the increased number of medicines whose pure effects are now known, and the bad effects resulting from it, when they do occur, are diminished whenever a subsequent medicine, of more accurate resemblance, can be selected. § 167 Thus if there occur, during the use of this imperfectly homoeopathic remedy first employed, accessory symptoms of some moment, then, in the case of acute diseases, we do not allow this first dose to exhaust its action, nor leave the patient to the full duration of the action of the remedy, but we investigate afresh the morbid state in its now altered condition, and add the remainder of the original symptoms to those newly developed in tracing a new picture of the disease.
We shall then be able much more readily to discover, among the known medicines, an analogue to the morbid state before us, a single dose of which, if it do not entirely destroy the disease, will advance it considerably on the way to be cured. And thus we go on, if even this medicine be not quite sufficient to effect the restoration of health, examining again and again the morbid state that still remains, and selecting a homoeopathic medicine as suitable as possible for it, until our object, namely, putting the patient in the possession of perfect health, is accomplished.