Re: ON THE PRIMARY AND SECONDARY ACTIONS OF DRUGS

THE PRIMARY AND SECONDARY ACTIONS OF DRUGS

The Organon Of Medicine
Sixth Edition
Samuel Hahnemann, MD(H)
1842

§ 63

Every agent that acts upon the vitality, every medicine, deranges more
or less the vital force, and causes a certain alteration in the health
of the individual for a longer or a shorter period. This is termed
primary action. Although a product of the medicinal and vital powers
conjointly, it is principally due to the former power. To its action
our vital force endeavors to oppose its own energy. This resistant
action is a property, is indeed an automatic action of our life-
preserving power, which goes by the name of secondary action or
counteraction.

§ 64

During the primary action of the artificial morbific agents
(medicines) on our healthy body, as seen in the following examples,
our vital force seems to conduct itself merely in a passive
(receptive) manners, and appears, so to say, compelled to permit the
impressions of the artificial power acting from without to take place
in it and thereby after its state of health; it then, however, appears
to rouse itself again, as it were, and to develop (A) the exact
opposite condition of health (counteraction, secondary action) to this
effect (primary action) produced upon it, if there be such an
opposite, and that in as great a degree as was the effect (primary
action) of the artificial morbific agent on it, and proportionate to
its own energy; - or (B) if there be not in nature a state exactly the
opposite of the primary action, it appears to endeavor to
indifferentiate itself, that is, to make its superior power available
in the extinction of the change wrought in it from without (by the
medicine), in the place of which it substitutes its normal state
(secondary action, curative action).

§ 65

Examples of (A) are familiar to all. A hand bathed in hot water is at
first much warmer than the other hand that has not been so treated
(primary action); but when it is withdrawn from the hot water and
again thoroughly dried, it becomes in a short time cold, and at length
much colder than the other (secondary action). A person heated by
violent exercise (primary action) is afterwards affected with
chilliness and shivering (secondary action). To one who was yesterday
heated by drinking much wine (primary action), today every breath of
air feels too cold (counteraction of the organism, secondary action).
An arm that has been kept long in very cold water is at first much
paler and colder (primary action) than the other; but removed from the
cold water and dried, it subsequently becomes not only warmer than the
other, but even hot, red and inflamed (secondary action, reaction of
the vital force). Excessive vivacity follows the use of strong coffee
(primary action), but sluggishness and drowsiness remain for a long
time afterwards (reaction, secondary action), if this be not always
again removed for a short time by imbibing fresh supplies of coffee
(palliative). After the profound stupefied sleep caused by opium
(primary action), the following night will be all the more sleepless
(reaction, secondary action). After the constipation produced by opium
(primary action), diarrhoea ensues (secondary action); and after
purgation with medicines that irritate the bowels, constipation of
several days' duration ensues (secondary action). And in like manner
it always happens, after the primary action of a medicine that
produces in large doses a great change in the health of a healthy
person, that its exact opposite, when, as has been observed, there is
actually such a thing, is produced in the secondary action by our
vital force.

§ 66

An obvious antagonistic secondary action, however, is, as may readily
be conceived, not to be noticed from the action of quite minute
homoeopathic doses of the deranging agents on the healthy body. A
small dose of every one of them certainly produces a primary action
that is perceptible to a sufficiently attentive; but the living
organism employs against it only so much reaction (secondary action)
as is necessary for the restoration of the normal condition.


§ 67 Sixth Edition

These incontrovertible truths, which spontaneously offer themselves to
our notice and experience, explain to us the beneficial action that
takes place under homoeopathic treatment; while, on the other hand,
they demonstrate the perversity of the antipathic and palliative
treatment of diseases with antagonistically acting medicines.1

1 Only in the most urgent cases, where danger to life and imminent
death allow no time for the action of a homoeopathic remedy - not
hours, sometimes not even quarter-hours, and scarcely minutes - in
sudden accidents occurring to previously healthy individuals - for
example, in asphyxia and suspended animation from lightning, from
suffocation, freezing, drowning, etc. - is it admissible and
judicious, at all events as a preliminary measure to stimulate the
irritability and sensibility (the physical life) with a palliative, as
for instance, with gentle electrical shocks, with clysters of strong
coffee, with a stimulating odor, gradual application of heat, etc.
When this stimulation is effected, the play of the vital organs again
goes on in its former healthy manner, for there is here no disease* to
be removed, but merely an obstruction and suppression of the healthy
vital force. To this category belong various antidotes to sudden
poisoning: alkalies from mineral acids, hepar sulphuris for metallic
poisons, coffee and camphora (and ipecacuanha) for poisoning by opium,
etc.

It does not follow that a homoeopathic medicine has been ill selected
for a case of disease because some of the medicinal symptoms are only
antipathic to some of the less important and minor symptoms of the
disease; if only the others, the stronger well-marked
(characteristic), and peculiar symptoms of the disease are covered and
matched by the same medicine with similarity of symptoms - that is to
say, overpowered, destroyed and extinguished; the few opposite
symptoms also disappear of themselves after the expiry of the term of
action of the medicament, without retarding the cure in the least.

* And yet the new sect that mixes the two systems appeals (though in
vain) to this observation, in order that they may have an excuse for
encountering everywhere such exceptions to the general rule in
diseases, and to justify their convenient employment of allopathic
palliatives, and of other injurious allopathic trash besides, solely
for the sake of sparing themselves the trouble of seeking for the
suitable homoeopathic remedy for each case of disease - and thus
conveniently appear as homoeopathic physicians, without being such.
But their performances are on a par with the system they pursue; they
are corrupting.

§ 68 Sixth Edition

In homoeopathic cures they show us that from the uncommonly small
doses of medicine (§§ 275 - 287) required in this method of treatment,
which are just sufficient, by the similarity of their symptoms, to
overpower and remove from the sensation of the life principle the
similar natural disease there certainly remains, after the destruction
of the latter, at first a certain amount of medicinal disease alone in
the organism, but, on account of the extraordinary minuteness of the
dose, it is so transient, so slight, and disappears so rapidly of its
own accord, that the vital force has no need to employ, against this
small artificial derangement of its health, any more considerable
reaction than will suffice to elevate its present state of health up
to the healthy point - that is, than will suffice to effect complete
recovery, for which after the extinction of the previous morbid
derangement but little effort is required (§ 64, B).

§ 69 Sixth Edition

In the antipathic (palliative) mode of treatment, however precisely
the reverse of this takes place. The medicinal symptom which the
physician opposes to the disease symptom (for example, the
insensibility and stupefaction caused by opium in its primary action
to acute pain) is certainly not alien, not allopathic of the latter;
there is a manifest relation of the medicinal symptom to the disease
symptom, but it is the reverse of what should be; it is here intended
that the annihilation of the disease symptom shall be effected by an
opposite medicinal symptom, which is nevertheless impossible. No doubt
the antipathically chosen medicine touches precisely the same diseased
point in the organism as the homoeopathic medicine chosen on account
of the similar affection it produces; but the former covers the
opposite symptom of the disease only as an opposite, and makes it
unobservable to our life principle for a short time only, so that in
the first period of the action of the antagonistic palliative the
vital force perceives nothing disagreeable from either if the two
(neither from the disease symptom nor from the medicinal symptom), as
they seem both to have mutually removed and dynamically neutralized
one another as it were (for example, the stupefying power of opium
does this to the pain). In the first minutes the vital force feels
quite well, and perceives neither the stupefaction of the opium nor
the pain of the disease. But as the antagonistic medicinal symptom
cannot (as in the homoeopathic treatment) occupy the place of the
morbid derangement present in the organism in the sensation of the
life principle as a similar, stronger (artificial) disease, and
cannot, therefore, like a homoeopathic medicine, affect the vital
force with a similar artificial disease, so as to be able to step into
the place of the original natural morbid derangement, the palliative
medicine must, as a thing totally differing from, and the opposite of
the disease derangement, leave the latter uneradicated; it renders it,
as before said, by a semblance of dynamic neutralization,1 at first
unfelt by the vital force, but, like every medicinal disease, it is
soon spontaneously extinguished, and not only leaves the disease
behind, just as it was, but compels the vital force (as it must, like
all palliatives, be given in large doses in order to effect the
apparent removal) to produce an opposite condition (§§ 63,64) to this
palliative medicine, the reverse of the medicinal action, consequently
the analogue of the still present, undestroyed, natural morbid
derangement, which is necessarily strengthened and increased2 by this
addition (reaction against the palliative) produced by the vital
force. The disease symptom (this single part of the disease)
consequently becomes worse after the term of the action of the
palliative has expired; worse in proportion to the magnitude of the
dose of the palliative. Accordingly (to keep to the same example) the
larger the dose of opium given to allay the pain, so much the more
does the pain increase beyond its original intensity as soon as the
opium has exhausted its action.3

1 In the living human being no permanent neutralization of contrary or
antagonistic sensations can take place, as happens with substances of
opposite qualities in the chemical laboratory, where, for instance,
sulphuric acid and potash unite to form a perfectly different
substance, a neutral salt, which is now no longer either acid or
alkali, and is not decomposed even by heat. Such amalgamations and
thorough combinations to form something permanently neutral and
indifferent do not, as has been said, ever take place with respect to
synamic impressions of an antagonistic nature in our sensific
apparatus. Only a semblance of neutralization and mutual removal
occurs in such cases at first, but the antagonistic sensations do not
permanently remove one another. The tears of the mourner will be dried
for but a short time by a laughable play; the jokes are, however, soon
forgotten, and his tears then flow still more abundantly than before.

2 Plain as this proposition is, it has been misunderstood, and in
opposition to it some have asserted that the palliative in its
secondary action, would then be similar to the disease present, must
be capable of curing just as well as a homoeopathic medicine does by
its primary action. But they did not reflect that the secondary action
is not a product of the medicine, but invariably of the
antagonistically acting vital force of the organism; that therefore
this secondary action resulting from the vital force on the employment
of a palliative is a state similar to the symptoms of the disease
which the palliative left uneradicated, and which the reaction of the
vital force against the palliative consequently increased still more.

3 As when in a dark dungeon, where the prisoner could with difficulty
recognize objects close to him, alcohol is suddenly lighted,
everything is instantly illuminated in a most consolatory manner to
the unhappy wretch; but when it is extinguished, the brighter the
flame was previously the blacker is the night which now envelopes him,
and renders everything about him much more difficult to be seen than
before.

§ 70 Sixth Edition

From what has been already adduced we cannot fail to draw the
following inferences:

That everything of a really morbid character and which ought to be
cured that the physician can discover in diseases consists solely of
the sufferings of the patient, and the sensible alterations in his
health, in a word, solely of the totality of the symptoms, by means of
which the disease demands the medicine requisite for its relief;
while, on the other hand, every internal cause attributed to it, every
occult quality or imaginary material morbific principle, is nothing
but an idle dream;

That this derangement of the state of health, which we term disease,
can only be converted into health by another revolution effected in
the state of health by means of medicines, whose sole curative power,
consequently, can only consist in altering man's state of health -
that is to say, in a peculiar excitation of morbid symptoms, and is
learned with most distinctness and purity by testing them on the
healthy body;

That, according to all experience, a natural disease can never be
cured by medicines that possess the power of producing in the healthy
individual an alien morbid state (dissimilar morbid symptoms)
differing from that of the disease to be cured (never, therefore, by
an allopathic mode of treatment), and that even in nature no cure ever
takes place in which an inherent disease is removed, annihilated and
cured by the addition of another disease dissimilar to it, be the new
one ever so strong;

That, moreover, all experience proves that, by means of medicines
which have a tendency to produce in the healthy individual an
artificial morbid symptom, antagonistic to the single symptom of
disease sought to be cured, the cure of a long-standing affection will
never be effected, but merely a very transient alleviation, always
follows by its aggravation; and that, in a word, this antipathic and
merely palliative treatment in long-standing diseases of a serious
character is absolutely inefficacious;

That, however, the third and only other possible mode of treatment
(the homoeopathic), in which there is employed for the totality of the
symptoms of a natural disease a medicine capable of producing the most
similar symptoms possible in the healthy individual, given in suitable
dose, is the only efficacious remedial method whereby diseases, which
are purely dynamic deranging irritations of the vital force, are
overpowered, and being thus easily, perfectly and permanently
extinguished, must necessarily cease to exist. This is brought about
by means of the stronger similar deranging irritation of the
homoeopathic medicine in the sensation of the life principle. - and
for this mode of procedure we have the example of unfettered Nature
herself, when to an old disease there is added a new one similar to
the first, whereby the new one is rapidly and forever annihilated and
cured.

Homeopathe International
.

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