KILLER AGGRAVATION – reality or misconception?

  The homoeopathic   aggravation Hahnemann explains, is the reaction of the  vital force to the artificial similar drug  disease  "called forth  in the diseased parts of the body by an  excessive  dose, diseased  parts being hypersensitive to `like' drug action".  With him  it  is "quite in order" and of good  prognosis  "if  excited within proper limits." Therefore,-"The doses of the homoeopathic medicines are invariably to be reduced (higher dilutions) so far that, after they have been taken, they  will merely produce an  almost    imperceptible    homoeopathic aggravation". And he says: "The doses be  reduced, provided  that the dose, immediately  after being taken, is capable of causing a slight  intensification  of  symptoms  of  the  similar   natural disease." Therefore, the higher the potency, shorter the duration of action on the physical level (though dynamic effect is increased), hence less the chances of an aggravation. i.e. if a patient were given a 30C potency and another a 10M, the chances of an aggravation are more likely in the patient taking the 30C.

ORGANON 6^th Edn. Aph 158: The globule of the high  potency  is best crushed in a few grains of sugar  of  milk which  the patient can put in the vial and be dissolved   in  the requisite quantity of water.**134*}     (with perhaps 8, 10,  12, succussions)   from   which  we  give   the   patient    one   or (increasingly)   several  teaspoonful  doses,  in  long   lasting diseases  daily or every second day, in acute diseases every  two or six  hours and in very urgent cases every hour or oftener.   Thus in   chronic  diseases,  every  correctly   chosen   homeopathic medicine,  even those  whose action is of long duration,  may  be repeated  daily for months with ever increasing success.  If  the solution is used up (in seven to fifteen days) it is necessary to add to the next solution of the same medicine if still  indicated one  or (though rarely) several pellets of a higher potency  with which  we continue so long as the patient  experiences  continued improvement ….. This quote explicitly means to say, that a drug can be safely repeated as long as its dynamisation is increased continuously.

This last strategy of suddenly jumping the potency in my experience can at times have disastrous results. I would prefer to add once again, the same drug in its previous potency to the solution and if necessary give a few doses with increased frequency to re-excite the Vital force and its  curative action.

As all Homeopaths would know, it is necessary to understand that the Homeopathic aggravation differs in its timing in acute and chronic diseases. In the acute disease it appears soon after commencing treatment. In chronic disease it may be expected towards the end of treatment – in other words just before cure is certain. Yet, if the above highlighted portion of the aphorism is read, it becomes obvious that the aggravation can be avoided and certainly need not be feared.

My interaction with thousands of patients and scores of Homeopathic practitioners has helped me interpret this event as follows:

1. The enthusiastic academician who in his haste to impress his patient embarks on a mission to enlighten his patient as well. Having learnt of this impending aggravation, the patient anticipates it and obliges the good doctor with his tale of aggravation.
2. The physician is not clear on the different concepts of acute and especially chronic homeopathic aggravations; hence poses leading questions to the patient who duly obliges the good doctor.
3. The physician is not certain of the disease and its natural progress and mistakes the deteriorating condition for a Homeopathic aggravation.
4. The hypochondriac patient who `jumps to the occasion’ because he is previously indoctrinated by another homeopathic enthusiast (many practitioners are not institutionally trained and may carry erroneous or preconceived ideas of this phenomenon). Incomplete and inappropriate information about homeopathy is freely transmitted from patient to patient and now is also available on the net.

I recollect losing several patients to this preconceived idea thanks to this increased `awareness’. It is amusing and defeating, to have patients paying my consulting fee, then refusing treatment saying “But doctor I cannot tolerate any increase in my suffering due to your treatment”. And this despite my fervent pleas that this is not going to happen! The Homeopath must learn to hold his tongue. To decide whether the reported increase in suffering is in fact an aggravation, it is always better to call the patient back to the clinic and re-examine him. The physician must judge for himself what the patient’s complaint is all about, rather than warn the patient about a phenomenon which may be nothing more than preconceived misinformation. Oftentimes the aggravation reported by the patient may either be an increase in the particular symptoms with relief of the generals (a classical Homeopathic aggravation), or a dissatisfied patient who insists that relief is not as quick as he/she expected it to be. In  this latter condition the patient irrationally  requests a change in remedy. 

To illustrate my point I will quote a case: Mrs M.P. was admitted to an orthopedic hospital for treatment of a fractured hip. She developed a severe diarrhea which was resistant to allopathic medication. After 12 days I was called to treat the lady who was passing 15 - 20 motions per day by her own admission. On the second day of treatment I went to see her and was confronted by an agitated patient who insisted that her condition far from being relieved, had worsened. I asked her repeatedly as to how many motions she had passed since morning. After avoiding the question several times she finally confessed that she had passed only one semi solid stools that morning!! Homeopathic aggravation or impatient patient????

To those who hold the theory of a Killer aggravation close to their hearts, I implore you to find such a reference in any of the provings (the basis of Homeopathy), where a pathology has been created or aggravated by Homeopathic medicines. 

Having practiced Homeopathy for 3 decades and more, and attended numerous seminars, I have come to the conclusion that there are three types of Homeopaths. 
1. The IMPRESSARIOS
2. The `HOLIER THAN THOU'  Go-by-the-book homeopaths and 
3. The PRACTICAL- `Let me cure my patient first' type.
The first type are not so worried about their cures. They do not have enough cures to produce a serial study of any disease. A serial study exposes the physicians approach, consistency and the efficacy of his approach. Instead they spend plenty of time and enough imagination to invent improbable theories using the liberty offered them by Homeopathic philosophy which they turn upside down on its head. It does make for great seminars, discussing ONE case for six hours. I have a better term for this hopeless exercise. I call it Mental masturbation!
The second type is the one who desperately wishes to sound academic and `accepted' and   `enlightened', like he just saw GOD. He forgets that we have all read the Organon and the Materia Medica which are our text-books. Text books are not gospels. They are knowledge repositories. Knowledge is to be applied skilfully through adaptation (if need be) to obtain a cure, whether by applying Key-note prescriptions, Generals or Mind symptoms. There can never be a `RULE' that defines our approach to every patient, just as a single size shirt wont fit every man. Some in this genre, stumble along, more interested in `LAWS' and the diagrams they draw in Power point presentations or the teacher's black board. Easier still is, when they attend a seminar and mimic the speaker as if he has just re-written the Homeopathic manuals.
The third type is the practical, no nonsense physician, who has the patient's interests in mind and will bring forth all the knowledge he has, adapt it to the case and the situation and cures the patient. He uses the text book as a frame work to support his prescription. He does not waste time on pontification. He does not waste time (more importantly other people's time) in improbable philosophy. This type of physician is the one who honestly and painstakingly accumulates data which can be analyzed, assimilated and disseminated for use by others. Dr. Samuel Hahnemann was this last type. He re-wrote the Organon 6 times as he gained knowledge and adapted it to the prevalent situation. The success of his doctrines are seen irrespective of whether you follow his fifth edition of the Organon or the sixth. For this very reason, Homeopathy is accepted and proliferates in India and many countries all over the world despite the onslaught of the `scientific' Allopaths and their Pharmaceutical industry. No Lancet can puncture our noble science thanks to the extremely meticulous and no-nonsense approach of the founder of Homeopathy. So solid was the foundation he cast, that after 250 years `SIMILIA SIMILIBUS CURENTER' remains the ultimate altruism.