Small doses of mercury given by Hahnemann before his discovery of homoeopathy. After his discovery he gave other medicine in ordinary doses- First indications of small doses-His doses in scarlet fever-Had the apothecaries persecution an influence on his doses?-Reasons for his sudden change to small doses-Rules he gives for the selection of the dose -Later he alleges that the dose cannot be too small-Examples of various doses he recommended of various medicines-Appreciable doses of some medicines given by him-The doses prescribed in the Materia Medica-He did not always go on diminishing his doses, but sometimes gave larger doses than he had previously ordered- Remarkable influence of the psora-theory on his doses-He makes the 30th dilution his standard dose-He often departed from his own standard-Expresses his disapprobation of higher attenuations- Approves of higher attenuations-If the medicine be repeated the dose should be increased-Various doses in a pocket-case used by Hahnemann just before his death- Hartlaub advises small doses for acute, larger for chronic diseases-Wolf recommends a variety of doses-Rau advises small doses for acute, larger for chronic diseases–Werber contends for various doses -AEgidi prefers the lower dilutions, but admits the power of all-Rummel opposes the idea of a standard dose-He says some medicines do not act in the higher dilutions-He attempts to lay down some rules for the doses- He allows that the 200th dilution still acts-Stapf says the insolubles are best in high dilutions-He prefers the lower dilutions in acute diseases-He treats itch and syphilis with low triturations-He approves of Jenichen’s preparations-Gross’s inconsistencies-He finally fails into the Jenichen trap-And recognises the apparent insanity of his conduct.
IN this and the next lecture it will be my endeavour to lay before you the principal opinions that have been expressed by Hahnemann and his disciples relative to the quantity of medicine requisite to be administered in disease, and to ascertain if there is any rule to guide us in the selection of the appropriate dose for each individual case; or, supposing no such rule can be found, if experience teaches us that there is one uniform appropriate dose for each medicine and for every disease, or that some forms or cases of diseases are most appropriately treated with larger, others with smaller doses.
And as I have proceeded in the case of the other doctrinal points of the homoeopathic system, so I shall commence my inquiry into the present question, by laying before you a historical exposition of Hahnemann’s opinions and practice on the subject.
In one of Hahnemann’s earliest works, that, namely, On the Nature and Treatment of Venereal Diseases, published in 1786, accordingly long before he had any notion of a general therapeutic rule for the employment of remedies in diseases; long before he had thought of any of those pharmaceutic processes that he subsequently held to increase the potency of the drug, and long before he thought it necessary, for the sake of obtained a uniformity of result, to advise one uniform dose for all medicines in all diseases-in this work, I say, we already find some peculiarities in reference to the doses of medicine he prescribed, especially in reference to the dose of the new preparation of mercury, to which his name is attached. It is well known that about the time when Hahnemann wrote this work, towards the end of the last century, the common treatment of syphilis consisted in giving enormous and repeated doses of mercury, so as to bring the system, as it was thought, as quickly as possible under the influence of this drug, with influence was believed to be only duly exerted when the patient presented those well-known but now happily more rarely seen symptoms of mercurial poisoning-salivation, spongy gums, foetid breath, swollen tongue, glandular enlargements, extremely febrile and wasted condition, racking pains in the bones, etc. etc.
Hahnemann’s treatment offers a very remarkable contrast to this heroic practice. He tells us that for the complete eradication of lues venerea, he has sometimes not had occasion to give more than one grain of his soluble mercury, and that the average quantity he requires for the treatment of moderately severe syphilis is not more than eight grains. He here talks of half a grain, of one, two, and three grains of this mercurial preparation as large doses, and the doses he commonly employs are a quarter, third, half, three-quarters, and one grain of the remedy. These comparatively small doses which he at this period prescribed, though they relate but to one medicine and to one disease, seem, however, to show the tendency of his mind to rebel against the enormous doses of ordinary practice, to give remedy in doses sufficient to produce its curative but not its pathogenetic action.