The “Aggravation Quiz” results

First of all, I acknowledge that the quiz I posted was essentially superficial.  My objective was to see what people out there think about aggravations in homoeopathic treatment.

Over the years I have heard so many people panic over new symptoms (OMG! it’s a proving…!), over extreme aggravations (what do I do?! what have I done?!) and more.  I have heard people express sentiments like “it’s just an aggravation, it will get better..” without thinking properly about what is happening to their patient.  I have heard of situations where patients were told “it’s just an aggravation” and landed up in the emergency room.  None of this does homoeopathy any good.

So, some comments on the questions and results:

1. Why does Hahnemann refer to aggravations as “so-called”?
54% of you said because they are really substance symptoms, not disease symptoms. I would go with that as the best answer although let’s look at the others.

23% of you said it’s because aggravation is really a good thing. Aggravation can be helpful in determining the value of the remedy, but the first answer is the most precise.

The problematic response in this question is “because they’re really provings.” The 8% who chose this response get the following punishment which is really a reward: read the Organon carefully, with focus on the aphorisms relating to how a proving is carried out, and to the reason for and nature of new or accessory symptoms in case management.

2. What are aggravations?  The most precise response is the first one – aggravations are usually an immune system response, and it can be good when the immune system responds.

Sadly 46% of the people who answered this question went for “aggravations are a good thing – the only way to see if a remedy is working.” A brief initial aggravation can indicate a good response – if it is brief and the patient moves on towards improvement. Sometimes a patient will only get aggravations from a remedy with no improvements whatsoever, however much the dose and potency are changed, even if it seems the remedy is the best homoeopathic fit for the disease state. Improvement is really the ultimate measurement for whether a remedy is working…

There is another option which for some reason rarely gets mentioned: The patient does not turn into a “still life” when he sits down in the clinic. His disease does not magically stop progressing during case-taking. It is possible that worsening of symptoms simply means worsening of the natural disease, and that our remedy did nothing to abate its progress. Which may lead us to the “call 911” option in another question.

3. Can you have good homoeopathic treatment without aggravations?

I would be interested to know more about the 15% who reported that their patients never get aggravations.

Most agreed that sometimes treatment without aggravations is possible, depending on the sensitivity of the patient and the size of the dose. I have known patients to aggravate from LM’s in triple dilution glasses, and even from olfaction. However, since this issue depends so much on sensitivity and size of dose, it should be possible to have good homoeopathic treatment with minimal aggravations if we keep to the minimum dose and assess the patient’s sensitivity as accurately as possible.

I have often heard those more spiritually inclined talking about deep, painful, healing processes required along the hard road to healing. I don’t buy it. The deep, painful healing processes usually involve someone talking codswallop to cover up the fact that they gave too large a dose, and possibly of the wrong remedy.

4. New symptoms may be pointing to a new remedy, or may simply be accessory symptoms due to inexactness of a good remedy. So it’s reassuring that most of you went for one of these answers. Those who chose “proving” are referred the the same punishment/reward mentioned above.

5. If an aggravation is really really bad, you may want to consider going the emergency conventional route. Do you know exactly what is happening? Is it possible the natural disease is simply getting worse? It’s important to maintain common sense and a sense of perspective with patients, especially with those middle-of-the night urgent texts. In cases of what looks like extreme aggravation, make sure the patient is checked out medically – by you if you’re an MD or be someone else wielding a stethoscope and a tongue depressor.

The coffee option – although it may have seemed like a joke – is also an option if you’re sure it’s the right remedy, but the dose may have been too strong (in triple dilution rather than quadruple).  A latte or espresso will muddy the case much less than an inappropriately given so-called antidote remedy.  And on the plus side, our (frequently) caffeine-deprived patients will be buoyed up by the prospect of a spark of joy in a dulled coffee-less existence.

A more suitable remedy is always a better option than an antidote. With a more suitable remedy, your case continues. When choosing a remedy purely to antidote another, you risk muddying the case.  A reward/punishment for those 60% (gasp) of you recommending antidotes – read the Organon on case management.  Perhaps my anti-antidoting stance will be more palatable to the 60 percenters if I reframe it as follows: a more suitable remedy will usually act as a case-specific antidote to a less suitable remedy.

More on aggravations and antidotes in future posts.  In the meantime, your mission if you accept it is to read the Organon on case management!

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