It appears that some of his disciples sought to excess Hahnemann’s limitations respecting the trustworthiness of symptoms produced in patients, by putting down as the pathogenetic action of the drug those symptoms of the disease which were aggravated after its administration, for in a letter to Stapf, dated Sept. 1813, he thus expresses himself:-
“You are right in supposing that the increase by a medicine of symptoms that had been previously present, most probable indicates that the medicine given can of itself also excite similar symptoms. Still we must not include such symptoms in the pure positive effects of the medicine, at least not in writing. All we can do is to bear them in mind, in order that we may pay proper attention to them when once they occur purely (that is, never having been present before) during the use of the same medicine.” (N. Arch., i. 1, 156). We shall presently see that in the last edition of the Organon he allows such symptoms to be registered among the pure effects of medicines.
Such then, as I have detailed them to you, were the principles on which Hahnemann acted in the commencement of his arduous undertaking of constructing a totally new Materia Medica. As years advanced, his mode of proceeding became altered to a certain degree, and I now propose to lay before you his notions as to how the remedial agents should be proved (as we term it), in order to ascertain their pathogenetic powers. I shall give you his latest and most matured ideas on the subject as they are to be found in the Organon; but as it would occupy too mush time, and probably exhaust your patience, were I to read all that he has said upon the subject, I think it best to lay before you a condensed view of the most material points, referring you to the last edition of the organon, from Aphorism cv. to cxlv., for more ample details on the subject.
Every medicine differs in its action on the human frame from every other. The stronger medicines developed their action sooner than the weaker on robust individuals is small doses. Weaker medicines must be given in larger powers, and the very weakest only show their action on every irritable subjects. We should take care that the medicines we employ for our provings are genuine and unadulterated. Indigenous plants should be taken in the form of fresh juice mixed with alcohol; exotic vegetable substances as powder or tincture, made when they were freshly gathered; salts and gums should merely be dissolved in water just before being taken. If we can only get the plant dry, and if it be weak, we should take it in the form of infusion, swallowing it while warm. The diet of the experimenter should be regulated, all medicinal and stimulating beverages avoided, and also over- exertion of the mind and disturbing passions. Both males and females are required for experiment. Recent experiment show that medicines do not exhibit nearly all their powers when given in the crude state, but that they do so when duly triturated and succussed. The best plan of proving medicines, even such as are deemed weak, is to give the experimenter, on an empty stomach, daily from four to six very small globules of the 30th dilution of the substance we wish to test, and continue this for several days, until an effect os produced. As, however, many people are affected by a very small quantity, it is best to commence with the smallest dose, and it is a great advantage when one dose takes effect at first, for then we can learn better the sequence of the symptoms, which we cannot do if it is requisite to give several successive doses of the medicine. If, however, we do not care about the sequential order of the phenomena, but merely wish to know what symptoms the drug produces, then the best plan is to give it every day in increasing doses. When we experience any sensation, we should try what effect change of position, walking, the open air, the close room, eating, drinking, coughing, sneezing, etc, have on it, and note the times of the day when it occurs. All the symptoms a medicine can produce are not observable on one person, so we require to test it on many, in order to ascertain them. The more moderate the dose used for our experiments, the more distinctly are the primary actions of the medicine developed. Too large dose give rise to disturbing secondary actions. All the phenomena that arise during the action of a medicine are solely derived from this medicine, and must be registered as its symptoms, even though the experimenter has observed the occurrence of similar symptoms a considerable time previously, as arising spontaneously. If the physician does not perform the experiments on himself, he should closely superintend the experiments of the person he employs for this purpose, but the best plan is for the medical man to make his experiments on himself; if he dose so he gains a great advantage in the accuracy of the symptoms, in acquiring habits and powers of observation, and his health, far from suffering, in the long run will be much benefited by the trials.
“But,” says he,” how some symptoms of the simple medicine employed for a curative purpose in diseases can be discovered even amid the symptoms of the original malady, especially in diseases of a chronic character, that usually remain unaltered, is a subject for the exercise of the higher order of inductive minds, and must be left solely to masters in observation. (Organon,Aphorism cxliv).
And yet he says, a few paragraphs previously :-
“If medicines be given to sick persons only, even though they be administered singly and alone, then little or nothing of a decided character is seen of their pure effects; as those peculiar alterations of the health to be expected from the medicine are mixed up with the symptoms of the disease, and can seldom be distinctly observed. ” (Ibid., Aphorism cvii).
So that, taking this paragraph into consideration, we may infer that Hahnemann does not propose actually to make provings of new medicines on diseased persons, but that careful observers may be able, from a watchful observation of the new symptoms developed in chronic cases after the administration of a remedy, to determine if these belong to the medicine or the disease, and by this means to eke out the symptomatology of the medicine. It does not look as if Hahnemann relied solely on this impure source for the knowledge of the pathogenetic powers of any medicine, but from his constant reference to it as a source, we are bound to believe that he did resort to it from his earliest experiments, as a method in judicious and careful hands deserving a certain amount of confidence.
There is no doubt, from what I have just adduced from Hahnemann’s directions in the Organon, that the proving of medicines with globules of the 30th dilution was latterly a favourite method of his, and this is not the only place where he distinctly recommends it, for we find also in the Introduction to the third edition of Part II. of the Pure Materia Medica the fallowing passage:-
“I would only observe here, that for the proving of medicines on healthy individuals, dilutions and dynamizations are to be employed high as are used for the treatment of disease, viz., globules moistened with the decillionth development of power. (Lesser Writings, p. 863.)
Indeed it is highly probably that many of Hahnemann’s later proving were performed exclusively with globules the 30th dilution, and it is also extremely likely that many of the subjects of his provings were his own patients, to whom he administered these globules, and desired them to watch the effects that ensued.
It can hardly fail to strike us that there is another point connected with Hahnemann’s directions for proving which we cannot regard as a very reliable source for ascertaining the virtues of medicines, and that is his statement that we are to regard as the pure action of the drug all symptoms observed by the prover, even though some of these may be such as he had noticed previously as occurring spontaneously. I am sorry that Hahnemann should have allowed this to be a pure source, for I fear it has opened a door for the admission into the Materia Medica of many symptoms that have no business there. I cannot help regarding the kind of experimenters he alludes to as very much akin to that class labouring under some chronic ailment, and if he rigidly rejects the morbid symptoms evidently caused by the disease of the latter, I do not see how he can consistently the morbid symptoms of the former, to which they were in a manner subject. We all know that there are many individuals, as a rule, robust and healthy, who are occasionally subject to some morbid symptoms of more or less severity, which symptoms are provoked by anything and everything that is calculated to derange their systems, and it will be obvious that if a number of such individuals are selected for experiment, and all their symptoms of this character registered, we readily obtain from almost any medicine an imposing pathogenesis, which, however, we should find at the bedside to be of not much practical value. And probably it is such a source as this to which we owe some of the symptoms in the work on the work on Chronic Diseases which occasionally disappoint us, when we think we have discovered in the pathogenesis of some medicine the exact parallel of a case under our care.
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.