Hirschel (Die homoeopathie, 136) says if we examine attentively the secondary actions, as they have been termed, we shall find- 1. That they do not belong to the organism alone, just as the primary actions do not depend on the medicinal action alone, but that they are a continuation of the phenomenon of the medicinal disease.
2.The so-called secondary action, as, for example, the constipation after Diarrhoea, is merely a sign that the medicinal action has ceased, and that the organism has resumed its ways.
3. In other cases the reaction that occurs is nothing more than the curative action, and alternation effected by the medicine, the prover being previously in an opposite state.
4. In other cases the secondary actions are merely alternating actions, that is, symptoms of one and the same medicine that are apparently contradictory.
Dr. Drysdale, in a paper on the proving medicines, (Brit. Journ. of Hon., Vol.i.) accepts without comment Hahnemann’s division of symptoms into primary and secondary. He insist strongly that the late shuttle be excluded from the pathogenetic record, but he does not tell us how they are to be recognized, consequently we shall be unable to obey his behest; for all so-called secondary symptoms in the Hahnemannian sense are not so easily recognized as the constipation that follows excessive purgation. Drysdale’s selection for the constipation in the schema of chamomilla as an illustration is, I think, unfortunate; for, in spite of Hahnemann’s assertion that it is secondary actions, I find that in two out of the four symptoms it occurred in from one to four hours after the ingestion of the remedy, consequently not as a secondary action in the sense Drysdale would attach to the word; indeed, one of the symptoms (183) should be rendered rather “tardy action of the bowels, ” or “slow expulsion of the the faces, than “constipation,” which it is not and cannot be, according as it does at so short a period after the ingestion of the drug. Another of the symptoms (182) might be rendered “constipation,” as it is followed by no explanation; but the remaining two symptoms (180, 181) are merely “sensations in the bowels, like those caused by constipation. All these, however, Hahnemann alleges to be secondary action, though, as before said, two of them are said to occur within four hours after the ingestion of the medicine.
Gerstel,(OEst. Ztsch., i.2, 191) in his re-proving of aconite, proposes, a some what odd variation of Hahnemann’s division of symptoms, and suggests that what Hahnemann terms the primary action or the stage of the invasion of the medicinal disease, the direct changes caused by the external agency, i.e., the drug, should be termed passive symptoms, and the reaction of the organism against this action he proposes to dub active symptoms. The former, the primary or passive symptoms, he alleges, in direct opposition to what Hahnemann says, are useless for homoeopathic curative purposes; the latter, the secondary or active symptoms, being exclusively available in Homoeopathic practice. In his arrangement of the symptoms of aconite, he actually attempts to institute this division, and we have his ‘passive symptoms” and his ‘active symptoms” distinguished from each other by being printed in different type. It is almost needless to remark that the worthy author loses himself in hopeless and helpless confusion in the execution of his impossible task-impossible because he starts with the fallacy that the symptoms caused by a medicine can be of the character he describes, and impossible because, even though they were such as he represents, it s utterly beyond the powers of a finite mind to tell which is which. In looking over Gerstel’s scheme, we cannot but wish that, in place of attempting to point out the two different kinds of symptoms, he had followed the celebrated showman’s plan, and allowed us, after paying our money for his or, to make our own choice. His reputation would not have been repelled from his scheme by its ridiculous pretensions to an unmeaning and useless separation of symptoms.
Dr. Schneider, in his recent work on Materia Medica, (Handbuch der reinen Pharmacodynamik, Magdeburgh, 1853) has committed himself to a classification of the symptoms obtained from the proving of medicines precisely analogous to Dr. Gerstel’s arrangement. In place, however, of dividing the symptoms into passive and active, he has arranged them into positive and negative. As he has not yet favoured us with an explanation of what he means by such a division of the symptoms, not of the practical advantage of his arrangement, I am not in a condition toe express a decided opinion respecting it value; but as far as I can judge, his positive symptoms correspond to Gerstel’s active symptoms, and his negative to Gerstel’s passive. I do not know, for he does not say, if he consider, like Gerstel, the first named class of symptoms alone available in practice; but if not and if he does not intend any practical advantage to flow from this artificial separation of symptoms, I cannot conceive why he should have complicated his Materia Medica by adopting it, as without that the arrangement is sufficiently complex and unpractical.
Griesselich (Handbuch zur Kenntniss, p. 101) has the following sensible observations on the subject of which I am now treating:- “With the disappearance of all phenomena, “he says, “which indicate an alternation of the regular state of the prover, the medicinal disease is at an end and the healthy vital action is restored. If the prover before the experiment was of a cheerful disposition, was in the habit of having a regular motion every days etc., if during the proving his disposition was gloomy, his bowels irregular, etc., and if after the expiry of these phenomena all becomes again quiet, this is not curative action, but simply a recitation in integrum. If the prover, during the course of his experiments, is at one time gay, at another melancholy, has at one time constipation, at another diarrhoea at one time strangury, at another incontinence of urine, etc., these are states that alternate with one another, alternating states; but if the previous state again recurs after the proving, then the alternating state has run its course and terminated, and this termination has nothing to do with the medicine. therefore, ” he continues, “I agree with Helbig, Piper, and Kurtz, and look upon all that occurs as only medical action, after the disappearance of which affairs return to the old state”.
I have thus presented you with a condensed view of the principal opinions that have been expressed relative to this point of Hahnemann’s doctrines, and I shall now in conclusion lay before you my own notions upon the subject. It seems to me that we cannot view the medicinal disease, or the abnormal symptoms produced by the action of a drug on the healthy human body differently from the natural disease that occurs from the ordinary morbific influences In the course of a natural disease we often observe symptoms directly antagonistic occurring Thus in the case of febrile disease, we often see coldness followed by heat, Diarrhoea followed by constipation, diminished urinary secretion of followed by diuresis, but no one thinks of saying such and such a symptom is the primary action of the morbific agent, such and such other the secondary action or reaction of the organism. We regard the disease as a whole, and look upon every symptom that presents itself as an integral part of that array of morbid phenomena which we denominate the disease. It is in this way that the various groups of morbid phenomena presented by the ingestion of a drug in a form and a dose sufficient to cause a disturbance of the health of a healthy individual must be studied. Difference of age, of temperament, of sex, of irritability, on the apart of the provers; of dose, of strength, of periods and intervals of its administration, on the part of the drug, will give rise to corresponding difference in the results obtained, just as the same difference will produce variations in the phenomena of a disease of a certain invariable fixed character. To the production of all morbid phenomena two things are essential, the exciting cause or morbific agent, and the predisposing cause or susceptibility of the organism. Accordingly all morbid action whatsoever is the product of these two factors, and it would be illogical to pretend to determine that one set of phenomena was the effect of the morbific agent, another set the reaction of the organism against such agent. All the subjective and objective phenomena are alternations in the vital functions, sensations, and structures and all are equally dependent on the invasion of the morbific agent. The morbific agent is in every case the cause the resultant morbid phenomena in every case the effect. It is true that in medicinal disease, as in natural disease, we have some symptoms that may be termed idiopathic, and others that are evidently sympathetic; but both sets of symptoms contribute to make up the features of the morbid picture, whether medicinal or natural, and it boots little to determine which are idiopathic, which sympathetic, provided we know what phenomenon do occur, and what is their sequential order and their mutual connection. What we have to do in a curative point of view is to find a medicinal disease an exact or nearly exact parallel to the natural disease, and that no merely as regards the derangement of one organ, but the concomitant deragement of all the organs affected in both. This Hahnemann perceived better than any man, and this he always practically acted on; and though we do indeed find that he inculcates theoretically the doctrine of primary and secondary actions in the sense shown in the passages of the Organon I have read, he, as I before pointed out loses sight in practice of the distinction he had so carefully made. The slow and strong pulse, caused in the first instance by digitalis, is not more an effect of digitalis on the organism than the rapid and weak pulse the is observed in the subsequent stage of the digitalis disease; and any one who would describe the action of that drug on the healthy economy would give us but a one-sided view of its powers were he to mention the first series of phenomena only. In like manner, opium in moderate dose causes in the first instance great excitement, elevated ideas, increased of physical power, and subsequently corresponding depression, gloomy thoughts, feebleness and exhaustion, and the second part of its effects is as characteristic as the first, and as certainly an action of opium as the first was. If we look at the phenomena of disease, we shall often find the same or similar alternations. A disease is often ushered in with great excitement, increase of muscular force, etc., and the next stage of it is equal depression of mental and bodily powers, just as we have seen the application of an irritant followed first by increased action and contraction of the capillaries, to be succeeded by diminished action, passive dilatation and consequent stagnation of their fluid contents. Hahnemann’s original ideas relative to primary and secondary, or, as he at first termed them, direct and indirect actions, exercise a fatal and pernicious influence on his mode of recording hate result of his physiological experimentations with drugs; so that, in place of giving us connected features of medicinal disease as they occurred, the different features of those diseases are cut up and dissevered from their natural connections. The hahnemannic schema is as unnatural and artificial an arrangement of the features of many allied morbid portraits as though an artist should paint a family group, arranging all the eyes of all the members of the family in one part of the picture, all the noses in another, the ears all together, the mouths all together, and so on. From such a picture, correct though each feature might be, it would be a difficult matter for us to build up each separate portrait, and it is equally difficult for us to ascertain the various morbid portraits from the tableaux Hahnemann has presented us with in his Materia Medica.
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.