But as the dose of a homoeopathic remedy can scarcely ever be made so small that it shall not be able to relieve, overpower, indeed completely cure and annihilate the uncomplicated natural disease of not long standing that is analogous to it (§ 249, note), we can understand why a does of an appropriate homoeopathic medicine, not the very smallest possible, does always, during the first hour after its ingestion, produce a perceptible homoeopathic aggravation of this kind.1
1 This exaltation of the medicinal symptoms over those disease symptoms analogous to them, which looks like an aggravation, has been observed by other physicians also, when by accident they employed a homoeopathic remedy. When a patient suffering from itch complains of an increase of the eruption after sulphur, his physician who knows not the cause of this, consoles him with the assurance that the itch must first come out properly before it can be cured; he knows not, however, that this is a sulphur eruption, that assumes the appearance of an increase of the itch.
The facial eruption which the viola tricolor cured was aggravated by it at the commencement of its action, Leroy tells us (Heilk, fur Mutter, p.406), but he knew not that the apparent aggravation was owing to the somewhat too large dose of the remedy, which in this instance was to a certain extent homoeopathic. Lysons says (Med. Transact., vol ii, London, 1772), The bark of the elm cures most certainly those skin diseases which it increases at the beginning of its action. Had he not given the bark in the monstrous doses usual in the allopathic system, but in the quite small doses requisite when the medicine shows similarity of symptoms, that is to say, when it is used homoeopathically, he would have effected a cure without, or almost without, seeing this apparent increase of the disease (homoeopathic aggravation).
§ 161 Fifth Edition
When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase somewhat the symptoms of the original disease, to the first or few hours, this is certainly true with respect to diseases of a more acute character and of recent origin, but where medicines of long action have to combat a malady of, considerable or of very long standing, where one dose, consequently, must continue to act for many days, we then occasionally see, during the first six, eight or ten days, the occurrence of some such primary actions, of the medicine, some such apparent increase of the symptoms of the original disease (lasting for one or several hours), while in the intervening hours amelioration of the whole malady is perceptible. After the lapse of these few days the amelioration resulting from such primary action of the medicine proceeds almost uninterruptedly for several days longer.§ 161 Sixth Edition
When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase somewhat the symptoms of the original disease, to the first or few hours, this is certainly true with respect to diseases of a more acute character and of recent origin, but where medicines of long action have to combat a malady of, considerable or of very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper small, gradually higher doses, each somewhat modified with renewed dynamization (§ 247). Such increase of the original symptoms of a chronic disease can appear only at the end of treatment when the cure is almost or quite finished.Sometimes happens, owing to the moderate number of medicines yet known with respect to their true, pure action, that but a portion of the symptoms of the disease under treatment are to be met with in the list of symptoms of the most appropriate medicine, consequently this imperfect medicinal morbific agent must be employed for lack of a more perfect one.
In this case we cannot indeed expect from this medicine a complete, untroubled cure; for during its use some symptoms appear which were not previously observable in the disease, accessory symptoms of the not perfectly appropriate remedy. This does by no means prevent a considerable part of the disease (the symptoms of the disease that resemble those of the medicine) from being eradicated by this medicine, thereby establishing a fair commencement of the cure, but still this does not take place without those accessory symptoms, which are, however, always moderate when the dose of the medicine is sufficiently minute.
The small number of homoeopathic symptoms present in the best selected medicine is no obstacle to the cure in cases where these few medicinal symptoms are chiefly of an uncommon kind and such as are peculiarly distinctive (characteristic) of the disease; the cure takes place under such circumstances without any particular disturbance.
If, however, among the symptoms of the remedy selected, there be none that accurately resemble the distinctive (characteristic), peculiar, uncommon symptoms of the case of disease, and if the remedy correspond to the disease only in the general, vaguely described, indefinite states (nausea, debility, headache, and so forth), and if there be among the known medicines none more homoeopathically appropriate, in that case the physician cannot promise himself any immediate favorable result from the employment of this unhomoeopathic medicine.
Such a case is, however, very rare, owing to the increased number of medicines whose pure effects are now known, and the bad effects resulting from it, when they do occur, are diminished whenever a subsequent medicine, of more accurate resemblance, can be selected.
Thus if there occur, during the use of this imperfectly homoeopathic remedy first employed, accessory symptoms of some moment, then, in the case of acute diseases, we do not allow this first dose to exhaust its action, nor leave the patient to the full duration of the action of the remedy, but we investigate afresh the morbid state in its now altered condition, and add the remainder of the original symptoms to those newly developed in tracing a new picture of the disease.
We shall then be able much more readily to discover, among the known medicines, an analogue to the morbid state before us, a single dose of which, if it do not entirely destroy the disease, will advance it considerably on the way to be cured. And thus we go on, if even this medicine be not quite sufficient to effect the restoration of health, examining again and again the morbid state that still remains, and selecting a homoeopathic medicine as suitable as possible for it, until our object, namely, putting the patient in the possession of perfect health, is accomplished.
§ 169 fifth Edition
If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine - owing to the insufficient number of known medicines, - but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.§ 169 Sixth Edition
If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine - owing to the insufficient number of known medicines, - but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, and much less to give both together (§ 272, note) for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.
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