What would they have risked if they had at once heeded my words and had first made use of these small doses? Could anything worse have happened than these small doses might have proved ineffectual? They could not have injured anybody! But in their unintelligent self-willed use of large dose in homoeopathic practice they only passed again through the same roundabout route, so dangerous to their patients, which I in order to save them the trouble had already passed through with trembling, but successfully, and after doing much mischief and having wasted much time they had eventually if they wanted to cure to arrive at the only correct goal, which I had made known to them long before faithfully and openly, giving to them the reasons therefor.
That Boenninghausen also passed through this “roundabout route” is witnessed by his words in his *Lesser Writings, quoting from an earlier statement in *Homoeopathy, a Reader for the Cultivated, Non-medical Public : “Since I also, led by the almost unanimous assertions as to the untenableness of this teaching, gave, though only for a short time, larger doses and with bad success.”
Homoeopathic dosage is based upon law, as is the selection of the remedy based upon the law of similars. ***ACTION AND REACTION ARE EQUAL AND OPPOSITE : this is fundamental, and it is this law that must guide us in the application of drugs.
The so-called primary action of drugs, and the so-called secondary action of drugs, are manifest to any observer. As a common illustration we may take the nausea and vomiting of *Ipecacuanha; yet in small doses it is curative in sickness with nausea and vomiting as prominent symptoms, other symptoms agreeing. *Opium causes profound sleep when used in the ordinary manner; yet *Opium is of inestimable value when given homoeopathically, in small doses, in cases of profound coma. These instances cited are of drugs classic in massive doses, or in common parlance, physiological doses, for certain common states of sickness.
The physiological action of a drug, however, has nothing whatever to do with the curative action from the homoeopathic point of view, because homoeopathic remedies are never used in physiological doses. This may seem at first illogical because we may use them in low potencies, yet we never use them for their physiological effect.
The physiological action is toxic on nature, therefore injurious to the patient. The physiological action of a drug is not its therapeutic or curative action; it is the exact opposite of a curative action and is never employed in homoeopathic practice for curative effects. The use of the drug in physiological form is an acknowledgment of the attempt to produce drug symptoms because of their primary action, and an acknowledgment also that the physician so using the drug has never observed the secondary symptoms. Speaking of narcotic drugs, in Paragraph 113 of his *Organon, Hahnemann has this to say :
… As these (narcotic drugs) destroy sensibility and sensation, as well as irritability, in their primary effect, a heightened state both of sensibility and irritability is frequently observed in healthy persons, as an after-effect following the administration of narcotics, even in moderate doses.
*Pathogenetic is the term used by the homoeopathicians as a more correct term for the primary symptoms produced by the drug, and as a synonym for the term *toxic; in other words symptoms may be produced by massive doses or by crude drugs, but these symptoms are pathogenetic and not curative. These symptoms may show forth family likenesses as many members of a family, under certain circumstances, will often have a similar general reaction; but to apply our knowledge of the drug as a curative measure we must know definitely what its capabilities are. These capabilities cannot be manifest from the pathogenetic symptoms.
The homoeopathic cure is produced without drug effects; it is accomplished without suffering; it is mild; it is developed through growth; it is dynamic in nature, therefore it must be given on the dynamic plane and never in a way to produce drug effects. It therefore must be the minimum amount of the drug that will act upon the vital force, which, as Hahnemann says, can scarcely be too small.
We must remember, in the dividing of the dose, no matter how far this is extended there is something of the drug left. Matter is never destroyed; it may be changed in potentization, but an absolute zero is never reached.
Homoeopathic dosages required that no new symptoms shall be produced as a result of their administration, for these would be drug effects; but we may find a slight aggravation of the symptoms already present immediately following the administration of the homoeopathic remedy, which soon recedes, and improvement continues. Only the single remedy in the smallest possible dose will usher in these happy results in this way; the suffering is quickly reduced; the strength is conserved; the patient is in a state of restored health.
We must not think that the infinitesimal dose cannot produce symptoms; this is frequently found in very susceptible patients. In fact, the best provings are obtained with the high potencies on susceptible people.
When the homoeopathic drug is administered, it is so similar to the natural disease that it therefore meets with no resistance, because the sphere of its action is already invaded by the similar disease and its resistance overcome by the similar acting disease-producing agent. The affected organs and tissues are open to attack susceptibility to the similar remedy is therefore greatly increased. The homoeopathic remedy acts upon the identical tracks involved in disease states in a similar way to the disease-producing cause. In order that the suffering and distress may not be increased, it is therefore necessary to use only the smallest possible dose. For this reason the homoeopathic dose is always short of the physiological or pathogenetic dose. It must be so small as not to produce too much aggravation of the symptoms already present, and never large enough to produce new symptoms.
There is a law of dosage as well as law of cure, and when we use a homoeopathic remedy it should be based upon that law, for if homoeopathy means anything, it is that it is based upon natural law and order. This law is fixed and unchangeable. It makes no difference with the law if we do not follow it, but it does make a difference with our results. *The quantity of action necessary to effect any change in nature is the least possible : the decisive amount is always a minimum, an infinitesimal.
It can hardly fail to be plain that the same power which establishes the curative relationship between drugs and diseases, and regulates this law, should at the same time and in the same manner determine the quantity and method of this administration. This places it, not upon a notion or whim of what strength shall be used, but our interpretation of the law.
Let us elucidate this law. Let us get a clear concept of the elements of this problem. They are of two classes: those which belong to the patient, and those which are associated with the drug.
In the first, we are dealing with the perverted stimulus of the organs or functions of the body and the natural relationships are disturbed. The susceptibility of these organs to impressions from these stimuli are exalted, depressed, or extinguished. The susceptibility may be exalted in respect to some influences even to the point of intolerance, or depressed in others to the point where we have the feeblest response to impressions, while others are entirely void of response to all stimuli. These are new susceptibility to impressions from external forces not found at all, or not existing to the same degree, in the healthy. The sum of these changes forms a class of facts most important in this investigation, and gives the basis of a proper understanding of the condition of the sick.
For our present purpose it will be necessary to consider only such of these changes as have reference to impressions from drugs. In a given case of disease the patient is often over- sensitive to the smallest quantity of some drugs, while there is an equal insensibility to even large quantities of others. We find this often. The answer to this is an illustration of the expression of the law of the dose. The changes of susceptibility constitute the first class of the general elements of the problem. Those of the second belong to the drug.
These consists of the power which belongs to drugs to produce disturbances in the action of living forces, so that they no longer act in harmony which maintain that sense of well-being which is health. It is this power so to act that constitutes a drug, and it is with this power so to act upon living organs in special conditions of susceptibility that we have to do in determining the dose in a given case of disease and also to comprehend as the law which governs the dose in all cases.
After having settled the first question in prescribing-What is the remedy?-this question of special susceptibility in the organs is just that which decides the next question we must answer: How much of this remedy is required to restore the lost balance of the vital force in the particular case? In these two questions lies the whole problem of cure.
