When the old “Chronics” begin to come in to see the New Doctor- “old rounders” upon whom the contents of the drug shops and the medicine cases of his tincture and low potency competitors have been exhausted in vain- “an’ he be wise” he will get out his little high potency case and prescribe from that. The result will surprise them, if it does not surprise him. It should not surprise him because he has been told before hand.
*The seat, character, and intensity of the disease has some bearing upon the question of the dose. Certain malignant and rapidly fatal diseases, like cholera, may require material doses or low potencies of the indicated drug. Hahnemann’s famous prescription of Camphor in drop doses of the strong tincture, given every five or ten minutes, with which so many thousands of lives have been saved, is and illustration. Later, after reaction has been established and other remedies, corresponding to the symptoms of later stages of the disease come into view, the higher potencies are required.
Generally speaking, *diseases characterized by diminished vital action require the lower potencies; while diseases characterized by increased vital action respond better to high potencies; but this again is modified by the temperament and constitution of the patient. Uncomplicated, typical syphilis, in its primary stage, the chancre still being existent may be cured speedily by Mercury in medium or high potencies, if the patient is of the nervous or sanguine temperament, and especially if he has not already received treatment. If he is of the sluggish type, however, mercury in the second or third trituration will probably be required.
If the patient presents himself later, having already received the conventional large doses of mercury and potash until the characteristic dynamic and pathogenetic symptoms of those drugs have been produced, low potencies will be of no avail. Either susceptibility has been exhausted, or a drug idiosyncrasy has been developed. The drugs must be antidoted and further treatment carried on by higher potencies. These remarks apply not only to mercury and syphilis but to practically all other diseases and drugs. It is not to be inferred that mercury is the only remedy for syphilis for in syphilis, as in all other diseases, we must individualize both case and remedy, if we expect to cure our patients.
What has been said of the use of higher potencies in cholera after reaction has been established by camphor tincture, is applicable in many other diseases of malignant character and rapid progress. In the beginning, when torpor or collapse indicate the dangerously low vitality and deficient reaction, a few doses of a low potency may be required until reaction comes about, after which the potency should be changed to a higher one if it is necessary to repeat the remedy.
The question is entirely one of susceptibility. The higher the susceptibility, the higher the potency. We must learn how to judge the degree of susceptibility if we would be successful as homoeopathic prescribers; and this applies not only to the normal susceptibility of the patient as evidenced by his constitution, temperament, etc., but to the varying degrees of his susceptibility as modified by the character and stages of his disease and by previous treatment. At one stage he may need a low potency, as already pointed out, and at another a high potency. the man who confines himself to the use of a single potency, or two or three potencies, by the low or high is not availing himself of all the measure of his art and will frequently fail to cure.
Attempts have been made to lay down rules governing the dose based upon a pathological classification of diseases; as, for example that the lower preparations should be used in chronic disease with tendency to disorganization of tissues and in acute diseases; or that the high potencies should be used in purely functional and nervous affections; but these classification are not reliable. They only serve to confuse the mind of the student and distract his attention from the main point, *which is to determine the degree of susceptibility of the particular patient at a given time.
Thus the whole matter of the dose, like the selection of the remedy, resolves itself into *a problem of individualization, which, as a principle, govern all the practical operation of homoeopathy. Looking at this subject broadly and having the highest degree of success in view, it is seen that it is as necessary to individualize the dose as it is the remedy, and that the whole scale of potencies must be open to the prescriber.
Occasionally a case will be met which is not at all susceptible to the indicated remedy. In such cases the temporary insensibility to medicine may be traced to the previous abuse of medicine, or to an exciting regimen. If time and the exigencies of the case permit, it is sometimes best to cease all medication for a few days and carefully regulate the diet and regimen. Then medication may be resumed using according to the temperament and constitution of the patient, either a low or a medium potency.
Hahnemann has recommended in such cases, the administration of Opium, is one of he lowest potencies, every eight or twelve hours until some signs of reaction are perceptible. By this means, he says the susceptibility is increased and new symptoms of the disease are brought to light. Carbo veg., Laurocerasus, Sulphur and Thuja are other remedies suited to such conditions. They sometimes serve to arouse the organism to reaction so that indicated remedies will act.
Remedies used in this way are known as “Intercurrents.” The nosodes, Psorinum, Syphilinum, Medorrhinum, Tuberculinum, are also to be remembered in this condition, in cases where the latent diseases represented by these medicines are present, as shown by the existent symptoms or by the history and previous symptoms of the case. A single dose of the appropriate nosode in a moderately high potency, will sometimes clear up a case by bringing symptoms into view which will make it possible to select the remedy required to carry on the case successfully. Such use or remedies must be based upon a careful examination and study of the history of the case and not merely upon empirical assumptions. Here, as elsewhere, individualization and the law of similia must guide.
Repetition of Doses.- It remains to speak of one more important matter connected with the general subject of Homoeopathic Posology- the repetition of the dose. The management of the remedy in regard to potency and dosage is almost as important as the selection of remedy itself. The selection of the remedy can hardly be said to be finished until potency and dosage have been decided upon. These three factors, remedy. potency and and dosage, are necessarily involved in the operation of prescribing. Not one of them is a matter of indifference and not one of them is a matter of indifference and not one of them can be disregarded.
The first question which confronts us is whether to give one dose or repeated doses. The second question is, if we give one dose when shall we repeat it? Third, if we give repeated doses, how often shall we repeat the doses and when shall we stop dosing?
Many expert prescribers begin the treatment of practically all cases by giving a single dose of the indicated remedy and awaiting reaction. This is an almost ideal method- for expert prescribers. Of course we all expect to become expert prescribers and will therefore accept that as our ideal!
Hahnemann’s usual teaching, the outcome of his long and rich experience, was to give a single dose and await its full action. The wisdom of this teaching has been amply confirmed since his day by many of his followers. The duration of action of a remedy *which acts (and no other counts) varies, of course, with the nature and rate or progress of the disease. In a disease of such violence and rapid tendency toward death as cholera, for example, the action of the indicated remedy might be exhausted in five or ten minutes and another dose be required at the end of that time. In a slowly progressing chronic disease, like tuberculosis, the action of a dose of a curative remedy might continue for two or three months. Between these two extremes are all degrees of variation.
The only rule which can be laid down with safety is to *repeat the dose only when improvement ceases. To allow a dose, or a remedy, to act as long as the improvement produced by it is sustained, is good practice; but to attempt to fix arbitrary limits to the action of medicine, as some have done, is contrary to experience.
Young practitioners and many old ones too, for that matter give too many doses, repeat too frequently change remedies too often. They give no time for reaction. They get doubtful, or hurried, or careless and presently they get “rattled” if the case is serious. Then it is ” all up with them, ‘ until or unless they come to their senses and correct their mistakes. Sometimes such mistakes cannot be corrected and a patient pays the penalty, with his life. It pays to be careful and “go slow” in the beginning; then there will not be so many mistakes to correct.
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.