It would be difficult to obey the first part of the directions without acting at variance with the second. However, even at this period it is evident that Hahnemann contemplated the occasional repetition of the medicine; for he says that when there is occasion to repeat it, we should always give smaller and smaller doses, and never give the patient the same dose. Some further explanation he gives us on the subject in this first edition of the Organon, where he says that the time for repeating the medicine is when some traces of one or more of the original symptoms of the former disease again showed themselves slightly. If, says Hahnemann–and here we have a diagnostic sign, the precise value of which it would be difficult to decide–if the patient require an equally large or still larger dose of the homoeopathic medicine (which always does him good) in order to prevent a relapse, this shows that the exciting cause of the disease still exists, or else that there is something wrong in the diet or regimen or circumstances of the patient that serves to keep up his malady.
In the fourth edition of the Organon he insists particularly on the necessary of not giving a fresh dose, or a new medicine, until the action of the first has expired, which we are able to pronounce it has not done as long as the slightest trace of amelioration is going on. This observation, he says, is the more important, as we are unable to tell the precise limits of the action of any medicine even in large doses, and even on the healthy individual, far less those of feeble doses in the great variety of diseases, and in patients of such very different constitutions. In a note he adds (Organon, 4th edit., Aphorism 241, note.) “This is true of the most acute as well as the most chronic diseases, because the duration of the action of a homoeopathic medicine is governed by that of each malady, and consequently it exhausts itself in a few hours in acute diseases, while it takes several weeks to complete its action in diseases that are very chronic.”
The fifth edition of the Organon, published in 1833, presents several striking differences from the fourth edition just quoted, and in nothing more than in reference to the repetition of the remedy. The same observation is retained here, to the effect that any new dose of the remedy administered before the former one has exhausted its beneficial action would do harm and could do no good; but immediately afterwards this observation is considerably modified, if not absolutely contradicted; thus, after stating (Organons, Aphorism ccxlvi.) and note. that the medicine will accomplish all the good it is capable of performing in forty, fifty, or one hundred days, he adds, that the beneficial action of it may be greatly accelerated by repeating the medicine at suitable intervals, and the cure abridged thereby to one half, one quarter, or even less time; and in Aphorism ccxlvii, he gives us the following directions, which, you will perceive, completely set at defiance the rule he had himself laid down at starting for the repetition of the dose:-“The dose,” says he, “may be repeated with the best, often with incredibly good results, at intervals of fourteen, twelve, ten, eight, seven days, and where rapidity is requisite, in chronic diseases resembling acute diseases, at still shorter intervals; but in acute diseases at very much briefer periods–every twenty-four, twelve, eight, four hours; in the most acute every hour, up to as often as every five minutes; in every case in proportion to the more or less rapid course of the disease or action of the medicine employed.” He retracts his former directions about letting the one dose exhaust its action before giving another, and says this method is only applicable to slight diseases, especially of young children and very delicate and excitable adults. Thus we here find him admitting another element as our guide in the repetition of the dose, viz., the rapidity of the course of the disease. Slow, lingering diseases, according to this plan will require the medicine repeated at longer, rapid acute disease at shorter intervals.
Not only was the rule inculcated in former editions of the Organon repealed by this sentence, but also the directions in the first edition of the Chronic Diseases, on the same subject published in 1828, where we find it stated somewhat dogmatically. “If,” says Hahnemann, “we do not allow the antipsoric medicines, be they ever so well selected, fully to exhaust their action, the whole cure will come to naught.” The same ideas are retained in the first volume of the second edition of the Chronic Diseases, published in 1835, where he dwells at great length (Chronic Diseases, 2nd edit. i., pp.153-158.) on the necessity of allowing the dose to expend its action in chronic diseases; this action will often last twenty, thirty, forty, or fifty days, nay, the practitioner must, he says, in some cases, be content to allow one dose to act uninterruptedly for weeks and months without giving another dose. The only case in which he will allow a rapid (?) repetition of the medicine is where the amelioration advances a certain length, and then stands still. Under such circumstances we may, he says, repeat the medicine in fourteen, ten, or even seven days, and he proposes the following mode of giving the remedy. If the 30th dilution have been first given, it should be repeated in the 18th dilution, and if this repetition, was advantageous, and more doses are required, we should give the 24th, then the 12th, or the 6th, if the chronic disease have assumed an acute character. In the same place he also proposes another mode of giving the medicine, which admits of an immediate repetition. The dose is to be dissolved in eight ounces of water, a third of this to be taken immediately, the second and third portions on the two following mornings; the solution being well stirred each time to alter the potency. That he actually at one period allowed one dose of a medicine to act for twenty or thirty days I have been assured by several who witnessed his practice about that time. His plan was to give one dose of the medicine he deemed most appropriate, and furnish the patient with ever so many powders of sugar-of-milk to take till next consultation, pour passer le tems, and make him imagine he was going on with the remedy. “Blind powders” (blind Pulver) was the appropriate name he bestowed on these make-believes.
But this was not the last of Hahnemann’s changes of views on the subject of the repetition of the remedy. In 1837, (Chronic Diseases, iii., 2nd edition, preface, quoted in my translation of the Organon, p.296.) he says, in direct opposition to the advice about repeating the same dose of the remedy which he had formerly (1833) given, “our vital principle does not well admit of the same unaltered dose of medicine being given to the patient, even twice, still less several times in succession. For in that case,” he continues, “the good effects of the former dose will be partly done away with, as there appear new symptoms and sufferings dependent on the medicine, and which obstruct the cure.
Hence,” he observes, “the many contradictions of homoeopathists among themselves in respect to the repetition of the dose.” But he asserts it is indispensable to give the same medicine repeatedly in many diseases, both acute and chronic, and he states the intervals he finds it necessary to repeat the medicines in: in acute diseases, it is necessary to repeat the medicine every six, four, two hours, and sometimes every hour or every half-hour; and in chronic diseases the remedy should be given not seldomer than every two days, but generally every day. But we have just seen that it does not do to repeat the medicine in the same dose,–are we then to give a different dilution every time we give the medicine? This is not necessary now that the dynamization-theory is an article of faith in the homoeopathic system, for what more simple way of altering the dose than by altering the dynamization,–and how, you ask, is this to be effected? merely by shaking the bottle in which the patient’s medicine is dissolved five or six times before each new dose. After he has taken a bottleful of–say the 30th dilution, in this manner, and we still consider it necessary to go on with the same medicine, we must not again dissolve globules of the 30th for his use, but go down the scale to the 24th, and give him the solution of this medicine as long as we judge fit, in the same manner. The same technicalities, mutatis mutandis, are applicable to the treatment of acute and of chronic diseases. If it was considered desirable to give the medicine by olfaction, the patient was made to smell as often as it was considered necessary, but each time in a bottle containing a lower potency; on this principle, supposing the patient were to go on with this olfaction for a month, at the end of that period he would be sniffing the mother- tincture of the medicine.
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.