Homoeopathic aggravation is the therapeutic indication of the modus operandi. It is many a way either is avoided or missed due to lack of insights of physicians. In this article we did an effort to bring the importance of homoeopathic aggravation referring to the available literature of stalwarts that how to follow the most important signs of commencement of aggravation to avoid any confusion regarding selection of remedy.
Homoeopathic aggravation, aggravation, aphorism, homoeopathy, Hahnemann, Organon of Medicine.
When the similar remedy has been given, the core of the individual has been touched, and the healing process flows from internal to external. As the inside is cleansed, disease process comes to the surface where they register as SYMPTOMS. To the person it very often appears as if they are actually getting sick. There is often a period of both physical and psychological crisis, after which the patient gets better.
We call this an AGGRAVATION, but do not cite it as a principle of healing. However, it was considered the universal law of healing by the HIPPOCRATIC Physician. They taught that every disease would pass through such a crisis before it could be healed.
The state of becoming worse or more serious; exacerbation, or – an exasperated feeling of annoyance. a change in your body or mind that shows that you are not healthy1.
Aggravation term used by homoeopaths for the healing crisis.
TYPES OF AGGRAVATION2
- HOMOEOPATHIC AGGRAVATION – Slight but apparent intensification of the patients existing symptoms which are similar to the symptoms of the homoeopathic medicines administered along with better feeling2.
- DISEASE AGGRAVATION – Appearance of new symptoms belonging to the sphere of disease due to its natural tendency to progress2.
- MEDICINAL AGGRAVATION – Appearance of new symptoms which belong to the medicine administered to the patient2.
DIFFERENT STALWARTS VIEWS:
- SAMUEL HAHNEMANN
- R.E. DUDGEON
- J.T. KENT
- STUART CLOSE
- H. A ROBERTS
- WILLIAM BOERICKE
- C. M. BOGER
DR C.F.S HAHNEMANN
ORGANON OF MEDICINE2
- Aphorism 253 (signs of aggravation)
- Aphorism 157, 158, 160, 161, 282 (homoeopathic aggravation)
- Appendix (157, 158, 159, 160 aphorism constitute only one in 1st edition)
Hahnemann’s FIRST OBSERVATION about homoeopathic aggravation is in the LESSER WRITINGS of Hahnemann – CASE OF RAPIDLY CURED COLICODYNIA IN 17973
A compositor , 24 yrs of age, lean, of a pale and earthy complexion, had worked at the printing press, suffering from gripping pain, anxiety, constriction of the chest, fever, loss of strength (previously taken medicine from our master Hahnemann & also from ordinary medicine). After that Hahnemann decided to give VERATRUM ALBUM2,3.
HAHNEMANN has mentioned, “I gave him four powders, each containing four grains, and told him to take one powder daily, but to let me know at once if any violent symptoms appeared. This he did not do. He did not return until five days thereafter. His unlimited confidence in my aid had nearly played him an awkward trick.”3
Actually the patient takes two doses instead of one daily, after 2nd powder without having eaten anything injurious there began an attack, and also after that taking the 3rd, 4th powder the following day, taken thus SIXTEEN grains in less than 2 days, this leads to dreadful extent3.
HAHNEMANN has mentioned, “I reprimanded him for his imprudence”.
IN LESSER WRITINGS – (MEDICINE OF EXPERIENCE)3
“ Every aggravation, as it is called, of a disease that occurs during the use of a medicine, in the form of NEW SYMPTOMS not hither – to proper to the disease, is owing solely to the MEDICINE EMPLOYED ; these symptoms are always the effect of the medicine, which, as an unsuitably chosen positive remedy, or as a negative ( palliative) remedy, either ill- selected or given for too long a time , and in too large doses, develops them by its peculiar mode of action to the torment and destruction of the patient 3“.
“The aggravation just alluded to by violent, new symptoms not PROPER TO THE DISEASE, BEARS NO RESEMBLANCE TO THE INCREASE OF THE APPARENTLY ORIGINAL SYMPTOMS of the disease during the first few hours after the administration of a medicine selected in a positive manner3.
This phenomenon of the increase of what seem to be the PURE SYMPTOMS OF THE DISEASE , but which are actually predominant medicinal symptoms resembling those of the disease, indicates merely that the dose of the appropriately selective curative medicine has been too large – it disappears, if the dose has not been enormously large3 ………………………”
IN THE CHRONIC DISEASES THEIR PECULIAR NATURE AND THEIR HOMOEOPATHIC CURE ( CHAPTER PSORA)4
Hahnemann also mentioned medicinal aggravation and homoeopathic aggravation –
“So-called homoeopathic aggravation is a sign of an incipient cure” –
Also mention about medicinal aggravation, due to – “Still ignorant of the strength of its medicinal power, I gave SEPIA in too large dose. This trouble was still more manifest when I gave LYCOPODIUM and SILICEA4 “…………………………….
Hahnemann asserts that in both these instances the apparent aggravation was owing to the medicine being given in too large doses, and that had it been given in smaller doses no such aggravation would have been observed.
- The next example of homoeopathic aggravation we meet in his writings is to be found in his essay On the Power of Small Doses. The aggravation in this case is stated to result not from too large a dose – in as far as quantity is concerned—but from a too powerful dose, the excessive power being communicated to it by a too prolonged succession. He states, for example, that a drop of Drosera rotundifolia, in the 30th dilution, each successive dilution having been prepared with twenty successions, would endanger life of a child affected with whooping cough, owing to the enormous aggravation it would cause, whereas the same dilution prepared with only two shakes for each dilution, would only effect a mild cure4.
- Here a homoeopathic aggravation did not occur from the employment of an excessively large, but of an unusually small dose of the medicine. It is the case of an epileptic lady, to whom Hahnemann gave a drop of the 90th dilution of sulphur, and within one hour after this ingestion an epileptic fit occurred4.
Again, in Hahnemann’s own practise, we find instances where he gave considerable doses without the production of any aggravation2.
- In the first Essay on a New Therapeutic Principle, a case of spasmodic asthma with head symptoms of a grave character is related, where a gradual cure without aggravation was affected by means of three grains of Veratrum album, given every morning for four weeks2.
- In the same essay another case is related of puerperal mania and convulsions, where the patient was cured by means of several half-grain doses of Veratrum, which seemed to produce no aggravation of the disease, though a few of the pathogenetic effects of the drug was observed2.
- In the essay On the Obstacles to Certainty and Simplicity in Practical Medicine, a case of spasmodic asthma is detailed, where four grains of Nux vomica, exhibited twice daily for some time, removed the complaint gradually, but perceptibly and permanently, without any aggravation2.
- In Hahnemann’s two essays, On Continued and Remittent Fevers, and On Hebdomadal Complaints, the remedies administered, most of them in full doses according to old school notions cured the diseases for which they were employed, without the production of any aggravation2.
- Again, in the essay upon Scarlet Fever, no aggravation is stated as having followed the administration of the various remedies employed1.
- There was a case of gastralgia, which was treated with a drop of the pure juice of Bryonia alba, a dose which certainly ought to have caused a violent aggravation, if aggravation was a necessary consequence of an unnecessary large dose, which Hahnemann tells us in a note this was; but no aggravation whatsoever occurred2.
- The other case was an attack of dyspepsia, cured by half a drop of the 12th dilution of Pulsatilla nigricans, likewise far too large a dose according to Hahnemann’s later views, but no aggravation ensued, only a rapid and effective cure2.
R. E. DUDGEON :
LECTURES ON THE THEORY AND PRACTICE OF HOMOEOPATHY5
“This homoeopathic aggravation has played such a great part in the drama of the new medical reform, that it would be unpardonable in me to pass it over cursorily; and I feel it incumbent on me to enter into a thorough examination of the whole subject, whereby we shall see whether, like other phantoms, it does not lose all its terrors when thoroughly examined and exposed to the light.” 5
Some example where Hahnemann gave considerable doses without the production of any aggravation –
- A case of spasmodic asthma with head symptoms of a grave character is related, where a gradual cure without aggravation was effected by means of 3 grains of VERETRUB ALBUM, GIVEN EVERY MORNING FOR 4 WEEKS. ( ESSAY ON A NEW THERAPEUTIC PRINCIPLE)5
- A case of spasmodic asthma is detailed, where four grains of NUX VOMICA, exhibited twice daily for some time, removed the complaint gradually, but perceptibly and permanently, without any aggravation. (ESSAY ON THE OBSTACLES TO CERTAINTY AND SIMPLICITY IN PRACTICAL MEDICINE )5
J. T. KENT
LECTURES ON HOMOEOPATHIC PHILOSOPHY6
CHAPTER – PROGNOSIS AFTER OBSERVING THE ACTION OF THE REMEDY.
According to Kent, the aggravation is of two kinds; we may have an aggravation which is an aggravation of the disease, in which the patient is growing worse, OR we may have an aggravation of the symptoms, in which the patient is growing better.
DISEASE AGGRAVATION – Patient is growing weaker, the symptoms are growing stronger6.
HOMOEOPATHIC AGGRAVATION – aggravation of the symptoms of the patient while the patient is growing better.
“Doctor, I Feel better.”
“Doctor, I am growing weaker.”
“Doctor, I am so much worse.”
Dr. Kent discuss about different prognosis after observing the action of the remedy – which is either Medicinal aggravation, Homoeopathic aggravation, or it may be Disease aggravation6.
THIRD OBSERVATION – Aggravation is quick , short and strong with rapid improvement of the patient. (HOMOEOPATHIC AGGRAVATION)6
FIFTH OBSERVATION – Amelioration comes first and the aggravation comes afterwards6.
SIXTH OBSERVATION – Too short relief of symptoms6.
SEVENTH OBSERVATION – A full time amelioration of the symptoms yet no special relief to the patient. (co-relates with the 256 aphorism of Organon)6
CHAPTER – HOMOEOPATHIC AGGRAVATION
“A disease ought always to be well considered as to whether it is acute or chronic. Where there are no tissue changes, where no ultimates are present ,then you may expect the remedy to cure the patient without any serious aggravation, or without any sharp suffering, for there is no necessity of reacting from a serious structural change…………………………………………….as a reaction of the vital force of the economy when order is established, this order, which is attended by reaction, as it were, COMMENCES A PROCESS OF HOUSE CLEANING6………………….”
Symptoms are the “ambassador of the internal man6” – KENT.
“With the true physician discrimination is not with the eye alone, the consciousness of discrimination seems to occupy his entire economy6” – KENT.
THE GENIUS OF HOMOEOPATHY7
CHAPTER 7 – The “homoeopathic aggravation” or slight intensification of the symptoms which sometimes follows the administration of the curative remedy, is merely the reaction of the organism, previously perhaps inactive or acting improperly because of lowered susceptibility, as it responds to the gently stimulating action of the medicine.
Under the NEWTONIAN principle of mutual action, (Action and reaction are equal and opposite) restated in medical terms by HAHNEMANN as “SIMILIA SIMILIBUS CURANTUR”7.
CHAPTER 11 – By aggravation is meant an increase or intensification of already existing symptoms by some appreciable circumstance or condition7.
Aggravation is also used in homoeopathic parlance to describe those conditions in which, under the action of a deeply acting homoeopathic medicine, latent disease becomes active and expresses of new symptoms. In such cases it represents the reaction of the organism to the stimulus of a well selected medicine, and is generally curative in its nature.
H. A. ROBERTS:
THE PRINCIPLES AND ART OF CURE BY HOMOEOPATHY8
CHAPTER 15 – REMEDY REACTION
Roberts has stated, among the most common reaction after the remedy has been administered is AGGRAVATION OR AMELIORATION. Aggravations are of 2 types –
- Aggravation of the disease condition, patient grows worse.
- Aggravation of the symptoms, pt reports as feeling better.
The aggravation when the patient is growing actually weaker is a SURE INDICATION that the symptoms are taking or a more internal phase and the vital organs are more affected. In other words, it is an illustration of the reversal of the order of cure8.
He has mentioned, “we should find whether the symptoms are tending toward the exterior and away from the inner parts. In other words we should know whether there is a peripheral tendency or a tendency in the reverse order,”8
Some remedies have an aggravation immediately after administration, and some have a sharp aggravation, some little time after administration.
EXAMPLE – Phosphorus may have a sharp aggravation, but it rarely occurs under 24 hours after administration and it may be 48 hr or longer, and it may last for some little time8.
A COMPEND OF THE PRINCIPLES OF HOMOEOPATHY9
CHAPTER 7 – THE APPLICATION OF HOMOEOPATHY
First or oldest symptoms ; – In the treatment of chronic diseases after a remedy has given, and old symptoms reappear in the inverse order of their development , it is an indication that the cure is progressively favourably , and no other medicine should be given.9
C. M. BOGER:
STUDIES IN THE PHILOSOPHY OF HEALING10
CHAPTER – CHOOSING THE REMEDY
BOGER MENTIONED – A change in the sick condition embraces 3 events, either
1st. The condition is ameliorated,
2nd. It is aggravated, or,
3rd. The disease alters its symptom complex10.
In the 2nd event we see the state of the sickness becoming worse; particularly do the characteristic symptoms heighten their intensity without changing or transposing themselves, the so-called homoeopathic aggravation10. Here the remedy has overcome the affection in its essence and for a while nothing further is to be done unless perhaps entirely too important complaints make the application of a proper antidote necessary, which on most occasions is found in a second, and , if possible still smaller dose of the same medicine.
si non juvat, modo ne noceat 2
- Symptom noun – Definition, pictures, pronunciation and usage notes | Oxford Advanced American Dictionary at OxfordLearnersDictionaries.com [Internet]. Oxfordlearnersdictionaries.com. 2020 [cited 14 August 2020].
- Hahnemann S. Organon Of Medicine, translated from the 5th ed, with an appendix by R E Dudgeon, With additions and alterations as per 6th ed translated by William Boericke, and Introduction by James Krauss. New Delhi : B.Jain Publishers(PVT) LTD, 2000
- Dudgeon R. The Lesser Writings of Samuel Hahnemann. 11th ed. New Delhi: B. Jain Publishers (P) Ltd.; 2013
- Hahnemann S .The Chronic Diseases, their Peculiar nature and their homoeopathic cure, Translated from the 2ndenlarged German Edition of 1835, by Prof. Louis H. Tafel with annotations by Richard Hudges, edited by Pemberton Dudley, 13th impression. New Delhi : B.Jain Publishers(PVT) Ltd., 2011
- Dudgeon R. Lectures on the Theory and Practice of Homoeopathy. 1st ed. New Delhi: B. Jain Publishers (P) Ltd.; 2003
- Kent J.T; Lectures on Homoeopathic Philosophy: Reprint Ed. New Delhi : B.Jain Publishers(PVT) LTD , 1999
- Close S. The Genius of Homoeopathy. Reprint Ed. New Delhi : B.Jain Publishers(PVT) LTD , 1999
- Roberts H.A. The Principles and Art of Cure by Homoeopathy, Reprint Ed. New Delhi : B.Jain Publishers(Pvt) Ltd., 1999
- Boericke W. A Compend of the principles of Homoeopathy. 2nd ed. New Delhi: B Jain Publishers (P) Ltd.; 2007.
- Boger C. Studies in the philosophy of healing. 2nd ed. New Delhi: B. Jain Publishers (P) Ltd.; 2003.
About Author: Dr Alok Nath Shaw1 , Dr Rup Nandi2
- Dr Alok Nath Shaw MD (Hom.), BHMS (Hons.), Former SRF posted at Dr. Anjali Chatterjee Regional Research Institute, Kolkata Under Central Council For Research In Homoeopathy (CCRH). Former Jt. Convenor All India Post Graduate Seminar Kolkata.
- Dr Rup Nandi MD (Hom.) From NIH, Kolkata. Working as MO AYUSH (RBSK) Govt. of India. Former Lecturer Dept. of Medicine, Burdwan Homoeopathic Medical College & Hospital.