He makes the size of the dose dependent on the condition in which the medicinal substance is; he admits that the process of trituration is effectual in awakening the latent powers of some substances, such, for instance, as sulphur; so far he acknowledges the dynamization-theory. Thus, oddly enough, we find, Dr., Schmid the advocate of the most material and massive doses, holding, as I have shown you in a former lecture, the most ultra dynamical notions respecting the morbid and curative processes, and adopting this other dynamical notion of Hahnemann’s respecting the dynamization of drugs by the pharmaceutic processes to which they are subjected. To be sure, his belief in dynamization does not go very far, for he considers that it attains its utmost limit in the 1st trituration. The doses recommended and administered by Schmid are certainly not large compared with those given by the allopathic school, consisting only of drops and fractions of grains of the medicament. He seldom gives a medicine in the diluted form; but veratrum he makes a special exception to this rule, and he states that he never gives it in the pure tincture, as he has often seen severe aggravations ensue from its use in this form. Arsenic is another remedy that he gives in comparatively small doses, usually about the 2nd trituration. He enters into a long defence of his doses, and argues at great length in favour of their being still within the limits of homoeopathy; but arguments in proof of this are only necessary for those who believe that homoeopathy is identical with infinitesimal doses. The exclusive employment of massive doses, as practiced, by Dr. Schmid, is equally absurd with Dr. Gross’s exclusive employment of high dilutions, and by adhering to either extreme the advantages obtainable by a variety of dose are lost.
Dr. Watzke of Vienna — the late learned editor of the Austrian Homoeopathic Journal, which effected more for homoeopathy in its brief career of four years than any other homoeopathic journal in ten — has furnished us (Hom. Bekehrungsepist., i.81.) with the results of his experience and reflections on the subject of the dose question. He says the proper selection of the remedy is the first thing in point of importance; to this the size of the dose is quite subordinate, but it is by no means a matter of indifference. He says that he himself has gone through both extremes of our homoeopathic posology. At one time he gave nothing but 30th dilutions, at another nothing but the 3rd, 2nd, 1st attenuations or pure tinctures; he hovered, as he expresses it, at first in the ether of decillionths, and then descended into the lowest depths of the material substance. From these two extremes he gradually lapsed into a happy medium, usually the 3rd to the 6th attenuation, prepared according to the decimal scale, without, however, altogether rejecting the higher and lower preparations. Supposing that the smaller doses would always effect all that the larger ones can do, still he prefers the latter; 1st, because it is of importance to divest our doctrines and practice as much as possible of the appearance of the paradoxical, the marvellous, and the incredible; 2nd, because he does not wish to pay dearer for what he may obtain cheaper; 3rd, because he can be more certain of the purity and genuineness of the preparations in the larger doses. He lays down as maxims -1, that the size of the dose must depends on the receptivity and on the sensitiveness of the patient, and of the affected organ or system, on the kind and magnitude, the course and the stage of the disease, as also on the character of the medicine; 2, that the dose must be the larger, the more rare, difficult, and tedious the cure of the disease is by nature alone, and vice versa. He gives examples of the beneficial action of the smallest doses, viz., the 30th dilution. On a subsequent occasion (Oest. Ztsch., i, 3, 236.) he details examples of the power of larger doses in an epidemy of measles. The doses were aconitum, in the 1st and 3rd, and belladonna and pulsatilla in the 3rd dilutions. In another place (Ibid., ii.1,133.) he gives us examples of the treatment of chronic diseases also with the larger doses. One dose consisted of a whole drop of oil of sabina, which caused no medicinal aggravation and indeed Watzke talks very little about such aggravations; and in a whole array of cases treated by the larger doses there is no instance of such aggravations having ensued. He inveighs against the high potencies of Jenichen, and states that he tried them repeatedly and carefully, without the slightest benefit. He does not, however, condemn the higher dilutions of the Hahnemannic scale; on the contrary, he believes there are some diseases for which they are indispensable, and he believes that by confining ourselves, as Schmid dose, to the massive doses we shall lose many advantages. In his proving of natrum muriaticum, he says, ” I regret to say I am forced to declare myself in favour of the higher attenuations.”
Dr.Trinks, so favourably known to homoeopathists by his valuable additions to the Materia Medica, as also by his recent complication of an abridged Materia Medica, handles the posological question with his usual ability, in the introduction to the last-named work. (Einleitung, p. xxxvi.) He says, that notwithstanding the vast quantity that has been written on the subject, and the incessant controversies the dose has given rise to in the homoeopathic camp, it cannot be said that a satisfactory solution of the problem has yet been arrived at. It is a question that a very extensive experience can alone decide, and it cannot determined, as hahnemann well remarked, by subtle reasoning or hair-splitting refinements of casuistry. In the present position of the question, the following, he says, seem to be a few of the maxims that experience, when honestly consulted, has determined: —
1. Acute diseases require the lower and middle attenuation.
2. Chronic diseases requite higher and often the highest attenuation, because they generally need for their cure such medicines as only attain their full development of power by means of repeated subdivision.
3.There are many exceptions to this — many chronic diseases requiring low dilutions, and even the mother tincture.
4. Many observations go to prove that he higher dilutions are of use in diseases, not only of a purely dynamic but also of a material or organic character.
5. Many medicines appear only to develop their full powers by long-continued trituration and succussion.
6. Many other medicines seem to possess their full powers in the original tincture or crude state, and all the subsequent processes, to which they are subjected seem but to diminish those powers.
The proper dose must be determined–
1.By the peculiar nature and essential character of the medicines. Their physiological provings throw all the light we possess upon their energy, intensity, extensity and duration of action. Among the medicines which, even in large doses, display great energy and intensity along with a short duration of action, are, aconitum, chamomilla, camphor, moschus, ignatia, ipecacuanha, hyoscyamus, coffea, stramonium, laurocerasus, sambucus, opium, etc. Those that have a less violent, but more intensive, penetrating, and longer-lasting action, are almost all the mineral medicines, the mineral acids, and not a few vegetable substances. The most energetic and intensively acting medicines and intensive medicines in the medium dilutions; the least energetic and intensive in the lowest dilutions and crude substance. The first class includes all our so-called heroic medicines; such are, belladonna, bryonia, arsenicum, calcarea, kali, lachesis, lycopodium, mercurius corrosivus, natrum muriaticum, phosphorus, sepia, silicea, sulphur, rhus, etc.
The second class, which should generally be used in the medium dilutions, included cannabis, china, euphrasia, coffea, arnica, asafoetida, agnus, bismuth, capsicum, chamomilla, chelidonium, crocus, dulcamara, digitalis, gratiola, hepar, ipecacuanha, laurocerasus, ledum, mezereum, phosphoric acid, nux moschata, oleander, opium, rheum, sabina, secale, senega, spigelia, squilla, tabacum, thuja, veratrum, etc.
The third class, which generally require to be used in the lower dilutions and crude substance, comprehends ferrum, verbascum, camphor, moschus, castoreum, viola odorata and tricolor, taraxacum, trifolium, chelidonium, etc.
The second determining circumstances is the nature and character of the disease to be cured. Diseases that display in all their phenomena great energy and intensity, rapidity of evolution, attack the most important organs, betray much malignancy, and threaten the integrity of the whole organism, or of certain parts of it, demand an energetic and rapid medicinal influence. To this category belong almost all the acute diseases, inflammations, gastric, bilious, catarrhal, rheumatic, typhus, and putrid fevers. Nervous fevers and nervous rheumatisms, on the contrary, demand the higher dilutions. Chronic diseases demand, as a rule, the higher dilutions, but there are exceptions to this, in the case of those diseases, namely where, along with inveteracy and long duration, there is torpor of the ganglionic system, as in the case of hypochondriac diseases, where the patient has led a dissipated life. In hysteria also the smaller doses can often not
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.