Dr. Vehsemeyer (Jahrb. i.2) of Berlin is a staunch advocate of the lower dilutions; in every case, he says, they are preferable to the higher potencies. In typhus fever his doses are, of phosphorus the pure spirit; of carbo vegetabilis the 3rd trituration, by grains; of arsenicum the 2nd and 3rd attenuations.
Dr. Schuler alleges that all potencies are useful in special cases. As a result of his experience, he tells us that he has found that in patients who have a great longing for spirituous drinks the small doses of medicine, even when frequently repeated, have no effect. The preparations he usually employs are the dilutions from 6 to 12, but he also occasionally goes much lower, and employs the remedies in pure tincture or even in infusion.
Dr. Noack shows his preference for the lower numbers in his Materia Medica (Handbuch, vol. i. passim.) but at the same time he does not approve of those who confine themselves exclusively to these preparations. (Jahr. von. Vehsemeyer, i.1.) He says the size of the dose must be determined in great measure by the peculiar character of the organism and of the medicine.
Dr. Goullon (Arch, xx.2,) of Weimar acknowledges the power and efficacy of the higher dilutions, and relates numerous causes illustrative of their curative action; but he at the same time insists upon the necessity of giving larger doses occasionally, the size of the dose to be determined by the power of reaction of the organism and the quality of the medicine. Occasionally we find him giving comparatively strong doses — thus ferrum carbonicum in doses of one-twelfth of a grain; chlorine water in doses of five to six drops at once.
Dr. Lietzau Vehsemeyer’s (Jahrb., iv.1.) says that the employment of the very smallest doses was a mere caprice on the part of Hahnemann.
Some powerful substances, which are very inimical to the human body– as, for example, arsenic — appear to be capable of acting when very highly diluted; but, as regards most medicines, he thinks that the pure tincture is the most appropriate preparation, and the so-called homoeopathic aggravation is but very rarely met with from its use.
Dr. Schneider (Allg. h. Ztg., xxv. 282,) is opposed to the exclusive employment of the 30th dilution. “The phantom”, he says ” of homoeopathic aggravation is laid, and the belief in the mystic dynamization theory extinct.” Very poetically expressed, but like most poetry, not much truth in it.
The late lamented Dr. Wahle of Rome, that veteran apostle of homoeopathy, who while propagating its principles in Italy, did not omit to increase at the same time our Materia Medica by several valuable substances, was in former days an implicit follower of of Hahnemann’s doctrines. On the subject of the doses he speaks very plainly. (Ibid., xxvii.138). He says that for the last twelve years he has been true to his maxim to employ all the preparations from the undiluted tincture up to the 30th dilution; he has seldom occasion to resort to either extreme of this scale, his doses ranging betwixt the 3rd and the 18th dilutions. ” Since”, he says, ” I have adopted this plan I have met with extraordinary success in my practice.” In chronic diseases he generally goes from the smaller to the larger doses; he is not so fond of the reverse of this plan. If No.3 of vegetable substances and No.6 of triturated medicines do no good, the probability is that the selection of the remedy has been erroneous. The interposition of a higher dilution will often bring back the susceptibility for the larger doses. Wahle holds in great contempt the anxious counting of the globules to be given: drops even, he says, won’t kill. The choice of the remedy is the kernel, the size of the dose and its repetition the husk.
Elsewhere, (N. Archiv, iii. 1. 17), Dr. Wahle thought he increased very much the efficacy of the homoeopathic preparations by giving 1000 succussions to each dilution. Medicines so prepared he seems rarely to have given higher than the 3rd or 6th dilution.
Dr. Kampfer (Allg.h.Ztg., xxiv.9.) has written an elaborate article on the subject of the dose. He says the homoeopathic law refers only to the selection of the medicine, and throws no light on the quantity in which it ought to be given; still, granting we have selected the right remedy, the success of the treatment depends on the manner in which we employ it. The apparent paradox that medicinal aggravations are frequently observed from the use of small doses, whereas none occur from the employment of large doses, he seeks to explain by this maxim: that the same medicine in the same dose can, under different circumstances in the same disease, produce quite different, even opposite, effects, and in very different doses exactly the same effect. He testifies to the fact of the 30th dilution producing excellent effects, and he brings forward many cases in proof; indeed, he states that he has often cured cases with the smaller doses, after the larger ones had been tried in vain. He thus acknowledges himself in some degree an advocate for the higher dilutions; still he declares that it so much more frequently happens that such small doses of very high dilutions have no effect, or but a very feeble action, where larger doses of lower dilutions have a sure and powerful action without any consequent bad effect, that he feels himself compelled, along with most homoeopathic practitioners, to employ as a rule most medicines in the medium and lower dilutions, from 3 to 12, in portions of a drop or in whole drops. He gives cases to show the necessity for employing these low dilutions in some instances, and he believes that it is requisite on some occasions to give the medicines undiluted. The choice of the dose within the limits Kampfer employs, viz., from 3 to 12, is determined by the strength of the medicine, by the disease, and the peculiarity of the patient’s constitution. Many medicines, however, he gives usually in high dilutions, from the 12th to the 30th, such as silicea, causticum, phosphorus, nux vomica; others he only gives in lower attenuations, viz., the 2nd and 3rd; among these are ipecacuanha, china, stannum, hepar, etc. Among those he often gives undiluted he mentions ipecacuanha, china, ferrum, carbo, and valerian; the last he gives in the form of infusion, from fifteen to thirty grains to three or four ounces of water. On the other hand, he admits that cases may occur in which china, ipecacuanha, and the others should be given in globules of the 30th; and again, cases where sulphur, phosphorus, calcarea, etc., require to be administered in low dilutions or triturations by grains or drops. It is curious to observe that in opposition to the opinions I have before cited of Schuler and Helbig, Kampfer has generally remarked a great sensitiveness to homoeopathic medicines in dram-drinkers. In typhus he found the lower dilutions necessary, the middle and higher dilutions had absolutely no action, pure tinctures, infusions and decoctions of china, arnica, rhus, etc., had to be given. In this disease we find that the practice of many of the homoeopathists is to give pretty large doses; thus Dr. Hartmann of Leipzic (Allg.hom.Ztg., xi., xii.) gave to a typhus patient a decoction of one drachm of cinchona bark. I cannot say that I have found it necessary to resort to such massive doses of any medicine in this disease, and have certainly never seen an indication for the employment of china during the fever at all. Hartmann also gave quinine in grain-doses to an intermittent fever case, and sulphur he occasionally prescribed in portions of a trituration made with five grains of sulphur and one hundred grains of milk-sugar.
The learned and fantastic Dr. J. O. Muller (Oest. hom. Ztsch., i.3, 12.) of Vienna has written an essay in the Austrian Homoeopathic Journal worthy of his reputation, in as much as it abounds in philosophical reflections, learned quotations, and quaint phrases, but I am unable to say that he throws much light on the subject. He shows himself opposed to Hahnemann’s later views, respecting the one uniform dose for all medicines, and says very truly that there is no constant, universal, absolute dose for all medicines, just as there is no one constant character for all individuals, diseases, and all causes of disease. The high potencies, so extolled by the erratic Gross, however, he would exclude entirely from the homoeopathic posology.
Dr. Attomyr (N. Archiv, i.2.) of Pesth, favourably known to us by many useful practical works, and famous also for some novel ideas, the value of which is not so apparent, seeks to ascertain the rules which should guide us in the selection of the dose. He endeavours to find them in the results of the provings of medicines on the healthy. The substances of his observations is to this effect. Medicines show a quantitatively different action on the healthy and the sick when given in the same dose, and a qualitatively different action, as regards the amount of the dose, on the healthy certainly, on the sick most probably. From the difference of the qualitative action he draws the inference that large doses act more quickly, more extensively, more intensively; small doses, on the other hand, act more slowly, more permanently, more extensively, and from this he lays down the following practical rules:-
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.