Homeopathic Posology

The selection of the dose is as much an integral part of the process of making a homoeopathic prescription as the selection of the remedy, and often quite as important. A well selected remedy may fail utterly, or even do injury, because of wrong dosage. …

By posology (from the Greek, posos, how much) we mean the science or doctrine of *dosage.

Small doses and homoeopathy are commonly regarded as synonymous terms. If they who have such an idea of it are favorably inclined toward homoeopathy, it is as likely to be because they have heard that the medicines are “pleasant to take” as for any other reason. While such an impression, taken with what it involves, is not altogether undesirable, it is to be regretted that a broader basis of judgment has not been furnished by those whose duty it is to instruct the public in the principles of homoeopathy. Had this been done such a juvenile conception would not exist, and homoeopathy would be more widely appreciated.

It is not to be denied that the subject of the dose in homoeopathy is a very important one. The three essential elements of the system are the *principle, the *remedy and the *dose; and the three are of equal importance. Posology, and the related subject of Potentiation were the subjects of so much misunderstanding, discussion and controversy in the early days of homoeopathy that the profession, after being divided into two opposing camps, grew tired of the subject. It came to be regarded as a kind of “Gordian Knot,” to be cut by each individual as best he could with the instrument at his disposal.

Hahnemann himself at one time, almost in despair of ever being able to bring his followers to an agreement on the subject, cut the knot by proposing to treat all cases with the thirtieth potency. Following this suggestions others tacitly adopted a dosage confined to one, or a very limited range of potencies. The materialistically minded restricted themselves to the crude tinctures and triturations, or the very low dilutions, ranging from 1x to 6x. Others ranged from the third to the thirtieth potencies, while another small class of metaphysical tendency used only the very high potencies, ranging from the two hundredth to the millionth, each according to his personal predilection.

Such a state of affairs is unfortunate. Assuming that there is a difference in the action of the various doses of medicines, and that a series of potencies or preparations of the different medicines has been available for use; it follows that the entire series should be open to every practitioner, and that each man should be competent, willing and ready to use any potency or preparation of the remedy indicated in a given case, without prejudice. If he confines himself to one or two potencies, be they low, medium, or high, he is limiting his own usefulness and depriving his patient of valuable means of relief and cure.

Under homoeopathic principles any potency may be required in any case. It is as unreasonable to expect to cure all cases with any two or three potencies as it is to expect to cure all cases with any two or three remedies. In either case, those who follow such a course are governed more by the love of ease and their prejudices than they are by their desire for efficiency.

The selection of the dose is as much an integral part of the process of making a homoeopathic prescription as the selection of the remedy, and often quite as important. A well selected remedy may fail utterly, or even do injury, because of wrong dosage. Does as well as remedy must be adjusted to the patient’s need.

The homoeopathic doctrine of dosage, like the law of cure, was based upon the discovery of the *opposite action of large and small doses of medicine. It is another application in medicine of the Law of Mutual Action – the third Newtonian law of motion “Action and Reaction are Equal and Opposite.” Every one at all acquainted with the action of drugs knows, for example, that Ipecac in large doses cause nausea and vomiting and in small doses, under certain conditions, will cure the same; that Opium in large doses will cause a deep sleep or narcosis, and in small doses, under certain conditions, will cure the same.

Closely allied to this is the so-called primary and secondary action of drugs, in which we see many drugs, in the first or primary stage of their action producing one group of symptoms, and in the second stage a directly opposite set of phenomena; as when the deep sleep of the primary action of Opium is followed by a much longer lasting wakefulness; or where the diarrhoea induced by a cathartic is followed by a longer lasting constipation. This applies, of course, only to drugs given in tangible form and considerable quantities, in what are called “physiological doses.”

Although the physiological antagonism between large and small doses is an illustration of the homoeopathic law of posology, the use of drugs in “physiological doses” has nothing to do with their homoeopathic use, because *homoeopathic remedies are never used in *”physiological doses.” This statement is true, even in those cases where the low reacting power of the patient sometimes requires *material doses of the homoeopathic remedy. It would be more accurate to say that homoeopathic medicines are never used for *their “physiological effect.”

It is necessary to a clear understanding of the subject that a distinction be made between three terms, physiological, therapeutic, and pathogenetic, used by two schools of medicine express the nature of the action of the drugs. There is a demoralizing tendency even in the homoeopathic school to use these terms without discrimination.

The word “physiological” as currently used in medicine in relation to drug action and dosage is misleading and inaccurate. The word has a reassuring sound, pleasantly suggestive of something normal and healthy. Its use tends to obscure, or keep in the background, the fact that the kind of drug action so designated is essentially a toxic action and therefore really painful and injurious.

*The “physiological action” of a drug is not its therapeutic or curative action. It is exactly the opposite of a curative action, and is never employed in homoeopathic practice for therapeutic purposes. The use of the word “physiological: in connection with drug action and drug dosage tends to mislead the unwary and justify the use of measures which would otherwise be regarded as illegitimate. In one word, is it a euphemism. Inasmuch as the action of the “physiological” dose and the purpose for which it is given is avowedly to *produce drug symptoms, in a direct and positive manner, that fact should be clearly expressed in the name, in order that there may be no misunderstanding.

The homoeopathic school has recognized the wisdom and justice of taking this position, and has compiled with the requirements of scientific accuracy in nomenclature by the adoption and use of the word, “pathogenetic” (Gr., *pathos, suffering and *genesis, origin, “producing suffering”) as properly describing the character of such drug action. The “suffering” of the organism produced by the drug is expressed in symptoms, which are the language of disease. In homoeopathic parlance. therefore these are termed “pathogenetic symptoms,” a term which is preferable because it is accurate and truthful.

*Therapeutic means curative, healing, alleviating. A pathogenetic action is never curative. The action of a drug may be pathogenetic (toxic), or therapeutic (curative), depending upon the size and strength of the dose, the susceptibility of the patient and the principle upon which it is given.

In the homoeopathic treatment of disease a drug is never given for its pathogenetic action. Pathogenetic doses may be given, however, for experimental purposes to a healthy person, in making what are called provings. In treating disease homoeopathically the objects is not to *produce symptoms but to *remove them. By means of the similar remedy in the minimum dose it is possible to do this in a direct manner without producing symptoms.

It is not necessary to resort to the indirect, antipathic or allopathic method of producing drug symptoms in part to remove a disease of the same, or any other part, and therefore it is not necessary to use “physiological” or pathogenetic doses. The homoeopathic cure is obtained without suffering, without the production of any drug symptoms, in a positive and direct manner, by the action of any drug symptoms, in a positive and direct manner, by the action of sub-physiological or sub-pathogenetic doses; in other words, by the *minimum dose, which is a dose so small that it is not capable of producing symptoms when used therapeutically. Homoeopathy requires that the therapeutic dose must be capable only of producing a slight temporary aggravation or intensification of *already existing symptoms, never of producing new symptoms.

Only the similar remedy, in the smallest possible dose, is capable of bringing about this highly desirable result. By this means the patient’s strength and vitality are conserved his suffering quickly reduced to the lowest possible degree and a true cure brought about, if the case has not passed beyond the curative stage.It is not to be understood that infinitesimal does are not capable of producing symptoms in healthy susceptible persons; for that is not true. Infinitesimal doses will produce symptoms in certain highly sensitive person, and many of our most valuable provings have been made with more or less highly potentiated medicines. Indeed, no remedy can be regarded as having been thoroughly proven until it has been proven in the potencies as well as in crude form.

Stuart Close
Stuart M. Close (1860-1929)
Dr. Close was born November 24, 1860 and came to study homeopathy after the death of his father in 1879. His mother remarried a homoeopathic physician who turned Close's interests from law to medicine.

His stepfather helped him study the Organon and he attended medical school in California for two years. Finishing his studies at New York Homeopathic College he graduated in 1885. Completing his homeopathic education. Close preceptored with B. Fincke and P. P. Wells.

Setting up practice in Brooklyn, Dr. Close went on to found the Brooklyn Homoeopathic Union in 1897. This group devoted itself to the study of pure Hahnemannian homeopathy.

In 1905 Dr. Close was elected president of the International Hahnemannian Association. He was also the editor of the Department of Homeopathic Philosophy for the Homeopathic Recorder. Dr. Close taught homeopathic philosophy at New York Homeopathic Medical College from 1909-1913.

Dr. Close's lectures at New York Homeopathic were first published in the Homeopathic Recorder and later formed the basis for his masterpiece on homeopathic philosophy, The Genius of Homeopathy.

Dr. Close passed away on June 26, 1929 after a full and productive career in homeopathy.