In aphorisms 63-71, Hahnemann explains primary and secondary action when a drug substance is administered to a healthy person during drug-proving. During drug-proving we get to observe two types of phenomena, namely Primary action and Secondary action. Primary action is the symptoms produced by the healthy body while the vital-force is in a receptive state (passive). Primary action is principally produced by the drug substance. Thus Primary action is what a drug can produce.
According to Newton’s law of Action-Reaction, every action has an equal and opposite reaction. Against this primary action, our Vital-force which is now aroused, actively endeavors to resist, in order to preserve the life. This is nothing but the secondary action. Secondary action is principally produced due to the automatic reaction of the life preserving Vital-force. In a homeopathic drug proving where a potency is administered, it produces a primary action. A secondary action by the Vital-force against it, is only so much as is necessary to restore the normal condition. This kind of secondary action is called curative action. Whereas, when a drug-substance is administered in large doses, the Vital-Force resists exactly opposite and as great as that of the Primary action. This kind of Secondary action is called a counter action. Also, there is a very interesting phenomena observed with certain drug-substances like Opium, which has in its state to produce the exactly opposite symptom. Here, in secondary action we observe the exact opposite reaction to the primary action, however, this Counter action is not principally produced by the automatic reaction of life preserving Vital-force but, from the action of drug-substance.
Hahnemann gives example of effects produced by Opium in aphorism 65, ” After the profound stupefied sleep caused by Opium ( Primary action ), the following night she will be all the more sleepless (reaction, Secondary action ). After the constipation produced by Opium ( Primary action ), diarrhea ensues ( reaction, Secondary action ).
Our vital force being unintelligent will not be able understand how much to react against the primary action of drugs like Opium in large doses or in crude form. This is the reason why Opium when indicated should not be given in too large doses or in too crude doses, so as to avoid producing the opposite symptom or state, which may instead of simply curing the case, make it all the more complicated because of intermingling of its two fold primary action with secondary counter action of the vital force and already existing symptoms of the natural disease.
A Case Study :
A 10 yr old girl came to me with recurrent Allergic rhinitis manifested by symptoms of hypertrophied turbinates, heavy snoring due to blocked nose, breathing through mouth, runny nose, throat pain, moist cough with chest congestion and vomiting of food and phlegm, body ache, malaise and fever. She craved for warm food and sweets, she had aversion to cabbage and her thirst was generally less. She also experienced flatulence which was better by eructation. She was very talkative, affectionate, cheerful and intelligent. Her parents said she was very curious to learn new things and showed deep interests in her studies. She was a favorite of school teachers, being very well mannered and she loved going to school. She would score excellent in her exams and she was very obedient to parents, teachers and elderly people. She would feel sad if she had to miss a day in school, sometimes due to illness.
I started with Lycopodium which gave beautiful result initially as she would recover fast from the acute episodes and she also started liking cabbage. However, she did not stop falling sick frequently and Lycopodium seemed to be exhausting its effect after some months. I prescribed Belladona, Sulphur and Phosphorus but somehow I would come back to Lycopodium as none of them proved as effective as Lycopodium.
She developed Typhoid with high temperature, severe body ache, severe headache and restless sleep in which she ran around the room and fell, cried loudly and threw tantrums during sleep without being aware about what she was doing and with no memory of it after she woke. Other nights she started moving her hands over her mother’s abdomen and asked why mom’s abdomen was feeling like plastic. Her mother said her sleep was so stupefied that it was difficult to wake her up from that unusual state. The next morning she did not remember anything. I prescribed Baptisia, considering Typhoid fever associated with delirium of body parts and it proved to be a successful prescription. Within five days she was completely cured.
Over a period of time, she started showing changes in her acute episodes of rhinitis symptoms. She would suddenly develop high fever with chills and vomiting of food and mucus without any inflammatory signs anywhere in her body. No throat pain. No chest congestion. Only severe body ache, weakness and mild coryza would be present, which would turn thick gradually. I thought this case was truly Baptisia as now she was showing symptoms of Baptisia in her usual acute episodes as well. Painless sore throat is the key symptom of Baptisia. I continued with Baptisia in infrequent doses for a couple of months during acutes, but she still fell ill repeatedly. At one point Baptisia stopped working and I started with China for fever with chills and body ache and weakness. China also showed its wonders but only for a while.
I again reviewed the case and this time her mother happened to mention the that bed-wetting was a symptom her daughter had since the beginning. She said the girl never gained control over her bladder and for this reason she was made to wear a diaper during the night. If she forgot to do that, the girl would wet the bed during sleep without her sleep being disturbed. Her sleep was so profound that she would not even realize she lost control over her sphincters. On previous nights she also passed stool like that. She was in a deep sleep and woke up with the great urgency to pass stool but lost control before she could rise from bed. She never had this problem during the day. It was her stupefied, comatose sleep which does not allow her to recognize the call. Three doses of Opium 1M relieved her from this symptom forever. I never thought this case could be truly Opium from its core unless this patient showed some changes in her attributes which I am going to describe later.
I again switched over to China in its higher attenuation, but without effect. Meanwhile, I moved out of the country and the mother started consulting me through phone calls and inter-net. I learned that the girl was again sick with the same complaint. The mother described a dream the girl had. In the dream, all her fish in the fish-tank died because of starving as she did not have food to feed them. The patient was so upset by this dream that she cried out loud the next morning was sad for the whole day. She had a real attachment with her fish. Her mother said that the girl had become more sensitive to other people’s suffering. Watching the telecast of a Tsunami in Indonesia had made her emotional and she had cried that time as well. I prescribed Causticum and she did well for that episode.
The next time, when Causticum also failed, I again reviewed the case through video-calling and this time the mother said that the girl who was once so obedient, had now become irritable and insolent, even telling lies. She also had no interest in her studies and was more interested in playing. She also started making silly mistakes. She became heedless about her hand writing. She became very talkative and disturbed other pupils in class. Teachers were complaining about her talkativeness, ill focus and disturbing behavior in class.
I was menaced with the thought of probably having suppressed this case. On further interrogation, I learned that she liked sleeping with her legs drawn up and she would throw off the coverings during sleep due to a feeling of heat. She liked sleeping with the fan on and windows opened. Her snoring due to blocked nose was still the same and she would keep her mouth open during sleep.
I asked about her emotional attachment with her fish and the mother said the fish actually died due to some disease. I asked how that affected the girl and the mother surprised me by saying the girl did not feel bad at all about the fish dying. She was neither bothered nor took it so seriously. I was highly surprised as the girl who got so affected once by the dream of dying of her fishes was not at all bothered when they died actually!
I started wondering what was wrong with this patient and where I was going wrong. I checked two rubrics: Sleep; position; legs drawn up, Uncovering; desires; sleep; falling asleep, and something clicked. I saw Opium in these rubrics. I knew this drug as many others in the Materia-medica for showing its manifestations in polarities. I discovered that it was not homeopathic suppression but Opium throughout…..I was so relieved!!
Let’s pick some important symptoms, states and phenomena right from the beginning and re-evaluate the whole case to confirm Opium.
– Snoring during sleep
– Lack of control over sphincters during sleep. I had successfully prescribed Opium for this symptom; I remembered.
– Stupefied comatose sleep.
– Mind: Groping as if in dark. This was the actual symptom during sleep in typhoid fever and not the one I wrongly interpreted as Delirium of body parts during fever.
”She developed Typhoid after some time with high rise in temperature, severe body ache, severe headache and restless sleep in which she ran around the room and fell, cried loudly and threw tantrums during sleep without being conscious about what she was doing and with no memory of it after she woke next morning. Other night she started moving her hands over her mother’s abdomen and asked why was her abdomen was feeling like plastic to her. Mother said her sleep was so stupefied that it was difficult to wake her up from that unusual state. And next day morning she would not remember anything. I prescribed Baptisia considering Typhoid fever associated with delirium of body parts and it proved to be a successful prescription. Within 2 to 5 days she was completely cured.”
– Numbness. Perhaps it was the numbness in hands which caused patient to feel her mother’s abdomen like that of plastic.
I understood why Baptisia did not hold being it only a partial simillimum.
– Horrible things; sad stories affect her profoundly. The little girl was so affected by hearing about natural calamities like floods and earthquakes, that it made her sad and she wept. She was so touched by the dream of her fish that she became very emotional and cried out loud while describing the dream to her mother and remained sad for whole day.
– Painlessness. On the other extreme painlessness is a great feature of Opium just like Baptisia. However Baptisia’s painlessness is limited to the throat whereas Opium expands itself with this characteristic to deeper levels of the mind where it becomes unsympathetic, insensitive and hard hearted. The girl who was actually so attached to her fish, did not feel sad at all when her fish died.
– High fever without any sign of inflammation.
– Sleep; position; legs drawn up
– Uncovering; desires; sleep; falling asleep
– And last but not least; in fact, most important in this case is its producing manifestations at extremes, at ‘ Polarity ‘. When we synthesize the above two points of ‘ Horrible things; sad stories affecting profoundly ‘ and ‘ Painlessness ‘ , we understand Opium at its deepest level of action. The girl who was once so obedient, well behaved, well mannered, had suddenly now became irritable, a liar, insolent, unsympathetic and insensitive, hard hearted.
Hahnemann has written in his proving of Opium that it is one of the most difficult drugs to understand in the homeopathic Materia-medica due to it producing Polarity in its manifestation. We do have many more drug substances like Opium which are capable of producing symptoms at their extremes.
I was so relieved, assuring myself with the above understanding of Opium that it was the inherent nature of this patient to producing manifestations at Polarity and not homeopathic suppression and hence, this patient would require either Opium or an Opium-like similar energy, whichever suited her most.
The mother said the complaint of bed-wetting never came back after those 3 doses of Opium 1M. I confidently prescribed Opium 1M again and repeated the dose infrequently as per the need for that single acute as wells as in following acute episodes. Not only did it cure that single acute episode but she showed remarkable improvement in her behavior and mood over a period of 3 months with infrequent doses of Opium1M only during acute episodes. The frequency of acutes reduced and also recovery from acutes became faster. After nearly 4 months of keeping her on Opium, I received this e-mail from the mother :
“ I have been seeing some considerable improvement in her overall growth ( physical as well as mental ) for the past month. She stopped telling lies, is showing great improvement in her studies, has neat hand writing, makes very few silly mistakes, shows interest in learning and she is most of the time happy. “
Continuing with Opium since then….