Discharge of mucus from the nose, and dry obstruction of the nose.
Dr. C. Hering, in 1844, rejected Hahnemann’s explanation of primary and secondary symptoms, but admitted that there are in every proving symptoms which appear early and late, and although they may appear opposed to each other, they are all to be made the basis of prescriptions. Indeed, he says the longer lasting, more permanent and more opposed the later symptoms are to the earlier, the more useful they are in practice. He declares that “all symptoms which arise in provings of the higher potencies are similar to the later effects of the lower or so-called stronger doses, and are not like the first effects of strong doses”-and adds that the great characteristics of remedies accompany both the earlier and later symptoms, e.g., the burning of arsenic”.
Hering therefore deduces the following law of dose: “Having chosen the remedy, according to the symptoms of a case, from the complete correspondence of the characteristics is disease and drug, we have only to consider whether the symptoms of the case generally have more resemblance to the earlier (primary) symptoms of the drugs, and then we give the lower potencies; or more resemblance to the later (secondary) effects, that is, to the symptoms produced by the higher potencies, and then we give the higher potencies”.
Dr. E.M. Hale, in 1860, expressed the belief, and in 1874 reiterated it, that he had discovered the law of dose. He states that “the proper dose for each case may be selected with as much certainty as the proper remedy.” Assuming that all drugs produce, and all diseases present, two series of symptoms (primary and secondary), and that in one or the other of these classes is embraced every symptom of drug or disease, he lays down the following rule:.
“If the primary symptoms of a disease are present, and we are combating them with a remedy whose primary symptoms correspond, we must make the dose the smallest compatible with reason; and if we are treating the secondary symptoms of a malady with a remedy whose secondary symptoms correspond, we must use as large a dose as we can with safety”.
Von Grauvogl, in his Lehrbuch der Homoeopathic, says:.
“In ignorance of the law of proportional oscillation, some have sought to generalize these motions, and to call primary effect that which we bring to pass, and secondary effect that which, is the reflex action of the organism after the effect is complete. In this another mistake was made, viz.:that it was generally thought that the secondary effect could always be considered and looked for as the opposite of the primary effect, and hereupon indications were to be built up.
This could only come to pass by the cotemporaneous but impractical further division of this alternation of phenomena into chemical and dynamical, of which the latter were held to be the more enduring. For example: primary effect of Quinine, swelling of the spleen; secondary effect, atrophy of the same; or, primary effect of Ipecac, nausea, convulsive cough, etc.: secondary effects, relaxation of the musculature, etc.
As the same time, the secondary effect was sometimes considered as only an intermediate stage, form which recovery might and should proceed; as for example, from Alcohol, first excitement, then bodily malaise (Katzenjammer), finally the normal condition again. And while, with the so-called dynamic remedies, the primary effect was to form the indication, it was to consist, with regard to chemical remedies, in the waiting for the secondary effect; e.g., with Arsenic, primary effect, paralysis and emaciation; secondary effect, convulsions, gain in flesh and invigoration of the body, and other similar arbitrary divisions, which, however, are not taken from practical life.
That the whole question of primary and secondary effects turns upon the dose, not upon the question whether substances operate chemically or dynamically, is easy to demonstrate. But first, we must have decided whether, in this question, we will set out from the large dose of the physiological school, or from the small Homoeopathic dose, since in both cases, there are primary and secondary effects.
Sulphur, for instance, in the Allopathic dose of the physiological school, produces at first watery diarrhoea, as a local effect upon the intestinal canal, according to the law of causation; but not always in the Homoeopathic dose, because it lacks this local effect according to the succession of cause and effect, for it brings the Sulphur first, not into the intestinal canal, but into the blood.
Soon, however, diarrhoea is produced by Sulphur even in a Homoeopathic dose, but not in consequence of accelerated secretion of the inner wall of the intestine, irritated by the Sulphur, but in consequence of increased formation of bile and of its discharge into the intestines. For this reason the diarrhoea produced by the large dose of Sulphur is, at first, not bilious, though this is the effect of the small dose.
The secondary effect, however, in both cases, as soon as no more Sulphur is given, is precisely the same, to wit, obstruction. But this obstruction is no longer the effect of Sulphur, whether given in an Allopathic or a Homoeopathic dose, but phoronomic, the result of the proportional oscillation of the organic activities.
If we take Sulphur in Homoeopathy dose only, then we have a series of phoronomic changes, according to the law of reciprocal action, by which always two symptoms, the one following the other, show that, in the interior of the organism, movements have arisen, of which the preceding is always the cause of the succeeding. In this instance we should not, and strictly speaking, cannot speak any more of primary and secondary effects, and for the reason that here the primary effect can be no longer established according to the individuality, since in one case, cough with mucous expectoration, is the first thing noticeable, in another, palpitation of the heart, in the third, a haemorrhoidal flow.
For the sake of curing, we must thus, in many cases, commit such a penetrating remedy as Sulphur in a minimal dose (often after one single dose), for some time to the counter-actions and reciprocal actions of the organism, and if the indication has been correct, the result cannot fail, and all the same whether we had to give the Sulphur for some kind of eruptions, an irregular menstruation, or a case of gout, etc., in accordance with the concomitant circumstances…..
Hence the cure of such diseases by Sulphur is effected not in consequence of a secondary effect, according to the law of proportional oscillation, as warmth succeeds the coldness of the hand which has been in cold water, but in consequence of reciprocal effects induced by it and propagating themselves from part to part, within the organism, whereby the Sulphur taken (by the organism) may have been removed therefrom long ago.
These are, therefore, no secondary effects, but series of effects which themselves again have become the causes of other effects, and if we allow these series of effects, or to speak scientifically, these reciprocal actions, to run their course, undisturbed, them we may again designate this only as “permitting the remedy to expend its force,” in direct contrast with the so-called secondary effects.
If we were harboring the delusion that we had to produce, or wait for these secondary effects in order to attain a cure, would we thus establish indications, that we first had to disturb the self-activity of the organism so that we might afterward restore its equilibrium again, then we should with such senseless indications, which at best, could be thought of only by the worshippers of the vis medicatrix naturae, have effected nothing but superfluous torture; for, to what would it lead, to give laxatives, that constipation might follow; or to hasten menstruation with Cuprum, Pulsatilla, etc., that it might afterward remit; to irritate or paralyze the functions of the organism to the very verge of their capability of resistance, that they might be able to help themselves?.
In other to bring to a decision in a practical way the contending opinion relative to primary and secondary effects of drugs, let us adduce an example of phoronomic motion.
If we take several times a day a few drops of tincture of Belladonna, our organism experience in various, but specific directions, an accelerated exchange, and in other directions a retarded exchange.
When first taking this drug in small doses, and for some days thereafter, there is evidently a greater quantity of carbonic acid excreted by the lungs, while during the action of stronger doses a smaller quantity is excreted. In general after the use of Belladonna the excretion of the infusible salts in the urine is diminished; on the country, the urea, the vesical mucus, the fusible salts, and the extractive matter are increased.
At first the pulse is retarded two or three beats in the minute, while as the same time an accelerated, i.c., an increased exertion from the mucous membrane of the organs of deglutition takes place. If we persist in the use of the drug, injection and inflammation of the same parts take place, but now with acceleration of the pulse, four or five beats in the minute, and thus beyond the usual individual frequency. Hence, if the capillary vessels in any part are overfilled, the beat of the heart is correspondingly retarded; but, if inflammation and swelling take place, then the pulsations are increased again, and remain at this height for three or four days even, without any more Belladonna having been taken.
