The following, then, are the conclusions at which I have arrived relative to the homoeopathic aggravation:-
1. That the true homoeopathic aggravation of Hahnemann, or increase of the actual morbid symptoms shortly after the administration of the medicine, is of rare occurrence.
2. That it does not always depend upon the magnitude of the dose administered, for it may occur from a small dose as well as from a larger one, and is more dependent on the kind of the disease or the susceptibility of the patient than on the magnitude of the dose.
3. That whilst it may undoubtedly be sometimes avoided by diminishing the dose, it is equally certainly often avoided by increasing the dose.
4. That it is sometimes the precursor of a cure, but not always, for cases are observed, e.g., of neuralgic affections, where many medicines aggravate but none relieve the disease.
5. That it has been confounded with several other things.
a. With the natural paroxysms of the disease.
b. With the natural increase of the disease before its decline.
c. With the so-called crises or critical discharges at the termination of the original morbid process.
d. With the transformation of the disease requisite to effect a cure, e.g., the suppuration of warts and other tumours, the natural opening of abscesses, etc.
e. With the effects of imagination or anticipation on a highly excitable patient.
f. With the pathogenetic effects of medicines administered for a curative purpose in susceptible individuals, termed by Drysdale and others medicinal perturbations.
6. That these medicinal perturbations occur from doses of all sizes.
7. That they are not always, as Hahnemann has said, indicative of an erroneous choice of the remedy, but rather of a preternatural susceptibility on the part of the patient.
8. That they are not desirable, as, if strong, they may interrupt the cure and require to be subdued by an antidote.
9. That they sometimes occur after the first dose or two of the remedy, but on repeating the same remedy cease to show themselves.
10. That effects very similar to them are often excited by the mere influence of the imagination or anticipation, even after the administration of a totally inert substance.
I have dwelt thus long and entered thus minutely upon the subject of the homoeopathic aggravation because I believe no harm but only good can result from the most rigid critical examination of all the tenets inculcated by Hahnemann, and none can deny that this doctrine of his has occupied rather a prominent place in the Hahnemannic system, and its importance has been very much exaggerated by many of those who consider themselves as the purest of Hahnemann’s disciples. On reading some of the cases recorded by these latter gentleman, we are astonished to perceive the amazing power they attribute to their medicines and the terrible effects they sometimes witness from their administration, even in the very smallest doses. Every increase of the disease after a medicine has been given is at once regarded as a homoeopathic aggravation, demanding the immediate suspension of the medicine in order to allow it, as the phrase is, to exhaust its action, though often the increase observed may have nothing earthly to do with the medicine given, but may be solely ascribable to the advance of the disease. It is a remarkable fact and at the same time a very significant one that aggravation are most frequently observed by those practitioners who do not avail themselves of the modern methods of physical diagnosis, who reject pathology and the study of pathological anatomy, who give habitually the smallest doses, and who have been bitten by the Jenichen delusion, whilst these aggravations are rarely, if at all observed by those who have kept pace with the modern advances in diagnosis and pathology, and who prefer the lower scale of dilutions as a rule.
I have pointed out how necessary a corollary the homoeopathic aggravation is to the Hahnemannic theory of the stronger medicinal disease expelling the weaker natural disease; but you will notice that from the explanation I offered of the mode of action of remedies no aggravation whatsoever ought to ensue, for the curative agent does not act by virtue of its superior strength over the diseases, but it acts as a stimulus to the morbid part, which is in a state of under-stimulation.
To some it may appear presumptions that I should thus venture to dispute the assertions of Hahnemann on points connected with his own doctrines, as though he was not a far better observer of all these things that he brings forward as facts than any of his disciples can possibly be, but I believe we shall best consult the interests of homoeopathy as a science by inquiring critically into every part of the system and ascertaining and carefully distinguishing what are really facts from what are mere assertions, and refusing credence to the latter until we have carefully sifted the evidence on which they rest, or if none is brought forward in their support, by subjecting them to a strict logical inquisition.
Now it so happens that Hahnemann’s theory of homoeopathic aggravation is a theory only. The cases he has recorded afford no evidence of its truth, and the only thing it has to rest upon is Hahnemann’s theory of the mode of action of homoeopathic agents, from which it is the necessary deduction. Now as I have, I think, shown the untenableness of Hahnemann’s explanation of the curative process, I think I am justified in rejecting this deduction from it, and in seeking to explain those occasional phenomena, that have been considered to be proofs of it, in some other way, as I have already done and as has been done by many other homoeopathists of greater experience and scientific acquirements than I can boast of.
It is often alleged by our adversaries that if we believe in homoeopathy we are bound to accept all the doctrines of Hahnemann, but nothing can be more preposterous. Because we believe in the phenomena of galvanism, are we bound to believe in the hypothesis by which Galvani attempted to explain them? because we believe in the utility and indeed the indispensableness of Dalton’s atomic theory, are we therefore bound to accept Dalton’s idea of ultimate atoms and elementary substances? The facts observed by Sydenham and the practical deductions he drew from those facts have still their value, whilst the theories he held are obsolete and absurd. The phenomena of mesmerism are undeniable, but who is to swallow all the reveries of Mesmer? Hahnemann was a great man, but not a prophet; his works are full of wisdom, but they are not revelations. And yet there are some of his disciples who hold it to be almost blasphemy to dispute any one of his sayings; there are some who think to overwhelm us with confusion when we advocate this or that practice, by saying triumphantly–“that is contrary to the doctrines of Hahnemann”.
I think the best homoeopathist is not he who is always prating about what Hahnemann did or was supposed to do, and who would try all practice by the Hahnemannic test, but he who boldly approaches the doctrines and precepts of Hahnemann in a spirit of enlightened scepticism, who refuses his credence to every tenet that will not bear the light of a searching criticism, and who who hesitates to accept even Hahnemann’s practical rules, without subjecting them to the scrutiny of reason guided by experience.
It is in this spirit I have examined the question of homoeopathic aggravations and found it defective, and it was in this spirit I investigated Hahnemann’s theory of the mode of action of homoeopathic remedies. This spirit has influenced me in accepting the law of similia similibus as the grand therapeutic rule, and in rejecting Hahnemann’s hypothesis to explain it and his doctrine of homoeopathic aggravations. Pursuing the same plan with regard to the other doctrines agglomerated round the homoeopathic law, I trust I shall succeed in proving to your satisfaction that whilst there is a vast deal that is of immense practical value connected with these doctrines, many of the theoretical views linked together with homoeopathy, which have excited the mistrust if not the derision of scientific inquirers, are non-essential to the truth of the healing law, and that if the real truths connected with homoeopathy be carefully picked out from amongst the crowd of hypothesis in which they are smothered, the whole system therefrom resulting will offer a more strictly scientific, logical, and rational character than it assumes in the writings of Hahnemann, and will carry more conviction to the minds of the majority of the profession.
My chief aims therefore will be to demonstrate the rationality of the essentials of the homoeopathic system, and to divest it of those non-essentials which have hitherto only served to retard its progress. Among the latter I consider the homoeopathic aggravation holds a prominent place.
There are, however, some phenomena connected with the favourable march of diseases and with the curative effects of medicines in disease that might, on a superficial view of the matter, seem to afford some countenance to the doctrine of homoeopathic aggravations, when observed only in connection with the curative action of the remedial agent. It is well known that some acute exanthematous diseases present unfavourable symptoms as long as the exanthema remains imperfectly developed, and that these unfavourable symptoms subside simultaneously with the full development of the eruption. This occurs sometimes spontaneously, but very frequently in consequence of the administration of the appropriate remedy; but though, as far as the mere eruption is concerned, this effect of the medicine is an aggravation, in respect of the whole disease it is a decided amelioration. It is commonly said that in such a case the morbid process is transferred from the internal vital organs to the external skin; but whatever be the proper explanation of the fact, its promotion by means of a proper curative agent cannot be regarded as an aggravation, but on the contrary, as a restoration of the disease to its normal mild course.
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.