These are clearly the specific effects of Belladonna, and specific counter-effects of the organism, because these occurrences as often as they are reproduced, must inevitably return in the same manner, and this, as long as the power of resistance of the organism against the influence of the Belladonna is not exhausted, or the movements of the Belladonna are not removed by those of some other substance.
If, for instance, during those inflammatory swellings in the organs of deglutition we take some drug retarding interchange, such as Coffee, in repeated doses, then the affections in the throat experience, of once, a marked alleviation, and on the second day have already disappeared, while the pulsation of the heart returns at the same time to its individual frequency, and thus much sooner than if these Belladonna affections had been left to themselves.
Coffee accelerates, indeed, the frequency of the pulse, but decreases its force manifestly, and the pulse afterwards is retarded below the individual (normal) frequency, and is small and weak. This increase of the pulse, however, is not accompanied by an increased excretion of carbonic acid from the lungs, as usually occurs in a proving of Belladonna.
Coffee not only diminished the exhaled carbonic acid for the moment, but constantly more and more, the longer it is taken, and thereby only the excretion of the solid substances of the urine, the urea, the uric acid, and urates, is diminished Although Coffee at first accelerates the movements of the bowels, it yet retards them afterward, more and more; in the blood, the solid substances the serum, the albumen, and the blood-cells, are increased, and the latter become even melanotic, as after the use of Belladonna, but they increase so that they manifestly diminish the reception of oxygen, and the exertion of carbonic acid, which again, is not the case after the use of small doses of Belladonna, when they are rapidly turned to bile in the liver, and are no more brought into the circulation.
But if, after the use of Belladonna we take Coffee in large quantities, then the inflammatory process induced by the action of the Belladonna is brought suddenly to a pause, and even the increased secretion of bile produced by the Belladonna is suddenly suppressed, with, at the same time, an increased frequency of the pulse. With Coffee, moreover, the augmented frequency of the pulse (a substitute in the motions of the central circulatory system for the stagnation of the blood in the peripheric system) constantly increases, and without any inflammatory condition being associated therewith (as is the case with Belladonna), this substitution is gradually weakened and finally lost entirely.
Here, we thus find not the least ground for the division of the symptoms of Belladonna or of Coffee into a primary and secondary effect; in both cases we saw, on the contrary, reciprocal actions in a specific manner, and varying only according to the dose. A contrary effect, however, we saw only between the action of Belladonna and that of Coffee following it, since the latter opposed the motions of the former.
Just as the so-called secondary effects must become known by the art of observation, by the differential diagnosis between the amount of motion of morbid substances and curative substances, just so it must be in the case of all drugs as regards the repetition of the dose. If we intend, for instance, in the scheme of Belladonna, nothing but lasting depression of the pulse, then it is self-evident that, when this depression is once reached, and not before, the does which produced this effect ought not to be repeated till a pause, or rather the proportionally too early restoration of the frequency of the pulse, or its renewed increase, announces itself; moreover, if we continue to administer the remedy without regarding, this, we got, at once, other Belladonna symptoms for which we did not seek-difficulty of swallowing, dilation of the pupils, etc.
As regards the quantity, it hence holds good, according to natural laws, that with a changed quantity of a dose of the same substance, a changed quality is always given, as regards the organism, although, naturally enough, not as regards the substance; and, as regards the effect, that, with every repetition of the dose a new primary effect is produced, at once, in the sphere determined by the quality. If we water a plant as often as is necessary for its growth, it will not be injured. If we repeat this watering to often it grows too luxuriantly, and perishes. This, however, is no secondary effect, but only the result of the primary effect too often introduced of the unsuitable repetition of the dose”.
Dr. P. Jousset, the clinical teacher in the Hospital Saint- Jacques, of Paris, thus states the doctrine in relation to dose:.
“1. Every medicine produces on the healthy body two successive actions, primary and secondary. These two actions are always opposed one to another.
2. The stronger the dose of medicine, the less marked is the primary action. If the dose is excessive, the secondary action only is developed.
3. The weaker the dose, the more manifest the primary action”.
Dr. Charles J. Hempel, now deceased, but well known as a translator of the works of Hahnemann and Jahr, and the author of a voluminous Materia Medica, held views similar to Dr. Hering, but goes deeper into the interpretation of the phenomena. In his lectures he says:.
“I shall have frequent occasion to show you that drugs seem to affect the organism in two opposite ways, and may, therefore, be Homoeopathic to two pathological conditions, holding towards each other relations of antagonism. We may illustrate this point by the well-known condition of fever. The first stage of an inflammatory fever is not a full and bounding pulse, a hot and dry skin, flushed face, and so forth; an opposite group of symptoms occur.
The patient experiences a chill, or cold creepings along the back; he looks pale, hollow-eyed, the hand and feet are cold; the pulse is thin, feeble, rather slower than natural, or, at any rate, not much accelerated. This condition is soon superseded by the opposite group of phenomena, generally designated as fever. The chill is the primary effect of the disease; the fever constitutes a secondary effect, or the reaction of the organism. In selecting a remedial agent for this derangement, it should be Homoeopathic, not only to the primary chill but also to the secondary group, fever. Aconite is such a remedy.
Aconite is Homoeopathic to the chill, which marks the first invasion of the disease, and to the fever which marks the beginning of the organic reaction. We are seldom called to a patient during the primary invasion of the disease; the organic reaction is generally dully established when we first see the patient. Nevertheless, we prescribe Aconite, knowing full well that the inflammatory stage must have been preceded by a chill.
We say that Aconite is Homoeopathic to the chill, and we prove this experimentally by taking a large dose of this drug, of course within conservative limits, which uniformly cause a more or less perceptible chill, coldness of the skin, depression of the pulse, all which symptoms disappear after a certain interval of time, and are followed by the opposite condition, fever. A small dose of Aconite will not produce the primary chill, but will at once excite the organic reaction characterized by the usual phenomena of heat, flushed face, dryness of mouth, etc. This shows the importance of proving drugs in massive doses. It is massive doses that develop the primary drug symptoms; small doses do not develop these primary symptoms because the organic reaction very speedily supersedes them.
In practice it is of the utmost importance that we should discriminate between the primary and secondary action. If we are called upon to prescribe for a group of symptoms corresponding with the primary action of a drug, we give a larger dose than we should do if we had to prescribe for a group corresponding with the secondary action or organic reaction”.
Dr. Hempel further adds that Aconite and Nux vomica may be used as Homoeopathic remedies in paralysis as well as tetanus; Ipecac may remove complete atony as well as spasmodic irritability of the stomach; Opium cures diarrhoea as well as constipation, excessive wakefulness as well as drowsiness and stupor; Mercury will check as well as promote the secretory action of the pancreas; Secale answers in uterine haemorrhage from atony as well as painful contraction from spasm.
The late Dr. Carroll Dunham and Dr. Richard Hughes, of Brighton, England, have given this subject very careful consideration, and I commend their writings for lucid and interesting discussions of the conflicting views of the authors I have quoted.
Dr. Hughes says: “This organism of ours into which we introduce drugs to prove them is a living one; it does not merely passively suffer under what is done to it, but reacts thereupon. If the impression made by a foreign agent is sufficiently potent, it bends before it with such subsequent recoil as the case demands. But it is readily conceivable that the impression may be so slight that the only notice taken of it by the organism is, so to speak, a resenting push in the opposite direction; and this also may be the earliest response to the influence of a drug, while, as its action gathers force, it bends the function it modifies in its own way”.
