We shall thus, if we continue our experiments a suitable length of time, obtain peripheral symptoms; and these small doses will not have so influence the system as to prevent out obtaining by subsequent larger doses the other varieties of effects. Inasmuch as, in the nature of things, the peripheral symptoms, representing, as they do, a cachexy, cannot be speedily produced, at considerable space of time should be devoted to our first experiments with small doses.
Finally, after an interval of non medication, larger doses should be taken until we have exhausted the whole dynamic action of the drug, and even obtained a fair picture of its chemical and revolutionary action, although this may in a measure be gained from records of poisoning.
But, in this relation, what are the “small does” with which we are to begin our proving? The term is comparative. Are they drop doses of the tinctures, or are they high dilutions? They are such doses as have, in the proving of some previous drug, shown themselves capable of producing unequivocal symptoms. We must search the records of the provings, therefore, for our standard initial dose. What this is at present we shall soon see: as our experience increases, this standard may from time to time be altered.
It is evident that the method of conducting a proving is a matter of great importance, and should not be left to caprice of accident. The completeness of our Materia Medica, and consequently our ability to cure disease, depend upon our selection of a happy method. This important subject has received the attention of the American Institute of Homoeopathy, to which the Central Bureau of Materia Medica has presented a report on Drug-Provings.
The majority of the Bureau repeat Hahnemanns directions for proving as contained in the Organon; and as regards the dose, they recommend “the prover who makes use of potencies” to make a trial of the high potencies first and afterwards, if necessary, to take the lower dilutions and triturations, or the crude substance or tincture, if satisfactory are not obtained with the attenuations.
This recommendation accords with our deductions and corresponds with the spirit of Hahnemanns direction. Hahnemanns instructions differed at different periods of his life. One essential idea, however, pervades them all-a small dose is to be taken at first, and the dose is to be increased until unequivocal symptoms manifest themselves. In the last edition of the Organon he adds, as result of his extensive observation, that “The most recent experience has taught me that medicinal substances, when taken in the crude state, do not for a long time display the full extent of their virtues, as they do when taken in higher developments.
Thus any one, even of medicines whose virtues are considered weakest, is not found to be most advantageously studies if four to six globules of the thirtieth dilution be taken every morning for several days.” In this statement Hahnemann does not contradict the spirit of his former directions for he adds, :should the effects of such a dose be weak, it may be daily increased.” He further adds, “The more moderate the dose, the more are the primitive effects developed, which are the most important to be known.”
We see nothing in Hahnemanns writings which shows that he ever thought of restricting the dose in proving to the thirtieth dilution, as some have stated: he simply assures us that unless provings with so high a dilution were made, the prover would fail to get all the symptoms which the drug is capable of evolving.
(DR. DUNHAM proceeds to discuss work by Dr. Hempel and reprovings of drugs in Austria. They are very interesting but too long to reproduce. So we will merely give his summary and conclusions, which contain all that is really important).
In conclusion we may assume the following points to be established by induction and by direct experience. In order to obtain an exhaustive proving:.
1. We must prove the drug both in dilutions and in massive doses.
2. The proving should be commenced with dilutions; and high dilutions should be employed until satisfactory evidence is obtained that the prover is not susceptible to their action. We thus obtain one of the unknown quantities of our problem, viz. the measure of the susceptibility of the prover.
3. Where a keen susceptibility is found to exist, the greatest care must be exercised to avoid blunting or perverting it. With this view, repeated experiments should be made at long intervals, with high potencies, until no new varieties of symptoms are evoked. Then, after a long period of non-medication, the prover should take lower potencies and then small doses of the crude substance repeated at intervals, and finally after another long period of repose, large doses of crude substance. A thorough proving after this fashion may require years for its completion but it will have an advantage over most of our recent provings, in the fact that it will be thorough, and that it will be of permanent and certain use to the practitioner.
4. In proving with dilutions, as well as with massive doses, a long period of time should be occupied in testing each preparation, in order that the full effect may be seen in the production of dyscrasias, etc.
5. The greatest care should be exercised in verifying symptoms by repeated experiments, in order that “imaginary” symptoms on the one hand and chemical and mechanical symptoms on the other may be excluded. The fashion, which has become very prevalent of late, of including in the pathogenesis every sensation which occurs during the proving, without distinction or verification and which may be called the Pre-Raphaelite method of proving cannot be too strongly rebuked.
Dr. Dunham graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. His works include 'Lectures on Materia Medica' and 'Homoeopathy - Science of Therapeutics'.