He contends that repetition is useful when, on account of defective reaction, the medicines, must be given again and again; in very painful disease the interval that elapses betwixt the doses should not be great. Thus he is in the habit of repeating the dose every two, four, seven, eleven, sixteen days, until reaction or new symptoms supervene. Likewise when the homoeopathic aggravation is too strong he finds it advantageous to repeat the medicine, but in this case once only, and in many cases it is best to give the antidote; but he has often observed that the second dose of the remedy is its own best antidote. Another case for repetition is when the reaction is too short, in this case the second dose may be given the following day. Another case for repetition is when the curative action has commenced, continued, but again come to an end; this he terms renewal of the dose.
Dr. Hering’s paper on this subject is extremely interesting, and I regret time will not permit me to give a more extended analysis of it.
At the Homoeopathic Congress held at Leipzic, in 1832, (Ibid., xii.2.) several members discussed the subject of the repetition of the remedy. Dr. Gross mentioned several cases of cures with repeated doses of belladonna, mercurius, antimonium tart., sepia, etc. Dr. Kretschmar removed a spasmodic affection with repeated doses of causticum; and Dr. Rau stated as follows:-“The more I think of the subject, the less reason do I see for not repeating a medicine several successive times. It is well known, “he continues (though this is not the general knowledge on the subject, I fear), “that the more acute the case is the greater necessity have we to give only the higher potencies, but that the action of the remedies is transient in proportion to their dilution. The first dose, on account of its very transient character, only takes away a portion of the symptoms; the second and third, if they are still indicated, act still more favourably.”
In another place (Werth d. hom. Heilv., 169) Dr. Rau expresses the following conclusions with regard to the repetitions of medicines:-
“Repetitions are useful-
“1. In all diseases where the remedy administered has mitigated the violence of the symptoms, but caused no further change. The proper time for repeating is when the amelioration has come to an evident pause.
“2. In cases where a perfectly indicated medicine has, after the lapse of the time in which it ought to have displayed its action, remained without any action at all. In such cases several repetitions are often necessary, in order to rouse the prostrate power of reaction. Such cases are met with among both acute and chronic diseases, and particularly where there is a well-marked topical disease, either alone or in combination with more general morbid symptoms. Hence,” he continues, “in incarcerated hernias I give a dose of nux vomica every two hours, and also in violent inflammations of the lungs I repeat the medicine indicated every two or three hours until the anticipated reaction appears. In obstinate diseases of the vegetative system, e.g. syphilis and itch, atonic gout and dropsy, old skin diseases and products of irregular plastic action, where the object is to effect a retrograde action of the formative process, it will be difficult to effect anything without repetition of the medicine.
“Repetitions are hurtful–
“1. On the occurrence of homoeopathic aggravations, which, when they are too violent and dangerous, or at least cause us to feel uneasy, demand the administration of an antidote, or, at all events, should be allowed to pass off, in order to permit the curative reaction to come into play. After such aggravations have passed off, if the same remedy is still indicated, it should be given in a higher dilution, in order to avoid a repetition of the aggravation.
“2. On the occurrence of an alteration of the morbid picture, which must always be an indication for the employment of another medicine. Such a case is chiefly met with in hysteria and hypochondriasis, but also in many other diseases, especially when they are passing into other stage, where, on account of the alteration of their general character, the previous indications can no longer exist. In such cases the administration of the former medicine would certainly not be so injurious as during the continuance of a homoeopathic aggravation; but at the same time it would not be of the slightest use.”
Dr. Kampfer (Allg., h. Ztg., xx.) has considered the subject of the repetition of medicine at considerable length. Hahnemann, he alleges, has ascribed to all medicines a much longer duration of action than they actually possess. Kampfer considers that the size and the repetition of the dose stand in a certain relation to one another, which he seeks to ascertain. In acute diseases, or when the intervals betwixt the several doses are very considerable, we may, he says continue to give the medicine at equal intervals and in unaltered doses to the end of the disease, but such cases are not, he says, of frequent occurrence; the continued repetition demands an alteration in the intervals and in the size of the dose. The receptivity becomes deadened, and where, as in chronic diseases, it is necessary to continue the medicine for a long time, the repeated doses must be given stronger; the quicker the repetition the more rapidly susceptibility for the impression of the remedy blunted. It is very rare that the susceptibility is exalted by repetition of the dose, especially in the case of small doses, but that this happens in some cases, he brings forward examples to prove. But, he adds, there are plenty of patients whose irritability remains for years in the same degree, provided intervals are allowed to occur without their taking medicine. As the duration of the action of medicines is shorter in acute than in chronic diseases, repetition is more demanded by the former than the latter. He also admits that some medicines have a longer action than others. In acute diseases it is, he alleges, necessary to repeat the shorter-acting medicines every four hours, every two hours, every hour, every half-hour, or quarter hour, but the longer – acting medicines every two to twelve and even twenty-four hours. In such cases, after giving a few doses quickly, we may make a pause of some hours duration. In chronic diseases, the long- acting medicines should be given only every twenty-four hours, some times even seldomer; the short-acting ones require to be given often several times in the twenty-four hours: it is seldom requisite to give several doses of the longer-acting medicines in one day. Kampfer disapproves of waiting too long as much as of repeating too hurriedly. The degree of the amendment is his guide in general for the repetition. When the critical reactions are strong enough he advises to pause in the repetition, after they are past decided amendment will follow; but if such reactions require to be supported, we must give the medicine in the same or a still larger dose; in this case it appears that the doses latterly given act in an antidotal manner to those first administered, by which the critical reaction, i.e., the curative homoeopathic aggravation, was produced; if this aggravation has become too strong, it may often be subdued by smaller doses of the same remedy, and thus this curative action expedited, in this case there is also an antidotal relation. In the repetition of larger doses of medicine Kampfer recommends us to be very cautious, lest we should produce a medicinal disease.
Dr. Attomyr, (N. Archiv, i. 2.) as I mentioned in a former lecture, has treated of the subject of the repetition of the medicine along with that of the dose. As with the dose so with the repetition, he seeks to obtain rules for it from the provings of medicines on the healthy. It is not the sick-bed but the Materia Medica that must furnish us with rules for the repetition of the medicine. He starts with the following examples: a bottle of wine will intoxicate a man if he drinks it all at once, but he may drink four bottles of wine at twenty times without being a bit the worse for it. Of course, it is requisite that these twenty times should be at some distance from each other, for he would get drunk enough if he drank his twenty draughts in twenty minutes; but if he took twenty days to drink the twenty draughts, the wine would have no effect on him. In like manner, says Attomyr, the difference in the action of medicines is to a certain extent dependent on the intervals at which the successive doses are administered.
On this subject the provings of medicines teach us-
1. That two identical doses given in rapid succession mutually increase one another’s medicinal action.
2. Two identical doses given at long intervals repeat the medicinal action without increasing it.
3. If a small dose be given a short time after a large one it increase the action of the latter.
4. If a small dose be given a long time after a large one it neither increases nor repeats the action of the latter.
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.