Hahnemann’s early notions on primary and secondary actions-He says some medicines have only a primary action-The importance he attached to distinguishing between primary and secondary actions- On it he founds his division of medicine into curative and palliative-Latterly he ascribes the primary action chiefly to the influence of the medicines, the secondary chiefly to the reaction of the vital force-Examples of the two actions-Secondary actions not noticed after small dose, or even after moderate doses on the healthy-Examples from the Materia Medica of primary and secondary actions-These two actions rarer in the later editions-Afterwards termed alternating actions-Finally not distinguished by a special appellation-Hahnemann seems practically to have abandoned the distinction-Hahnemann’s self- contradictions-His alternating action-Examples of it-Probable reasons for the adoption of the term-Hering combats the notion of primary and secondary actions- Piper disapproves of the distinction-Helbig rejects it-Watzke ideas on the subject- Attomyr’s notions directly opposed to Hahnemann’s Kurtz rejects the division-Trinks does the same-Schron would retain the division and use it to prune the Materia Medica-Arnold dissents from Hahnemann-Hirschel agrees partially with Hahnemann-Drysdale accepts Hahnemann’s division-Gerstel proposes the division into active and positive and negative symptoms-Griesselich repudiates Hahnemann’s division-The division into primary and secondary untenable-Hahnemann’s original notions had a bad influence on his mode of recording symptoms-Faults of the Hahnemannie schema- Example of a complete picture of a medicinal disease-Hahnemann’s Materia Medica is little more than an index- Reductio ad absurdum of the primary, secondary, and alternating actions-Great preponderance of subjective symptoms in the Materia Medica- Hahnemann’s provings fall short of his original standard-We ought to strive to bring them up to this standard-Notwithstanding all faults, Hahnemann’s Materia Medica is a wonderful work-His earlier provings are especially valuable.
Primary Secondary Alternating actions of medicines
HAVING in my last lecture endeavoured to explain to you how we ought to interrogate the organism in reference to the pathogenetic powers of drugs, I shall now attempt to ascertain the exact signification of the answers we receive.
And first let us hear what Hahnemann says on this subject. In his first essay to often alluded to he has the following (Lesser Writings, p. 312):-
“Most medicines have more than one action; the first a direct action, which gradually changes into the second, which I call the indirect secondary action. The latter is generally a state exactly the opposite of the former. In this way most vegetable substances act.” As an example of these two actions he instance the effects of opium, which, in its primary direct action, causes a fearless elevation of spirit, a sensation of strength and courage, and imaginative gaiety; but in its secondary indirect action, which occurs from eight to twelve hours afterwards, there ensue relaxation, dejection, diffidence, peevishness, loss of memory, discomfort, fearfulness.
“A few medicines are exceptions to this rule, continuing their primary action uninterruptedly of the same kind, though always diminishing in degree, until after some time no trace of their action can be detected, and the normal condition of the organism is restored. Of this kind are the metallic and other mineral medicines, such as arsenic, mercury, lead, etc.”
In the Medicine of Experience he has the following observations on the same subject (Ibid., p. 517):-
“In the action of simple medicines on the healthy human body there occur, in the first place, phenomena and symptoms, which may be termed the positive disease, to be expected from the specific action of the medicinal substance, or its positive primary (first and principal) effect. When this is past, there ensues in hardly appreciable transitions the exact opposite of the first process (especially in the case of vegetable medicines), then occur the exact opposite (negative) symptoms, constituting the secondary action.”
In the first edition of the Organon he distinguishes the two actions by the terms primary and secondary symptoms.
The discrimination of the primary and secondary action was a point of some importance according to Hahnemann, as the choice of the homoeopathic specific medicine was dependent upon it; for, as he says in the Medicine of Experience, (Lesser Writings, p. 517.) it is the symptoms of the primary action of the drug that should correspond to those of the disease, in order that the drug should be a positive or curative remedy, and not a mere palliative.
Thus by his doctrine of primary and secondary actions he divides medicines into homoeopathic-which alone are the curative ones-and palliative, which are those generally employed in the old system. A palliative medicine, he tells us in the Medicine of Experience, (Ibid., p. 519.) is one whose positive primary action is the opposite of the disease. This, he elsewhere informs us, is the enantiopathic or antipathic method-that founded on the principle contraria contrariis curantur.
In the last edition of the Organon we have a still fuller explanation of the primary and secondary actions of medicines, which I shall now read to you:-
“Every agent that acts upon the vitality, every medicine, produces more or less change in the vital force, and causes a certain alternation in the health of the individual for a longer or shorter period. This is termed primary action. Although a product of the medicinal and vital powers conjointly, it belongs principally to the influencing power. To this influence our vital force endeavours to oppose its own energy. This reaction belongs to our preserving vital force, of which it is an automatic action, and it is termed secondary action or counter-action.
“During the primary action of the artificial medicinal agents (medicines) on our healthy body, our vital force seems to conduct itself merely in a susceptible (receptive, as it were passive) manner, and appears, so to say, compelled to permit, the impressions of the artificial power acting from without to take place in it, and thereby alter its state of health; it then, however, appears to rouse itself again to action, and to develop (a) the exact opposite condition (counter-action, secondary action) to this effect produced on it (the primary action), if there be an opposite to it, and that in as great a degree as was the the effect (primary action) of the artificial morbific or medicinal agent on it, and in proportion to its own energy; or (b) when there is not in nature a state exactly the opposite of the primary action, it appears to endeavour to recover its lost balance, that is, to make its superior power available in the extinction of the change wrought in it from without (by the medicine), in the place of which it substitutes its normal state (secondary action, curative action).
“Examples of a are frequent enough. A hand bathed in hot water is at first much warmer than the other hand that has not been so treated (primary action), but when it is withdrawn from the hot water and again perfectly dried, it becomes in a short time cold, and at length much colder than the other (secondary action). A person heated by violent exercise (prime action) is afterwards affected with chilliness and shivering (secondary action). To one who was yesterday heated by drinking much wine (primary action), to-day every breath of air feels too cold (counter-action of the organism, secondary action). An arm that has been kept long in very cold water is at first much paler and colder (primary action) than the other; but removed from the cold water and dried, it subsequently becomes not only warmer than the other, but even hot, red, and inflamed (secondary action, re-action of the vital power).
Excessive liveliness follows the use of strong coffee (primary action), but torpor and drowsiness for a long time afterwards (reaction, secondary action), if this be not always again removed for a short time by imbibing fresh supplies of coffee (palliative). After the deep stupefied sleep caused by opium (primary action), the following night will be still more sleepless (reaction, secondary action). After the constipation produced by opium (primary action) diarrhoea ensues (secondary action); and after purgation with medicines that irritate the bowels, constipation and costiveness of several days’ duration ensue (secondary action). And in like manner it always happens, after the primary action of an agent that produces in large doses a great change in the health of a healthy person, that its exact opposite, when, as has been observed, there is positively such a thing, is produced in the secondary action by our viral force.
(Organon, Aphorism 1xiii., ixiv., ixv).
In the next paragraph of the Organon, he seems to imply that in his experiments with medicines only the primary action was produced.
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.