On another page, Hahnemann gives the most certain indication that the remedy is acting curatively when he says: “In favorable cases, the strength of the patient returns immediately and lingering period of convalescence, usual under other modes of treatment, is not met with.”
In paragraphs 155, 160, 161 and elsewhere in The Organon, similar instructions are given. He says in paragraph 161 that when he limits the homoeopathic aggravation to the first few hours, he refers especially to its occurrence in acute diseases of recent origin, but, “where medicines of long action have to combat a malady of considerable or very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper, small, gradually higher doses.” He then refers the reader to paragraphs 247, where he describes his “new altered but perfected method of repeating the dose” in chronic cases, raising the potency slightly with each dose.
But in paragraphs 280 and 281, he warns the physician against continuing to repeat in chronic cases, when, after it has been accompanied by general improvement, the “patient begins to feel in a mild degree, the return of one or several old, original complaints. This” he says, “indicates that the similar medicinal disease in order to lose the sensation of the natural disease. It indicates that the life principle now free from the natural disease, begins to suffer something of the medicinal disease, hitherto known as the homoeopathic aggravation.
In order to be convinced of this, the patient is left without any medication for eight, ten or fifteen days meanwhile giving him only some powders of sugar of milk. If the few last complaints are due to the medicine stimulating the original disease symptoms, then these complaints will disappear in a few days or hours. If, during these days without medicine, while continuing good hygienic regulations and nothing more of the original disease is seen, he is probably cured.”
In paragraph 263 the author amplifies a statement, made in The Medicine of Experience, that in the best cases the strength of the patient returns immediately after the administration of the medicine by saying that “among the signs that, in all diseases, especially in such as are of the acute nature, inform us of a slight commencement of amelioration or aggravation that is not perceptible to everyone, the state of mind and the whole demeanor of the patient are most certain and instructive.
In the case of ever so slight an improvement, we observe a greater degree of calmness of the mind, higher spirits- a kind of return of the natural state.” In other words he lays the basis for that most important tenet of homoeopathy, that cure is from within outward or from above downward.
Although Hahnemann gives some instructions in The Organon as to the management of cases in which there is an underlying taint or miasm,” he is more explicit in his work on the Chronic Diseases. [7] Speaking of the suppression of the external manifestation of psora in the form of an eruption on the skin, he says that in some vigorous itch patient, the vital force, following the law of nature on which it rests (“her instinct showing more wisdom than the intelligence of her destroyers”), after some weeks, drives back to the skin the eruption suppressed by ointments and purgatives, the patient returns to the hospital and the mischievous destruction of the eruption by means of ointments or lotions in repeated.
In its complete state i.e., so long as the original eruption is still on the skin, so as to assuage, the internal malady, the entire disease of the psora may be cured easily, quickly and surely. But when by the destruction of this original cutaneous eruption which acts vicariously for the internal malady, it has been robbed, then the psora has been put in the unnatural position of dominating, in a merely one-sided manner, the internal finer parts of the whole organism, thus of being compelled to develop its secondary symptoms, which are in effect, “all chronic functional and organic, non-venereal diseases, and which, when complicated by numerous artificial drug diseases, is exceedingly difficult to cure…”
If, Hahnemann continues, [when] the well-chosen antipsoric remedy is still acting, a slight headache, a sore throat, a diarrhea or a moderate pain should arise in one part or another, the physician should not, at once, give another remedy, but should allow the one that has been given to finish it course without interruption.
“For, if the symptoms occurring during the action of the remedy have occurred in a similar manner some weeks or some months before.. they are a sign that this medicine is acting deeply into the very essence of the disease and that, consequently, it will be more effective in the future… But if these aggravated original symptoms appear on subsequent days, still of the same strength as in the beginning or even with increased severity, it is a sign that the dose of this antipsoric remedy, properly selected according to homoeopathic principles, was too large.”
“Now if we consider the great changes which must be effected by “the medicine in many variously composite and incredibly delicate parts of our living organism before a chronic miasm so deeply rooted and, as it were, parasitically interwoven with the economy of our life as psora is, can be eradicated; then it may well be seen how natural it is that, during the long continued action of a dose of an antipsoric medicine assaults may be made at various periods on the organism, as it were in undulating fluctuations during this long continued disease.”
“As a rule, the antipsoric medicines in chronic diseases continue their action the longer, the more tedious the diseases are… Whoever can restrain his impatience as to this point will reach his object the more quickly and the more certainly.”
The direction of the curative action of the remedy is illustrated on page 135 of The Organon, where Hahnemann says, “The latest symptoms that have been added to a chronic disease which has been left to itself (and thus not aggravated by medical mismanagement) are always the first to yield to antipsoric treatment; the oldest ailments, among which are the constant local ailments, are the last to give way.”
Even before Hahnemann re-discovered the law similia, he recognized the deterring effects of the patients habits of eating, drinking and other factors that are apt to hinder the action of the medicine prescribed. It is not surprising, therefore, that in a note to paragraph 260 of The Organon, he gives a long list of foods and drinks that will interfere with the treatment. He forbids the use of tea and coffee entirely. In the work on chronic diseases, he is equally emphatic in his warnings, saying that when the medicine fails to yield results, the physician should inquire into the patients habits and the “mishaps,” as he calls them, before selecting a new remedy.
It is not essential that the student of homoeopathy accept Hahnemanns theory of the chronic miasms in toto, provided he recognize the basic principle therein involved. Few will question the ill-effects of suppression in acute as well as in chronic affections, for it is a fundamental tenet of homoeopathic therapeutics. For this reason he should read with care Hahnemanns instructions regarding the treatment of “mixed miasms,” on page 93 to 95 of The Chronic Diseases and familiarize himself with the symptoms which characterize the several miasmatic taints. Including the materia medica of anti-psoric remedies, they comprise almost nine-tenths of this great work.
Probably most chronic patients are burdened with two miasms, and occasionally with all three. When the symptoms of psora are in evidence, an anti-psoric remedy is given and repeated until they disappears. In that event, the symptoms of one of the other taints manifest themselves, and the suitable anti-miasmatic remedy must be administered. When it has run its course, the third miasm will take the field. If psora has not been entirely eradicated, the reappearance of its characteristics will confirm the fact, and the same or another anti-psoric must be given which, as a rule, completes the cure.
As previously stated, the majority of the early writers have little to say on our subject. Schron, for instance, says that if we take into consideration the fact that what were supposed to have been medicinal aggravations are generally to be ascribed to the natural course of the diseases and that an occasional aggravation is not to be avoided, though we use the smallest doses; it is not easy to see why we should waste precious time by the administration of the smallest doses which sometimes have no effect whatsoever. He says that he has never witnessed any -so- called homoeopathic aggravations.
Kampfer attempts to explain the apparent paradox that medicinal aggravations may occur from the use of small doses, while none are observed after the employment of larger ones, by stating that the same dose of the same medicine, in the same disease but under different circumstances, may produce quite different, even opposite results, and in very different doses, identically the same results.
