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Acute disease, exacerbation from a chronic illness, homeopathic aggravation, proving symptoms and worsening case .... How can we differentiate them?



Dear All:

These are issues that sometimes seem to have been confused by Hahnemann himself. Although homeopathic aggravation seems not to be a great problem to define, certainly it seems to be more confusing in the case of:

1.-Acute disease with exacerbation of a chronic disease.
2.-Proving symptoms with worsening of the case.


In the number 1 case: How do you do to differenciate acute disease of an exacerbation from a chronic disease without diagnosis?


In the number 2 case: How do you do to know that the symptoms that your patient is experimenting are coming from proving symptoms and not from a worsening case regardless the symptoms could be compatible with the remedy what you are giving?



I am looking forward to read your sharings.


Best regards

Dr. Guillermo Zamora



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What an interesting question! I'll take a stab at it.

It seems to me that, if you give a remedy that matches a patient's symptoms - and you don't keep repeating it - then a reaction must be an aggravation. Otherwise, a proving would, I think, happen only if the patient's symptoms do not match the remedy.

If that's correct, then a remedy could not result in a proving if its symptoms match the patient's, and if the patient isn't given it too often.

Does this make sense to others? I'm interested in this topic, too.
Hello Heidi:

My problem is that i was learned that a homeopathic aggravation is the increase of the disease symptoms straight after giving the remedy for a few minutes to about an hour. Not any longer.

You are right when you write:

"Otherwise, a proving would, I think, happen only if the patient's symptoms do not match the remedy."

But then, the obligated question comes: How do you do to know that the symptoms that your patient is experimenting are coming from proving symptoms and not from a worsening case regardless the symptoms could be compatible with the remedy what you are giving?

Thank you for your always welcome comments.
Dr. G
Hi Guillermo,

The way I see this, if a homeopath is reasonably competent and applies a remedy that's reasonably appropriate, then there's little chance of a proving. My thoughts assume that the chosen remedy isn't too far from correct. If a homeopath does a reasonably good job of prescribing, then I don't think that provings should be much of a concern.

Trying to determine whether a worsening of symptoms is an aggravation or worsening case is difficult, I think. Thank you for bringing that up - I've never thought on this question before. On thinking about it, my idea is:

If we look at the patient's state of mind, it might provide a clue. If the patient's mental outlook is improved, then worsening physical symptoms are probably an aggravation. If the symptoms are strictly mental, especially if there seems to be a release of emotions, it's probably an aggravation. (Although, if the problems are strictly mental-emotional, this would not be true.) If the mental state is poor and the physical symptoms worsen, I'd be concerned that the patient is deteriorating.

I'm interested in what others think on this. It's a very interesting question.
Good day Guillermo,
These are interesting questions.
I would like to offer a few brief thoughts

1] Speaking in general ( and in to a certain extent from my own experience) this is an unusual phenomenon as the acute disease usually overwhelms the chronic symptomatology which actually subsides during the acute.

2] Proving symptoms. This could be a long discussion, breaking down all the details and categories of response.
I think the ' bottom line' short answer is that in any case where the remedy is acting and symptoms are arising from this action, if the remedy is correct there MUST be an increase of vitality.

Then the symptoms are an appropriate discharge of old stuff consequent upon the increase in vitality.

If there is just a change of symptoms - some which correspond to the remedy are increased, some others are decreased, then the remedy is close enough to shake things up and most likely when the dust settles nothing has changed.

Of course the evaluation of these events takes time - time has to pass. How much time depends upon one's experience and the intensity of the case
Dear Jonathan:

I apreciate so much your are sharing your experience with us, overall, refering to the point 1 i just would like to extend a little more from the organon in order that external readers can be more informed.

Regarding this issue we can sumarize the paragraph 38, 39, 40 etc etc from organon as follows:

1.-If the new disease is much weaker than the patient is suffering the second will be rejected by the stronger. The patient will continue with his initial disease

2.-if the new disease is stronger than the previous one, the second is installed in the body, while the former remains dormant, as if asleep, until it disappears the second, and then resume its trayectory.

3.-In individuals greatly weakened by their illness over for improper treatment, by malnutrition or other causes (i, e, AIDS), two (or more) diseases are installed, each taking the organs that are more similar, and both, without mixing, simultaneously, continue their journey.

Regarding your point two, to me, the problem comes when we analyze the principles of aplication of the remedies.

This is a summary of the law of action of remedies and morbific agents:

Healthy patient: Using any kind of agent (priciple), the primary action is symptoms, the secondary is back to health.

Sick Patient:
Using contrary, primary is: improving, sec, agravation.
Using diferent: Primary is: improving, sec: back to disease.
Using similar: Prim: agravation, sec: improving or cure.

In this context i think that Hahnemann commited a mistake in 274 paragraph

..."and supposing the worst case to happen, that it was not chosen in strict conformity to similarity of symptoms, and therefore does no good, it is yet so far useful that it promoted our knowledge of therapeutic agents, because, by the new symptoms excited by it in such a case, those symptoms which this medicinal substance had already shown in experiments on the healthy human body are confirmed, an advantage that is lost by the employment of all compound remedies"

Does Hahnemann forgot his own rules?, because i consider that to get proving symptoms we need a healthy person and not sick (please read paragraph 50 organon)

Sometimes it seems he confuses betwen what is a worsening case and proving symptoms from a remedy.

Best wishes.
Regarding the idea that a person must be healthy to have proving symptoms:

That has never made sense to me. I think it's more accurate to say that a proving can happen in anyone who is healthy enough to mount a response. Otherwise, I don't think that anyone would ever prove any substance, because I don't think that anyone is in perfect health. Besides, at what point is a person to be deemed healthy?
Der Heidi, members:

Your comment make me think about of another important point which often throw back reliability of homeopathy. How reliable are the experimentations ?.... Sometimes it seems that we forget how it was discovered the Homeopathy. Hahnemann himself got sick severely due to intoxication. At the point which I wanna arrive is that if you keep an eye into the Hahnemann´s cases, he often used Mercurius, belladonna, etc. ....well known remedies from the toxicological field.

I have read things that honestly I consider unreliable from an pure experimentation like for Aethusa Cynapium (given as a key symptoms by Nash MM): -He/she imagines he has seen a rat or a mouse running around the room.

Since this point i believe important we should make an analysis about it:

1.-The healing power of medicines is inversely proportional to the degree of cure and directly proportional to the grade of dilution (more dilution, more healing power=more symptoms).

2.-The toxicity of a substance is directly proportional to its concentration (but also to its nature and source, i mean, if it is well known since toxicological field).

Until this point i believe that the confusion comes when we misunderstand the point 2 with the number 1 (Concepts points), I mean strong with powereful.

The problem could has been that Hahnemann could not to see great results in his practice with very high potencies and simply he return to low potencies (LM) arguing they were better.

Look at this:

I only am trying to resolve a circunstance from a Homeopathic Pharmacopeia Book (By one of my teachers Dr. Luiz Zepeda) wich mentions that there are 9 Rules to preparate homeopathic Remedies (i don´t know de source of this Rules)...But Dr Zepeda mentions that LM potencies are prepared from rule number 7 for trituration...Honestly, I don´t see great changes in paragraph 270 and footnotes....i.e.

"...and in the third 1/1,000,000 of the drug used"

"...(b) one grain of this powder is dissolved in 500 drops of a mixture of one part of alcohol and four parts of distilled water, of which one drop is put in a vial. To this are added 100 drops of pure alcohol2 and given one hundred strong succussions with the hand against a hard but elastic body.3 This is the medicine in the first degree of dynamization... "

Then only calculating in a simple way:

If 3c= 1/1 000 000 (one millonecima of medicine substance.)


4c=1/100 000 000
5c=1/10 000 000 000
6c= 1/1 000 000 000 000
7c= 1/100 000 000 000 000...and so sucessivly

According b) incise:

1 grane (3c) + 500 drops= 1/1 000 000 + 1/500= 1/500 000 000

a grane from this (1/500 000 000) + 100 drops alcohol (1/100)= 1/500 000 000 + 1/100= 1/50 000 000 000....Therefore, = LM 1 or the first degree of dynamization.

Therefore the frequency of LM1 is found after C5 (10 000 000 000) and before of C6.

If LM1 (1/50 000 000 000) + 1/100 (and 100 shakes)= 1/ 5 000 000 000 000= LM2


LM2 is after C6 and before 7c

I think all LM are equivalents to CH (regardless they can get another properties)...may be...Hahnemann had to back to this because he saw "homeopathic agravations" with others (may be complications from the same nature disease=worsening case)

A worsening of the case, is a condition when after a dose is given, the symptoms or a single symptom gets worse and remains getting worse. there are no independant improvemnt signs present.

Hi Guillermo,

I'm not sure that I understand all you wrote, but have a couple of comments regarding what I think I'm comprehending.

I don't think you can correlate C and LM potencies. My understanding is that the first succussion of an LM is done after the 1 in 50,000 attenuation. However, the first succussion of a C potency is done after the 1 in 100 attenuation. That makes them two different things and, therefore, not comparable. Or am I missing something in what you wrote?

You wrote:
1.-The healing power of medicines is inversely proportional to the degree of cure and directly proportional to the grade of dilution (more dilution, more healing power=more symptoms).

I don't think that more dilution necessarily means more symptoms. It could actually mean fewer symptoms. What I understand it to mean is deeper, more pathological, symptoms.
Hi Heidi: You are right about succusion as key factor to make diference...I just still think that dilution has its own aim to earn more properties and diminishing the physical impact of the dose...Otherwise there is no sens in footnote 248: ... There are patients of so great sensitiveness that a third or fourth glass, similarly prepared, may be necessary
.... even when Hahnemann did it in an empiric way.

If I may, let me write a definition of dinamization (for external readers):

Definition: Taken from Nueva Farmacopea Homeopática by Dr. Luis Zepeda)

Dynamization: A procedure to provide or increase the healing power of substances intended to be used as drugs. There are some substances, which in its natural state have no medicinal action, but the dynamization they reach it and develop it significantly. The drug energized is the sum of solute and solvent, is a new physico-chemical, no description at present. Gold insoluble, becomes soluble by becoming a drug, alcohol or water, also inactive on their own take on the powers of gold and preserved in the dilutions, according to the current editing methods, lack the slightest trace of gold or any other substance subject to this procedure. It consists of two phases: crushing (trituration) or dilution and agitation or sucución. The process is owed to Samuel Hahnemann. The pharmacopoeias recorded nine ground rules for the dynamizaion of the drugs, which always requires succussion or agitation.

I apologize for my writing way.

Best regards.
I just read that note in the Organon and see your confusion about it - and I share it. To be frank, I've seen other statements in the Organon that didn't make sense to me.

Perhaps I should take a different approach, but it's not my way to focus too heavily on Hahnemann, other than his overall thoughts. I don't think he was perfect or that the Organon should be read as a bible. To me, it's a guide, not truth encapsulated.

I'm just not interested in picking apart every detail of his writing to find some sort of ultimate truth.

By the way, I have used almost that same approach to stop a proving in myself. This was before I became a homeopath, but was desperate because my condition was deteriorating and there was no question in my mind that the remedy given was the cause. It worked. In effect, I treated the symptoms by creating a very mildly succussed, but highly attenuated version of what caused the symptoms. Since then, other homeopaths have tried to treat me with the same remedy. The first time, it scared me because of my original experience - but I think that I'd been cured by using that method, because I had no further ill effects, though it's never offered any benefit to me.

Well, actually, that's not entirely true. A few days ago, I used that remedy to treat a bone spur in a finger joint, and it's working beautifully. (I treated the bone spur as an acute, since it's fairly recent.

But I've gone way off-topic.
I just came across this extract from a discussion on another board that I believe addresses your question about Hahnemann's contradiction of his own rules

"He says in effect that Hahnremann on the one hand he states that the
> medicinal substances affect all organsims unconditionally &30-33
> and later on says that the effect of such substance can only be
> ascertained by the effect on healthy organisms

> Hahnemann is very careful and accurate in all his expressions.
> He states
> 1. that all medicinal substances affect all human organisms
> unconditionally producing set of symptoms &30-33
> 2,That each substance has a particular set of symptoms that is
> unique to it &120-124
> 3.The peculiar set of symptoms that belong to each remedy can become
> apparent in particular if the proving is done on healthy organisms.
> &21

> Where is the important word is in &21 in the phrase
> "....nothing can be observed that can constitute them medicine or
> remedies except that power of causing distinct alterations in the
> state of health of the human body, and PARTICULARLY in that of the
> healthy individual" the emphasis is in the word PARTICULARLY on
> healthy organisms that J fails to recognize.
Dear Jonathan:
You got it!!!

If i may, i jus would quote some others paragraphs as a complement of your comment.

Then according to the above, the fact that proving symptoms are not reproducible in a sick patient is possible. is it?

Paragraph 22

"But as nothing is to be observed in diseases that must be removed in order to change them into health besides the totality of their signs and symptoms, and likewise medicines can show nothing curative besides their tendency to produce morbid symptoms in healthy persons and to remove them in diseased persons; it follows, on the one hand, that medicines only become remedies and capable of annihilating disease, because the medicinal substance, by exciting certain effects and symptoms, that is to say, by producing a certain artificial morbid state, removes and abrogates the symptoms already present, to wit, the natural morbid state we wish to cure....".

§ 107

"If, in order to ascertain this, medicines be given to sick persons only, even though they be administered singly and alone, then little or nothing precise is seen of their true effects, as those peculiar alterations of the health to be expected from the medicine are mixed up with the symptoms of the disease and can seldom be distinctly observed."

To all members and external readers, again, ,kindly i invite you to read my blog "Rules for an authentic experimentation":

Best Regards.
Dr. G


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