Blog - Shilpa Bhouraskar

Remedy Response - Aggravations


When I first read Kent's 12 observations and Robert's Remedy Reactions as a student, I found them extremely confusing.
It wasn't before I was actually in practice that these observations started making sense.

Hence years later when I had my first class on helping students understand remedy response and secondary prescriptions, I simply wanted to provide them a protocol that was clear and practical. Through the years, I love that part of my lecture where they bring huge sheets of paper and together we create these flow charts as we work our way out of every clinical situation that they would encounter.

The aim is to provide them a good reference sheet that has clear guidelines to help them make decisions during the followups with reasons and action plans.

Today I will introduce one critical part of that chart ie the Aggravations In Our Clinics.

Here is a summary of the three types of aggravations with their clinical presentation, reasoning, prognosis and action plan.

Homoepathic Aggravation -

Type of Response

There is a marked short term or prolonged aggravation (anywhere from a few hours to a few weeks) of presenting complaints soon after the dose. This is followed by a long lasting amelioration and gradual unfolding of the disease process in reverse order of appearance of symptoms in due course. Some older symptoms belonging to other systems may reappear and resolve as a part of this process.

Reasoning and Prognosis

This response indicates that the remedy and potency are correct. The duration of aggravation depends on the depth of pathology, susceptibility and potency.


You may need to Wait and Watch until the unfolding happens. Whenever the unfolding slows down, the remedy is generally repeated in same or gradually increasing potencies to get the best out of the remedy. Although one remedy can complete the process, in most cases complementary remedies may be required if the original remedy is no longer indicated.

Medicinal Aggravation -

Types of Response

Here new annoying symptoms may appear that belong to the remedy picture shortly after every dose.

Reasoning and Prognosis

This generally means that the patient has expressed an idiocyncratic sensitivity to the medicine. The other reasons may be that the potency may be too high or the doses are repeated too frequently than necessary.


Again you may need to Wait and Watch until the effect of the remedy subsides.
If the remedy is correct, then introduce the same medicine in the future in a lower potency with lesser repetition.

Other ways to reduce the aggravations in patients with high susceptibility is to introduce a double dilution method, reducing the number of succussions, use other modes of administration ( eg Olfaction) or switch to an LM scale.

If the remedy is wrong, then retake the case and start with lower potencies.

Disease Aggravation

Types of Response

Here patients continues to express new symptoms that belong to the disease process ie. There is a gradual worsening of the patient at all levels due to the natural progression of the disease process.
(The main difference between a hormeopathic and disease aggravation is that the homoeopathic aggravation is associated with general mental and physical wellbeing even when the local symptoms are intensified.
In a disease aggravation the patient is worse and there is a decline in his state at general and local level.)

Reasoning and Prognosis

This aggracation indicates that remedy selected is completely off the track and does not register at all. So the disease continues to run its course.


The case is retaken as soon as possible and a suitable well indicated remedy is prescribed on the presenting complaints. It is also important to understand and work within the scope of homeopathy here and have a referral plan if you cannot find the right remedy or the case is beyond the scope of a homeopathic treatment.

I now invite you to watch a video where I will discuss three clinical case examples of these aggravations from my practice.

Hope this has offered you some perspective on how these patients present and what questions you can ask to clarify and choose further action.

I would love if you could share your experiences and your own protocol as well.

Warmest Regards


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Thank you.
I find use of serial dilutions useful at times

I have that chart from Homeopathy 4 still stuck up on my wall at home Shilpa & refer to it when I get a bit stuck with "What to do?". I must be a visual kind of person cause I find the structure of the chart very reassuring & it really helps clarify what kind of remedy reaction I'm dealing with & what to do next!

Glad it is still on your wall Lee!!
And I am sure with your own enriching experiences in the clinic now, the same chart will continue to provide a lot more depth than it did as a student.


unfortunately table to download the recent information. Thank you for a great blog. Would like to ask you how to contact you private by mail. I am unable to get in touch with you throughout phone or visit as I am from Denmark.

Thank you

your blog is not easily readable.

Sanjiban,Dhaka,Bangladesh. Sept.16,2012.
Thank you Shilpa.
I am very glad & enrich to know by sharing your discussion through your video & great blog.

Thanks Sanjiban.
Glad to connect with you.


Dr.Shilpa this blog is extremely helpful in distinguishing the clinical aggravations that we generally come across. Its very practical and advantageous as it is with case examples from your experience.

A great job dear Shilpa

Thanks Surekha :)

I've got a great aggravation story which happened to me way before I became a Homoeopath:


This story goes back a few decades - when I had my first daughter and was playing dedicated earth-mother. This meant breast feeding day, night, and any time in between...being the very best mother I could be. And - whoops - forgetting to look after myself properly.

So there I was, somewhat bedraggled and run down, with straggly hair, calling in at my aunt's place, baby on my back, like a good little earth mother should.

Her homoeopath was just making a home visit.

(This was in Germany in the 70s, BTW, where people understand and respect homoeopathy. And medical doctors and homoeopaths - who are often the same person - still made home visits).

"Can you prescribe something so I don't get so tired with all this feeding the baby? And for my hair...." I asked him.

What I did not know was, that he was not the best (actually I would say USELESS!) at listening properly. Homoeopaths, the wonderful listeners?? Hah! He did not even bother actually trying to hear what I was saying. He just assumed I was complaining about not having enough milk...

Off I trundled to fill the script. In went the little white pills that were going to give me lots of energy and make my hair all lush and shiny.

Well, that is not what happened.

Remember what it was like when you've just had a baby and your milk comes in? It's called 'engorgement', but it's more like being landed with built-in bazookas. (Just be grateful I have not got any photos to post...)

Suffice it to say, I turned into a fountain of nourishment, who found herself walking down the street and actually squirting through the fabric of my top!

"What the heck have you given me??!" I asked him.

"Did it not work? Haven't you got more milk now?" he replied.

What a twerp.

But also: What a neat way to disprove the theory that "It's just Placebo", as I had no idea it was designed to do that!

Oh Eva:)
Thanks for sharing this.
You express your story so beautifully