Are remedy aggravations caused by the remedy alone? Do not other conditions precipitate or decisively contribute to them?.
Pardon a personal illustrations as I have no better subject to raise up before you just now. Last May 8 I took the 500th potency of a very good similar, if not the similimum, one which had done very good work before. I had never taken that potency before, but had taken higher ones of the same remedy and had had aggravations from, them. But the first 500th had aced very smoothly and promptly with no perceptible aggravation. In about three months a repetition was needed, but it was held off because I was getting quite an appreciable benefit of another sort through vacation and exercise.
A few days after returning to work the 500th was taken the second time. Severe aggravations followed so that a good part of the third and again the sixth day had to be spent in bed. The symptoms of the aggravations were characteristic of what had gone before, no new symptoms whatever appeared. But I noticed that the intervals of amelioration were better than before taking the medicine so that I knew (as time has since proven) that the sickness was remedy aggravation.
Why should there have been such a difference in the two reactions? In each instance the single dose was used; diet and all external conditions, even the phase of the moon were, so far as I know, the same, except one. viz.: for five days before taking the remedy, the first five days of work, I was called out either at night or very early in the morning and it made me feel tired, sleepy and dull, physically and mentally.
My theory as to this instance is this: that the content of vitality had been temporarily muffled by the loss of sleep (which is not now well endured because of the impression of years of abuse in this respect) and was unable to cope at once with the dynamic power of the remedy. I believe that it would have been better to have at first taken a remedy to offset the loss of sleep or perhaps better still to have waited until sleep had been caught up.
Is it desirable to observe such special conditions and times with intent to select those most favorable? Might not such observation help in management of people who because of various condition of susceptibility have a tendency to prove or aggravate their remedy action?.
Personally, I believe that remedy aggravation as such do no good to the patient. WATERBURY, CONN.
DR. STEVENS: Just lately I have had two or three tiresome cases one especially of mixed miasms-which show marked > on first having a remedy but soon are < again. On waiting a little there may be a second > but not so marked as the first. I have felt that this showed little hope for real recovery. Am I right?.
If a case has a regular time aggravation is it wise to give a remedy at that time? I have thought not. A few weeks ago I gave a high potency during a time of < and the patient really suffered a good deal. I felt that I was at fault.
In giving any remedy that has a marked time <, is it not wise to avoid that time? For instance, Lycopodium should be given in the morning rather than late afternoon?.
In regard to the aggravation belonging only to the remedy, I think DR. Hayes is right in saying that the lowered vitality would increase the aggravation. People often fail to understand that extreme fatigue or some other adverse condition does markedly lessen the good effect of a remedy and delay a recovery.
DR. WOODBURY: I have more often than not attributed a good many aggravations to such adventitious circumstances as dietetic, weather, emotional changes, etc., hence do not put so much upon the remedy as some who are always noting excessive aggravations. I recall prescribing, while in hospital work, for a case of chronic haemorrhoids in a Jewish patient, to whom I was unwise enough to remark that before the was better he might be a great deal discomforted, with the result that he was very angry when he did get an aggravation, and hinted that a doctor who would do such thing should be sued for it.
My impression about repetitions and aggravations is based a good deal upon what we were taught at Boston University by Dr.Maurice W.Turner, namely: that it was wise to wait until a natural exacerbation of the disease, e.g., chill in malaria, etc., had passed, and to give the remedy immediately following its cessation. This I find confirmed by conversation with my East india friends, Drs. M.G. and P.N. Raju, who since their term at the Postgraduate School of the Foundation, are spending some time in Boston in further study. I believe that the same rule regarding aggravations as applied originally (undoubtedly by Hering and his associates of the old American Provers’ Union) should be pertinent here:.
“Sec. 4. Art. v., Diet and Manner of Living. (Suggestion for Proving of Drugs on the Healthy. Reported tot he American Provers’ Union, Pbil. Hom. Journ. Vol. II, Nov. 1853.) Unusual exertion cannot always be avoided, and may interrupt a proving, but experienced provers may obtain on such occasions the most valuable symptoms or peculiarities, if they only have sufficient power in mind to extend their observations and while their attention is called aside, remain still able to observe their own feelings.
The same is the case with sudden interruptions of the regular diet, and even transgressions. “Sec. 7. Persons who are not susceptible to the action of drugs, and get no symptoms, are recommended to commence proving with opium, coffee, or any quick acting or exciting drug.
“Sec. 8. Provers ought not to be too hasty in taking antidotes; but when required they should be ascertained by the law of similia similibus, and the observation of all changes be
still continued, as every antidote is only a partial one”.
From the foregoing, it would seem that had Dr.Hayes antidoted the aggravation, the relief might have been, as the last section states, “only a partial one.” It is evident that the aggravation was due to the fatigue, and would have passed off more quickly if the necessary rest could have been obtained.
DR. BELLOKOSSY: Your remedy was a simile, not a similimum. If late or early hours tire you and you need a vacation, it means you have not taken the similimum, three months before. Your remedy is fooling you. A simile may work smoothly and promptly in its first prescription and deceive the most experienced prescriber. If its second prescription causes troubles, it is a sigh that it is not the similimum. New symptoms are not absolutely necessary in the finest way, the second, however, may be treacherous or the first is fine and every subsequent less fine and making the patient weaker and weaker and more and more sensitive.
DR. FARRINGTON: It is more difficult to given adequate reason for the doctor’s experience than in a patient who has been under one’s personal care. There are so many factors operative in producing the various phenomena following in a prescription. It would seem that the loss of sleep, etc., are to blame in this case. Dr. Bellokossy’s observation s are pertinent and yet, I think he may be wrong in asserting that the remedy was only the simile. It is not always true that when an aggravation does not follow the first dose, that there will be none after the second- although it is true in the majority of cases.
In Dr. Steven’s case, however, I believe that her remedy is only a simile-else, as she herself suggests, the case is incurable. The older men were keen observers and it is wise to heed their warnings regarding the times to give a remedy-as Nux in the evening, Lyc. or Puls. in the morning, and as a rule, the indicated remedy after an attack or between paroxysms; also in the case of women, not too near the menstrual nisus.
DR. D. T. PULFORD: At the risk of being called a yes-man I can see truth in all discussion to date. If an obstacle to recovery can interfere with the action of a remedy why cannot it influence the aggravation? The action of any law time after time depends on all the circumstances being equal. Occasionally we get a surprise when the similimum seems to act like an old doctor my father knew said, “though hell’s fire.” I think Dr.Hayes’ explanation is both logical and plausible.
Briskly we slid along the surface of homoeopathy trying to get a toe-hold, but homoeopathy seems to be as impenetrable as life itself.
DR. HUTCHINSON: This is one of the most interesting and entertaining papers of the year. Personally, I doubt lots of aggravations, but advise doing nothing further after a prescription when possible. As Dr. Farrington has more than intimated, Nature does something sometimes. In a given concrete case there are many factors from influences that beggar description. So as well as well as we can I constantly led to the conviction that God does not permit us the ultimate: and what Dr. Dayton says of the “impenetrable ” is true. My “aggravations” are blunders.
DR. SLOAN: I have always supposed that in order to get an aggravation the prescription had to be very accurate, and that a prescriber who never saw one to the similar rather than the similimum. I may be wrong. I remember a throat case alternating sides which Lac can. 200 did not hold. My next higher potency was the 40M.- and did I get an aggravation! After a few hours everything cleared up nicely. I feel that Dr. Hayes did the similimum in his case.
DR. HAYES: I think some aggravations are caused by the effects of external vital force, too easy susceptibility, and still other are provoked by ill fitting prescriptions either of remedy or of potency.
The discussion seem to uphold all these ideas. It has been suggestive.
Dr. FARRINGTON: To say that homoeopathy is “impenetrable” is true if by it we mean that we are unable to solve the mysterious process following the administration of the potencies. We have at least penetrated the surface to the extent that the potency must not be too high or too low; that it must not be repeated too soon; that there is such a thing a as homoeopathic aggravation, etc.
I believe that Dr.Solan’s observation is correct-only the similimum can be followed by an aggravation of symptoms already present. But, unless the patient was a “susceptible” the potency was too high. For instance, I have a lady patient 46 years old who gets a marked aggravation from anything above the 30th. A single dose of the 30th acts promptly and its effects continue for two to three weeks, sometimes longer, with no initial exacerbation. I have a notion that Dr.Hutchinson’s “blunders” occured, only when, in rare instances, he gave the wrong potency of the right remedy.