To recapitulate:-
1. At the outset of his career, Hahnemann seems to have repeated his doses in much the same style as was usual among the ordinary practitioners.
2. He afterwards attempted to lay down a rule, that the medicine should not be repeated until its action was fully exhausted.
3. The conditions of the repetition, as I have shown, were of such a character as practically almost to prevent the medicine being ever repeated.
4. Subsequently the advantage of repeating the remedy at longer intervals in chronic diseases, and shorter intervals in acute diseases, was acknowledged, and the rule for repetition came to be, the medicine should be repeated at shorter intervals, in the direct ration of the rapidity of the disease.
5. At a still later period the repetition of the same potency was said to be injurious, and the medicine, though still ordered to be repeated, in some cases, as often as every half-hour in acute diseases, and not seldomer than every two days in chronic, was ordered to be given at each dose in a fresh dynamization, made by merely shaking the bottle that held the solution some five or six times.
From this statement it will be apparent to you how much and how often Hahnemann’s views respecting the repetition of the medicine altered. It is noteworthy that the period when he first mentions the necessity of giving medicines at very short intervals in acute diseases was about the time when the cholera invaded Germany, and it was probably an observation of the necessity of repeating the remedy with great rapidity in this disease, that thus modified his practice with regard to acute diseases generally. The dynamization-theory, which he had developed to a great degree, had doubtless its influence in altering his views respecting the necessity of giving another dynamization every time the medicine was to be repeated.
Let us now examine what others have written and practiced in reference to the repetition of the medicine.
Dr. Aegidi, in an article in Stapf’s Archiv, x Archiv, xii.i. expresses his dissatisfaction with the ordinary method of treating chronic diseases. He says, that giving one dose of a medicine, and waiting for six weeks or so without giving another, was often to lose six weeks of time, and though chronic diseases were undoubtedly sometimes cured by this method, yet the treatment generally lasted an outrageously long time. He considers that our success might be greater and speedier, if we adopted some alteration in respect to the frequency of the administration of the remedy, and he seeks to lay down some general rules for the repetition of the medicine. “After the administration of the suitable medicine,” he says, “one of two events certainly happens in the course of eight days: either,–
“A. The morbid state undergoes an alteration, or,–
“B. It undergoes no alteration.
“The alternation it undergoes is one of three kinds:
“1. The state alters for the better.
“2. It alters for the worse.
“3. The disease merely alters its totality of symptoms.”
In the first case, we have only to wait without giving any medicine, and see how long the amelioration will go on; and in such a case, however slow the progress made in the improvement, it would be imprudent to disturb it by administering a fresh dose. If, however, the amendment becomes stationary, then, if there be no contra-indication, no remedy is so appropriate to be given as the one that brought the improvement on so far, and it may safely be repeated not only once but often, every seven days, or every four days, or even every other day.
If in place of amelioration we observe aggravation of the morbid symptoms, we are thereby assured of the action of the remedy on the disease, and we either wait till the aggravation has subsided, or, if the symptoms of aggravation are too severe, we give an antidote, and the best antidote in most cases, says Aegidi, is a second dose of the medicine. After this improvement takes place, and when that becomes stationary we must either administer the medicine again (but this time in a smaller, more highly potentized dose), or we must give another medicine more suitable for the actual symptoms.
Where, from the administration of a medicine, the disease is not improved, and the symptoms it presents are only altered, this shows that the selection of the remedy was false, and we should then give a more accurately selected one as speedily as possible.
If after the first dose no alteration is perceptible for better or for worse, and still the selection of the remedy seems to have been accurate, we repeat the dose more or less frequently, according to the susceptibility of the patient, until either a homoeopathic aggravation ensues, whereafter the amendment will proceed vigorously, or until several symptoms peculiar to the remedy show themselves, which were not contained in the original morbid picture, and after which the state often begins to improve, or, if the contrary be the case, an indication is presented for another medicine. Aegidi says that attention to the directions just red will often give us the happiness of seeing chronic diseases cured in a much shorter time than they have hitherto been by the usual mode of treatment.
On a subsequent occasion, (Hyg., ii.201.) Dr. Aegidi advised not only the giving of stronger doses than was usual, but to repeat the remedy much oftener also; “by which continuous assault,” he says, “it is alone possible to effect a powerful and curative reaction, an event that seldom follows from the administration of a single dose.”
At a later period, (Allg.h.Ztg., 27, No. 9.) Aegidi stated that in some cases the repetition of the medicine was inappropriate, whilst in others it was by repetition alone that we could attain our object. The character of the case we had to treat must determine for us the propriety, or the reverse, of repetition. By cautious hesitation we could not lose much, but by a rude and frequent assault we might spoil everything.
Dr. Wolf a (Archiv, xi,1.45.) had already, before Aegidi, touched upon the subject of the repetition of the medicine, and alleged that where the reaction of the organism to the antipsoric medicine was defective, it might be advisable to repeat the dose in rapid succession. A year later, (Ibid., xii.2.) he treats of the subject of the repetition of the medicine at much greater length, and seeks to obtain some fixed rules upon the matter. He says, that a lengthened experience has convinced him that Hahnemann’s advice not to repeat the dose must not be followed in certain cases, for that some were evidently greatly benefited by a repetition; on the other hand, however, he warns against too rapid repetition, which he has often seen to be productive of harm. A consideration of the good effects of the drinking of mineral waters, of the success often attending the allopathic mercurial treatment of syphilis, of the cures effected by the use of certain vegetable extracts and infusions, of the beneficial results often attending the administration of the homoeopathic remedy in allopathic doses–and here he adduces two cases of amaurosis cured by the application of strychnia to a blistered surface, and asks if homoeopathists have ever obtained such good results–all these circumstances Wolf declares point to the necessity for the repetition of the dose in some cases. He admits, however, that we have not distinct rules to guide us in the repetition, because we are still ignorant of the medicines adapted to repetition, of the diseases to which this technicality is applicable, and of the criteria to guide us in fixing the proper periods for the repetition.
There are, he says, three principal methods in which the repetition of the dose may be effected.
1. The repetition of the specific remedy in the smallest dose, in very rapid or somewhat slower sequence, until we may consider that the system is brought under the influence of the medicine, or this influence has shown itself by the development of primary symptoms.
2. Repetition of the specific remedy in constant sequence and proportionally short intervals until amelioration is apparent, with or without distinct evidence of the influence of each dose.
3. Repetition of the specific medicine at long intervals, after one dose has effected amelioration of the state, and the amelioration has become stationary.
Dr. Wolf then gives a long list of medicines which, he says, he has found it useful to repeat, which I need not weary you by enumerating.
Dr. Hering of Philadelphia wrote an article upon the repetition of the remedy about the same time. (Archiv, xiii.3.) Hahnemann, as we have seen in the first edition of the Chronic Diseases, set his face against the repetition of the remedy in successive doses. Still, with respect to some medicines, such as causticum, natrum muriaticum, and sepia, he admitted that it was occasionally useful to repeat the remedy, interposing, however, some other remedies betwixt the two doses of the antipsoric. This Hering calls “repetition after other medicines.” When the repetition is made after only one interposed medicine, Dr. Hering calls this “repetition in alternation.”
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.