At first the drug should be taken in small doses, and the dose increased or doubled every day. One single very large dose certainly produces greater effects, but it may prove injurious to the health. A moderate or even a pretty large dose seems to have scarcely any perceptible action; only a few symptoms are developed during the first few hours. At the same time Piper admits that large doses are often rejected by the organism very rapidly, and do not penetrate the system. He gives as a rule, to commences taking the medicine in doses of one-teeth of what he calls the lowest normal dose; by which he means the dose enjoined in the ordinary works on Materia Medica. He found that, for example, if he began with one drop of the tincture, by the time he had reached four drops and effect developed itself, but that when he began with four drops he had to take twelve or more before any effect was produced. As regards the repetition of the dose, he says that there should be an interval of at least twenty-four hours betwixt two doses. There are few drugs that complete their action in the healthy body in less than twenty- four hours; if they do so it important to ascertain this. A repetition of the drug at another period than the twenty-four hours must disturb what there is of a typical character in the reaction. In the case of drugs that act for a longer period than twenty-four hours, a repetition of the dose at the end of twenty- four hours causes no disturbance, but merely an increase of its action. On repeating the medicine, its dose should be increased. If after several doses on more symptoms make their appearance, we should then resort to the smallest doses, and after a few days give suddenly a large dose. When no decided effect follows the ingestion of a good preparation of powerful medicine, Piper inclines to think this is owing to the increase of the dose not being conformable to the nature of the drug. When objective symptoms make their appearance the drug-taking should be immediately stopped; on the disappearance of the symptoms, if within twenty-four hours no new symptom appearance, a somewhat larger dose of the drug should be taken, and the daily dose increased until some other objective symptom appears. In the evening of the same day that symptoms first occur a pretty large dose should be taken and the effect watched, undisturbed by any fresh dose. If, notwithstanding the observance of these rules, no particular effect should ensue from a decidedly powerful medicinal agent, the following method should be adopted. No supper (dinner) should be eaten, and whilst the feeling of hunger continues a pretty large dose of the drug should be swallowed. If nevertheless nothing occurs, then the prover may conclude that he is insensible to the action of the particular drug. A person liable to acidity of the stomach will be insensible to the action of a number of vegetables substances. Abnormal states of the intestinal canal may check the development of many medicinal diseases, and on the other hand the abnormal or unhealthy condition of an organ-for instance, the lungs-may increase enormously the action of a drug that has a special affinity for it. In such a case it may frequently happen that a curative action ensues, if the drug be a specific remedy for the particular affection under which the person labours, and the records of physiological provings are not without occasional instances of this kind. Idiosyncrasies on the part of the provers are of importance; indeed, as I have formerly pointed out, Hahnemann considers that the symptoms caused by such idiosyncrasies should be regarded as medicinal symptoms. Piper finally thinks that we should not confine ourselves to a register of the purely physiological symptoms, but should include the chemico-physiologicals symptoms of medicines also in the Materia Medica. These rule and directions of Dr. Piper’s for the conduct of physiological provings are not without their value, and should be considered by those who undertake such provings; but they are far from exhausting the subject, and many variations from them and improvements upon them will naturally suggested themselves to all who are engaged in this important undertaking.
Schron (Naturheilprocesse, ii. Aphorism 176-188) is of opinion that the proving of medicines is equally important for all the three methods of treatment, but I think I have shown that the utility the antipathist and the allopathist could derive from them is small indeed, in comparison with that they offer to the homoeopathist. He says the objection often made, that our so- called experimented on the healthy are impossible, as there are no absolutely healthy persons, is absurd, as for all purposes relatively healthy individuals are sufficient, and we do not seek to restore patients to a state of absolute but of relative health. The symptoms that occur in each person by virtue of his weak or unhealthy organ will not disturb the purity of the proving, if several persons are engaged in the trial of the remedy; for the symptoms produced by this cause will then be easily detected and omitted from the list of the pure effects of the medicine. Shron is not opposed to the proving of medicine on the sick, put the symptoms got from this source are only to be used as corroborative of effects obtained from a more reliable quarter. Both sexes should of course be employed in the provings. With respect to the age of provers, it is obvious that it is desirable in all cases to have those who are able to give a distinct and lucid account of their symptoms. But if we employ only grown-up people, we shall not be able to ascertain the effects of medicines on the thymus gland or on the process of the first medicines on the thymus gland or on the process of the first dentition. We should have to content ourselves with purely objective symptoms, however, in the case of infants. In reference to the substances to be proved, Schron is of opinion that it would be much more useful to perfect the provings of the medicines we already have, than cumber our Materia Medica with fragmentary provings of new substances. He is opposed Hahnemann’s later idea to prove all medicines only in the 30th dilution, and refers to the much more satisfactory nature of the provings in the first six volumes of the Pure Materia Medica, obtained from larger doses of the medicines, than those of the later period of Hahnemann’s career. With respect to the arrangement of the provings, Schron says that each proving should be preceded by an introduction, stating the order in which the symptoms appear, and giving a sort of general pathological view of the effects of the medicine. After this should come the list of the symptoms, arranged so that symptoms should form a first class, which have appeared in all or almost all the provers. These symptoms will always refer to the organ or organs for which the remedy has a decided specific attraction. Of course care should be taken not to confound such symptoms with those general and universal symptoms that accompany the action of almost every medicine and morbific agent, such as loss of appetite, weariness, etc., to which no value can be attached except as being mere sympathetic phenomena. Such unmeaning symptoms, however, from a large item in Hahnemann’s provings, and only severe to increase the difficulty of obtaining a correct view of the effects of the remedy. If among a number of persons of both sexes proving a remedy, one symptom should only appear among all those of the same sex, we may consider this as a symptom of the first class, and one connected in some way with the sexual organs. It is therefore necessary that in every instance it should be distinctly stated of what sex the provers were who exhibited the different symptoms. In the second class of symptoms should appear those which occurred only in a limited number of the provers. These will generally be found to be symptoms that have a sympathetic relation to the organ for which the medicine has a special affinity, and they will be of great use in assisting us to arrive at a correct knowledge of the sphere of action of the drug we are engaged in proving. Symptoms that occur in but one or in very few of the provers have on great value, but should not be altogether discarded, but registered in an appendix to the general schema, as future observations may corroborate their genuineness, and they may not be without their use in guiding us to a selection of the proper remedy.
Griesselich (Handbuch d. hom. od. spec. Heilk., p. 90) justly remarks that as with diseases so it is with all other influence the susceptibility must be there in order that the prover shall be affected by any medicine; and even among susceptible persons the susceptibility is present in very different degrees among different persons, and very differently towards different medicines in the same person. Some persons seem to exhibit when well an almost total insensibility to many or to all drugs. Griesselich himself was one of these unsusceptible persons. Others again are most powerfully acted on by any, even the weakest medicine substances. We must, he says, remember that in the proving of medicines, as in other things, a person may become habituated to them, and thus his susceptibility blunted. Thus, if the prover should have taken a drug for a certain length of time, and a certain array of symptoms have been developed, it often happens that a longer persistence in the use of the medicine will not only not develop any more new symptoms, but will not even prevent those that may have occurred from dying away; a sort of saturation ensues, and the prover experience no particular morbid phenomena, but only a great repugnance to taking any more of the drug. If he now waits length of time without taking any medicine, and begins again with very small doses, it frequently happens that the symptoms he formerly experienced return in full force, just as though they had been in a latent state. Hence it is not advisable to perform such physiological provings in rapid succession; for even a different drug, if it have any action in common with the one that has just been proved, will often stir up the organism to reproduce a miniature representation of the symptoms caused by the other drug, if taken too soon after the first one. Dr. Griesselich warns against proving medicines; in tinctures, where it is requisite, in order to obtain an action, to take as many as fifty, one hundred, two hundred, or more drops; for the vehicle of the medicine, the alcohol, will often disturb the pure effects of the drug by its own pathogenetic power in such quantities, and it is an undoubted fact that alcohol has an antidotal relation to many drugs. Therefore it is in such, and indeed in all cases preferable to take the drug in the form of the freshly expressed juice of the plant, as a powder, in water or otherwise, or in the form of a carefully prepared infusion of decoction.
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.