For the cure of the first stage of scarlet fever, the dose of belladonna prescribed was only the 432,000th part of a grain of the extract, a quantity intermediate betwixt our 2nd and 3rd dilutions. For prophylactic purpose the preparation of belladonna used was thus made:- A grain of the powdered extract was mixed up in a mortar with one hundred drops of distilled water; three hundred drops of diluted alcohol were then added, and the whole well shaken up in a little. One drop of this strong solution was added to three hundred drops of diluted alcohol and shaken for a minute, and of this one drop was added to two hundred drops of alcohol, and this again shaken for a minute. Each drop of this last solution, which is the prophylactic preparation, contains accordingly the twenty-four millionth part of a grain of extract of belladonna; accordingly, twenty-four drops of it are equal to one drop of the 3rd dilution of the co-called centesimal scale.
Of this weak solution of belladonna Hahnemann recommends us to give-to a child below one year, one drop; to a child of one year old, two drops; to one of two years, three drops; to one of three years, four drops; to one of four years, five or six drops; to one of five years, six or seven drops; to one of six years, seven or eight drops; seven years; nine or ten drops; eight years, eleven to thirteen drops; nine years, fourteen to sixteen; and with each successive year up to the twentieth, two drops more; from the twentieth to the thirtieth year, not above forty drops; to each a dose every seventy-two hours (as the action of belladonna, he alleges, only lasts three days), well stirred with teaspoon in any kind of drink, as long as the epidemic lasts, and for four or five weeks thereafter.
Half of the dose recommended as a prophylactic, given every three hours, will, he says, often suffice to suppress the scarlet fever in its first germ. For some of the after-sufferings of scarlet fever, the same doses of belladonna recommended for prophylactic purposes, given frequently, are recommended.
The dose of chamomilla for some of the after-sufferings of scarlatina, and its preparation, differed somewhat from that of belladonna. One grain of the dry extract was dissolved in five hundred drops of water and five drops of alcohol, and of this solution one drop was mixed with eight hundred drops of diluted alcohol. A drop of this, containing the 800,000th part of a few years old; two drops for one of ten years, and so forth.
Such, then, were the first infinitesimal doses mentioned by Hahnemann in his work. We cannot fail to be struck with the sudden transition from the massive doses he prescribed in 1798 t the unheard-of minuteness of his doses only one year later, and we can but guess the causes for this sudden and extreme change. He nowhere assigns any reasons for this abrupt transition, and still less does he give us any details respecting the steps by which he descended from the massive doses we saw him administering in 1798 to the real infinitesimal of 1799.
In this paper on scarlatina he indeed says, respecting opium, that larger doses than those he prescribes occasion raving, hiccough, peevishness, weeping, etc., but he does not state now much larger they must be to have these awkward effects.
You will recollect that in my introductory lecture I mentioned that it was about this time, viz., in 1799, that the persecution of the apothecaries began, and it was probably a desire to evade their harassing annoyance that led Hahnemann to try if, on diminishing the dose to such an extent that it was beyond the ken of chemical or other research, the medicine still possessed the power of influencing the organism. No doubt he was encouraged to make those experiments by certain analogies that must have presented themselves to his mind, and particularly by the theoretical views he began at this time to entertain respecting the purely dynamic character of diseases; but these of themselves would hardly, one would think, have sufficed to make him drop so suddenly from grains to millionths of grains. Having however, from whatever cause, found that these infinitesimal quantities did act, and that more certainly and effectually than the grosser doses, he was not slow of adopting them, and he soon began to find reason for their superiority in medicinal power; and as we saw in my last lecture but one, he ascribes in this very essay great virtues to the process of succussion in the preparation of the dilutions, as a means of making the medicine present more points of contact to the living organism.
It was but natural to expect that practice so extra-ordinary and doses so minute should be strongly commented on by his allopathic colleagues. This was accordingly the case. Among others, Hahnemann’s friend Hufeland demanded a public reply to the objections formally made to this new posology. Hahnemann was not long in giving the reply (Lesser Writings, p. 443.) so imperatively called for; but I should be stating what is contrary to the fact if I said that this reply gives my satisfactory solution of the question that now interests us, viz., how it was that Hahnemann fell so suddenly, as it would seem, from palpable grain and scruple doses of medicines to ten-thousandths, hundred-thousandths, and millionths of a grain.
In the article I allude to as being the reply to the question of Hufeland, Hahnemann refers to the greater power of medicines in solution than in the hard dry state, to the more severe effects developed by giving the same quantity, in divided doses, to the greater susceptibility of the diseased organism for its medicinal stimulus, but he does not mention what it was that produced the violent and complete revolution in his own posological notions. We are, after all, then, only left to infer the reasons for this sudden change. These reasons I conceive to be as follows:-
1. An observation of the greater power of a medicine when given in solution than when taken in the dry state.
2. An observation of the greater power of a certain quantity of medicine when given in divided doses than all at once.
3. An observation of the greater susceptibility of the diseased organism for the medicine having a special or homoeopathic relation to the affected part or parts.
4. some still obscure notions with regard to the increase in power of a medicine by thorough admixture of it with a non- medicinal vehicle, by means of succussion-a foreshadowing of the dynamization-theory.
5. A desire to avoid aggravation of the disease by the larger doses; for he says, if any aggravations occur during the use of a small dose they will not last long, and are easily removable by some antidote.
6. A desire to evade the persecutions of the apothecaries, who had begun to institute legal proceedings against him for infringing on their privileges by dispensing his own medicaments.
That he was not successful in evading the penalty against the infraction of the apothecaries’ privileges by this maneuver, has sudden flight from Konigslutter to Hamburg and his fierce tirade against the apothecary system a few years later, in his Aesculapius in the Balance, (Lesser Writings, p. 492.) amply testify.
These considerations, and probably others of which we are ignorant, no doubt induced Hahnemann to diminish his doses with considerable rapidity; and finding that his medicines still acted, though removed beyond the reach of chemical analysis, he adopted such minute doses as his rule, whereby this advantage was obtained-that the dose was not sufficient to cause any disagreeable or dangerous effects, an advantage not attached to the large doses of the old school-that his enemies, the apothecaries, could not prove that the white powder he administered contained any medicinal substance whatever.
In the essay to which I have just referred, that, namely, where he replies to Hufeland’s question relative to the action of very minute of very minute doses, he gives us some rules for the selection of the appropriate dose for different diseases, which are worth recording.
“The nearer the disease approaches the acute character,” says he, “the smaller are the doses of the medicine it requires in order to disappear. Chronic diseases also, combined with debility and general derangement of the health, do not require larger ones. It is only in cases where, along with a local affection, the general health seems to be good, that we must proceed from the at first small doses to larger ones; to the very largest, however, in those cases where the medicine can only act in a palliative manner.” (Ibid., p. 446.)
The rules laid down at this period are, we see, as follows:-
1. In the most acute disease, and in chronic diseases combined with debility, in which the general derangement of the organism is obvious the smallest doses are to be given.
2. These smallest doses are equivalent, in the amount of medicinal substance they contain, to the 2nd and 3rd dilution of the ordinary or centesimal scale.
3. In what are called local diseases-those chronic diseases, to wit, where the morbid affection is localized and the general system does not seem to be much implicated-the doses must be gradually increased in strength.
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.