Aphorism 57

In antipathic method, most severe symptoms is selected from among large number of symptoms. Unimportant symptoms are discarded altogether. After selection of the most important symptoms medicines that produce  opposite effect to the selected symptoms  is given. Agreeably  it is  the fifteen - centuries - old traditional rule of the antiquated medical school (contraria contrariis).

EXAMPLES.

OPIUM FOR PAIN: because this drug soon benumbs the sensibility.

OPIUM FOR DIARRHEA: because it speedily puts a stop to the peristaltic motion of the intestinal canal and makes it insensible; 

OPIUM FOR SLEEPLESSNESS. Opium rapidly produces a stupefied, comatose sleep;

PURGATIVES FOR CONSTIPATION.

BURNED HAND PLUNGED IN COLD WATER.    Which, from its low degree of temperature, seems instantaneously to remove the burning pain.

COMPLAINTS OF CHILLNESS AND DEFICIENCY OF VITAL HEAT  into warm baths, which warm him immediately

PROLONGED DEBILITY IS TREATED BY WINE  whereby he is instantly enlivened and refreshed

If, in estimating the value of this mode of employing medicines, we should even pass over the circumstance that it is an extremely faulty symptomatic treatment (v. note to § 7), wherein the practitioner devotes his attention in a merely one-sided manner to a single symptom, consequently to only a small part of the whole, whereby relief for the totality of the disease, which is what the patient desires, cannot evidently be expected, - we must, on the other hand, demand of experience if, in one single case where such antipathic employment of medicine was made use of in a chronic or persisting affection, after the transient amelioration there did not ensue an increased aggravation of the symptom which was subdued at first in a palliative manner, an aggravation, indeed, of the whole disease? And every attentive observer will agree that, after such short antipathic amelioration, aggravation follows in every case without exception, although the ordinary physician is in the habit of giving his patient another explanation of this subsequent aggravation, and ascribes it to malignancy of the original disease, now for the first time showing itself, or to the occurrence of quite a new disease¹.

¹ Little as physicians have hitherto been in the habit of observing accurately, the aggravation that so certainly follows such palliative treatment could not altogether escape their notice. A striking example of this is to be found in J. H. Schulze’s Diss. qua corporis humani momentanearum alterationum specimina quoedam expenduntur, Halae, 1741, § 28. Willis bears testimony to something similar (Pharm. rat., § 7, cap. I, p.298): "Opiata dolores atroscissimos plerumque sedant atque indolentiam - procurant, camque - aliquamdiu et pro stato quodam tempore continuant, quo spatio elapso dolores mox recrusescunt et brevi ad sol itam ferociam augentur." And also at page 295: "Exactis opii viribus illico redeunt tormina, nec atrocitatem suam remittunt, nisi dum ab eodem pharmaco rursus incantuntur." In like manner J. Hunter (On the Venereal Disease, p.13) says that wine and cordials given to the weak increase the action without giving real strength, and the powers of the body are afterwards sunk proportionally as they have been raised, by which nothing can be gained, but a great deal may be lost.

commentary:

Here in antipathic method is a faulty  method of treating symptoms because it considers only the important symptoms and discard all other symptoms. Here the practitioner devotes his attention in a merely one-sided manner to a single symptom. Consequently to only a small part of the whole, whereby relief for the totality of the disease, which is what the patient desires, cannot evidently be expected. 

ANTIPATHY IN CHRONIC DISEASE. 

And every attentive observer will agree that, after such short antipathic amelioration, aggravation follows in every case without exception, although the ordinary physician is in the habit of giving his patient another explanation of this subsequent aggravation, and ascribes it to malignancy of the original disease, now for the first time showing itself, or to the occurrence of quite a new disease.

Important symptoms of persistent diseases have never yet been treated with such palliative, antagonistic remedies, without the opposite state, a relapse - indeed, a palpable aggravation of the malady - occurring a few hours afterwards. For a persistent tendency to sleepiness during the day the physician prescribed coffee, whose primary action is to enliven; and when it had exhausted its action the day - somnolence increased; - for frequent waking at night he gave in the evening, without heeding the other symptoms of the disease, opium, which by virtue of its primary action produced the same night (stupefied, dull) sleep, but the subsequent nights were still more sleepless than before; - to chronic diarrhoeas he opposed, without regarding the other morbid signs, the same opium, whose primary action is to constipate the bowels, and after a transient stoppage of the diarrhoea it subsequently became all the worse; - violent and frequently recurring pains of all kinds he could suppress with opium for but a short time; they then always returned in greater, often intolerable severity, or some much worse affection came in their stead. For nocturnal cough of long standing the ordinary physician knew no better than to administer opium, whose primary action is to suppress every irritation; the cough would then perhaps cease the first night, but during the subsequent nights it would be still more severe, and if it were again and again suppressed by this palliative in increased doses, fever and nocturnal perspiration were added to the disease; - weakness of the bladder, with consequent retention of urine, was sought to be conquered by the antipathic work of cantharides to stimulate the urinary passages whereby evacuation of the urine was certainly at first effected but thereafter the bladder becomes less capable of stimulation and less able to contract, and paralysis of the bladder is imminent; - with large doses of purgative drugs and laxative salts, which excite the bowels to frequent evacuation, it was sought to remove a chronic tendency to constipation, but in the secondary action the bowels became still more confined; - the ordinary physician seeks to remove chronic debility by the administration of wine, which, however, stimulates only in its primary action, and hence the forces sink all the lower in the secondary its primary action, and hence the forces sink all the lower in the secondary action; - by bitter substances and heating condiments he tries to strengthen and warm the chronically weak and cold stomach, but in the secondary action of these palliatives, which are stimulating in their primary action only, the stomach becomes yet more inactive; - long standing deficiency of vital heat and chilly disposition ought surely to yield to prescriptions of warm baths, but still more weak, cold, and chilly do the patients subsequently become; - severely burnt parts feel instantaneous alleviation from the application of cold water, but the burning pain afterwards increases to an incredible degree, and the inflammation spreads and rises to a still greater height;¹ - by means of the sternutatory remedies that provoke a secretion of mucus, coryza with stoppage of the nose of long standing is sought to be removed, but it escapes observation that the disease is aggravated all the more by these antagonistic remedies (in their secondary action), and the nose becomes still more stopped; - by electricity and galvanism, with in their primary action greatly stimulate muscular action, chronically weak and almost paralytic limbs were soon excited to more active movements, but the consequence (the secondary action) was complete deadening of all muscular irritability and complete paralysis; - by venesections it was attempted to remove chronic determination of blood to the head, but they were always followed by greater congestion; - ordinary medical practitioners know nothing better with which to treat the paralytic torpor of the corporeal and mental organs, conjoined with unconsciousness, which prevails in many kinds of typhus, than with large doses of valerian, because this is one of the most powerful medicinal agents for causing animation and increasing the motor faculty; in their ignorance, however, they knew not that this action is only a primary action, and that the organism, after that is passed, most certainly falls back, in the secondary (antagonistic) action, into still greater stupor and immobility, that is to say, into paralysis of the mental and corporeal organs (and death); they did not see, that the very diseases they supplied most plentifully with valerian, which is in such cases an oppositely acting, antipathic remedy, most infallibly terminated fatally. The old school physician rejoices² that he is able to reduce for several hours the velocity of the small rapid pulse in cachectic patients with the very first dose of uncombined purple foxglove (which in its primary action makes the pulse slower); its rapidity, however, soon returns; repeated, and now increased doses effect an ever smaller diminution of its rapidity, and at length none at all - indeed - in the secondary action the pulse becomes uncountable; sleep, appetite and strength depart, and a speedy death is invariably the result, or else insanity ensues. How often, in one word, the disease is aggravated, or something even worse is effected by the secondary action of such antagonistic (antipathic) remedies, the old school with its false theories does not perceive, but experience teaches it in a terrible manner.

¹ Vide Introduction.
² Vide Hufeland, in his pamphlet, Die Homoopathie, p.20.

commentary:

Every drug has two kinds of action 

• primary action

• secondary action.

Before defining the two action of the drug lets see many examples of primary and secondary actions in antipathic drugs after which it will be easier to define it.

1.  Coffee for sleeplessness.                                                                         For a unrelenting tendency to sleepiness during the day the physician prescribed coffee, whose primary action is to enliven; and when it had depleted its action the day - somnolence increased.

2.  Opium for Sleeplessness                                                                        For frequent waking at night he gave in the evening, without minding the other symptoms of the disease, opium, which by virtue of its primary action produced the same night (stupefied, dull) sleep, but the subsequent nights were still more sleepless than before.

3. Opium for Diarrhoea                                                                          Patient suffering from  chronic diarrhoeas he opposed, without regarding the other morbid signs, the same opium, whose primary action is to constipate the bowels, and after a transient stoppage of the diarrhoea it subsequently became all the worse.

4. Opium for pain.                                                                             Violent and frequently recurring pains of all kinds he could suppress with opium for  a short time; they then always returned in greater, often intolerable severity, or some much worse affection than before  the treatment.

5.  Opium for cough                                                                       For nocturnal cough of long standing the ordinary physician knew  administer opium, whose primary action is to suppress every irritation; the cough would then perhaps cease the first night, but during the subsequent nights it would be still more severe, and if it were again and again suppressed by this palliative in increased doses, fever and nocturnal perspiration were added to the disease

6.  Cantharides in retention of urine                                    Weakness of the bladder, with consequent retention of urine, was sought to be conquered by the antipathic work of cantharides to stimulate the urinary passages whereby elimination of the urine was certainly at first effected but thereafter the bladder becomes less capable of stimulation and less able to contract, and paralysis of the bladder is imminent.

7.  Purgatives and laxatives.                                                       With large doses of purgative drugs and laxative salts, which stimulate the bowels to frequent evacuation, it was sought to remove a chronic tendency to constipation, but in the secondary action the bowels became still more confined.

8. Wine in debility.                                                                         The old school  physician seeks to remove chronic debility by the administration of wine, which, however, stimulates only in its primary action,  and hence the forces sink all to much lower in the secondary action.]

9. Bitter and heating condiments in weak and cold stomach          By bitter substances and heating condiments he tries to strengthen and warm the chronically weak and cold stomach, but in the secondary action of these palliatives, which are stimulating in their primary action only, the stomach becomes yet more inactive.

10. Warm bath in chill                                                                                   Long standing deficiency of vital heat and chilly disposition ought surely to yield to prescriptions of warm baths (primary action), but still more weak, cold, and chilly do the patients subsequently become in its secondary action.

11. Burnt part in cold water                                                                            Severely burnt parts feel instantaneous alleviation from the application of cold water (Primary action), but the burning pain afterwards increases to an incredible degree, and the inflammation spreads and rises to a still greater height (secondary action).

12.  Sternutatory remedies in stoppage of nose                              By means of the sternutatory remedies (sternutatory = a chemical substance that causes sneezing and coughing and crying)  that provoke a secretion of mucus, coryza with stoppage of the nose of long standing is sought to be removed (primary action), but it escapes observation that the disease is aggravated all the more by these antagonistic remedies (in their secondary action), and the nose becomes still more stopped.

13. Electricity and galvanism in paralysis                                                  By electricity and galvanism {galvanism = The therapeutic application of electricity to the body (as in the treatment of various forms of paralysis)}, with in their primary action greatly stimulate muscular action, chronically weak and almost paralytic limbs were soon excited to more active movements, but the consequence (the secondary action) action is complete deadening of all muscular irritability and complete paralysis.

14. Congestion of blood and venesection.                                                 By venesections  (venesections = Surgical incision into a vein; used to treatment) it was attempted to remove chronic determination of blood to the head (primary action), but they were always followed by greater congestion (secondary action)

15.   Mental and physical unconsciousness using valerian                Ordinary medical practitioners know nothing better with which to treat the paralytic torpor of the corporeal and mental organs, conjoined with unconsciousness, which prevails in many kinds of typhus, than with large doses of valerian, because this is one of the most powerful medicinal agents for causing animation and increasing the motor faculty; in their ignorance,  they knew not that this action is only a primary action, and that the organism, after that is passed, certainly falls back, in the secondary (antagonistic) action, into still greater stupor and immobility, that is to say, into paralysis of the mental and corporeal organs and death.

16. Foxglove in small rapid pulse                                                               The old school physician rejoices that he is able to reduce for several hours the velocity of the small rapid pulse in cachectic patients with the very first dose of uncombined purple foxglove (which in its primary action makes the pulse slower); its rapidity, however, soon returns; repeated, and now increased doses effect an ever smaller diminution of its rapidity, and at length none at all - indeed - in the secondary action the pulse becomes uncountable; sleep, appetite and strength depart, and a speedy death is invariably the result, or else insanity ensues.