Knowing this peculiarity of Hahnemann’s mental organization, we have less difficulty in understanding his virtual abandonment of the doctrines of secondary actions, whilst it still retains a place in the systematic exposition of his doctrines.
Having thus seen that Hahnemann after a time ceased to employ the term secondary action (or rather after-action, for that is the exact meaning of the word nach-wirkung, which I have hitherto rendered secondary action), and that the expression alternating action became for a time a frequent epithet attached to certain symptoms in his schemas, let us for a moment look to a few examples of this alternating action, expressly indicated as such by himself. Thus among the symptoms of arsenic in the Materia Medica, we have the following:- “Bitter taste in the mouth after eating,” and this is said to be an alternating action with another symptom, “bitter taste, without having ate anything.” In the same medicine, the symptom “adypsia” is said to be an alternating action with “thirst.” In the pathogenesy of aurum there are some symptoms marked “alternating action” that in former years would inevitably have been called secondary or curative action. These symptoms are “gaiety and good humour,” in opposition to “melancholy and low spirits,” the latter being the most characteristic action of gold, and indeed the moral state that chiefly influences us in our employment of it as a therapeutic agent.
In the pathogenesy of digitalis, “retention of urine” is stated to be a rare alternating action of that medicine, but this would probably have figured in Hahnemann’s earlier career as a secondary, action, and therefore useless in a curative point of view.
In stannum, “extravagant gaiety” is stated to be an alternating action, whereas mere “good humour and sociability” are denominated secondary or curative action; it is obvious that these two states are merely different degree of the same moral condition, and it is difficult to conceive why the lesser should be unfit for therapeutic use while the greater is.
I might multiply these examples also ad infinitum, but I think I have adduced instances enough to convince you that the so-called alternating action latterly usurped the place of secondary action in Hahnemann’s system. This alternating actions as regarded by Hahnemann as quite available for the purposes of therapeutic indication and the epithet, when it occurs after a symptom, is not to be understood as diminished the value of that symptom in the slightest. It would almost seem as though Hahnemann and invented the term in order to preserve from annihilation many symptoms of his provings, which in his earlier days he would have left out altogether or only inserted with a qualifying epithet that would have diminished their value to the homoeopathic practitioner; as though he had in his later years become so avaricious of every symptom that presented itself whilst taking the medicine, and for weeks or even months afterwards (for to such a length of time do some of his observations refer),. that he could not bear the thought of expunging one of them. Or more probably, he found that hat he was an first disposed to reject as secondary symptoms were equally available for curative purposes with those he termed primary symptom; and he therefore found it necessary, as far at least as his own physiological experiments went, to modify his theory of primary and secondary actions accordingly he limited the occurrence of the latter to the consequences to the ingestion of enormous doses of the medicament, whilst he at the same time contended that moderate or small doses could only produce primary actions; and aware that these were often apparently of an antagonistic character, the invented the expression alternating actions for these contradictory symptoms, an expression which involves an altogether new theory of the action of drugs. But it seems soon to have become apparent to Hahnemann, that having abandoned the notion of the occurrence of secondary actions after the moderate doses in which he proved the medicines, it was not necessary to indicate by any particular term the antagonistic symptoms that presented themselves in his provings. Every symptoms that occurred after the administration of a medicine to a healthy person, in the smallest dose, he registered as medicinal action, therefore as indicative of curative power; and the length of time that might elapse after the ingestion of the medicine, before the observation of the symptom, was something incredible in his alter proving; ten, twenty, thirty, forty, or fifty days being no usual period. Accordingly we find that the expression alternating action becomes very rare in the medicine treated of in the chronic Diseases, and even many or these every symptoms of a medicine, which in the Materia medica were stated be alternating actions, a are simply recorded in the Chronic Disease without any such qualifying epithet. Thus the symptoms I have just cited from the Materia Medica belonging to arsenic, there stated to be alternating action, are not so designated in the Chronic Disease. The same is the case with the symptoms of stannum I have alluded to, and I might quote many other similar facts to show that as Hahnemann had previously abandoned the secondary action in his provings, so also he gradually dropped the alternating action. How very different Hahnemann’s notions on the subject were at different times will be most strikingly observed if we compare his first Essay on a New Principle, where for every medicine mentioned the primary and secondary actions are carefully noted, with his later provings in the Materia Medica and Chronic Diseases, where eat first the secondary action becomes modified into alternating action, and afterwards both expressions are quietly consigned to the tomb of all the Capulets.
For many years Hahnemann’s disciples accepted unquestioningly his division of symptoms into primary and secondary, curative or reactive, and alternating, especially as Hahnemann at first professed to found his therapeutic law upon these several kind of actions. One of the earliest of his disciples to enter the field against this division of symptoms was Dr. Hering of Philadelphia, who in several places combats this idea. What Hahnemann denominates secondary actions, he is inclined to regard as nothing more than alternating actions, and in what Hahnemann calls the reaction of the organism, he sees nothing more than the restitution in integrum, therefore no action properly so called, but just a cessation or termination of all action properly so called, but just a cessation or termination of all action on the part of the medicine. Strictly speaking, then, he sees only action from the administration of a medicinal agent to a person in health, and that action limited to what Hahnemann denominates primary action, of which nature, he also contends, the opposite states occur consist; those states that Hahnemann latterly termed alternating actions, (Arch., xv).
In Dr. Hering’s last work (Amerikanische Arzneiprufungen i,26). he alludes with satisfaction to his attack on Hahnemann’s notion of primary and secondary symptoms in the following words:-“This,” he says, in allusion to the slower than normal pulse some provers of glonoine experienced after the primary acceleration of the pulse, “This gives a good picture of that wave-like medicinal action which Hahnemann would have had us distinguish as primary and secondary action, and which he only in all exceptional manner denominated alternating action, but which, according to my view, which is now almost universally accepted, must be regarded simply as medicinal action first to last be the time longer or shorter, for what is called reaction of he organism has no existence” (is a nonentity).
Piper, whose views I detailed in my last lecture on the subject of physiological proving, regards the disease as a whole, and the medicinal disease or effect of he medicine given to a person in health likewise as a whole, and cannot see the property of denominating the symptoms observed primary and secondary, or in fact anything else but merely symptoms of medicinal disease.
Helbig, in his Heraclides, (Opiumcit., Part I. p.14, note; Part II. p.31) considers the contradictory, primary and secondary actions to be extremes that meet, mere alternating actions.
Watzke, in his Proselytising letters, (Bekehrungsepist, p.80) states that in the primary action the clue to the secondary action is given; that the latter is determined by the quality and intensity of the former; it would be perfectly erroneous to represent the one as standing in direct opposition to the other, there being, in fact, no well-defined limits between the two. He considers the alternating actions as two extremes that touch each other. He recognises the primary and secondary actions as the common product of medicine and vital reaction; what figures in one place as primary action and in another as secondary action merely indicates the preponderance of one or another factor in one and the same process.
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.