Fleischmann, at the same time, was giving the mother tincture or the lowest dilutions. His diagnosis was careless, his success neither rapid nor, except as compared with heroic allopathic treatment, very striking. His prescriptions were not accurate. He did not individualize his cases, but prescribed according to a coarse and rude generalization. On the subject of the potency, his opinions, I learned from himself, were immovably made up. I perceived that he had ceased to be capable of learning, although he still lived; that, in knowledge, as in stature, he had attained his growth; ossification was complete in his perceptive intellect no less than in his physical skeleton.
In Paris, Tessier was treating acute diseases in the hospital Ste. Marguerite with the sixth, twelfth and fifteenth dilutions. His success exceeded that of Fleischmann. It was inferior to that of Wurmb, but it was easy to perceive how inferior he was to that excellent physician in minute and comparative knowledge of the materia medica.
In Paris, Dr. Perry was prescribing at his dispensary the two hundredth potency, with but few exceptions, in all forms of disease. The reports indicated a very wonderful success, but, from the nature of a dispensary practice, this could not be made the subject of exact observation.
My conclusions from all these observations were favourable to the high potencies, so far as to admit their energetic action on acute as well as chronic diseases and their general superiority in the treatment of the latter; but I was not satisfied that they were so trustworthy, as a general rule, in the treatment of acute diseases as to be preferable to the lower potencies. I therefore began, in my own practice, with the use of the lower and medium dilutions (third to twelfth and fifteenth) in acute diseases. When very sure that my selection of the remedy was entirely correct and that the case would not suffer should my first prescription prove inert, I venture, d during the first few years of my practice, to give a high potency in acute diseases. I now look back on this period with wonder that the idea of a definite and direct relation between the curative power and the material quantity of a drug should have been so hard to eradicate from my mind.
Experience of the action of the higher potencies, on my own person, in very acute illness, first fully convinced me-perhaps, because in my own case I took the risk of trying the experiment more freely and fully than I had ever done in the case of others.
For the last five year (1 Written in 1863) I have used the high potencies (two hundredth of my own manufacture and of Lehrmann’s, indiscriminately) in all forms of disease that occur in a general practice. I am very sure that my practice has grown more successful every year. While I trust than an increasing knowledge of the Materia Medica may have contributed greatly to this result, I cannot be mistaken in the belief that much is also due to my more and more frequent use of the high potencies.
I cannot say that every prescription has done everything I expected or hoped from it. Nobody’s practice can be free from painful failures. In such cases, wherever I have been tolerably sure that my choice of remedy was correct, I have repeated the same remedy in a higher or lower potency as the case might be, and while I have collected from my practice many instances in which a high potency has acted promptly where a low had failed to act, I have noted only one case in which s high potency acted but inefficiently while a lower gave prompt and complete relief.
From my own experience, then, the presumption would lie in favor of the high potencies in both acute and chronic diseases.
A few instances will serve to illustrate what has been said. They are presented only as illustrations, by no means as the evidence on which my convictions rest.
A gentleman who had suffered many years from necrosis of the femur was subject to acute attacks of periostitis. The twelfth potency of Asafoetida was found to relieve his suffering, and repeated doses of it generally effects a cure within three of four days. After treating several attacks in this way, I gave him, at the commencement of a fresh attack, a dose of Asafoetida (200). The cure was effected in the space of six hours. A difference so remarkable was very obvious to the patient, who, learning from me the difference between this and my former prescriptions, requested to be treated always thereafter with the two hundredth. Here, whatever cavils may be raised about the diagnosis or other points, the fact remains incontestable, that attacks which required for their cure several days and repeated doses of Asafoetida (12), were cured in six hours by a single dose of the two hundredth. Could it be that repeated treatment of these attacks had modified their severity, and that the amelioration chanced to coincide, in point of time, with the change of potency? To satisfy myself on this point, I once reversed the experiment, and without my patient’s knowledge gave the twelfth instead of the two hundredth potency. The attack came on with its ancient severity and persistence, much to my patient’s disgust, who was abundantly satisfied with the high potency, but much ashamed of my want of confidence.
Even after I had become quite satisfied of the superiority of high potencies in most acute diseases, I yet hesitated to employ them in a malady so fearful and so rapid as croup. In this I still adhered to the low (the third) dilutions of Aconite, or Spongia, or Hepar, as the case might require, or to the watery (first centesimal) dilution of Bromium or Iodine, if these remedies were indicated. Notwithstanding I had actually witnessed most surprising success in Dr. von Boenninghausen’s practice with the two hundredth potencies in severe croup, I hesitated to use them. I argued to myself: “These low potencies have served me well. The majority use them. I do not know that the high are better, even if they be as good. The success with them may be exceptional. I dare not risk the loss of time which would accrue from an unsuccessful experiment with them”
Thus it turned out that I never used the high potencies until, three years ago, in the most severe case of membraneous croup I ever saw, the low potencies in which I had always trusted failed me utterly, and I knew not what else to do. A resort to the use of the two hundredth potencies of Aconite, Hepar sulphuris and Spongia saved my patient from this extremity of danger, and satisfied me that a trial of the high potencies in the outset of an attack of croup, instead of involving a risk of wasting time, does in truth obviate such a risk from the employment of the lower potencies. From this time on, in the treatment of croup, I have uniformly begun with the two hundredth potency of whatever remedy was indicated. My success has been more uniform and much more rapidly attained than ever before.
My first use of a high potency of Bromine was accidental. Called to prescribe for a several case of croup, in which that remedy was indicated, I found that the crude substance or a low dilution was not to be obtained. I had the two hundredth potency in my pocket-case. I gave it with a result equally happy, and much more speedy than I had ever before witnessed. This was altogether contrary to my preconceived notions concerning Bromine, and its summarily upset a very pretty chemical theory I had formed.
As already remarked, I have sometimes met with fact of a contrary significance. In a case of chronic asthma, of great severity, I have recently found Glonoine of the greatest service. I first prescribed the sixth potency, having no other at hand. When the action of this dose was exhausted I gave the two hundredth. The results was by no means satisfactory. The sixth again produced happy effects as before. Repeated experiments of this kind convinced me that in this instance the high potency did not act so favorably or so efficiently as the low. Whether this peculiarity should be accounted for by assuming an idiosyncrasy on the part of the patient, or a peculiarity of Glonoine which renders it incapable of high potentization, or whether the action of the Glonoine in this case will prove to have been only palliative, and therefore temporary, is a questions which can only be solved by wider experience than I possess in the use of various potencies of this new but valuable remedy. (1 The subsequent history of this case confirms the suspicion that the great relief afforded by Glonoine was palliative. After a few months the disease recurred with its original severity, and no form of Glonoine (nor of any other remedy that I tried) availed to give relief.)
But this fact that a low potency succeeded where a higher had failed, together with similar facts reported by other practitioners, must have a bearing upon general conclusions.
In conclusion, I think the following statements are warranted:
1. In prescribing, the first essential is the correct choice of the remedy. The second point-which is also, in many cases, though not always, essential- is the judicious choice of the potency.
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'.