The Homoeopathic Aggravation


The Homoeopathic Aggravation. The smaller the dose of the homoeopathic remedy is, so much the slighter and shorter is this apparent increase of the disease during the first hours….


Hahnemann’s first allusion to it-His first case of aggravation owing to an over-dose-he first taught that it was necessary to the cure-Afterwards that it was only an occasional occurrence-And that it depend on the size of the dose-Duration of aggravation in acute and in chronic diseases-False aggravation by the production of medicinal symptoms- Always indicative of unsuitableness on the part of the medicine-Very slight medicinal symptoms of no importance-Hahnemann’s examples of true aggravation from a too powerful dose-The drosera aggravation examined-Cures with large doses mentioned by Hahnemann without aggravation-Schron denies the reality of the homoeopathic aggravation-Rummel considers it exceptional-Kurtz confounds the true and the false aggravation- Gross considers the quality of the aggravation dependent on the size of the dose-Schmid asserts that it only occurs with too small doses-Kampfer’s critical and non-critical aggravation- Hirschel’s four kinds of aggravation-None of these resemble Hahnemann’s Trinks says true and false aggravations are independent of dose-Schneider says Hahnemann’s aggravation is a phantom, but admits five kinds-Romano’s rule for distinguishing betwixt the homoeopathic aggravation and the natural increase of the disease-Rau’s peculiar aggravation-Griesselich admits and denies the homoeopathic aggravation-Arnold’s definition of it-Is it a reality?-Foundation for the belief in it-Writers have generally confounded the false with the true-General conclusions on the subject- Classes of practitioner who talk most of aggravations-Necessity for examining critically all Hahnemann’s doctrines-A desirable aggravation-Cutaneous diseases.


INTIMATELY connected with Hahnemann’s theory of the mode of action of the homoeopathic medicine is his doctrine of the homoeopathic aggravation, as it is termed, a doctrine that has been very much misunderstood by many of his followers, by whom it has been misstated, and often represented as a terrific bugbear, frightening the timid practitioner and the credulous patient with imaginary dangers and disasters.

This homoeopathic aggravation has played such a great part in the drama of the new medical reform, that it would be unpardonable in me to pass it over cursorily; and I feel it incumbent on me to enter into a thorough examination of the whole subject, whereby we shall see whether, like other phantoms, it does not lose all its terrors when thoroughly examined and exposed to the light.

The first hint we meet with in Hahnemann’s works respecting anything of the kind is in his first Essay on a New Principle. (Lesser Writings, p. 313.)

“If,” say he, “in a case of chronic disease a medicine be given, whose primary action corresponds to the disease, the indirect secondary action is sometimes exactly the state of body sought to be brought about; but sometimes (especially when a wrong dos has been given) there occurs in the secondary action a derangement for some, hours seldom days. Thus a somewhat too large dose of henbane is apt to cause, in its secondary action, great fearfulness” etc.

This, however, it will be observed, does not correspond to his later notions respecting the homoeopathic aggravation, as we shall presently see, but is merely as though he had said when the dose is too strong the remedial agent produces some derangement of the system, over and above its effect upon the disease,’ which, of course, is sufficiently plain and obvious.

In the next page of the essay I have just quoted from he gives the first instance of the actual occurrence of an aggravation. The case was that of a pregnant woman who, in order to cure cramp in her leg, took five drops of the volatile oil of chamomile, whereby the cramp was vastly increased, and a number of other symptoms peculiar to the drug occurred.

But the first very distinct and decided case mentioned by Hahnemann of a real homoeopathic aggravation, followed by a well- marked curative effect, and resulting distinctly from an over- dose, was published by him in the following year, 1797. The case was one which he denominates colicodynia, or spasmodic colic of excessive severity, which had already been treated by himself and others with all imaginable drugs and systems of medication. At length the similarity of the effects of veratrum album on the healthy induced him to try this medicine. He accordingly gave the patient four powders, each containing four grains of veratrum, with orders to take one powder every day. In place of doing so, however, the patient took two powders a day, and when he had finished the whole sixteen grains he was seized with such a dreadful attack of his colic that he seemed almost at the point of death. However, after this he was not again troubled with his complaint; he was perfectly cured of all his morbid symptoms.

It has been stated that this case taught Hahnemann the expediency of at once diminishing the dose to the infinitesimal point; but Hahnemann was not at this period capable of jumping so rapidly to a conclusion from a single observation, and accordingly we find that in the cases published by him for several years after this occurrence the doses of medicine he gave were by no means so small, far less infinitesimal. Several grains of arnica root, two or three grains of ignatia, a third of a grain of opium, fifteen to twenty grains of camphor, six or seven grains of ledum, a drachm and a half of cinchona bark, in the course of the twenty-four hours, which we find him giving ordinarily in 1798, are full doses according to the notions of the old school. Not till three years later do we find him recommending anything like infinitesimals; but even then the homoeopathic aggravation is not yet taught as a doctrine, but merely incidentally alluded to and confounded with the aggravation arising from an improperly-selected medicine. We must turn to the Medicine of Experience, that precursor of the Organon, for a distinct allegation respecting the homoeopathic aggravation and the part it plays in the curative process. We shall there find the following statement:-

“If we have not only selected the right remedy but have also hit upon the proper dose, the remedy causes within the first few hours after the first dose has been taken a kind of slight aggravation, which the patient imagines to be an increase of his disease, but which is nothing more than the primary symptoms of the medicine, which are somewhat superior in intensity to the disease, and which ought to resemble the original malady so closely as to deceive the patient himself in the first hour, until the recovery that ensues after a few hours teaches him his mistake.”(Lesser Writings, pp. 518, 519.)

This is the inevitable corollary from the Hippocratic axiom, or the stronger vanquishes the weaker, which I have shown that Hahnemann adopted for the explanation of the homoeopathic cure; for the stronger power–the medicine–must exhibit its superior strength in the act of superseding the disease, and hence the apparent increases of the disease, which, however, we are told is only apparent, for this increase is medicinal not morbid action.

Immediately after this Hahnemann tells us that if, notwithstanding the administration of the perfectly-adapted remedy, no aggravation occurs, then the dose has been too small, and we shall require to give one or several more doses to make it superior to the disease.

In this same essay he warns against confounding the aggravation just described with the so-called aggravation by the production of new symptoms peculiar to the medicine given. The following are his words:-

“Every aggravation (as it is called) of a disease that occurs during the use of a medicine, in the form of new symptoms, not hitherto proper to the disease, is owing solely to the medicine employed; these symptoms are always the effect of the medicine. An aggravation of the disease by new, violent symptoms during the first few doses of the medicine is never indicative of feebleness of the dose, but it proves the total unfitness and worthlessness of the medicine in this case of disease. (Lesser Writings, pp. 538-9.)

This doctrine of the homoeopathic aggravation was somewhat softened down by Hahnemann afterwards. It was not represented by him as so invariable and necessary a concomitant of the remedial effect of the homoeopathic medicine. I shall now read what he says upon the subject in the last edition of his Organon:-

“But though it is certain that a homoeopathically-selected remedy does, by reason of its appropriateness and the minuteness of the dose, gently remove and annihilate the acute disease analogous to it, without giving expression to its other, unhomoeopathic, symptoms, that is to say, without the production of new, serious disturbances, yet it usually, immediately after ingestion–for the first hour, or for a few hours-causes a kind of slight aggravation (where the dose has been somewhat too large, however, for a considerable number of hours), which has so much resemblance to the original disease, that it seems to the patient to be an aggravation of his disease. But it is, in reality, nothing more than an extremely similar medicinal disease, somewhat exceeding in strength the original affection.

R.E. Dudgeon
Robert Ellis Dudgeon 1820 – 1904 Licentiate of the Royal College of Surgeons in Edinburgh in 1839, Robert Ellis Dudgeon studied in Paris and Vienna before graduating as a doctor. Robert Ellis Dudgeon then became the editor of the British Journal of Homeopathy and he held this post for forty years.
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.