be borne, especially in those cases where in some parts the irritability is abnormally increased, in others abnormal torpidity is present. In those cases we sometimes find that neither the high nor the low potencies do any good. In other cases of hysteria we sometimes observe the best effects from the high dilutions. Where there is great irritability of the cerebro- spinal system, there is often little susceptibility to medicinal influences, and, on the contrary, a high degree of susceptibility often co-exists with great torpor and even partial paralysis of the nervous system. Disturbances of the mental state of a chronic character often demand the utmost caution in the choice of the dose. Often the smallest dose suffices to restore the lost balance of harmony of the most chronic description, in other cases large and repeated doses are required.
Diseases of the mucous membranes of the alimentary canal, of the uropoietic and sexual organs, and of the respiratory passages, may be treated at once with the medium dilutions, and the lower dilutions may be had recourse to where there is great atony and torpor, especially if this has lasted long.
Neuralgias and spasmodic affections sometimes requite high, sometimes low dilutions.
Syphilis and its various developments demand the lower dilutions and stronger doses of the appropriate medicine; but the most inveterate cases never require the mercurials in the crude state.
Chronic gout demands great circumspection in the selection of the dose; the smallest doses often cause intolerable aggravations.
Chlorosis requires iron in large and repeated doses, but other medicines in the highest dilutions.
The medicinal dyscrasias caused by the abuse of such medicines as mercury and iodine require a cautious administration of their antidotes, but the cinchona disease and the lead-poisoning require larger doses of their antidotes.
The other determining circumstances in the selection of the dose detailed by Trinks I shall only briefly enumerate; they are–
3. The individuality of the patient.
4. The constitution.
5.The sex. The female is most susceptible, and therefore requires the smallest doses.
6. The temperament. The melancholic, sanguine, and choleric temperaments display the greatest susceptibility, the lymphatic the least.
7. The manner of life of the patient.
8. His idiosyncrasies.
9. The epidemic and endemic influences.
10.The influences of climate. The inhabitants of warm climates seem to possess a greater susceptibility for medicinal influences than those of more temperate and colder climates.
Dr. Trinks has many other very valuable directions and, maxims respecting the choice of the doe, which are well worth a careful study, but which time would fail me to detail in this lecture. We find from the Materia Medica which he published conjointly with Dr. Noack and Muller, that practically he is an adherent of the lower dilutions and triturations, and that he often prescribes the pure medicine. He is of opinion that many diseases are curable by stronger doses, whereas the smaller and smallest doses often merely irritate without producing any curative reaction.
Dr.Schron (Hauptsatze, p.63.) was one of the first who combated Hahnemann’s views on the subject of posology. He is, however, no bigoted defender of the more massive doses, on the contrary, he relates a case where spongia 6 caused an extraordinary aggravation, whilst spongia 45 diminished the symptoms, in a remarkable degree. He says he acknowledges the undeniable efficacy of such small doses, and seeks for an explanation of this efficacy in the delicate power of reaction of the organism, and not in any dynamization or increase or power in the medicinal preparations; the smaller and smallest doses are not, he says, to be regarded as essential to homoeopathy, since the properly chosen medicine will display its curative powers in the larger doses also. What to give? is the first question to be determined. How to give it? is the second and secondary consideration; and yet, notwithstanding that this is invariably the distinct declaration of all the advocates of the lower dilutions, their unthinking opponents, the partisans of the exclusive treatment with globules of the highest potencies, allege that the quantity prescribed by their opponents is meant to make up defective quantity, in other words, that the large dose is intended to be a substitute for an imperfect and erroneous selection of the drug; than which nothing can be more unfounded. It would perhaps be nearer the truth to assert that the high dilutionists are much more intent on giving a medicine in a high dilution than in attending to all the circumstances connected with the disease that could determine the choice of the remedy. In another place, (Naturheilprocesse., ii.200.) Dr. Schron says that many observations have shown that the more massive doses have produced the desired effect, where the very small ones were of no avail. If, he continues, we take into consideration the face that homoeopathic aggravations occur very rarely, that what have been termed medicinal aggravations are generally to be ascribed to the natural course of the disease, and that an occasional aggravation is not to be avoided though we use the smallest doses, it is not easy to see why we should waste precious time by the administration of the smallest doses, which sometimes have no effect whatever. We cannot, however, he goes on to say, deny that there are certain cases, especially in very irritable patients, or diseases of a very excited character, where we may with the greatest advantage employ the high dilutions, and, in fact, where we cannot dispense with them; but in the generality of cases it will not be necessary to go beyond the 3rd or 6th dilution, whilst there are many medicines which can be advantageously employed in the pure tincture or 1st attenuation. In spite of giving such doses, he asserts he has never witnessed any so-called homoeopathic aggravations. He ridicules (Hyg., xxi.1.) the absurdity of the high potencies of Jenichen, and will not waste time by testing them at the sick-bed.
Dr.Elwert (Allg. h. Ztg., ix.) of Hanover early wrote an article to prove that the dilutions from 1 to 8 given in drops, were the most suitable doses as a rule. He regards the stronger doses as much more certain than the more highly diluted preparations; they cure, he says, without aggravating the disease, and they also cure in those cases where from the patients inattention to dietetic rules, the higher attenuations would have no chance. He confesses that good results are often obtained by means of the smallest doses, but not superior to those attainable by the larger ones. But as he has become convinced by extensive experience that in many cases the higher dilutions may be given without the slightest effect, whereas in the very same cases the lower dilutions produce the best effect, he now almost invariably gives the lower numbers only, He says that primary medicinal actions are often observed under the use of the dilution from 1 to 5, but that these do not interrupt the cure in the least. To children in the first years of life he generally gives globules; in chronic diseases he is not less successful now that he uses the lower dilutions, than he used to be in those days when he only employed the higher preparations from 12 to 30. In a book that he published in 1844 Die Hom. und Allop. auf der Wage der Praxis. he gives us a long array of cases, in which we find he gives almost always the stronger and strongest doses.
The philosophically minded but somewhat fantastic Dr. Helbig (Hyg., vii.27) of Dresden says that it is absurd to contend exclusively either for the high or low dilutions; admitting the occasional efficacy of homoeopathic medicines when given in the very highest dilutions, he says that there are cases where the homoeopathic medicine requires to be administered in even larger doses than what are usually employed in ordinary practice. He cites the case of inveterate habits of intoxication, for the cure of which he has often found it necessary to give a whole ounce of sulphuric acid. In another work (Macht der Aehnlichkeit, 81) which you will find reviewed in the first volume of the British Journal of Homoeopathy, Helbig speaks still more decidedly on this point. By smallest dose he understands the 30th dilution, and he alleges that he has found arsenicum, belladonna, aconite, nux vomica, and other medicines still possessing power in these exalted preparations, but he says that the general or exclusive employment of such high dilutions is “a stupidity; he has almost entirely abandoned them, because in so many cases they are utterly destitute of power, where the lower dilutions and the pure tincture still act most favourably, and because the lower dilutions are more easily prepared, and we can be more certain of their genuineness. All rules, he asserts, that would make the dose dependent on the age, sex, temperament, etc., he hold to be mere ex cathedra dogmatizing.
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.