The Homoeopathic Aggravation



“This slight homoeopathic aggravation during the first hours-a very good prognostication that the acute disease will most probably yield to the first dose-is quite as it ought to be, as the medicinal disease must naturally be somewhat stronger than the malady to be cured, if it is to overpower and extinguish the latter, just as a natural disease can remove and annihilate another one similar to it, only where it is stronger than the letter.

“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.”

“But as the dose of a homoeopathic remedy can scarcely ever be made so small as that it shall not be able to relieve, overpower, indeed completely cure and annihilate, the pure natural disease of not very long standing that is analogous to it, we can understand why a dose of an appropriate homoeopathic medicine, not the very smallest possible, does always, during the first hour after its ingestion, produce a perceptible homoeopathic aggravation of this kind.

“When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase in some degree the symptoms of the original disease, to the first or few first hours, this is certainly true with respect to diseases of a more acute character and of recent origin; but where medicines of long action have to combat a malady of considerable or of very long standing, where, consequently, one dose must continue to act for many days, we then see, during the first six, eight or ten days, occasionally some acute primary actions of the medicine; some such apparent increase of the symptoms of the original disease (lasting for one or several hours) makes its appearance, whilst in the intervening hours amelioration of the whole malady is perceptible. After the lapse of these few days, the amelioration resulting from such primary action of the medicine proceeds almost uninterruptedly for several days longer. (Organon, Aphorism clvii-clxi.)

But his opinion respecting the other or false sort of aggravation he expresses with even greater force in the Organon than in his previous essays. I shall now read what he there says on that point:-

“Every medicine prescribed for a case of disease, which, in the course of its action, produces new and troublesome symptoms not appertaining to the disease to be cured, is not capable of effecting real improvement, and cannot be considered as homoeopathically selected; it must therefore either, if the aggravation be considerable, be first neutralized in part as soon as possible by an antidote, before giving the next remedy chosen from a more accurate similarity of action; or if the troublesome symptoms be not very violent, the next remedy must be given immediately, in order to take the place of the ill-selected one.” (Organon, aphorism ccxlix).

And he adds more emphatically in a note:-

“Every aggravation by the production of new symptoms-when nothing untoward has occurred in the mental or physical regimen- invariably proves unsuitableness on the part of the medicine formerly given in the case of disease before us, but never indicates that the dose has been too weak.”

We are, it would seem from the following passage, not even to take the patient’s word for any improvement, if the pathogenetic effects of the remedy given show themselves:-

“If the patient mentions the occurrence of some fresh accidents and symptoms of importance-signs that the medicine has not been homoeopathically chosen-even though he should good-naturally assure us that he feels better, we must not believe this assurance, but regard his state as worse than it was, as it will soon be perfectly apparent it is.”(Ibid., Aphorism cclvi.)

Unless the medicinal symptoms are serious or numerous however, they are not to be regarded as always indicative of an erroneous selection, for he says, in another place:-

“There is almost no homoeopathic medicinal substance, be it ever so suitably chosen, that, especially if it be given in an insufficiently minute dose, will not produce, in very irritable and sensitive patients, at least one trifling unusual disturbance, some slight new symptom, whilst its action lasts, for it is next to impossible that medicine and disease should cover one another as exactly as two triangles with equal sides and equal angles. But this (in a good case) unimportant difference will be easily done away with by the power of action (energy) of the living organism, and is not perceptible to patients not extremely delicate; the restoration goes forwards, notwithstanding, to the goal of perfect recovery, if it be not prevented by the action of heterogeneous medicinal influences upon the patient, by errors of regimen or by passions. (Organon, Aphorism clvi).

From these passages it is perfectly obvious what Hahnemann understands by the homoeopathic aggravation, and what he does not mean by that term. The true homoeopathic aggravation is, according to him, an increase of the actual symptoms of the disease shortly after the administrations of the medicine, and the cause of it is the dose of the medicine being too powerful. It is an inconvenient and unnecessary accompaniment of the curative action, and is to be got rid of by diminishing sufficiently the size of the dose.

The first distinct instance of this homoeopathic aggravation Hahnemann gives us is, as I before stated in the case of the individual affected with colicodynia, (Lesser Writings, p.353.) and the violent increase of the disease was evidently caused by the enormous doses of veratrum swallowed. The next occasion on which we find him giving examples of this homoeopathic aggravation is in the Organon, (Organon, 238, note.) where he states, on the authority of Leroy, that viola tricolor given for the crusta lactea of infants primarily increases the eruption before it cures it; and, on the authority of Lysons, that the skin diseases cured by elm-bark are primarily aggravated by it; and he asserts that in both these instances the apparent aggravation was owing to the medicine being given in too large doses, and that had it been given in smaller doses no such aggravation would have been observed.

The next example of homoeopathic aggravation we meet with in his writings is to be found in his essay On the Power of Small Doses. (Lesser Writings, p.823.) The aggravation in this case is stated to result not from a too large dose-in as far as quantity is concerned-but from a too powerful dose, the excessive power being communicated to it by a too prolonged succussion. He states, for example, that a drop of drosera, in the 30th dilution, each successive dilution having been prepared with twenty succussions, would endanger the life of a child affected with whooping-cough, owing to the enormous aggravation it would cause, whereas the same dilution prepared with only two shakes for each dilution, would only effect a mild cure. This case, though stated as if it had actually occurred, is, as I have elsewhere, shown, (Lesser Writings, p.823.) a purely hypothetical one, and we have no evidence to show that there is any probability that it would occur, so that we may safely pass it over. The only other instance I can meet with in Hahnemann’s works, which is anything like a homoeopathic aggravation, did not occur from the employment of an excessively large, but of an unusually small dose of the medicine. It is the case of an epileptic lady, to whom he gave a drop of the 90th dilution of sulphur, and within one hour after its ingestion an epileptic fit occurred. (Ibid., p.857) I know not whether this would be considered by him as an example of aggravation, but it is probable it would, and if so, it is one occasioned by a much smaller in place of a much larger dose than usual.

On the other hand, among all the examples he cites from the works of allopathic authors of the administration of medicines on the homoeopathic principle with good effect, there is no evidence that the dose, which was in every case enormous when compared with those he himself advised, produced the slightest aggravation.

Again, in his own practice, we find instances where he gave considerable doses without the production of any aggravation.

In the first Essay on a New Therapeutic Principled (Ibid., p.349) a case of spasmodic asthma with head symptoms of a grave character is related, where a gradual cure without aggravation was effected by means of three grains of veratrum album, given every morning for four weeks. In the same essay another case is related of puerperal mania and convulsions, where the patient was cured by means of several half-grain doses of veratrum, which seemed to produce no aggravation of the disease, though a few of the pathogenetic effects of the drug were observed. In the essay On the Obstacles to Certainty and Simplicity in Practical Medicine,(Ibid., p.386) a case of spasmodic asthma is detailed, where four grains of nux vomica, exhibited twice daily for some time, removed the complaint gradually, but perceptibly and permanently, without any aggravation.

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.