In Homeopathy, remedies are selected on the basis of Totality of symptom. The most appropriate remedy suitable to the patient is called similimum. When such a similimum is given to the patient, at times a temporary intensification of the symptoms may occur to the patient. This aggravation shall be mild and usually last only for a short period. Such an effect sometimes occur following the first dose of the remedy or when the remedy has been taken more often than needed or if the person is unusually sensitive.
Most of the homeopathic medicines do not contain pharmacologically active ingredients, but only posses certain dynamic properties. This dynamic effect of the remedy is the one that acts on the patient. Homeopathy believes that the diseases originate at the life force, which is dynamic in nature and when a dynamic remedy interacts with the life force, it produces an artificial or transient set of symptoms, provided that remedy is similimum. This intensification of the symptom is called Homeopathic aggravation.
The homeopathic aggravation after the administration of the curative remedy is the reaction of the organism, as it responds to the gently stimulating action of the medicine. This aggravation may only be a slight worsening of symptoms and may hardly be noticed by the patient. As Hahnemann said in aphorism 158 of Organon of Medicine, a slight homoeopathic aggravation in the first hours is a good indication that the acute disease will probably be cured. If aggravation is marked, or if it persists, this may because the patient is proving the remedy, because a remedy that is poorly matched may actually induce new symptoms in the patient.
"An appropriately chosen homoeopathic remedy gently removes the disease without arousing any new symptoms. It is, nevertheless, usual in the first few hours if the dose is too large (too low a potency) for it to effect some small aggravation" (Organon, aphorism 157). "Aggravations do not occur if the accurately chosen homoeopathic medicine is given in low potencies which are gradually increased and modified by higher potencies" (Organon, aphorism 161 and 247).
"Nevertheless, there is hardly any homoeopathic medicine, even well chosen, which during its action does not bring about in very sensitive patients some very slight new symptom, because it is almost impossible for the symptoms of the medicine to coincide" (Organon, aphorism 156).
From these, it is evident that homoeopathic aggravations is a part of homoeopathic treatment, as such concept do not exist in other medical system.
Other stalwarts in Homeopathy has further studied this phenomenon and observed that when a homeopathic remedy is taken, any one of the following response is expected:
· A curative response – the symptoms get better.
· A similar aggravation – the symptoms first worsen and then improve.
· A dissimilar aggravation – new symptoms appear for a short time but the old ones stay the same.
· Accessory symptoms – The symptoms improve but in the process a new one appears for a short period.
· Return of old symptoms – The existing symptoms improve but in the process, old symptoms from the past return for a short period.
· A surrogate discharge or eruption appears for a short time.
· Absolutely nothing happens.
In the sixth edition of the Organon, Hahnemann limited the homeopathic aggravation to the first or first few hours in acute diseases. It usually occurs immediately after ingestion for the first hour, or for a few hours, when the dose has not been sufficiently small, and for a considerable number of hours when the dose has been somewhat too large. (§160 Organon)
In chronic diseases, however, and with the application of Hahnemann’s advanced methods as described in the sixth edition of the Organon, an intensification of the original symptoms shall only appear at the end of treatment, when cure is almost finished – provided the accurately chosen remedy was given in gradually increased potency and properly small and modified doses. (§ 161 Organon) When cure is almost finished the vital force does not need further medicine to continue its curative reaction. If further medicine is applied, the symptoms of the medicine are called into play. However, if the first dose causes a homeopathic aggravation in chronic diseases, and in the same way every repeated, modified dose, this indicates that the dose was too large. (§ 282 Organon)
An aggravation caused by the smallest possible dose will be easily overcome by the vital force and does not prevent cure. It is often not perceptible in patients unless they are oversensitive. (§156, 283 Organon)
The intensity and duration of the similar aggravation gives us a clue about the correctness of the chosen remedy, the patient’s vital force, prognosis, and for case management.
Hahnemann, Samuel, Organon of Medicine, 5th Edition, B Jain Publishers, New Delhi
Kent, James Tyler, Lectures on Homoeopathic Philosophy, B Jain Publishers, New Delhi