OK, you prescribed Ignatia. You’re absolutely sure of the remedy. You’ve looked at it, repped it, slept on it, thought about it, checked materia medica, checked your patient notes, and you know. You just do.
You gave the remedy and it did nothing. Or it aggravated but didn’t seem to do anything interesting, worthwhile or exciting for homoeopathy. But you were absolutely certain!
Time to look at Hahnemann’s Organon aphorism 251, and (if you can stomach what looks like an 11 line sentence with nary a full stop but lots of commas) the introduction to the proving. Time to examine Ignatia’s membership in the club of remedies with alternating actions.
Here’s Aphorism 251. The bold in the text is mine.
“There are some medicines (e.g., Ignatia, also Bryonia and Rhus, and sometimes Belladonna) whose power of altering man’s health consists chiefly in alternating actions – a kind of primary-action symptoms that are in part opposed to each other.
Should the practitioner find, on prescribing one of these, selected on strict homoeopathic principles, that no improvement follows, he will in most cases soon effect his object by giving (in acute diseases, even within a few hours) a fresh and equally small dose of the same medicine.
(Hahnemann’s footnote: As I have more particularly described in the introduction to “Ignatia” (in the first volume of the Materia Medica Pura).)”
And I’ve paraphrased the introduction to the proving to make it readable – with a little literary license (the original is in italics just below, I did warn you about the sentence…):
When Ignatia is used, sometimes the first dose doesn’t help as it’s acting on the disease with its opposite symptoms and not as a similar. It could even aggravate. Don’t give any other remedy, just give one more dose of Ignatia in the same dilution. You’ll get the cure with the second dose. This is probably because of the alternating actions of this amazing remedy. But you won’t see this often, as usually in an acute disease (which is what Ignatia is best for), the first dose will do all it can if it was really homoeopathic to the case. (my version)
Original: (breathe deeply)
“In its employment it sometimes happens, which is seldom the case with other medicines, that where the first dose has not done what was intended, because (for some unknown cause) it first acted on the disease with its opposite symptoms and consequently soon caused an aggravation of the disease in its secondary action, like a palliative remedy, then (without any intermediate medicine having been given in alternation) a second dose of the same dilution can be given with the best curative effect, so that the cure is only obtained by the second dose. This is no doubt owing to the directly opposite symptoms (alternating actions) of this remarkable drug, of which I shall speak further on. But such cases do not often occur, for, as a rule, in an acute disease, the first dose effects all that this medicine can do in a homoeopathic way, if it has been accurately selected according to similarity of symptoms.”
So from Hahnemann’s directions here, we can use Ignatia’s alternating symptoms to understand and manage the progress of a case where we have prescribed Ignatia, are absolutely sure of our prescription, but the remedy doesn’t seem to be doing what we want it to do.
Where can these alternating symptoms be found? Here are several examples from the proving, taken from Hahnemann’s notes referring to alternating states:
Does stooping low aggravate or ameliorate?
Symptoms 16, 17, 19, 47 and 51 describe situations where the prover must keep his head down, where raising the head will aggravate.
Symptoms 20, 21, 22 and 58 describe situations where stooping aggravates.
Do the pupils dilate or contract?
Symptom 106 describes contracted pupils.
Symptoms 107 and 108 describe pupils that are dilated, and have a tendency to dilate easily.
Is music agreeable to the Ignatia patient or not?
Symptom 120 states that “music causes an uncommon and agreeable sensation”.
Symptom 121 describes “insensibility to music”.
How about sour things or fruit?
According to symptoms 194 and 197, they really like sour things and fruit and do well on it.
But symptoms 193, 196 and 328 imply that it would be best to keep the Ignatia patient far away from the fruit bowl.
What about fears – fearful or fearless?
Symptom 762 says “fears every trifle”, whereas symptom 763 declares – “audacity”.
These are only a few of the alternating states highlighted by Hahnemann in the proving – Hahnemann notes around 25 issues in total. If we work based on the principle that Ignatia is a remedy with alternating states – it’s very likely that we could see many situations of alternating states that won’t appear in the proving.