“An obvious antagonistic secondary action, however, is, as may readily be conceived, not to be noticed from the action of quite minute homoeopathic doses of the deranging agents on the healthy body. A small dose of every one of them certainly produces a primary action that is perceptible to a sufficiently attentive observe; but the living organism employs against it only so much counter-action (secondary action) as is necessary for the restoration of the normal condition.” (Ibid., Aphorism 1xvi).
And this opinion is more decidedly expressed in a subsequent paragraph, (Ibid., Aphorism cxii) where we find the following statement:-
“In the older descriptions of the often dangerous effects of medicines ingested in excessively large doses, we notice certain states that were produced, not at the commencement but toward the termination of these sad events, and which were of an exactly opposite nature to those that first appeared. These symptoms, the very reverse of the primary action, or proper action of the medicine on the vital force, are the reaction of the vital force the organism, its secondary action, of which there is seldom or never the least trace from experiments with moderate doses on healthy bodies, and from small doses none whatever.”
And in another paragraph he has these words:-
“In experiments with moderate doses of medicine on healthy bodies we observe only their primary action.” (Organon, Aphorism cxiv).
He reiterates this statement with still greater force in another place:-
“The more moderate, within certain limits, the doses of the medicine used for such experiments, the more distinctly are the primary actions developed, and these, which are most worth knowing, occur alone, without any admixture of secondary actions or reactions of the vital force. When excessively large doses are used, on the other hand, there occur not only a number of secondary actions among the symptoms, but the primary actions also come on in such hurried confusion and with such impetuosity that nothing can be accurately observed.” (Ibid., Aphorism cxxxvi).
In Hahnemann’s Materia Medica we find various instances of primary and secondary action noticed. Thus in the pathogenesis of china we find the following observation in a note:- “The constipation of cinchona bark is secondary action or reaction of the organism against the great tendency of this medicine to cause diarrhoea in its primary action.” Of chamomilla he says, “All symptoms of constipation of the bowels are secondary action, i.e., reaction of the organism against the effort of chamomilla to produce diarrhoea in its primary action.” In his remarks on digitalis, he states that the diminution of the velocity of the pulse is primary action, but that after a few days the pulse becomes increased in velocity and smaller, and this is counter- action or secondary action. Again of squilla, he says that in its primary action it causes great diuresis, but in its secondary action there ensues diminished secretion of urine. Of sarsaparilla he states that the diuresis it causes is secondary action, but in the same medicine, as it stands in the Chronic Diseases, this symptom is recorded without any such damning expletive, and therefore we are to conclude that he looked upon it as primary action, as indeed we observe it to be in the provings of other individuals; at least, it occurs very shortly after the ingestion of the medicine. Of opium, he says it weakens the muscular force in the secondary action, whilst in the primary action it exalts the same force.
Although in the earlier editions of the Pure Materia Medica the designation of certain symptoms as primary and secondary actions is very frequent, we observe, as we trace Hahnemann through the later editions of his works, that what he would formerly have denominated by these names he subsequently calls alternating actions, and it will be found that in his last works we very seldom meet with either designation; and even in the case of medicines the original provings of which appeared in the Materia Medica, many symptoms of which were marked as secondary actions, as they stand in the Chronic Diseases the epithet secondary action is either altogether omitted or only very rarely inserted, and in the new medicines, although exactly similar symptom abound, the term secondary action is seldom or never applied to them. This fact seems to indicate that Hahnemann’s mind underwent some important change in reference to his original idea of primary and secondary actions of medicines; indeed, he seems to have almost if not quite abandoned it, and to have admitted all the symptoms that occur during the action of the medicine as available for therapeutic use, which we have seen was not the case whilst he divided the symptoms into primary and secondary actions; for the distinctly states that the disease must resemble the primary action of the medicines, in order that the latter should be a positively curative agent. (Medicine of Experience, Lesser Writings, p. 517).
Indeed, from the passage I quoted just now from the 112th paragraph of the Organon, it is quite obvious that he latterly regarded all the symptoms whatsoever that occurred during the proving with moderate and still more with small doses, as primary action, though it is manifest, if we look into the earlier editions of the Materia Medica, that he then frequently met with secondary actions. My own opinion, judging from all these facts, is, that Hahnemann latterly gave up altogether the notion of primary and secondary actions, but that he did not exactly like to recant actually his dogmatically expressed notions on the subject, and so he contented, himself with doing so virtually, by alleging that in his provings only the one kind of action was observed. It is very obvious that the distinction of primary and secondary actions, which Hahnemann at first regarded of so much importance, was subsequently nearly if not altogether neglected by him. We may, then, conclude that the doctrine of primary and secondary actions of drugs is not a cardinal point in Hahnemann’s system, and we may therefore freely criticise it, without fear of incurring the censure of the self-constituted champions of pure Hahnemannism.
But though Hahnemann, as we have just seen, denied that the moderate or small doses which he administered in order to test the physiological action of drugs could produce what he denominated secondary action, or the exact opposite condition of that first produced, he found that even his moderate or small doses often produced states directly antagonistic to each other. At first, as we have noticed, the last of these was denominated secondary action, and held to be useless as a therapeutic guide, and therefore undeserving of being recorded as an effect of the medicine in the Materia Medica, unless accompanied by the warning epithet of “secondary action, ” as the Humane Society warms us off unsafe part of the Serpentine by labelling them “dangerous,” but whether Hahnemann found that if he excluded all the antagonistic symptoms he would thereby greatly curtail the dimensions of each schema, or whether it was that experience taught him that some antagonistic against actions are serviceable in a therapeutic point of views, as, for example, nux vomica, pulsatilla, sulphur, etc., are capable of producing but certain it is that secondary action became a much less frequent expletive in his pathogenetic records, and its place was for a while taken by a new expression, viz., alternating action. Without revoking formally his previously expressed notions of primary and secondary action, Hahnemann states that he applies this new expression to designate “the alternating condition of the different paroxysms of action of the primary action,” (Organon, Aphorism xxv.) and he virtually excludes the secondary action from his provings, though he still retains the notion in his Organon.
It cannot escape any student of Hahnemann’s works that an idea once entertained or an opinion once broached by him is rarely entirely abandoned or formally rejected in his works, even though it is virtually superseded by another idea; and the consequence is, that in his writings, and more especially in the Organon, and particularly the later editions of it, we find statements side by side almost diametrically opposed to each other. He seems unwilling to efface that he had previously written, but retains the order notion, though the more recent one virtually extinguishes it. Of this we shall see frequent examples as was advance, but I may merely remind you to certain anomalies and contradictions I hinted at in my last lecture. Thus, in one place, he describes minutely the mode of testing remedies in their crude state, and lays down dogmatically the rules that should guide us in giving the medicine in tincture, powder, infusion, or solution, and the various quantities in which which stronger or weaker drugs should be ingested in order to develop symptoms; and a few paragraphs further on he lays down as a rule that all medicines should be proved in globules of the 30th dilution, for in that state they are best adapted to develop their peculiar effects, the stronger as well as the weaker. The former of these notions was his first one, but though he virtually does away with it by his later opinion, he retains both. Again he states in one paragraph that it is a useless and uncertain plan to test medicine on patients-this being his original opinion. A few paragraph further on he says it is quite a commendable and proper plan to test medicines on the sick- apparently forgetful that he had ever denounced it. Though, as we shall hereafter see, Hahnemann does occasionally solemnly recant an opinion he previously held, yet he generally evinces an insuperable repugnance to do so, and shows a great dislike to cancel any opinion he had previously expressed, diametrically opposed though it may be to his later views.
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.