Dr. Mure (Doctrine de l’Ecole de Rio, p.76.) of Rio de Janeiro though full of extravagances on many points, and of the most consummate vanity, allows occasionally a glimpse of good sense to gleam through the clouds of bombast and absurdity that abound in all his writings. He says, and believes, poor fellow! that he was the first who, in 1837, pointed out that the lower dilutions were more suitable for acute, the higher for chronic diseases, and that all those who have expressed the same opinion since that time are his unblushing plagiarists; he does not inform us what he is with respect to those who professed the same belief long before 1837. The lower dilutions, he says, are more suitable for acute diseases because their effects are violent but transient, the higher dilutions are more adapted to chronic, because their action is prolonged, latent, and tenacious; he does not inform us how he knows all this. In very acute diseases he employs the 2nd and 3rd dilutions; in less acute but still acute diseases, he uses the 5th, 6th, 7th, and 8th dilutions. In chronic cases he commences with the 9th and goes up to the 100th. He has little confidence in the 1000th or 10,000th. The lower dilutions are best adapted to the infantile age, because their diseases are almost all acute; the higher to the diseases of old age, as these are always complicated with chronic maladies. The male sex demands the lower dilutions, the female the higher. The sanguine temperament demands the lowest dilutions, after that comes the bilious, then the lymphatic temperament, and the nervous temperament requires the highest dynamizations. As regards the tissue or systems of the organism, and the doses their diseases require, he gives the following list–the first requiring the lowest, the last the highest dilutions:-
1. Cellular tissue.
2. Muscular system.
3. Osseous system.
4. Joints, cartilages.
5. Vascular system.
6. Glandular system.
7. Cutaneous and mucous tissues.
8. Nervous system.
As regards the organs, the following is the order in which dilutions are required from the lower to the higher:-
1. Locomotive apparatus.
2. Circulatory apparatus.
3. Digestive apparatus.
4. Genito-urinary apparatus.
5. Respiratory apparatus.
6. Nervous apparatus.
Of all those who have written on the subject of homoeopathic posology, Dr. Nunez of Madrid undoubtedly bears away the palm for excessive attenuation. In his own Spanish organ of homoeopathy (Boletin official de la Sociedad Hahnemanniana Matritense, Nos. 1,2,3,4.) he has written a series of papers on the dose, and the following are the conclusions at which he has arrived:-
“1. All dilutions, from 0 to 2000, may in certain cases be of use; it rests with the feelings and the tact of the physician to choose the appropriate one for each case.
“2. In general the most appropriate dose for the treatment of acute diseases must be sought for in the dilutions from 2000 upwards.
“3. Chronic diseases may generally be treated with the 2000th potency, but in most cases it will be best to select a higher dose.
“4. Chronic diseases, combined with organic alterations, are always aggravated by the 2000th potency, nor does the reaction of the vital force suffice to remove entirely the aggravation so produced, and hence they require much higher doses.”
If the conclusions of this learned Spaniard are correct, Hahnemann must have made sorry work of the treatment of chronic and even of acute diseases, as he, poor soul, knew nothing of these 2000th potencies and upwards, and it was reserved for Dr. Nunez to teach the world how to treat diseases successfully, and to fix the minimum dilution for all diseases at a point a long way beyond Hahnemann’s maximum attenuation. I may remark that the high potencies he employed were all prepared by our old friend Jenichen.
It often happens that when the learned are puzzling their brains to solve some intricate problem, or to clear up some knotty point, and straining all their powers of logic to arrive at some legitimate conclusions from the premises in their possession, some philosophic genius steps in and with a few words immediately clears away all difficulties, removes all doubt, and makes the problem, which appeared hopelessly intricate, so simple that a child can comprehend it. The solution of the posological problem proposed recently by Dr. Cruxent (Bull. de la Soc. Medorrhinum Hom. de Paris, April, 1847.) of Mataro, in Spain, possesses all the simplicity of an explained phenomenon. I shall leave it to you to determine whether it possesses any other recommendation in reference to our posological difficulty. Dr. Cruxent’s key to the whole mystery is this terse proposition:- The dose of the medicine, says he, must be proportioned to the duration of the disease. Do we ask how? Our Castilian philosopher at once replies thus:- If the disease has lasted less than one day, give the mother-tincture; if it has lasted one day, give the 1st dilution; if two, the 2nd dilution; if three, the 3rd; if ten, the 10th; if a hundred, the 100th; if a year, the 365th; or in what the almanacs call the bissextile or leap-year, the 366th; if ten years, the 3650th. Admirable simplicity! And yet who would have dreamt of this wonderful connection of the revolutions of the earth on its axis and the homoeopathist’s dilution bottles–this sympathetic alliance of the great and the small? The conception reminds us of Newton’s discovery of the relation betwixt the movements of the planetary spheres and the fall of the apple on his own philosophic fate. Still, notwithstanding the grandeur of this conception of our occidental philosopher, Dr. Cruxent, I would not exactly make it a reason for doubting the accuracy of the biblical statement that the wise men came out of the East.
In a paper by Dr. Scott of Glasgow, which has come under my observation, still in manuscript, but shortly, I hope, to be published, there are some views respecting the dose and repetition of the remedy which, like everything that proceeds from Dr. Scott’s pen, are marked by originality and thought. I may be permitted to give a brief summary of these views. The conclusions at which our learned friend arrives are:- 1, That in the stage or form of acute diseases which is marked by exaggerated vital action, low potencies should be employed and repeated frequently, the period of reaction being of short duration; 2, that in the stage or form of exhausted vitality the higher potencies should be employed and frequently repeated; 3, the potency to be chosen is determined by the character of the disease, combined with the completeness or incompleteness of its remissions. (This requires some explanation. Dr. Scott considers that where the vital action is exaggerated, a greater amount of medicinal power, in other words, a low dilution, is requisite than in opposite circumstances, viz., when there is depressed vital action. Again, most, if not all, acute diseases have intermissions, or at least remissions. He argues that the more complete the intermission or remission is, the larger should be the dose administered, and the smaller, the less perfect the remission, and the nearer the disease, approaches to the purely continued character); 4, that the repetition of the medicines is determined by the duration and completeness of the intermission or remission of the disease, and by the activity of the system principally affected by the disease. Thus he says, where the circulation is chiefly affected the repetition should be very frequent, less frequent where the respiration is the chief function involved, still less where the digestion is concerned, and finally, the interval of the repetition should be very much greater where the catamenial function is mainly at fault. Dr. Scott, of course, merely throws out these observations as hints, without any claim to their being anything more; but they seem to me deserving of attention, and they may lead to some useful result.
Before concluding this lecture with a statement of my own views regarding the subject of homoeopathic posology, I would recommend to your careful perusal an article on the subject, in the sixth volume of the British Journal of Homoeopathy, where it is treated more at length than your time can afford that I should do it in this place.
I conceive it will be generally allowed that in therapeutics it is advisable that we should be assured of the genuineness and medicinal power of our remedial agents, and that it is injudicious to have recourse to complicated and intricate preparations, if the desired end can be attained as readily by means of simple and easily prepared medicaments. Again, it may be laid down as a rule that, in diseases of most rapid course and serious character particularly, it is always better to give our remedy in a somewhat greater dose than is absolutely necessary to produce the desired curative effect, than in a dose too small to produce the desired curative change. (Such seems also to have been Hahnemann’s opinion at one period. In his treatise on Scarlet Fever (Lesser Writings, p. 436), after detailing a brilliant cure with a somewhat larger dose of belladonna than was absolutely necessary, he says: “I cannot advise an exact imitation of this case, but yet neither can I advise that it should not be copied, for the scarlet fever is a much more serious evil than a few troublesome symptoms produced by a some- what too large dose of belladonna.”) If these premises be granted, and if it be likewise granted that the strength of the remedy is absolutely diminished by its dilution, then I think we shall be justified in preferring the lower infinitesimal dilutions to the higher as a rule.
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.