Healer Do No Harm!
The question has been asked "Can Homoeopathy be dangerous?". Homoeopathy is an extremely safe healing art when the practitioners is well trained in this healing art. Homoeopathy is only dangerous when the cardinal principles which Samuel Hahnemann integrated into Homoeopathy are ignored. The cardinal principles are similars cure similars, the single remedy, the minimal dose, and the potentized remedy. These four principles form the checks and balances which make Homoeopathy a safe and effective healing art. When the cardinal principles and methodology of The Organon of the Healing Arts are carefully learned they provide the foundation of a safe, rapid and gentle cure.
On this solid basis a homoeopathician learns how to avoid and manage the potential side-effects encounter ed during the process of healing. For this reason it is important to learn proper case management procedures. One of the most important areas of study is the nature of various remedy reactions and their causes. If this basic material is understood Homoeopathy is extremely safe when compared with other systems. If, however, homoeopathic remedies are used without an understanding of the basic principles and methodology of Homoeopathy they have the potential to be dangerous. Homoeopathy provides its own safety net which can not be found in other systems which use homoeopathic potencies in unhomoeopathic ways.
It is most important point is to understand homoeopathic posology and methodology very well. This avoids most of the potential trouble and offers effective counter measures for those negative situations which may arise. In order to offer some light on this subject we offer the following material for study which reviews the safety factors integrated into Homoeopathy by Samuel Hahnemann.
1. Appendix 1a., The 4 Cardinal Principles of Homoeopathy.
2. Appendix 1b. A Concise Review of Remedy Reactions.
3. Appendix 1c. Questions and Answers.
The Four Cardinal Principles of Homoeopathy
Homoeopathy is based on four cardinal principles: likes cure likes, the single remedy, the minimal dose and the potentized remedy. These are the checks and balances which make Homoeopathy a safe and effective system. Thus Homoeopathy has a safety net integrated into the use of similars. The following article is a post from my archive that deals with this subject. This sets the foundation of homoeopathic philosophy.
1. The First Principle of Homoeopathy is Similars cure Similars.
Homoeopathy uses the similar remedy to cure similar diseases. All homoeopathic remedies are tested on healthy volunteers so that the symptoms they produce demonstrate the nature of the illnesses they will cure. After careful provings they are tested in clinical trials on those who are ill with similar disorders. After a detailed assessment of their potential causative rubrics and symptomatology these similar remedies are entered into the homoeopathic repertory and materia medica. Thus the homoeopathic reference works are a careful balance of provings and clinical confirmations. Homoeopathic remedies are chosen by similar constitutional factors, aetiology and the totality of the signs and symptoms. A remedy chosen in this way is called the "simillimum".
All diseases have an effect on the entire human organism which manifests as signs and symptoms on the mental and physical levels. The instinctive vital force attempts to externalize constitutional disharmony in the form of local affections and one sided complaints in the more external parts. This movement outward acts as a pressure valve which seeks to protect the inner most sensitive organs of the mind, nervous system, lungs, heart, liver, kidneys, etc. Therefore, the constitutional vital force may set up a local discharge, a regional affection or a persistent one-sided complaint to palliate an internal disorder. This phenomena has been observed since the time of Hippocrates (c. 450 B.C.), the father of the constitutional philosophy.
If a local manifestation of this constitutional derangement is treated one-sidedly by a single symptom or a common disease name it may suppress this palliatory expression of the vital force causing the disease to metastasize to the interior regions producing a more complex pathological state. This is a primary aspect of the suppression syndrome as recorded in the Introduction of The Organon of the Healing Arts (page 32 & 33) and The Chronic Diseases. Such phenomena can be caused by homoeopathic, naturopathic and allopathic remedies when used improperly. For example, I once gave a remedy which cleared up a digestive problem and rapidly caused maddening headaches and a crisis of the inner ear. One would have to be in tremendous denial not to admit such a mistake. Fortunately, those trained in the complete homoeopathic system have been taught to watch for such negative signs and know how to apply the appropriate counter measures.
For these reasons traditional homoeopaths collect all the data related to the spirit and mind, domestic and social relationships, the physical constitution, aetiology, miasms, iatrogenesis, suppressions and the signs and symptoms (Org. § 5, 6, 7, etc.). In this way a homoeopath avoids treating any one single symptom and the use of nosological disease names as a basis for a prescription. A homoeopath uses the symptoms of the complete mind-body complex as the basis for the administration of a homoeopathic potency. In this way the suppressive potential of homoeopathic remedies is neutralized.
Many eclectics mix several healing methods in such a manner that can only be called unique. Some are using potentized remedies in combinations under the illusion that they practice a new improved form of Homoeopathy or naturopathy. Others give new-age health products which have vitamins, minerals, herbs and homoeopathic remedies. These remedies are not administered by the law of similars and can truly be called unhomoeopathic. The combination remedies of old times were low potencies given by simple indications. Today's new age combinations have high potencies or all potencies mixed together. These individuals are under the illusion that homoeopathic remedies are completely safe no matter how one uses them. Nothing could be further from the truth.
Some individuals use potentized remedies in a questionable manner because they remove the safety features Hahnemann integrated to lower the chance of side-effects. One such system is the Sequential Therapy (ST) of Elgimer which uses combinations of high potency remedies chosen by causations, disease names, and isopathy. Some of his students claim that Hahnemann had two methods of giving remedies, the homogenic and homoeopathic. These so- called "homogenic remedies' are prescribed by disease names without any recourse to the signs and symptoms of the patient. Such methods increase the chance of suppression, prolonged aggravations and remedy produced diseases.
2. The Second Principle of Homoeopathy is the Single Remedy.
Homoeopaths do not look at each individual disease name or symptom in isolation. They look at the entire constitutional expression of the individual through the totality of the symptoms. As each individual represents a single mind/body organism any mistunement of the unitary vital force produces a syndrome of signs and symptoms. This singular constitutional state is most similar to the single remedy that is the simillimum of the entire derangement. The singularity of the similar remedy reflects the integrated nature of the defensive powers as well as the unitary nature of the vital force. The single remedy allows the vital force to concentrate its maximum healing power on the essential picture of the illness rather than dispersing vital energy in reaction to several medicinal influences simultaneously.
The reason homoeopaths do not use combination remedies is that it makes case management of complex problems almost impossible. Combination remedies often have remedial qualities which are contradictory in nature. The practitioner has no idea what the combined action of several remedies and potencies may have on the individual. There is no way to manage a case because you can not tell what may be causing aggravations, new symptoms or amelioration. Combinations have no provings which test their actions on the healthy so their indications in disease are completely unknown. Hahnemann also experimented with dual remedies in 1832 but found them ineffective and their actions difficult to assess. For these reasons he left them completely behind. These are a few of the reasons homoeopaths do not use combination remedies. They are inherently allopathic in nature.
A homoeopathic remedy works by being similar to the disease state but slightly stronger due to potentization. The primary action of the homoeopathic remedy is opposed by the secondary healing action of the vital force which leads to the cure. If a constitution is too warm a similar warm remedy in potency will stimulate the opposite reaction of coolness from the instinctive vital force bringing the individual toward a balanced state of health. This is Hahnemann's model of how homoeopathic remedies work (Organon, § 63, 64, 65, 66). Sensitive constitutions make the best provers (remedy testers) of homoeopathic remedies because they will react to almost any remedy. This has been demonstrated many times. The homoeopathic materia medica is based on provings on the healthy as well as clinical confirmations on the ill. In this way homoeopaths know the remedial actions of their potentized remedies.
It is those with sensitive constitutions, hidden pathology, and weakened vitality who are prone to be hypersensitive to homoeopathic remedies. They make up a significant percentage of our contemporary cases. If such a constitution is too warm, and they are given a cold remedial potency, the vital force will oppose this primary coolness by producing more secondary heat making the disease worse not better. Such phenomena have been documented. If we give a combination of remedies including a shy remedy, an aggressive remedy, a cold remedy, a hot remedy, a dry remedy and a moist remedy, the secondary action of the vital force may become fragmented running the danger of confusing secondary reactions, coincidental suppression and disruption of the natural symptom pattern. Such reactions are often mistaken for deeper layers, cleansing crises or new diseases by those who have not mastered the fundamentals of homoeopathic methodology. Such difficulties can be avoided by a proper education in homoeopathic philosophy.
3. The Third Principle of Homoeopathy is the Minimum Dose.
Hahnemann learned early in his career that medical practice was dangerous. The side-effects he experienced with orthodox medicine upset him so much he stopped using allopathic drugs and treatments. After this bitter experience he decided to practice the natural healing arts in the tradition of Hippocrates, the father of western medicine. The ancient Greeks were very careful with the use of medicines. They relied on diet, lifestyle, exercise and philosophy for cure as well as materia medica. Hahnemann's use of the Hippocratic methods was so successful that the first "Hahnemannian Treatment" was pure Greek naturopathy. As the young doctor applied his 'new' treatments he began a search for the proper ways to use remedial agents. This was the beginning of Homoeopathy.
Hahnemann was very careful with his doses of homoeopathic remedies. Many homoeopaths misunderstand the nature of the minimal dose. Most modern homoeopaths believe that there is no difference in the action of one homoeopathic pill and one thousand pills ad infinitum. They confuse the small amount of original substance in a high potency with the maxim of the minimal dose. In truth they are two different synergistic principles. The concept that the dose does not matter can be traced to James Kent and can be found in his classic Lectures on Homoeopathic Philosophy in the chapter called On Simple Substance. In this work Kent explains the Swedenborgian theory that energy is based on a fourth state of matter called the "simple substance". Hahnemann noticed right from the very start that a homoeopath must be very careful with both the potency and size of the dose. He found that the size of the dose was as important as the potency factor in the producing the phenomena of aggravation. For this reason the amount of the dose is as carefully regulated as the level of the potency in Hahnemannian Homoeopathy. Vide aphorism 275.
"The suitableness of a medicine for any given case of disease does not depend on its accurate homoeopathic selection alone, but likewise on the proper size, or rather smallness, of the dose. If we give too strong a dose of a medicine which may have been even quite homoeopathically chosen for the morbid state before us, it must, notwithstanding the inherent beneficial character of its nature, prove injurious by its mere magnitude, and by the unnecessary, too strong impression which, by virtue of its homoeopathic similarity of action, it makes upon the vital force which it attacks and, through the vital force, upon those parts of the organism which are the most sensitive, and are already most affected by the natural disease."
Modern physics states that all forms of energy are contained in small energy packets called quantums. The amplitude of a force is increased when the number of quantums of energy present are expanded at any given wave length. In the same way, Hahnemann taught that each pill of a homoeopathic remedy possessed a certain amount or "quantum" of medicinal energy. In a sense the potency of a remedy represents the wave form or frequency of the energy and the number of pills represents the amplitude or power of the signal. This is why the power of a homoeopathic dose increases each time the practitioner uses more pills when preparing the remedy for ingestion. Hahnemann gave a direct warning about the abuse of the small number #10 pills. Vide The Chronic Diseases.
"The physician can, indeed, make no worse mistake than first, to consider as too small the doses which I (forced by experience) have reduced after manifold trials and which are indicated with every anti psoric remedy...."
As the potencies of homoeopathic remedies became higher Hahnemann progressively reduced the size of the dose. This is why he stopped using drop doses of the alcohol base potencies and began using the small pills we are all so familiar with. Even here he found that the number of pills still needed to be strictly controlled. In the note to this page Hahnemann speaks of the mistakes he made in his earlier experiments when he used too many pills in his homoeopathic practice.
"I have myself experienced this accident, which is very obstructive to cure and cannot be avoided too carefully. Still ignorant of the strength of its medicinal power, I gave Sepia in too large a dose. This trouble was still more manifest when I gave Lycopdium and Silicea, potentized to the one-billionth degree, giving four to six pellets, though only as large as poppy seeds. Discite moniti!"
Most modern homoeopaths interpret the size of the dose as being synonymous with the level of the potency. They mistakenly believe that using the smallest dose relates to the tiny amount of the original substance present in a high potency remedy. This is not the full story as Hahnemann speaks of the difference between the size or amount of a dose and the potency factor in his writings. Hahnemann taught that the phenomenon of the aggravation was not only linked to the potency, but also to the number of pills used when giving the dose. The unwarranted use of a random number of pills of a high potency remedy is the exact opposite of what Hahnemann taught as the minimal dose.
The minimal dose means that the homoeopath should use the least amount of medicinal stimulation necessary to bring about a healing reaction. This is why the maxim of the minimum dose includes three variable factors, i. e. the size of the dose, the level of the potency, and the number of times the remedy is used. Hahnemann recommends that a homoeopathic remedy be given in a dose as "sufficiently minute i.e. as small as possible". This is because even the correct homoeopathic remedy given in proper potency but in an unnecessarily large amount will aggravate the case and delay the cure. In patients with severe pathological tissue changes, hypersensitivity, or suffering from lack of vitality, large doses may be dangerous.
4. The Fourth Principle of Homoeopathy is the Potentized Remedy.
Some remedy combinations are low potencies, some are high potencies, some are mixtures of both. Some have several potencies of several remedies. None of the potencies in such combinations can be individualized to the disease state nor symptoms. There is absolutely no standard of manufacture nor uniform code of administration. Potentized remedies are extremely powerful and should not be treated like some new age holistic "good for everyone" health product. Most combination practitioners do not understand the homoeopathic posology system nor how to apply it to an individual state of disease. This is because they do not understand the science and philosophy of Homoeopathy. *This increases the risk of side-effects.
* In this document I have exclusively used the words like "potential to, may cause and runs the danger of, etc.." This is because such negative phenomena depend on variable causes and circumstances and are not absolute in nature. Nevertheless, the percentage of cases in which they do occur should be of concern to healers in all fields.
Discite Moniti! (Heed this warning!)
"Discite Moniti!" cried Hahnemann in The Chronic Diseases (page 206) after he misused his new anti-psoric remedies in ignorance of their potential powers. Homoeopaths have always tried to learn from their mistakes and prevent others from repeating them. It is the principles of individualization, likes cure likes, the single remedy, the minimal dose and the potentized remedy which makes Homoeopathy a safe and effective system. Without these cardinal principles the use of similars is potentially dangerous. These are the checks and balances that Hahnemann integrated into his system as he perfected the method. It is these principles which provide the path to a gentle, rapid and permanent cure.
Why do classical homoeopaths respect these principles so much??? Because over the years in our ignorance we have given the wrong remedies and caused negative affects, suppressed symptoms with partial simillimums, given the wrong potency, used too large a dose, disrupted the vital force with untimely repetition, and aggravated cases to the point of danger on occasions. Such difficult moments are great teachers. They cause one to go back to basics and see where one has gone wrong. Our cautions are not given lightly nor with lack of personal experience. We have also witnessed suppressions, over medication, and symptom disruptions coming from other healing disciplines. Remember the first Hippocratic maxim is "Healer ,do no harm!"
The night can be long and sleepless for a homoeopath with a conscience. Hahnemann learned by trial and error and so must we. That is the lonely path a healer must tread. No one has a perfect track record. Homoeopaths have always been very honest about this. As one's remedies become more accurate, and one's cases more serious, the potential for difficulties only deepens. Some say they have never seen any problems, suppressions, aggravations nor side-actions caused by homoeopathic remedies. For them such a thing is impossible, and therefore, it does not exist at all. Do they mean that all those homoeopaths who have witnessed such things over the last 200 years must be crazy? Such is the state of their denial.
To those of us who have caused problems in our own cases, as well as discussed them in the cases of our honest colleagues, such absolute claims sound very, very hollow. We have case histories which demonstrate the negative affects of giving an incorrect homoeopathic remedy and the wrong potency and dosage. We have accepted our mistakes and try to learn from them as all responsible healers must do. If one carefully follows the cardinal principles of Homoeopathy such difficulties can be reduced to a minimum and mistakes easily rectified. Without the homoeopathic principles the power of potentized remedies is very difficult to control.
This wisdom is born of two centuries of clinical experience and is not religious dogma, fundamentalism nor prideful fanaticism. Many do not understand the chain of human experience behind these cardinal principles and cautions. Even to become a homoeopath takes 5 years of training to learn the basics and another 5 years of clinical experience to master those fundamentals. For the next 10 years one must keep studying case histories and materia medica daily. Then one finally is an experienced homoeopathician. There is no other way. Of course, many are looking for a short cut because they lack the dedication it takes to be a real homoeopathician. I have watched such healers over the last 25 years and their knowledge of Homoeopathy never grows. They do the same things today as they did all those years ago. If one takes a "short cut" in the beginning one's knowledge is "cut short" in the end. You get out exactly what you put in!
A Concise Review of Remedy Reactions
The Organon of the Healing Art is the text on which Homoeopathy is based. It teaches homoeopathic methodology and case management in a grand fashion. One of the subjects is a detailed study of the positive and negative signs which may be elicited by homoeopathic remedies. Much of the material on remedy reactions seems very complex, but when it is broken down into its basic components, it becomes easier to understand.
The first dose of a homoeopathic remedy is a test dose. No one can judge the constitutional sensitivity of each individual perfectly. For this reason the safest thing to do is give one single test dose and carefully watch for signs of action of the remedy. There are always three questions to consider right at the start of any treatment i.e., is the remedy the true simillimum, is it a wrong remedy, or is it a partial simillimum? Of course, the best sign is a striking improvement in all the symptoms and the state of vitality. What does it mean when there is an increase of the symptoms present or the production of new ones? What does the return of old symptoms mean? The answers to these questions revolve around the following four queries
1. What is similar aggravation?
A similar aggravation is an increase of the symptoms the individual already suffers. For example, a remedy is given for a chronic backache and the pains become worse after the dose. This is caused by too large a dose (too many pills or teaspoons), too high a potency (C or LM), or the repetition of the remedy when not needed. No further doses are needed as the primary action of the remedy is too strong for the vital force to begin its secondary reaction. If the aggravation is not severe it is best to wait and watch the symptoms closely as there soon will be a healing secondary action which will not only bring relief but start the road toward a greater state of health. If the aggravation is causing great pain and distress the remedy may have to be canceled.
2. What is a dis-similar aggravation?
A dis-similar aggravation is when a remedy produces "new and troublesome symptoms" not appertaining to the disease being treated. For example, one is treating the chronic backache and the person gets a stomach ache after taking the remedy and feels bad all over. If the headache is no better and these new symptoms persist it is a sign of the wrong remedy. The key here is "the new and troublesome" aspect. A new case should be built around the combination of the natural and new remedial symptoms and a corrective remedy given. If a dis-similar aggravation is severe it should be antidoted.
3. What are accessory symptoms?
Sometimes a remedy will bring out side-actions which are called accessory symptoms. These are symptoms of the remedy that are unhomoeopathic to the person who is taking the remedy. If they are mild and transient they will not interfere with the cure. If they increase it is a sign that the remedy is only a partial simillimum and has done all the work it can do. The case should be retaken.
This often leads to the question; what is the difference between accessory symptoms and the symptoms of a dis-similar aggravation? Both involve an increase of new signs rather than an increase of the symptoms present or the appearance of old ones from the past. The differential analysis used to assess these two states are as follows.
A. A dis-similar aggravation produces "new and troublesome symptoms" not directly related to the case while the mental state, general vitality and health of the person seems to be getting worse. The person's chief complaints are not improving while new symptoms of a troubling nature increase. It is time to retake the case and find an alternative that suits the situation.
B. Accessory symptoms are seen when the person is improving in health and vitality but new symptoms begin to appear. These symptoms are side-actions of the chosen remedy that are unhomoeopathic to the individual's complaint. When these symptoms are trifling and pass off rapidly they will not interfere with the cure. If the symptoms increase or become persistent this means the remedy is a partial simillimum that is beginning to obstruct the cure. This is a sign it is time to retake the case and give a more perfect remedy. It is only when such symptoms become severe that an antidote is needed.
Thus in a dis-similar aggravation new symptoms increase and the vitality is lowered. A partial simillimum produces new symptoms while the person's health is improving and vitality increasing. If the partial simillimum is close enough to the center of the derangement it will move the constitution closer to a greater state of health. If the partial simillimum is too distant from the central core of the vital disruption it will continue to produce its own signs until they dominate the symptomatology. Such a situation can be aborted if the homoeopath readily understands the nature of the presenting signs and acts accordingly. All of these essential aspects of case management are carefully explained in the aphorisms of The Organon.
4. What is a natural healing crisis?
Lastly, the homoeopath must know the difference between the 3 types of homoeopathic reactions and a natural healing crisis.
A. A homoeopathic aggravation is controlled by the primary action of a homoeopathic remedy while a natural healing crisis is controlled by the secondary action of the vital force. Therefore, natural healing cycles are under the curative power of the vital principle within the constitution. Such a natural crisis is not overly prolonged nor dangerous to the health of the individual.
B. A homoeopathic aggravation is the increase of those things present (similar aggravation) or the production of unrelated new symptoms (dis-similar aggravation). A true natural healing crisis produces the return of old symptoms and suppressed disease signs as well as surrogate eliminations. A natural healing crisis is always quickly followed by a greater sense of health and an increase in vitality. This is the basis of Hering's Laws. If the return of old symptoms is prolonged, or more painful than the original complaint, it is a sign of a similar homoeopathic aggravation. In this situation the primary action of the similar remedy forces a severe crisis as the old symptoms return. This is a sign that the size of the dose is too large, the potency too high, or the remedy was repeated when it was not needed.
Sincerely, David Little
Questions and Answers
I do so love the way you tease out a complex question into component parts. This is an area that can trip us all up! Can I ask some daft questions as I'm very fascinated by all of this?" You wrote: A similar aggravation indicates the right remedy in the wrong dose. I assume you mean a worsening of the symptom picture?"
Yes! For example, if we had a Rhus-t. client who has a backache, and the backache becomes intensified, this is a similar aggravation. A similar aggravation is caused by the primary action of a homoeopathic remedy as it replaces the natural disease with its remedial action. If the size of the dose, the level of the potency, or the number of repetitions are excessive, the symptoms of the remedy which are truly homoeopathic to the individual will be heightened for a longer or shorter period of time. Normally, it is only a matter of time before the remedial effect lessens and the secondary counteraction of the vital force moves the constitution toward the state of health. If the remedy preparation was exceptionally excessive for the sensitivity of the individual, the primary action may dominate for long time periods, thus weakening the vitality of the organism, and lessening the curative secondary effects. If the primary action is so excessive it is dangerous the remedy must be canceled by a dynamic antidote.
"What do you do with cases that have a hair trigger eg: thuja 6c one dose leading to status asthmaticus and 8 weeks in hospital? (this was her first ever homoeopathic remedy and a very close match). I don't know if you caught the trauma debate in the autumn, but this issue came up a lot with cases that through trauma were tightened up real tight and tended to explode on contact - no matter what technique or potency was attempted. This was always worse when you got a simillimum as it tended to remove defensive structures/symptoms, thus releasing the state - often memory of the trauma or flash backs would come up."
Her sensitivity must have been 1000 +++ on Hahnemann's sensitivity scale. If the dose is carefully adjusted in a medicinal solution, and given in small doses, most of these side-effects can be overcome. In such cases it is wise to prepare the remedy in a medicinal solution with the addition of a dilution glass. In the extremely sensitive patients a second, third, or more dilution glasses can be used. Even if it is a 6c, the dose should be prepared in the same way as an LM potency. Hahnemann was witnessed administering his centesimal potencies in this fashion. In the last two recorded cases he prepared the centesimals and the LMs in exactly the same fashion. If one gets strong reactions such as in the above case, it is best to antidote the remedy as fast as possible with a dynamic antidote. The same remedy can be reintroduced, if thought to still be indicated, at a later time in a much more refined dose.
"Could you clarify your following statement?"
"A dis-similar aggravation indicates the wrong remedy".
A dis-similar aggravation occurs when the remedy produces new and troublesome symptoms not appertaining to the disease at hand. To use our same example of the Rhus-t and the backache: after administering the remedy the backache is no better and the person develops headaches and chill which they have never experienced before. This is a sign of a wrong remedy. If the disruption is not severe the case should be retaken and a more perfect simillimum given as soon as possible. The will regularize the vital force and move the case forward. If the reaction is severe, the remedy should be canceled by a dynamic antidote.
"David wrote: accessory symptoms means a partial simillimum. So a partial simillimum can produce accessory (proving symptoms) of that partial simillimum?"
Hahnemann states in The Organon that is very difficult to get a remedy which fits the disease exactly like two triangles of the exact same size one over the other. There are always a few edges or corners that will stick out. These edges represent areas where the remedy is not perfectly homoeopathic to the case at hand. When a remedy is a partial simillimum it has the potential to bring out "side-effect" symptoms of the remedy which are unhomoeopathic to the individual. This is somewhat common, but when the remedy is close enough, the remedial symptoms are so slight and trifling they pass off easily without much bother. The farther away from the central disturbance the remedy is, the more potential there is for the production of strong accessory symptoms. A partial simillimum moves the case forward, but at the same time, it produces new symptoms which may mix with the natural symptoms impeding the cure. When this is the situation, the case must be retaken, and a new more perfect remedy given. This new remedy should regularize the vital force, remove the remedial symptoms, and ameliorate the natural symptoms.
"If it was the wrong remedy and not a close simillimum would it do anything at all? This may be true with acutes, but I tend to think that a reasonably carefully chosen remedy (even if it is wrong) will affect the case on some level."
That depends on the individual. Some sensitive individuals will act like "provers" and produce many symptoms from any remedy they take. When the dose is given in a proper small amount in a conservative potency a wrong remedy often has no effect on the vital force. Since the remedy does not suit the susceptibility within the constitution, there is no specific hypersensitivity to the remedial potence. Of course, during the process of rejection there may be a slight shift in the vital force but it should not disrupt the constitutional reserves of vitality.
"About the reversal of symptoms. A suppression is a reversal of the Law of Cure. This is the easiest to see. Presumably antidote (restoring the original picture) comes in here?"
Yes, Hahnemann's direction of cure, or as it is more commonly known, Hering's laws, make this quite clear. If a suppression produces an acute crisis the medicinal and natural symptoms are combined in a grand totality and the most similar remedies given. The long term effects of suppression often require constitutional treatment and intercurrent remedies. This will restore the original symptom pattern and then remove the disease from the organism.
"A healing crisis can show new symptoms - my father developed a leg ulcer with treatment, but this soon became a discharging vent which has been producing pus for months now, leading to amelioration on all levels. The vent is now showing signs of healing up!"
Yes, a surrogate elimination can be set up by the vital force to drain morbid energy from the more important vital organs. One might suspect a active chronic miasm behind this phenomena. There is a chance that this ulcer was experienced sometime back in the family tree in one of your ancestors. I do not have the details of the case so I cannot comment further. One can tell which miasm is behind the ulcer by the nature of its discharge, the sensation associated with it, its visual appearance, and other concomitant symptoms. A hopeful prognosis can be attained when the central disturbance is healing while the one sided local complaint has developed. Nevertheless, it is important not to over medicate the individual as it can aggravate the local lesion if one is not careful. At the same time, Hahnemann also mentions increasing the amounts of medicinal solution when a local lesion lags too far behind the healing process of the general constitution. Very careful adjustments of the medicinal solution can make a big difference in such situations. This a part of the "finer arts" which Hahnemann taught to his colleagues in Paris.
All of this information can be found in The Organon and Hahnemann's Lesser Writings. Much of this information points in the opposite direction to the theory that the remedy effect disappears as soon as the remedy is ingested. The primary action of a remedy acts for a longer or shorter time depending on the nature of the dose and the internal state of the individual under treatment. There is a transition period where there is an interchange between the primary action of the remedial potency and the secondary action of the vital force. It is the interchange between the remedial powers and the life force that produces the signs of similar and dis-similar aggravations as well as accessory symptoms. When the size of the dose, the potency, and number of administrations, are in perfect harmony, the secondary action of the vital force removes the remedial affects in an appropriate period of time. This is not always all at once nor immediate. It may happen in stages as the healing process reverses the time-line of the disease toward a new state of health.
I hope I haven't raised more question than I have answered. Maybe I have. After all, the question is sometimes more important than the answer.