“A disease that is of no very long standing ordinarily yields without any great degree of suffering to the first dose of this remedy,” which is to say that in acute disease we seldom see anything like striking aggravation unless the acute disease has drawn near death’s door, or is very severe, unless it has lasted many days, and breaking down of blood and tissue is threatened, or has taken place. Then we will see sharp aggravations, great prostration, violent sweating, exhaustion, vomiting and purging following the action of the remedy I have seen most severe reaction which seemed to be necessary to recovery.
Such a state in acute disease where it has gone many days without a remedy and a great threatening is present will be to an acute disease what many years would be to a chronic disease of long standing. Long standing means as a matter of progress, if we say a disease of much progress, or of considerable ultimates, we understand it better. If the disease has ultimated itself in change of tissue, then you see striking aggravations, even aggravations that cannot be recovered from, such as we find in the advanced forms of tissue change, e.g., where the kidneys are destroyed or the liver destroyed, or in phthisis, where the lungs are destroyed.
A disease ought always to be well considered as to whether it is acute or chronic. Where there are no tissue changes, where no ultimates are present, then you may expect the remedy to cure the patient without any serious aggravation, or without any sharp suffering, for there is no necessity of reacting form a serious structural change. Where there is a deep-seated septic condition, where pyaemia must be the result, you will find sometimes vomiting and purging. As a reaction of the vital force of the economy when order is established, this order, which is attended by reaction, as it were, commences a process of house cleaning.
It does it itself, the drug does not do it; if a crude substance is used it is the action of the drug, of course, but the action of the dynamic drug is to turn the economy into order. So it is with chronic disease. When the chronic disease has not ultimated itself in tissue changes, you may get no aggravation at all, unless, perhaps, it be a very light exacerbation of the symptoms, and that slight exacerbation of the symptoms is of a different character.
It is the establishment of the remedy as a new disease upon the economy instead of the reaction which corresponds to a process of house cleaning. Elimination must take place, as we know, probably from the bowels, or stomach, by vomiting, by expectoration, or by the kidneys, in those cases where everything has been suppressed.
It may look like an aggravation when you have had for years a limb paralyzed from a neuritis. Suppose, after you administer a remedy that goes right to the spot, that is in the very highest sense homoeopathic, or truly specific, that paralyzed limb commences to tingle and creep like the crawling interiorly of ants, tingling sometimes from which he cannot sleep for days and nights. This is due to the reaction of the nerves of the part. They are called into new life, into activity.
I have seen this in paralysis. You take, for instance, a child who has lain in a stupor for a long time, from inaction of the brain, the tingling that comes in the scalp, in the fingers and toes is dreadful, the child turns and twists and screeches and cries, and it requires an iron hand on the part of the doctor to hold that mother from doing something to hush that cry, for just so sure as that is done that child will go back into death.
That is a reaction, so that all over the benumbed parts, or where the blood begins to flow into parts where the circulation has been feeble, where the nerves take on sensation again, we have reaction, which is but the result of that turning into order. That part has been benumbed and dead, and when circulation takes place in the part in order to repair its tissue we have reaction, which is attended with distress. If the physician cannot look upon that and bear it, he will have trouble. If he thinks it is an indication for another remedy he will spoil his case.
We must discriminate between that which is reaction and that which calls for a remedy. These things are only seen in Homoeopathy, never in any other practice. Sometimes the physician will be driven to his wit’s end in dealing with these reactions. It is sometimes a dreadful thing to look upon, and the physician may be turned out of doors. Let him meet it as a man; let him be patient with it, because the ignorance of the mother or the friends can be no excuse for his violence of principle, even once.
A disease of very long standing sometimes fails to yield without this aggravation and disturbance and turmoil in the economy, and the deeper it is the more tissue change you have to contend with, and the more wonderful and distressing and painful is this reaction. When a patient comes back after every dose of medicine with violent reaction, with violent aggravation of the disease, with violent aggravation of the symptoms, you know then that there is some deep-seated trouble.
There is a difference between the ultimates of disease and absolute weakness of the vital force. There is such a state as weakness of the economy, and there is such a state as activity of the economy, with much tissue change. In feeble patients you may expect feeble reactions, or none at all after your remedy, but in the feeble cases they are of such character that you have few symptoms, and you can very seldom find a remedy truly specific.
For example, say you get a patient that is destined to go into consumption, a merely suspicious case. You administer the right remedy and a violent reaction comes, a foreshadowing of what he will go through years from now if he is not cured by the remedy. A shocking condition will come upon him; he may be frightened and come back and tell you that that was an awful dose of medicine, poison, etc. That is the remedy disease, those are the symptoms of the remedy foreshadowing the future of that case, because if that remedy was not similar enough to him it could not do such things, and it is because of the similitude of his state; and he may only have those symptoms in shadow.
But the remedy cannot give him symptoms that he has not. It cannot give him symptoms that are not related to him except in those cases that are called oversensitives. Oversensitives, you know, are such as are capable of proving everything that comes along. You must know whether the patient is oversensitive and proving the drug, or whether he has a vigorous constitution and is getting an aggravation. The remedy will be exaggerated in oversensitives and sometimes in those of weakly constitution, especially those with a very narrow receding chin, those who have sunken eyes, those who have senility marked in the eyes.
The next paragraph continues this one to a certain extent. Par. 155. “I say without any degree of suffering, because when a perfect homoeopathic remedy acts upon the body, it is nothing more than symptoms analogous to those of the disease laboring to surmount and annihilate these latter by surping their place.” This is only speaking from experience. Whenever Hahnemann makes such a remark he does not place any value upon it, because it is a matter of opinion.
You will find as a general thing in acute diseases, that if a slight aggravation of the symptoms comes in a few minutes, you will hardly ever think of giving another dose. The remedy is so similar and searches so thoroughly that it is hardly ever necessary to repeat it. Now there are circumstances when it is necessary to repeat, but this is so difficult to teach, and so difficult to lay down rules for, that the only safe plan is to begin cases without repetition, to give a single dose and wait, and watch its effects. I very commonly give in vigorous, typhoid fever patient medicine in water, because it is a continued fever; but I watch and wait, giving it several days, and the slightest sign of the action of the remedy causes me to stop it always. I never vary from that. In a fever where the patient is feeble, to gain an immediate reaction that should never be done.
In a remittent fever the reaction may come in a very few hours and the one dose should be the rule, while in a typhoid the reaction will seldom come in a few hours. It is a matter of a few days, and hence the repetition is admissible. In typhoids that are somewhat delicate never do such a thing. The more vigor there is in a constitution the more the remedy can co-operate with that vigor to bring about a safe and quick action.
The more feeble the patient the more cautious you should be about using the smallest dose you can give. In many chronic disease it is possible to bring about a reaction in the first night, hence the danger if repeating the remedy. If the delirium subsides, or a moisture comes upon the skin, and he slumbers placidly, the medicine should never be given beyond such a state. There are times in diphtheria when the repetition of the remedy will kill, and there are times when repetition will save life. I hope some day to be able to discover the principles.