4. It does not appear what Hahnemann understood by these stronger doses, but as he wrote for the ordinary practitioners in a journal of general medicine, I presume he meant by this expression such doses as were commonly in use.
5. It is evident that at this time he did not contemplate the exclusive treatment of diseases by means of specific or homoeopathic medicines, but that he admitted the propriety of the palliative or antipathic treatment in certain cases, and that for such treatment he considered the very largest doses used in ordinary practice to be necessary.
The next work of Hahnemann’s where the subject of the dose is touched upon is that remarkable essay, the forerunner of the Organon, entitled the Medicine of Experience. He there says: (Lesser Writings, p. 525.)
“A medicine of a positive and curative character may, without any fault on its part, do just the opposite of what is ought, if given in too large a dose; in that case it produces a greater disease than that already present.” He illustrates this by the various effects of different degrees of cold and of heat, applied on homoeopathic and antipathic principles.
Although he does not define in this essay that quantity he means by the small doses he speaks of, it is evident he implies doses of extreme minuteness, for he says the smallest possible dose suffices; and “as the sole condition for the full and helpful action of the remedy is that it should come in contact with the susceptible living fibre, it is of little or no importance how small the dose is.”
As as illustration of this, he says, that if a certain quantity of diluted tincture of opium will remove a certain array of morbid symptoms, the hundredth or thousandth part of that quantity suffices almost equally well, and the diminution may even be carried much farther without the medicine losing its effect. He now tells us that action of the medicine is almost spiritual, and therefore gives us to infer that no material portion of it is required. As he talks in this essay of giving opium in doses a million times less than those in ordinary use, it is probably that he meant by the smallest possible dose one not exceeding in minuteness what we now understand by the 3rd or 4th dilution. It is, however, not probable that he confined his doses to these very minute quantities; indeed, we shall presently find that ten years and more after this he gave medicine in appreciable quantities.
In his letter to Hufeland, published in 1808, he alludes to the quantity of medicine required by the homoeopathist as being incredibly small, (Lesser Writings, p. 590.) but beyond this vague expression we have no clue in this latter for determining how small those doses were.
In the first edition of the Organon, which appeared in 1810, Hahnemann, speaks much to the same effect. He there says that “scarcely any dose of the homoeopathically selected remedy can be so small as not to be stronger than the natural disease, and not capable of overcoming it.” Again, he says “the smallest doses are always equal to the disease.” In this edition of the Organon we have no distinct directions as to the doses actually, used, as to what these smallest doses were; but in an essay published the year previous to the publication of the Organon we find the strength of the dose more precisely indicated. The essay I allude to is entitled On the Prevailing Fever. (Ibid., p. 628.) After giving an excellent and minute description of a severe epidemic of a typical fever that prevailed over a large tract of Germany in 1808-9, he recommends for its treatment nux vomica of the 9th dilution, and arsenic of the 18th dilution. He gives excellent indications for the employment of each of these two drugs, and the whole essay is well worth your careful perusal.
In the Spirit of the Homoeopathic Doctrine, first published in 1813, there is some allusion to the dose of the remedy. It is here stated that the smallest dose is sufficient, and that a greater one is not necessary, ” because the spiritual power of the medicine does not in this instance accomplish its object by means of quantity but by quality or dynamic fitness,” (Lesser Writings, p. 710), and a larger dose does not cure the disease better, but leaves behind it a complex medicinal disease. Here, then, the reason for giving the small dose is that the larger one is apt to produce accessory medicinal symptoms. It is again hinted at in this paper that the more acute the diseases, the smaller should be the dose of the remedy.
In an essay (Ibid., p.712), published in the following year, viz., 1814, containing instructions for the treatment of fatal epidemy of typhus or hospital fever, occasioned by the extensive warlike operations then prevailing all over Germany, and notably by the disorderly retreat of the French army from Russia, he recommends the employment of bryonia and rhus toxicodendron, each in the 12th dilution, prepared, not according to the centesimal scale, but in the proportion of one drop to six drachms, or 1 to 360, which would make this 12th dilution equal to between the 15th and 16th dilutions of the centesimal scale. Each dilution he directs to be shaken for three minutes at a time. A single drop of each of these medicines in this state of attenuation is directed to be given for a dose. ” Neither of them, ” he observes, “Can be used in a lower dilution or in a larger doe, they are too strong.,”(Ibid., p. 714)
Hyoscyamus is directed to be used for some states of this fever in the 8th dilution, prepared after the fashion I have described, which will be about equivalent to the ordinary 10th dilution in point of strength.
Sweet spirit of the nitre, which is also indicated in certain conditions of this disease, he directs to be given thus: — One drop is to be mingled with an ounce of water, and this given by teaspoonful, so as to be all taken within the twenty four hours.
Hahnemann has given us specimens of his practice towards the end of 1815, by detailing the histories of the two cases of gastric affections he treated at that time. (Lesser Writings, p. 861.) The doses he gave of each of the medicines he prescribed were very different. To the first he gave a drop of the pure juice of bryonia-root, and to the other, half a drop of pulsatilla in the 12th dilution.
In a curious paper he published in 1816, on the Treatment of the Venereal Disease, (Ibid., p. 728) he advises for the cure of such cases as have been mismanaged by the old treatment, his preparation of mercury to be given until the development of the certain symptoms peculiar to the actions of mercury,” but among which,” he says, “neither salivation, nor toothache, nor ulcers of the mouth, nor pains in the bowels, nor diarrhoea are to be found ‘(Ibid., p. 742.) He does not say what are the symptoms we ought to produce, but as in this essay he constantly refers approvingly to his greater work On Venereal Diseases, published in 1789, and as he there tells us what symptoms we must produce in order to be sure of the sufficient action of the mercury, we must presume, in their absence of more explicit directions, that the state there described is what he alludes to in this later essay. On referring to this work, then, we find that the mercurial symptoms that should be developed, in order that we may be assured of the sufficient action of the metal, consist of what he terms the mercurial fever — a state characterized by symptoms of considerable severity, and which cannot be produced without the administration of mercury in appreciable doses. (Ibid., p. 77.)
In a short article, written in 1819, On the Treatment of Suicidal Mania, (Ibid., p. 781) the dose of gold he recommends is the 6th dilution or trituration. In the first edition of then Materia Medica (Vol. iv.), published shortly before, or perhaps after, this time, he counsels the administration of gold in similar cases, in doses of the 1st and 2nd trituration. In 1825 he advises the 12th dilution to be given.
In 1821 he advises for the treatment of purpura miliaris, which was then raging epidemically, aconite in the 24th dilution, and coffee in the 3rd dilution, (Lesser Writings p. 782.)
It may be interesting to quote from the second edition of the third, fourth, fifth, and sixth volumes of his Pure Materia Medica the doses in which he directs the various medicines to be given. These volumes were published betwixt 1825 and 1827. The last edition of the first and second volumes was published after the invention of the psora-theory, which we shall presently find had a revolutionary effect on Hahnemann’s posology.
In the third and fourth volumes, published in 1825, the following are the doses prescribed of the medicines contained in these volumes: —
Digitalis is directed to be given in the15th of 30th dilution. Ledum in the 15th dilution.
Cham, chin., verat., hyos., aurum. in the 12th dilution.
Stramonium in the 9th dilution.
Ipecacuanha in the 3rd dilution.
Hepar sulphuris in the 3rd trituration.
Sulphur and argentum in the 2nd trituration.
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.