Perhaps all homoeopaths will remember the very valuable paper published by Dr. Dunham, in his treatise on the science of Homoeopath, entitled, “The Primary and Secondary Symptoms of Drugs as Guides in Determining the Dose.” Perhaps all will remember a similar treatise by Dr. Hale upon his imaginary law for selecting the potency. Also, that since these papers have been before the public, the homoeopathic mind has been frequently directed toward the paragraphs in which this doctrine is treated of in Hahnemann’s Organon, namely, 63 and 64, coupled with 115, which is as important in its bearing on the subject as the two sections named.
The sixty-fifth section should be studied, because it furnishes examples of action and reaction illustrating the doctrine taught in these sections.
As Dr. Dunham’s main idea was to refute the doctrine of Dr. Hale, that the primary and secondary symptoms furnish a sufficient guide for the dose, and as that is not particularly the aim of this paper, we may advance to a different view of these sections and the doctrine therein taught, believing that Dr. Dunham has left a sufficient argument against the folly aimed at.
62. On one hand, the pernicious results of the palliative or antipathic treatment; and on the other hand, on the contrary, the happy effects which the homoeopathic method produces, can be explained by the following considerations, which have been deduced from numerous facts, which nobody had discovered before myself, although they had been, so to speak, within grasp, so that they might have been perfectly evident and of infinite benefit to medicine.
63. Every medicine and every power which acts upon life deranges more or less the vital force, and produces in the individual a certain change, which may last for a longer or shorter time. This change is called the primitive effect. Although produced by the medicinal force and the vital force at the same time, it belongs chiefly to the power whose action is exerted upon us. But our vital force always tends to unfold its energies against this influence; the effects which are the result of this action, and which are inherent in our vital power for preservation, and which depend upon its automatic activity, bear the name of secondary effect, or reaction.
64. As long as the primitive effect of the artificial morbific (medicinal) power lasts upon the healthy body, the vital force appears to play a purely passive part, as if it were obliged to submit to the influence of the power acting on it from without, and to allow itself to be modified by it. But after a while it seems in some way to become aroused. Then, if there can exist a state directly contrary to the primitive effect or impression which it had received, it manifests a tendency to produce it (secondary action, reaction) which is proportioned both to its own individual energy and to the degree of the influence exercised by the artificial morbid, or medicinal power; but, if there can not exist in nature a condition opposite to this primitive effect, then it seeks to establish its preponderance by effacing the change which had been worked upon it by the force from without (that of the medicine), and by substituting for it its own individual normal state (secondary action, curative action.)
115. Among the primitive effects of certain medicines are found many symptoms which, in part, or under certain accessory conditions, at least, are the reverse of some other symptoms that appeared either earlier or later. Properly speaking, however, this circumstance is not sufficient to make us consider them as consecutive effects, or as the actual result of the reaction of the vital force. They constitute an alternating action of the different paroxysms of the primitive action only; and are called alternating effects.
After due consideration of these sections, I have come to the conclusion that there is but one action of drugs, which is always to make sick. That which has been considered the secondary action is the action of the vital force, which always tends to cure. If we limit, as Dunham did, the basis of a prescription to the primitive effects, so stated, it becomes necessary to qualify our knowledge by an understanding of what is known or considered the primitive effects.
This involves a study of symptoms that occur after the prescription has been made and the remedy has acted. It also involves a study of symptoms that appear a long time after a proving has been made upon the healthy subject. These reactive symptoms often indicate what is going on, and indicate whether the patient is curable or not; often indicate when the action of the remedy is inimical to the cure. From the old teaching the so-called secondary symptoms never call for a prescription. This is true in fact, but to understand the full application of this statement, an extensive study of action and reaction must be had. The symptom picture to be prescribed for must be made out of the sick feelings that endanger life or health, and reaction the evidence of repair of the vital force; hence the importance of knowing the full power of these curative energies.
In some instances, large doses of potent drugs produce violent effects, making deeper and longer lasting actions, such as are observed more particularly with potentized drugs. What are often mistaken for secondary symptoms are simply such symptoms as would come from highly potentized drugs as primitive effects or direct effects of the drugs in use. The more dynamical effects last longer and appear to be secondary to the more toxicological effects, but it is only an appearance. For example, one who has long been using Arsenic takes on the continuous appearance of the poison, in which we see the true drug action. So long as the drug is continued, the stimulating action of the crude Arsenic appears to keep up the nervous force of the subject; but as soon as the drug is withheld, the awful crisis comes. This is where reaction, if there be any reaction, must show itself, but often the vital force has been completely subdued by the toxic habituated influence of the Arsenic. Nothing but more Arsenic will save life.
In like manner we see the toxic habituating influence of Opium and other drugs. After the continued use of Opium, such a depression of the vital force comes that the discontinuance of the drug is followed by a fatal diarrhoea, which necessitates more Opium being given. In such instances it would seem that the drug dynamis actually usurps the place of the vital force.
Under the action of small doses, we see the order of symptoms reversed. Some provers of Opium become constipated; others have loose stools, so that what would appear to be primary in one, would seem to be secondary in another case. One family under my observation always has a diarrhoea-every member-after taking a small dose of opium; while it is common for most subjects in proving opium to have a constipation as what appears to be the primitive action of the drug.
The vital force attempts to oppose the primitive disturbance produced by outward forces, hence the reactive manifestations seem to be opposite in many instances. Hence, if opium begins the attack by a diarrhoea, it will end by constipation. This must furnish us, in some cases at least, a wonderful example upon which to reason.
Now, if we attempt to measure the reactive energies in the state of health by our observation, we will see that the reactive energy is always greater than the primitive shock, as will be observed by reading the 65th section.
65. Examples of (a) (primitive effect) are before the eyes of everyone. A hand that has been bathed in hot water has, at first, a much greater share of heat than the other that has not undergone the immersion (primitive effect); but shortly after it is withdrawn from the water, and well dried, it becomes cold again, and in the end much colder than that on the opposite side (secondary effect). The great degree of heat that accrues from violent exercise (primitive effect) is followed by shivering and cold (secondary effect). A man who has overheated himself by drinking copiously of wine (primitive effect) finds, on the next day, even the slightest current of air too cold for him (secondary effect). An arm that has been immersed for any length of time in freezing water is at first much paler and colder than the other (primitive effect); but let it be withdrawn from the water and carefully dried, it will not only become warmer than the other, but even burning hot, red, inflamed (secondary effect). Strong coffee in the first instance stimulates the faculties (primitive effect), but it leaves behind a sensation of heaviness and drowsiness (secondary effect), which continues for a long time if we do not again have recourse to the same liquid (palliative). After exciting somnolence, or rather a deep stupor, by the aid of Opium (primitive effect) it is much more difficult to fall asleep on the succeeding night (secondary effect). Constipation excited by Opium (primitive effect) is followed by diarrhoea (secondary effect) and evacuations produced by purgatives (primitive effect) are succeeded by costiveness which lasts several days (secondary effect). It is thus that the vital power, in its reaction, opposes to the primitive effects of strong doses of medicine which operate powerfully on the healthy state of the body, a condition that is directly opposite, whenever it is able to do so.”