Perhaps all homoeopaths will remember the very valuable paper published by Dr. Dunham, in his treatise on the science of Homoeopathy, 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, Aphorism 63 and 64, coupled with Aphorism 115, which is as important in its bearing on the subject as the two sections named.
The sixth-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.
Aphorism 62. On the 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.
Aphorism 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.
Aphorism 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 directly 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).
Aphorism 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 often indicate whether the patient is curable or not; often indicate when it is necessary to repeat the dose; 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 violent 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 witheld, the awful crisis comes. this is where reaction, if witheld, 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 diarrhea, 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 becomes 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 diarrhea-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 the opposite in many instances. Hence, if opium begins the attack by constipation, it will end by diarrhea. if it begins the attack by a diarrhea, 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.
Aphorism65. Examples of (a) (primitive effect) are before the eyes of every one. 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 becomes warmer than the other, but even burning hot, red, and inflamed (secondary effect.)
Strong coffee in the first instance stimulates the faculties 9primitive 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 effects) is followed by diarrhea (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”.
We must observe from these examples furnished us by the master-and it is always well to cling to his examples as closely as possible-that the reactive energy is always greater than the primitive shock. Were it not for this increase of the expressions of nature in the reaction, a cure might be quite impossible, and it may well be said that woe is man when the vital force does not react against the extraneous noxious influences.
Not so much of value will be observed when strong doses of crude drugs have been made use of. In proportion to the grossness of lack of detail in the primitive effect will there be lack of detail in the reactive effect of the vital force. This lack of detail will often be due to the grossness of the dose administered; a crude dose of drug will be followed by catharsis without specific detail, and when the reaction comes, the constipation will lack th finer sensations which are swallowed up in the intestinal paresis, and nondescript actions and reactions are almost meaningless.
This should point out the lesson to provers, and place a limit on the value of such crude provings. This should teach the advocates of such effects that the individualizing indices are not to be found here.
If we follow out the sentiment of the text, we observe the reactive effect in a given case is generally the opposite of the primitive effect, or as though intended to oppose the primitive shock, whether from a burn, or from freezing, or from a drug, or the fixed diseases, as will be observed by carefully re- reading the 65th section. The symptoms or appearance of the reaction are generally found in the pathogenesis of the drug causing the primitive shock. The reaction seems to work within the limit of the cause of the primitive shock. The reaction, in other words, is limited to the sphere of the drug causing the primitive effect. In one prover Opium has produced constipation (primitive effect) and in the reaction we observe a diarrhea. In another prover the primitive effect will be a diarrhea, and the reaction will be constipation.-See Aphorism 65, Organon.
The reaction in healthy people will always be greater than the primitive shock. To state it in another way, the symptoms that appear in one person as primitive effects, appear in another as the reactive influence of the vital force; because the vital force in its efforts to resist the force from without must establish directly opposite actions, and all such reactions are within the line of actions found in the drug or disease cause which the vital force is acting or reacting against.
Whatever symptoms or expressions are found in a given reaction will be found in the pathogenetic symptoms of the entity that the given reaction is opposing. There can be no reaction outside of the action of a given entity, whether it be a sick cause or drug.
It must not be supposed that this can furnish a doctrine whereby we can claim or suppose symptoms that have not been actually produced. I am well aware that this doctrine may be criticised before it is accepted, but the study of provings, thus far, has led me to fully believe in it as a fact.
To understand the action of drugs in the primitive effects, one must not attempt to study it upon the sick, but healthy persons should be chosen, which will give much that is useful by observing what is felt and seen.
Again, to understand reaction one must compare what he sees in healthy persons with what appears in various degrees of sickness in unhealthy people. if we commence the study of the primitive effect through a proving of a drug upon a healthy subject, we will naturally avoid the effect of gross medicines if we would learn much.
As has been said, the finer details have been swallowed up in the grossness of effects; but we observe that the few symptoms however seem to repeat themselves with an exactness that is surprising, some appearing on the 1st, 3rd, 5th, 7th and 9th days for many weeks with an exactitude of repetition that is surprising. Especially is this the case if the dose that Hahnemann mentioned, which was the 30th potency, should be the lowest resorted to for proving. In comparison with the gross effects which soon pass off, the effect of potencies upon healthy provers is most wonderful in the variety of the symptoms and in the length of time after the potency was administered.
Even many weeks after the proving, we find symptoms coming or occurring in intervals of 7, 14, and 21 days. Particularly did i observe this upon a healthy woman in the proving of Cenchris, who had menstrual symptoms four months after the proving, recurring at each menstrual period with perfect regularity; a symptom that is now a confirmed symptom and valuable. If this could then appear as what we term a reactive effect it would puzzle a philosopher to know why the effect from a ten-thousandth potency had not long before disappeared.
So that it must be reasonable to conclude that all the symptoms that appear after the taking of the drug that was administered, are the genuine symptoms of the drug, are the primitive and specific effects of that drug, whether occurring in he first day or many months afterwards. Habits and customs have been established by provings that have lasted the provers for years. These, considered as symptoms, have been cured by the same drug under similar conditions, and should be considered a fundamental primitive effect of the drug’s use; they are really th sickness of the drug.
If we now undertake to consider the action of the drug when no apparent reaction comes against it to oppose it, we then see still more wonderful effects. If we administer to a patient in the last stages of consumption a drug in suitable form that would have cured this patient when he was yet curable, we now observe wonderful and striking things. we notice that after the administration of this drug that he is made worse, the course of his disease is more rapid, and he may be, by the careless use of such drug, hastened to a premature grave.
In this instance we notice the lack of reaction. We notice the continued primitive shock, which united with his disease, instead of curing it, hastens him on toward the grave. We observe then that which we had not observed in healthy reaction, a continued downward course in the primitive action of the drug united with the disease; hence it may, well be said that woe is man when reaction does not come.
We observe this state of things in incurable cases of Bright’s disease, consumption, cancer, so that the remedy that was deep enough to cure him, is now poison. We further observe that the remedies that help the severe sufferings in these incurable cases are such as are similar only to the few symptoms in his sufferings. These furnish examples of the primitive action of a drug when not opposed by vital reaction.
The primitive expressions become changed by the vital force in healthy reaction, and some have mistaken these for the secondary action of the drug administered; especially this is the case in provings. Then it is that we must consider the primitive action, when reaction does not oppose it, that we can know very much of its interior. Observe again the periodicity that comes in symptoms. The periodicity that follows the action of drugs, and what may be studied in a drug may also be studied in disease cause.
What is true of the action of a drug is also true of the action of a disease. The most suitable way of studying diseases in their actions is also true of studying drugs in their actions, their conduct. Take for instance an intermittent fever. The paroxysm composed of chill, fever and sweat. The primitive action of that fever cause is attended throughout by the paroxysmal expressions that follow in which the reaction of the vital force has been, either aided or unaided, sufficient to oppose the sick cause.
It might be well to consider the erratic nature of some symptoms belonging to drugs, such as Ignatia having extremes and opposites and alternations of symptoms. Symptoms that change about in a most erratic manner, yet they are all the sick expressions of the one drug. I am aware that I have scarcely touched upon the important part of the truth that is yet to come out of reflecting upon the actions of nature. To be conversant with the signs of drug action is an important road to truth, and the knowledge thus gained must be useful, as a new drug, or the repetition of one chosen will often turn upon what is known about the meaning of actions observed.
It is now well known that reaction is going on favorably when mental symptoms are improving and general feelings express a general bodily improvement, even through symptoms are more painful. The successful healer is one who knows much about the signs of reaction and what is intended by nature. It is well known that chronic symptoms engrafted upon the economy either by drugs or chronic miasms are due wholly to deficient reaction of the vital force.
Incurable results of disease are incurable for two reasons: First, destruction of the tissues of the organism. Second, deficient reaction of the vital force. The latter may be again divided into congenital weakness and acquired debility. But as these divisions of inner complexities belong to other subjects, I will dismiss the subject entered upon in this paper, hoping that sufficient consideration will be given it to expose its weak points, that the strongest light may shine upon the real truth.
Dr. Hawley: I have one objection to make to the paper. Dr. Kent seems to me to be a little mixed in his use of the words “action” and “reaction.” He states, if I understood him right, that all the symptoms resulting from the drug are drug action; then he speaks frequently of the reaction of the vital force. There is some confusion here to my mind which might have been avoided by a little circumlocution.
Dr. Custis: The diarrhea produced by the Opium must have been due to some idiosyncrasy in the patient, and shows that Opium was not a proper remedy for that person. Different people are subject to different diseases, and the same drug will operate differently upon different constitutions, and hence by a study of the peculiar susceptibilities our patients, we may often get a clue to the class of remedies needed.
One man, for instance, will always have rheumatic conditions follow an exposure, and he will have a certain class of remedies to which he is most susceptible and among them you will find his remedy. Some people are so susceptible to certain remedies that they can never take them without producing aggravations. These are due to the idiosyncrasy of the person and not to the double action of the drug.
When a patient is so susceptible to Belladonna, for instance, that patient will never be helped by Belladonna, and would be a poor person on whom to prove Belladonna, because you would not get the finer symptoms.
The two fields for study are the nature of the disease and the action of the drug.
Dr. Johnstone: The gentlemen who followed Dr. Kent and preceded me have hardly criticised the paper, but simply confirmed it. The action of the drug is purely primary and causes the vital force to react towards health. The drug has an action and the body has a reaction; th drug gives the impulse, the push, to the deranged vital force, which causes it to react towards. normal life. Drugs have only one action, and that is always sick making, it is the body (vital force) which reacts.
Drugs sometimes kill people when very accurately fitted to the symptoms of the case, especially if too frequently repeated. This is true, especially when the vital force is so far below par that its reaction (so-called non-reaction) overreaches and becomes exhausted in the effort. I have had one case of that kind where the patient did not improve under the indicated remedy, and I believe would have lived longer without it (over-reaction).
Dr. Hitchcock: There seems to be some difficulty in understanding the terms, action and reaction. i can not see how anything but the reaction of the body can ever be manifest to us. Whatever the individual is made sick by a drug or by a natural cause, it is the vital power trying to overcome the disturbing influence that makes symptoms, which are the only things of disease that are manifest to us.
Hence, it is plainly the reaction of the vital force, in all cases that make symptoms, and the only thing that we see is reaction and not action. Where we give a remedy to a prover we get certain results; these results are simply the efforts of the vital force to get rid of, or overcome, the power which is disturbing it; they are the reaction of the system, not the action of the drugs; of this latter we know nothing, and therefore no line can be drawn between action and reaction.
In the case of the hand plunged into cold water, the first effect is entirely mechanical and can not be compared to the effect of a potency; the after effects are also entirely different. I do not think it is a fair example.