I have nothing original to offer you, but I have a great many quotations, some of them very pregnant. Most of my quotations are not from medical works. Let me begin with a quotation from Benjamin Disraeli: “Never apologize, never explain.” That may be a good maxim for politicians, but I have always had the deepest contempt for that advice.
Therefore I am going to begin by committing two cardinal sins. First I want to apologize to Dr. Moncrieff because I was very rude to her when she rang me up and asked me to fill a gap to-day. She said that something on the lines of my “Drug Portrait Gallery” would be very welcome, and I turned that down flat.
Now for the second cardinal sin! Let me explain. When I collected that Portrait Gallery of sulphur patients I put a good deal of work into it, but the point I wanted that paper to make was contained in one much too sententious phrase. I said, “The spirit cannot live by science alone.” Let me be sententious again to-day and say, “Mankind cannot subsist by art alone.”
A further explanation: in all the time I have been connected with this Faculty and the British Homoeopathic Society I have been vexed by two things chiefly. Discussions crop up, not fruitfully but very frequently, on the questions: “Is Homoeopathy an art or a science?” and that perpetual silly wrangle about low potencies versus high.
To-day I am going to be scientific, but to make amends for my rudeness I want you all to help me and present this discussion in another art form, in the art form of the theatre. Following on one item in the business part of to-days agenda, let us give it the character of an examination.
Dramatis personae: You yourselves, ladies and gentlemen, acting as candidates in this examination.
Costumes: Your own choice. We have no coupons, but candidates are not required to appear in white robes, nor to display their wounds.
Scenery: As you see it.
Candidates will mount this rostrum when summoned by our President (this makes him a call boy, but we shall ask him also to be a censor). At the rostrum candidates will be asked to answer three question all, any, or none giving the reasons for their answer, and if necessary drawing a diagram. The blackboard is the only stage property we are providing. We have no orchestra. Sound effects, if any, will be supplied by Hitler, Goring, and company, and, let us hope, will be limited to a minimum. The questions are:.
(1) In speaking about the action of internal medicines what distinction do you draw between power and potency?.
(2) What do you mean by the terms “low potency” and “high potency”?.
(3) On what indications do you select (a) a low potency and (b) a high potency?.
Now I retire to the wings and ring up the curtain.
The President said that Dr. Rorke had his own way of doing things, but he was rather expecting that he was going to help him out.
Dr. Rorke said that he was quite willing to proffer himself as the first “candidate.” He went on:.
As candidate, most of what I am going to say is again, to quote other peoples words. I shall begin by quoting a patient. He had had no training in medicine at all, but he was a science graduate of London University, a member of the Institution of Civil Engineers, a member of the Institution of Mining Engineers, and all his life he had been engaged in scientific mining, prospecting, etc.
He had been so employed in Britain, in Russia, in Turkey, in Africa, north, south, east, and west, in Australia, and in South America. While he was working in West Africa he contracted a tropical ulcer. That was many years ago. It was treated at home here by many different kinds of treatment, and in the end the ulcer was healed. But it left, as is common, a big patch of dry chronic non-irritant eczema.
Every spring and autumn that eczema “blew up” into what looked like, and to him felt like, an erysipelas. He had much treatment for that too, but in the end he consulted a homoeopathic physician, and it cleared up very rapidly, not only the erysipelas but the eczema.
That is a man of scientific mind, and he wanted to know something about homoeopathic medicine, so he was lent a Life Hahnemann, and he read it carefully and with great interest. His chief comment after reading it was this: “It is very surprising to find that as long ago as the end of the eighteenth century Hahnemann realized how power could be developed by the extension of surface.” I said that was known a long time before Hahnemanns day.
Physicians all knew that a nugget of solid sulphur weighing a dram did not do much, but a dram of flowers of sulphur had a great deal of power. Hahnemann went a long way further than that. I told him how Hahnemann right from the beginning of his researches had insisted that these very extreme dilutions did contain something, and that that something held the characteristics of the original drug. He very rightly said, “You have only got to try it and see.” But a good many physicians, homoeopathic and other, could not be satisfied with that and wanted an explanation.
About 1890 the Swedish chemist Arrhenius tackled the question and evolved the theory of dissociation. He said that when a very small quantity, say, of common salt, was put into a very large bulk of distilled water, undoubtedly the whole bulk contained something of that common salt, and he evolved the theory that in solution the atoms of the molecule were dissociated and dispersed. But that did not account for it, he had to go further and say that these atoms were dissociated into ions. That was the beginning of the electronic theory of which so much is said still.
However, a homoeopathic physician I think a German , but he might have been an American consulted Arrhenius and asked him if his theory would explain that a high potency dose of, say, common salt carried in it all the characteristics of sodium chloride. Arrhenius thought it over and said quite definitely “No”. What then, is in a dose of say, 10m of sodium chloride? There is something, as we all know, and we all know that it is the same thing.
Now for another quotation, this time from the report of the very first experiments conducted in homoeopathic medicine. Hahnemann wrote this: “When cinchona bark is accurately indicated as a remedy, and when the patient is seriously and intensely affected by a disease that China is capable of removing, I find that one drop of a diluted tincture of cinchona bark, which contains a quadrillionth (1-1000000,000000,000000, 000000th) of a grain of china powder, is a strong (often a too strong) dose, which can accomplish and cure all that China is capable of doing in the case before us, generally without its being necessary to repeat the dose in order to effect a cure; a second dose being rarely, very rarely, required.” That is one quadrillionth. If you care to work that out you will find that, regarded as dilution, it is the 12th c. That was the very first remedy with which he experimented.
What did he mean by saying that it was sometimes too strong a dose? The use modern medical cant, where a sick person presents the symptoms calling for China very fully, that patient is “hypersensitive” to China, he has an “idiosyncrasy” to China, he is “allergic” to China. I have hunted through Hahnemanns work, which is the most thorough record of experimental work in Homoeopathy to this day.
It has been enriched by many others, but Hahnemanns Materia Medica Pura is the finest register, the fullest record of experimental medicine that was ever published. I have hunted through it all, and I cannot find a single instance where he used a lower potency than that. When he published that he did not talk about potency, but Aconite and Belladonna were probably experimented with quite soon in the series we have no record of the dates and in both cases he says that the most effective and the least disturbing dose of Aconite and Belladonna was what he calls the decillionth which is equivalent to the 30th c.
The most hardworking and conscientious experimenter in Homoeopathy never used the decimal attenuations, never wanted them, and although he found that this 30th c. was good enough for him, he very frequently said that further potentizing might be helpful. Dr. Tyler always maintained that there was record of his having used 200th c. She was never able to find the passage to satisfy me, but here is another quotation: “With a thousandth part of a drop of the decillionth so far as I remember this is from the introduction to Belladonna “it is seldom that a second dose is required.” and he gives directions for making this thousandth part of a drop preparation. The directions are to use small globules of such a size that 300 go to one dram.
It was when he was dealing with Belladonna that he first used the word “potency”. He describes the making of the decillionth dilution by thirty successive dilutions with succussion. He called that decillionth development of power a “potency” and he gave it the make x.
Somewhere else he talks about the decillionth development of drug power: “10x”. My next quotation is this. At one of the meetings of the British Homoeopathic Society a very eloquent and very enthusiastic speaker, after declaring that he was convinced that the future of Homoeopathy lay with the higher and even the highest potencies, went on to tell us that he was having potencies made by succussion by one of those road drills you all know too well, and he said, “I hope that these potencies will prove to have devastating effects.”
A comment made at that time was this: “Any man who can talk like that knows no more about Homoeopathy than a praying parrot knows about theology.” That was uttered in heat, but quite calm I quote it now as a very just comment.
Another quotation: we had in the London Homoeopathic Hospital a doctor trained in Germany, knowing nothing about Homoeopathy. He came here as resident, and while he was here he was called on by a homoeopathic physician who also was trained in Germany, and the visitor said to the resident, “You know, it is a pity that London teaches the high potencies,” and following on that he invited him to attend a series of lectures elsewhere. Well, the gentlest thing to say about that is this, that the poor devil was educated in Germany!.
What do we mean by low potency and high potency? By low potency do we mean the decimals, and by high potency the centesimals? If you make that distinction then there are going to be discussions about high high potencies and low low potencies, and no end of it. On what indications do you select a low potency or a high potency? And there, ladies and gentlemen, I think the right answer is in a quotation from memory from our Presidents Inaugural Address:.
“If the patient does not present very full indications for the remedy that is used, the remedy will be more effective in low potency than in high”.
My own stud of this question has brought this conclusion: if a remedy is given in high potency to patient who has no indications for that remedy, the dose does nothing at all; but if your patient presents rich indications for the remedy and that remedy is given in material dose or in low potency, the patient will suffer aggravation of his symptoms such as to make him ungrateful and distrustful.
Dr. C. E. WHEELER said that the questions could be fairly succinctly answered. Potency was the result of a process through which any substance could be put. It could be carried through various stages. Power he took to be the quality which was, they imagined, enhanced, if not altogether developed by the process of potentization. As regards high and low, he could well remember when 30 and downwards was regarded as a low potency. Now 12 and downwards would be rather thought of as low, and 30 as the beginning of what might be called high. Hahnemann satisfied himself of the truth of Homoeopathy on material, if small doses.
For the first ten years of his practice he was giving such doses, and he did not discover the meaning of potentization until he had practised Homoeopathy roughly for that time and had made his first communication on the subject. He thought that Dr. Tyler did show him a quotation indicating that Hahnemann was aware that followers of his had carried potentization beyond 30, though he himself thought 30 was the best potency. There was no indication that he himself used potencies beyond that. He was in the habit of using 30 as his habitual one.
With regard to the other potencies, he had read somewhere in one of the Lives of Hahnemann that his medicine case after his death did contain some drugs in potencies other than 30. That not in the least improbable. After all, he introduced that idea of the plus potency at the very end of his life, and was always experimenting.
On the selection of potencies, he himself had given up thinking in terms of high and low. For him there was for every case an optimum potency, if he could find it, just as there was an optimum drug. He did not believe that it was always high or always low. If one stared with the idea that there was an optimum potency if one could find it, one would have a freer mind.
As for the first choice, according to his own instinct, the more of an end result the case was and the more one had something approximating or more than approximating to tissue change. the more inclined he was to think that low potencies would do better than high. But there were endless exceptions to that rule, and a good deal depended on the sensitiveness of the patient. Certainly with a very thick skinned person, a person rather unresponsive, one could go as high as one pleased. A vast amount of experiment was required before a principle could be laid down in any dogmatic way governing high or low. If patients seemed to respond particularly well to a certain range the doctor was inclined to begin with that the next time.
He himself believed, as a second rule, that what he called dilution in time was more important than dilution in space, and the old low potencies would have done better even in chronic diseases if they had been given the same chance in time as the potency dose. One of the most remarkable cures of a chronic disease that he had seen of recent years not one of his own cases was effected in nine months by four doses of Sulphur in the third potencies.
It was ended with a 30. It so happened that that particular potency had tuned in rightly to that patients needs and was for her the optimum or pretty near to it. If one could once bring oneself to trust the effectiveness of ones drug, he was quite sure that there was a variation of dose which might usefully be employed.
Dr. Fergie-Woods said that, as to what was a high potency and what a low, one way of looking at it war to take the point at which nothing further could be found by known scientific methods. That was about the sixth potency. From that point of view, he would say that up to the sixth were low potencies, and beyond that high. It was still matter, of course, but matter in a form which could only be detected by special instruments such as the emanometer and by the ordinary physical tests.
How was one to decide whether to give a high potency or a low potency? Dr. Wheeler had given most of the points on that. Three cardinal factors were: (1) The remedy, (2) The stage of the disease, (3) The patient. With a very sensitive patient of artistic type, one should start low, because such a patient was subject to aggravations started if one with a high potency. As for the nature of the disease, when there was more organic change a lower potency should be given to avoid excessive reaction.
As for the remedy, there were certain ones with which he always started low, no matter what the nature of the case, partly because those remedies, he had learned, were specially suited to the very sensitive type. Two of them were Phosphorus and Lachesis. When he got either of those remedies indicated he started no higher than the twelfth.
Dr. Le Hunte Cooper said Dr. Rorkes “points” necessarily involved “the relative value” of Homoeopathy, and the older methods which was of very great importance at the present time.
Dr. Rorke had chosen his points very well. because they were the very ones on which homoeopaths branched out from the Old School.
The danger of Homoeopathic being ignored by the dictatorial proposals of the Beveridge plan, and its very existence being imperiled, made it incumbent upon them to emphasize the greater efficacy of their methods in dealing with disease. At the present time, the medical world is obsessed with the various “Sulphanilamide” preparations, which deal with disease conditions purely from the antiseptic, and anti-bacterial point of view, and it is danger of overlooking the fact that the most scientific way of combating disease is to strengthen the bodily resistance to it, which Homoeopathy alone can achieve effectively.
The word “potency” must call up in the uninitiated medical mind something very different from the Homoeopathic conception, for homoeopaths do not regard the “power” of a remedy as dependent on the amount of physiological disturbance it can evoke, but on its effectiveness in stimulating the body resistance to disease factors.
The usual professional concept of giving “the maximum quantity of a remedy short of poisoning the patient is translated by us into giving “the quantity of the remedy which best brings out its curative effect.”.
In a plea for “simplifying prescribing” made, when President of the British Homoeopathic Society (as it then was) he. Dr. Cooper, had dealt with the “potency question” as it appealed to him. This was based on some years work with unit doses of mother tinctures, and various potencies, and he had no reason for changing the conclusions he then arrived at.
First, it must be recognized that their aim was to “cure,” that is “to rid the system of all evidence of ill-health, so that this did not return when treatment was stopped.” To achieve this it was necessary to allow sufficient time for reactive forces set free by the remedy to act, before repeating the remedial stimulus, otherwise the results obtained were mainly palliative. Recoveries under antiseptics, or bactericides, could not be regarded as “cure”. It was well known that crude substances, whether animal, vegetable, or mineral, too frequently repeated, could not cure; but they could do so, in appropriate circumstances, if the doses were repeated at sufficiently long intervals. His own fathers work proved this conclusively, at any rate in the case of the vegetable kingdom.
Strangely enough, he himself did not find that this applied equally well to the “lower potencies”, say up to 6c. but the curative value of potencies above these was well known. if they were given sufficient time to act. He had not found that the 3rd centesimal, or any of these lower potencies, had the curative effect which Dr. Wheeler had apparently obtained in the particular case he mentioned, or, at all events, he did not find results sufficiently definite to expect much likelihood of a cure from a single, or many, doses of these lower potencies.
The question of “the time of repetition” of remedies was one of the chief factors making for incredulity on the part of those investigating their science. He had therefore tried to reduce the time of repetition necessary for various potencies, to achieve beneficial results; for the more frequently a remedy can be repeated without destroying its curative value, the less difficulty the tyro has in comprehending it.
His experience justified him in saying that remedies in the 30th potency can be repeated every third day, while 100c and even 200c will act satisfactorily at intervals of week, though much longer than this may, in special cases, be required for either. He personally had not found any adverse effects from such frequent repetition. Above these potencies the length of the intervals was capable of almost limitless increase, in accordance with the reactions of the individual patient.
However, such a wide latitude was possible that he only offered the above as a working hypothesis to commence with, and to tread as delicately as possible on the beginners preconceptions. The necessity for this was evidenced by many enquirers being choked off by incredulity, before they had time to make any practical, individual, and convincing, experiments in homoeopathic prescribing, for themselves.
Dr. BLACKIE said that the question which she wanted to answer was the third question which Dr. Rorke had posed. She found that in cases of real organic change that is, in chronic disease often set up by some old-standing infective trouble a high potency would clear them up completely. She had had cases of rheumatoid arthritis and old sinusitis and conditions such as that which a 30c or 100c or a single dose of 10m had cleared up completely.