Methinks the perfection of art would be to give the simplest preparation, in other words the lowest dilution, or the greatest quantity of medicinal material we could administer without incurring the risk of aggravating the disease, or of exciting medicinal perturbations–I mean producing the pathogenetic action of the drug.
I showed in one of my earliest lectures that the administration of medicines in small doses was a necessary corollary from the homoeopathic law similia similibus, but this law cannot determine the amount of the dose to be given in each case. It is experience alone that can do this. Now, if we look at the history of Hahnemann’s discovery and development of the homoeopathic system from first to last, and particularly if we examine those cases he has himself adduced from the writings of practitioners of the ordinary school in order to illustrate the homoeopathic application of drugs, and if we cast our eyes over the records of cures that have been performed by his followers of every way of thinking, we shall be forced to admit that the latitude of the curative dose is very great, and one of the rarest things to meet with, in all these histories of cures, is the cure of a case by a medicine in one dilution that had resisted the influence of the same medicine in another dilution. I do not say that such things never happen; on the contrary, I could point out to you several remarkable instances of such an occurrence. I shall, however, content myself with referring you to one case by Dr. Black, recorded in the sixth volume of the British Journal of Homoeopathy, where lachesis 30 had no other effect on a patient than to cause disagreeable nervous symptoms, whereas the same medicine in the 6th or 8th dilution produced a curative action and no disagreeable symptoms at all. Experience has certainly decided that very minute infinitesimal doses are capable of curing, but reflection will teach us that the preparations in highly diluted forms are very apt to be uncertain for various reasons, which must be sufficiently obvious to you. Experience has likewise shown that much larger doses produce an equal curative effect, and that the organism has the power of rejecting a considerable excess of medicine over and above what is necessary for the curative purpose.
In this country we have happily no idea of the acerbity of feeling that has entered into the discussions on the comparative merits of the different dilutions on the Continent, and most British practitioners, allow themselves and others a considerable latitude in respect of the doses they prescribe. The general feeling seems to be that the lower dilutions are more applicable to acute, the higher to chronic diseases; but there are, I am convinced, many exceptions to this rule. I believe that Hahnemann committed an error when he departed from his first plan of seeking to adapt the dose to the peculiarities of the disease and of the patient, and first fixed upon a particular dose for each remedy, and afterwards indicated a uniform dose for all remedies. In this all Hahnemann’s disciples who have any pretensions to science agree, and I am not aware of the existence of a single homoeopathic practitioner who abides by Hahnemann’s latest published posological directions.
There is and can be no normal dose for all medicines, for all diseases, and for all patients; for medicines differ vastly among themselves in respect of power, diseases in point of intensity, and patients in point of susceptibility for medicinal impressions. These three points must all be attended to in our selection of the dose or dilution of medicine we prescribe, and though we are still considerably in the dark with respect to the suitable dose of a remedy for the different circumstances for which that remedy is indicated, I think this darkness has been partially dispelled by the experience of so many homoeopathic practitioners extended over so many years. This experience seems to show that the more material doses, or the lower dilutions of medicines, have a more rapid and intense action, and are best adapted to diseases of rapid course and considerable violence, and that the higher dilutions have a more continued and profound action, and are therefore better adapted to diseases of a more chronic character; but there are many exceptions to this. Thus, according to my own experience, and that of many of my colleagues, syphilis in almost all its stages demands an administration of material doses of mercury. I generally employ the 1st or 2nd dilution of corrosive sublimate and the 1st triturations of mercurius vivus, or the 1st trituration of the red precipitate. Iron seems to be of no use in chlorosis except in comparatively large doses, such as the 1st trituration of the carbonate. Cannabis and petroselinum are best adapted for the cure of gonorrhoea in the lower dilutions; and many diseases accompanied with extensive change of structure seem to require the lower preparations. In chronic diseases I find it useful to vary the dilution of the medicine, for the same dilution frequently repeated seems often to lose its effect. If I have commenced with a low dilution I generally find it useful to proceed up the scale to the higher potencies; if with the higher dilutions, down the scale to the more material doses. Without absolutely denying the power of the higher dilutions in acute diseases, I believe that all that can be done by medicine in them can be effected by the dilutions below No. 6.
As regards the Korsakoffian infected globules, and the secret preparations of the horse-trainer Jenichen, called “high potencies,” I think their introduction into practice was an unmitigated misfortune for homoeopathy, and that they should by no means be encouraged by scientific practitioners, for the reasons I stated in a former lecture. They may be safely abandoned to such dilettanti practitioner as Boenninghausen and such enthusiastic gobemouches as Gross and company.
Besides the medicines of little power, such as verbascum, sarsaparilla, oleander, dulcamara, euphrasia, and many others, which Hahnemann continued to advise the administration of in low dilutions or mother-tinctures until his invention of the psora- theory, and which I think should generally be given in that form, there are other substances the solubility of which, even when triturated, is doubtful, and which I therefore think we should prefer to administer in the lower preparations, as Hahnemann also advised up to 1827; such are the metals, especially those that are not easily oxydizable, as gold, silver, platina, etc., carbo veg. and anim., and several others, which will readily occur to you.
In conclusion, I may state that it is the dilution and not the amount or size of the globules that indicates the dose, and the refinement as to whether we should give one globule or half a dozen for a dose, or whether our globules should weigh three hundred, or fifty, or ten to the grain, as well as the outcry against drop-doses of a given dilution, serve but to bring posology, ridicule upon our system, and give occasion to the enemies of homoeopathy to blaspheme.
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.