***IN considering the amount of medicine to be used at one time, or to answer the query, What constitutes a dose? it is very important to have some concept of the history of homoeopathy, for this throws light upon the development of the problem of dosage.
Before Hahnemann’s time, and indeed in his early work, the dose played an important part. Nothing but crude and massive doses had ever been used in the care of the sick. All physicians used these massive doses as a matter of course, and Hahnemann, being a product of the best training of that day, followed, in his early career, in the footsteps of his predecessors. Even after Hahnemann began to see the light of the ***LAW OF CURE he continued to use massive doses, and it is to be remembered that he made cures with massive doses of crude medicine, but from his close observations and continual experiments he found that he was obtaining drug effects oftener than he was making a successful cure.
When he became convinced of this, he reduced the dose, dividing and again dividing the dose, watching closely the results. He soon found that the smaller the dose, the more beneficent the results. His experiments with the divided dose did not come until after he had discovered the dynamic action of disease; then with his logical mind he must of necessity have correlated his results from the larger doses and brought his ideas of dosage in to correlation with the same concept. For if disease be dynamic in nature, the use of a remedy to cure, or even to reach the disease, must be dynamic, rather than physiological, in form and power.
The more Hahnemann became convinced of the dynamic nature of disease, the more he sought the dynamic plane in medicine, and the more beneficial he found the administration of the similia. Very, very gradually, the minimum dose, which is always a flexible measure, became ever smaller and smaller, until it has developed into the infinitesimal.
However, it has been a long road to the use of the minimum dose, and many animosities have developed, all because of the failure of many minds to grasp the idea of the dynamic nature of disease and the natural tendency to look upon material substance as the remedy and the pathological state as the disease, and the failure to see the expression of diseased states in subjective symptoms.
The gradual recognition of the power of the minimum dose is manifest even in the dominant school of medicine, and is being proven in the laboratories of modern science. As a result, gradually lessening doses are being adopted by many who have formerly derided the possibility of effectiveness from small doses. Many of the leading pharmacies have followed this road in preparing drugs for the use of the general physician. This trend is manifest in the colloidal preparations and the ductless gland therapy. Of late the physiologist has shown the power of vitamins, and as a particular instance we might point to recent experiments with Vitamin D. It has been found that one part of the crystalline form to three-trillionths has a curative action on rachitis, while one part to fifty-thousandths has a destructive action to the points of causing rickets. This again verifies Hahnemann’s dictum on the power of the small dose and the harmful effects of the more material dosage, although this proven material would be classed as infinitesimal by many.
This also demonstrates the Arndt-Schulz law of action and reaction. So we are coming to a point where we fully recognize and comprehend the soundness of Hahnemann’s deductions. Let us go to Hahnemann’s *Organon (fifth American edition) for his teaching in regard to the dose, remembering that in every edition this was plainly taught. Each edition progressed one step further in the development of the minuteness of the dose.
Paragraph 112. In older descriptions of the fatal effects of overdoses of medicines, it is often to be noticed that the close of such deplorable accidents was marked by certain effects which were of very different nature from those witnessed at the beginning of the case. These symptoms which are called forth in opposition to the primary effect, or actual operation of drugs upon the vital force of the organism, are its counter-effect, or after-effect. But these are rarely if ever perceived after moderate doses administered to healthy persons for the purpose of experiment; and they are altogether absent after minute doses. During the homoeopathic curative process, the living organism exhibits only that degree of counteraction against these minute doses, which is required to re-establish the natural state of health.
128. The most recent experiment have taught that crude medicinal substances… will not disclose the same wealth of latent powers as when they are taken in a highly attenuated state, potentiated by means of trituration and succussion. Through this simple process the powers hidden and dormant, as it were, in the crude drug, are developed, and called into activity in an incredible degree.
156. There is, however, scarcely a homoeopathic remedy which, though well selected, if not sufficiently reduced in its dose, might not call forth at least one unusual sensation, or slight new symptom during its operation on very susceptible and sensitive patients….
157. Although a homoeopathically selected remedy, by virtue of its fitness and minuteness of dose, quietly cancels or extinguishes an analogous disease…. Aggravation caused by larger doses may last for several hours, but in reality these are only drug-effects somewhat superior in intensity, and very similar to the original disease.
159. The smaller the dose of the homoeopathic remedy, so much the smaller and shorter is the apparent aggravation of the disease during the first hours.
160. The dose of a homoeopathic remedy can scarcely be reduced to such a degree of minuteness as to make it powerless to overcome, and to completely cure an analogous, natural disease of recent origin, and undisturbed by injudicious treatment. We may, therefore, readily understand why a less minute dose of a suitable homoeopathic medicine, an hour after its exhibition, may produce an appreciable, homoeopathic aggravation of this kind.
In Hahnemann’s *Chronic Disease he is equally emphatic when he says :
But when these aggravated original symptoms appear later on in the same strength as at the beginning, or even more strongly later on, this is a sign that the dose of this antipsoric remedy, although it was correctly selected, was too great, and caused the fear that no cure could be effected through it, since medicines given in so large a dose are able to establish a disease which in some respects is similar, but even greater and more troublesome, without extinguishing the old disease. This is caused by the fact that the medicine used in so large a dose also its other symptoms which nullify its similarity and thus establishes another dissimilar disease, also chronic, in place of the former.
Again he says :
This ( the large dose of medicine) finds its decision already in the first sixteen, eighteen or twenty days of the effect of the medicine given in too large a dose, as it much then be checked, either by prescribing its antidote, or when this is not known, by giving another antipsoric medicine, as suitable as possible to the symptoms then prevailing, and this in a very moderate dose, and when this is not yet sufficient for abolishing this sinister medicinal disease by prescribing a second medicine as suitable as possible at that time…. When the stormy assault of the excessive dose of even a correctly selected homoeopathic remedy has been assuaged by the following use of an antidote or the later use of some other antipsoric remedy, this remedy which had only proved injurious through its excessive strength may be used again, and indeed as it is homoeopathically indicated with the best success, only in a far smaller dose and in a far more potentized attenuation.
And still again :
No harm will be done if the dose given is even smaller than I have indicated. It can hardly be too small if only everything is avoided that might interfere with the action of the medicine or obstruct it…. they will even then do everything of good that can in general be expected of medicine, if only the antipsoric was selected correctly in all respects as to the carefully examined symptoms of the disease and was thus homoeopathic, and the patient did not by his actions disturb the medicine in its action…. On the other hand, we have the great advantage that even if in some case the selection should not have been made quite suitably, we have the great advantage that we can easily put out of the wrong medicine in its minimal dose in the manner indicated above, when the treatment can be continued with a suitable antipsoric delay.
If prescribes in general, and especially those starting on the path of homoeopathic prescribing, would take special note of this warning, they would save themselves much trouble and their patients much needless suffering. Hahnemann felt the waste of time, effort, and actual suffering needlessly caused, when he cried:
