Homoeopathic aggravation is a temporary worsening of existing symptoms following the administration of a correct homoeopathic prescription. Hahnemann in his magnum opus Organon of Medicine has suggested that aggravation will follow after every true homoeopathic prescription, as it impossible for the symptoms of the medicine to coincide with the symptoms of the disease. Moreover, Kent’s analytical way of understanding the observations after prescribing a medicine correlates with the concept described by Master Hahnemann in his Organon of Medicine.
The aim of this study was to explore and compose criteria that correlate the homoeopathic aggravations with the Kent’s observation.
Keywords: Homoeopathic aggravation, Kent’s observation, Organon of Medicine.
Homoeopathic selection of a medicine calls for utmost patience from the physician. Several aspects of a patient are taken into account from the different spheres of his life. It is a realisation of that ‘man’ as an individual which is the guiding principle for a simillimum. This task of individualisation of the patient is most important one and is done in accordance with the homoeopathic principles. Homoeopathy is explicitly live, unbiased by opinions, based upon experiment rather than uncertain assumptions.
After administration of a well selected medicine, the physician expects relief for his patient. Earliest signs of improvement in a case are perceptible through the state of mind of the patient, viz., a greater degree of comfort, increased calmness and freedom of the mind, higher spirits a kind of return to the natural state. On the other hand, an aggravation of the patient’s condition calls for an introspection into the case to estimate the action of the medicine and prognosis of the case. In such condition, the physician has to go through every symptom and evaluate it properly, any addition of new symptom or dimunition of previous symptom confirm us whether it is aggravation or amelioration.[4 ] Every aggravation by the production of new symptoms-when untoward has occurred in the mental or physical regimen-invariably proves non-homoeopathicity on the part of the medicine formerly given in the case concerned, but never indicates the weakness of the dose.
Homoeopathic medicines have been believed to be free of all sorts of risks and relatively safe in comparison to the traditional system of medicine. However, a proper understanding of the Organon of Medicine brings upon a contrary realisation of aggravations in different forms. In such cases the physician has to find out whether it is disease aggravation or medicinal aggravation or homoeopathic aggravation. The disease aggravation is the increase of the disease process and intensification of the disease symptoms in the flow of the pathology and the progress of the disease remains unchecked by the medicines. Maintaining causes may also attribute to a continued diseases aggravation and should always be investigated. The disease aggravation suggests that medicine was an incomplete simillimum wherein the inadequate treatment was insufficient to halt the disease process.
Medicinal aggravation on the other hand is the result of an incorrectly chosen medicine which produces new, persisting and possibly troublesome symptoms which the patient had never experienced before. One is often misguided to interpret this occurrence of new symptoms as a sign of improvement as the concept of uncovering of the layers and reappearance of the suppressed symptoms. However it is to be borne in mind that this reappearance of old suppressed symptoms has to be followed by an overall feeling of well being which is lacking in the present circumstances. Moreover, these new symptoms are the one which the patient had never experienced in his lifetime.[7 ]
Altogether different is the case when we analyze the homoeopathic aggravation after administration of a homoeopathically chosen medicine. Homoeopathic aggravation is a welcome circumstance which every rationale physician expects after administration of the medicine. The principles of homoeopathy in consonance with the modus operandi of homoeopathic cure suggests that the induced artificial disease has taken over the vital principle of the patient and he is cured of his illness once the vital principle overcomes this change brought on by the artificial disease. This slight intensification of the symptoms of the patient suggest that the medicine is correct and moreover in an appropriate dose.
In homoeopathic theory, homoeopathic aggravation is generally seen as a favorable response to treatment and is expected to be followed by an improvement. §156 of Organon of Medicine suggests that every homoeopathic medicine produce its effect on sensitive patient, but it is so slight and for so short duration that it is nearly imperceptible by the patient. However, he stresses on the fact that this slight homoeopathic aggravation during the first hours is a good prognostic indication suggestive of a probable cure.[9 ]
The miracles of Homoeopathic medicines can be noticed only when the problems of such aggravation are watchfully realised and correctly assessed. Here the patients feel mentally better , enjoys a feeling of general well being though his physical symptoms appear to have aggravate; as the disease originates in the dynamic plane and gradually the mind, will ,etc.., and ultimately the different parts if the body are affected and manifestations are felt.[10 ]
Effectiveness of the prescribed medicine can be well understood by analysing the homoeopathic aggravation in the patient. Dr Hahnemann has well explained its importance and its analysis in different aphorisms of Organon of Medicine for both, acute and chronic diseases.[11 ]
Kent’s perspective on homoeopathic aggravation
J.T. Kent, a converted homoeopath, studied and understood Hahnemann’s homoeopathy very well. He was a man of exceptionally keen observation. He was a philosopher and a scientist of high order in the world of medicine. Dr Kent has interpreted and explained the various aspects of Hahnemann’s Organon of healing art and has also well discussed the observation of action of the remedy. He says, “If the homoeopathic physician is not an accurate observer, his observations will be indefinite; and if his observations are indefinite, his prescribing is indefinite.”[12 ] Patient should be the aim of the physician, his ideas should be centered on the prognosis of the patient and this can be only done by judging the symptoms as the symptoms are the physician’s most satisfactory evidence. Considering the symptoms indicating homoeopathic aggravation as an indication for another remedy can spoil the case i.e. misinterpreting the evidence can bring a big homoeopathy injustice.[13 ] Physician must discriminate between that which is reaction and that which calls for a remedy.[12 ]
Homoeopathic aggravation has been seen as a ‘reaction’ of the vital force of the economy when order is being established. A physician must learn to differentiate this reaction with an actual aggravation that calls for a remedial measure. Homoeopathic aggravation can manifest in varying intensity and colours depending on the pathological condition of the patient.[13 ] Analysing the prognosis after observing the action of the remedy has been explained by Dr Kent in a very detailed manner complying with principles of Organon of Medicine. Aggravations have been explained by him in his initial four observations and their analytical interpretations have been explained along with.
The first observation suggests that the symptoms of the patient would intensify followed by final decline of the patient. This has been related to medicinal aggravation, where the antipsoric medicine was too deep acting and resulted in gross pathological damage of the patient.[12 ]
The other 3 observations following this observations related to homoeopathic aggravation in true sense and can be exemplified by understanding through the cases.
Second observation states that- “long aggravation, but final and slow improvement”. Here it indicates that the disease is still in the curable state, organic or pathological changes are not advanced and the vital force is still in the form of reactive stage; hence the aggravation has lasted for a long time, followed with final slow improvement. Selected remedy is the simillimum. Dr Kent has confirmed it a good prognosis and advised not to repeat or change the remedy, and wait and watch for the reaction.
It is always better to start any medicine in low potencies. In doubtful cases, antidote has to be kept ready to meet any type of untoward incidence.[14 ]
Kent’s second observation is well illustrated in this case of a female patient, 23 years of age with severe discharge from both ears, with impaired hearing and tingling sensation. Discharge was much yellowish and offensive in character. She also suffered from vertigo and roaring sound in ear. Her appetite was normal, thirst less with moist tongue, desire for sour, fatty food; intolerance for oily food, which caused loose stool with indigestion complains. She was a housewife, of mild nature introvert and apprehensive about her illness.
The symptoms considered important in this case included apprehension about her illness, mild nature, ear complains associated with vertigo, yellow offensive ear discharge with tingling sensation and impaired hearing, desire for sour and fatty food, intolerance to oily food.
The case was repertorised using RADAR opus software. 16 The repertorial analysis was as follows-
Repertorial totality was in favor of Pulsatilla nigricans. Moreover, patient’s mildness, introspective nature, thirstlessness and yellow colour of discharge also strongly suggested Pulsatilla nigricans. After analysing the case in consultation with materia medica, Pulsatilla nigricans 17 200/4 doses OD was prescribed to the patient. On the next visit, the vertigo increased but still the indications of Pulsatilla nigricans as the simillimum were very strong and this increase of vertigo was considered as homoeopathic aggravation and patient was administered placebo. Subsequent two follow up of the case no marked improvement was seen but the totality of symptoms was still in favor of Pulsatilla nigricans. From the fourth follow up, there was reduction in the discharge and also the other symptoms. Slowly patient recovered from her complaints.
Third observation states- “aggravation is quick, short and strong with rapid improvement of the patient”. This is classical homoeopathic aggravation and the most favourable one. It indicates there is no structural or tissue change, simillimum medicine has been indicated. Dr Kent confirms it as very good prognosis and not to disturb the case.
It brings a long lasting improvement in the patient; in acute case, aggravation is seen in few hours after remedy administration while in chronic case in few days.
Kent’s third observation is illustrated through this case of a female aged 50 years suffering from burning urination. There was frequent passage of small quantity of urine especially at night, offensive in character. She also complained of lethargy, weakness and acidity. In physical generals, appetite was found to be normal, thirst was intense but for small quantity and at frequent interval, there was desire for spicy and sour food and aversion to sweets. Mentally, she was very restless, anxious and was afraid of her illness, and even slight exertion caused much weakness.
The symptoms considered for totality included anxiety about her health, fear from her illness, restlessness due to fear, thirst for small quantity of water, burning during micturition, offensive urine, desire for sour and spicy food and aversion to sweets.
The case was analysed using the RADAR opus software16 and the reportorial result was as follows:
Arsenicum album covered all the rubrics. Patient’s restlessness and anxiety were the guiding features in the support of this medicine. Consulting materia medica, Arsenicum album18 was found to cover these symptoms and was also the reportorial totality. The medicine was prescribed in 200 potency and 1 dose was prescribed followed by placebo. After only 2 week, her complaints markedly reduced. Burning urination was improved, with slight diminution in offensiveness. When inquired, she told that after taking the medicine on first day only, suddenly her complains aggravated the next day, there was severe burning and frequent urination. She got scared and left the remaining medicine. But slowly she got better. She was kept on placebo till she was finally cured.
Fourth observation states- “no aggravation whatever”.[12 ] This indicates a situation where the medicine will homoeopathically cover the case like two triangles with equal sides and equal angles. It is considered as an ideal situation where the homoeopathic aggravation is so slight that it is not perceptible to the patient himself. The artificial disease is just slightly stronger than the disease, as such it overpowers the disease without any perceptible aggravation.
Fourth observation of Dr Kent is illustrated in this case of COVID-19 where the patient, a male in his 40s complained of sore pain in the throat which was accompanied with severe coryza. His voice was so hoarse that he could hardly narrate his complain and he said although there was no difficulty in breathing but there was a desire to take deep breath. Thirst was profuse for cold water. He had excess flatulence as a result of which his abdomen remained distended. The patient had dryness of the mouth although he was thirstless. The taste was insipid and was suffering from the anticipation of his disease.
The case was repertorised using RADAR opus software 16 and the repertorial analysis was as follows:
Phosphorus was indicated on the basis of reportorial totality. The intensity of coryza and hoarseness besides his nature of mixing up easily (patient was already under treatment before developing COVID-19) prompted to Phosphorus; Phosphorus19was confirmed with reference to materia medica. This medicine was prescribed to the patient in 30 potency thrice daily. The patient was relieved of all his complains on the very next day. He got himself tested after 10 days, the result of which was negative.
A feeling of well-being emerging soon after taking the remedy was the most important criterion for discriminating between homoeopathic aggravations and adverse effects in clinical practise. The homoeopathic aggravation is seen as a positive reaction of the patient’s vitality after administration of a perfectly chosen medicine. Even Dr Hahnemann explained this paradigm-specific concept in the Organon of Medicine as similar to the original disease that to the patient it appears to be an aggravation of his own complaint.
It must be realised by all rational practitioners that this concept of homoeopathic aggravation is good prognostic indication in consonance with the homoeopathic philosophy which has also been elaborated by Dr Kent in his explanations on observing the effects after administration of the medicine.
- Sarkar,B.K.; Hahnemann’s Organon Of Medicine ; Ninth revised edition,2003-2004; Birla Publication; p.76
- Arya,Dr.M.P.; A Study of Hahnemann’s Organon of Medicine ;First edition 2008;B.Jain Publishers(P) LTD; p. 6
- Sarkar,B.K.; Hahnemann’s Organon Of Medicine ; Ninth revised edition,2003-2004; Birla Publication; p. 425
- Arya,Dr.M.P.; A Study of Hahnemann’s Organon of Medicine ;First edition 2008;B.Jain Publishers(P) LTD; p. 537
- O’Reilly, Wenda Brewster; Organon Of The Medical Art; First edition 2010; B.Jain Publishers (P)LTD; p. 223
- Dey, S.P.; Essentials of Principles and Practice of Homoeopathy; Fourth edition, 2009; published by Smt. Aparna Bhattacharya; p. 59,60
- Arya,Dr.M.P.; A Study of Hahnemann’s Organon of Medicine ;First edition 2008;B.Jain Publishers(P) LTD; p. 702
- O’Reilly, Wenda Brewster; Organon Of The Medical Art; First edition 2010; B.Jain Publishers (P)LTD; p. 166
- Arya,Dr.M.P.; A Study of Hahnemann’s Organon of Medicine ;First edition 2008;B.Jain Publishers(P) LTD; p. 370-373
- Dey, S.P.; Essentials of Principles and Practice of Homoeopathy; Fourth edition, 2009; published by Smt. Aparna Bhattacharya; p. 58
- Hahnemann,Samuel; Organon of Medicine; Fifth and sixth edition; Fifth impression 2009; B.Jain Publishers (P) Ltd. P. 97-99
- Kent, James Tyler; Lectures on Homoeopathic Philosophy; B.Jain Publishers (P)LTD. p. 5,215-229
- Close,Stuart; The Genius Of Homoeopathy, Lectures and Essay on Homoeopathic Philosophy; Eighteenth impression 2017; B.Jain Publishers(P)LTD. p. 117,76
- Babu, Dr.G.Nagendra; Comprehensive Study of Organon An Attempt To Understand The Organn Of Medicine As A Scientific Treatise;First edition, 2009; B. Jain Publishers (P) LTD; p. 419-420
- Sarkar,B.K.; Hahnemann’s Organon Of Medicine ; Ninth revised edition,2003-2004; Birla Publication; p. 405
- RADAROPUS Software.
- Kent, J.T.; Lectures on Homoeopathic Materia Medica;Low price edition 2002; 11th impression 2013; B.Jain Publishers (P) LTD. p. 857-870
- Kent, J.T.; Lectures on Homoeopathic Materia Medica;Low price edition 2002; 11th impression 2013; B.Jain Publishers (P) LTD. p. 148-165
- Kent, J.T.; Lectures on Homoeopathic Materia Medica;Low price edition 2002; 11th impression 2013; B.Jain Publishers (P) LTD. p. 824-836
Dr Manila Kumari, PGT
R.B.T.S. Govt. Hom. Med.
College & Hospital, Bihar