THE DOSE AND ITS REPETITION



This table is growing all the time. I am only giving the main points in the investigation, that is all. I have occasionally been struck with the idea that possibly the table might be of use to other physicians, but the former publication wasnt asked for strongly, and I have kept it in manuscript form in my own library.

The Doctor has opened up a vast field, a field upon which we can only make tracks, that is all.

In speaking of the periodicity and the times and remedies, if you look through homoeopathic literature you will find that very many reports along that line are based on insufficient data. Some fellow cures a case of Calcarea carb. in the full of the moon, then he marks it down that Calcarea carb. should be given in the full of the moon, on one or two observations. Homoeopathy is just full of that sort of thing. If we are going to know our remedies, we cant count up two or three verifications and then mark that down as characteristic of the remedy. That is one of the weak points in our materia medica. You make a hundred observations on one symptom and then find out of the hundred observations how many confirmed the particular symptom you are talking about. That is the real basis of prescribing. You have got to have a good solid foundation for this thing.

The further I progress in that sort of work, the more I come to the conclusion that a lot of our work is, to speak mildly, highly inflationary. It has that tinge in it, there is no doubt about it at all.

DR. A. PULFORD: I have been very much interested in the dose and its repetition. I have come to look on disease in an entirely different light from what I formerly did. I would like to give you my own views on this point and you can take them for what they are worth. As to the dose, none of us knows the exact amount nature appropriates and uses from the drug mass given. As to the repetition of the dose, that depends on circumstances. If the shock merely interferes with the direction of the normal current directly involved, as soon as the offending factor is removed, a spontaneous cure will take place without any drug, but if that infinitesimal amount of energy is taken in from the affected part, then its equal amount of energy must be supplied to the affected part. If the proper dose has been given, unless there has been interference, it should not be repeated. I have seen some wonderful results from a single dose.

If nature is unable to extract the proper amount of energy required from the first dose given, the dose should be repeated only so the proper amount may be extracted, then stop. If interference from other sources should cause a relapse, then and only then should the drug dose be repeated. I find that, as far as I have gone, a safe rule to follows.

DR. TURTON: I have been able to follow for five years a case that given Nux vomica,45 M. About three years after that dose was given, my preceptor called me to his office. He asked what on earth I gave to my sister. I said I gave Nux vomica 45M. He said, “Good land, I have given her kegs of Nux vomica.” I said, “Of course, and it is quite evident she got an aggravation every time you repeated it, “which was true.

DR. BRYANT: I wonder if this body will forgive me if I repeat what I said last year. I only do it because I think in constant repetition it is finally fastened upon our minds something about the length of action of these potencies.

Walter James, who really caused me to because converted to homoeopathy. I think, gave me this diagram many years ago, and incidentally told me something that made a great impression upon me. Dr. James and Dr. Lippe worked it out over a period of seventeen years. It is something we can use for everything. It gives us an opportunity to have a definite diagram by which we can be assisted in any potency we use. I knew this paper was going to be read by Dr. Underhill, and I have come 3,000 miles, and if I hear nothing else, I will feel well repaid.

This is the diagram that was given to me a good many years ago (illustrating on the blackboard). [ Dr. Bryant has furnished the editors a copy of the diagram used, and this, with Dr. Bryants comments, appears immediately following the discussion.] Dr. James tried to impress upon me the importance of holding onto that remedy until it had acted itself out, and made this diagram. This upper line represents health, and the lower line represents disease. Here is our patient. In this instance we are going to use the 200 potency. If our remedy is properly selected, one of two things will happen. The patient usually improves and he draws this line, calls it the line of primary amelioration. So he put a P.A. there.

It is as distinct in my mind as if it were yesterday, because it has never left me. Then comes your period of aggravation, and there he puts an AG. If you are using the 200 potency, this period of primary amelioration will last approximately two days. The period of aggravation will last three days, and the secondary amelioration which he places here and puts an S.A for it, will last from one to two days. Now, you have gotten all out of that potency that you are going to get, but as he explained this, he also told me something else. He said there is another group of patients who do not go through that cycle, and that class of patients have their aggravation first, and that is the patient that calls you the following day, or the day after that, and explains to you that he cannot take that medicine because it is making him worse, and he is coming back to the office, because he knows you have something that is going to help him.

If you fail to bear that in mind, you are going to interfere with the action of that remedy, so that the patient goes down. You have got to make up your mind as to whether it is a disease that is really progressing, or whether the patient has that type of reaction. Then he simply misses out on his short period of primarily amelioration, and he goes on this way. So he only has a period of aggravation and a period of amelioration. You got the patient up that far. These lengths of action vary according to the potency used until you get up to the millionth.

I have a few potencies of five hundred million, and when you stop to think that I spent nearly ten years of my life in a regular school of medicine and was taught at once that the proper dose of calomel was 40 grains you realize how deep was my conversion.( I administered it once to a negro on consultation with a fellow allopathic physician, when he told me that this negro child would die unless I gave that child 40 grains of calomel in one dose. He was a great deal older and I didnt say it, but I thought to myself, “I think he will die under the 40 grains.”

At any rate, I had a pleasant surprise. The patient didnt die, and what happened was exactly what he told me would happen, that that calomel would go through that patient with such rapidity that it would not only relieve an engorged liver, but would sweep that tract with the enormous amount of influx of secretion from the gastro-intestinal tract all the way through, and that the patient would recover quickly. The patient did recover, but the after effects for years were still there.).

I have nothing further to add to this except to suggest that you use this with your patients, particularly those patients who are inclined to be skeptical of homoeopathic prescribing and skeptical of the length of action. I have taken that very patient who has come into my office and explained to me that she could not take that medicine because it immediately made her worse and because I feared that she would not hold during that aggravation and had her sit down close by me and I have taken my pen and drawn that little diagram, and before I got half way through she said, “Now I understand; I am perfectly satisfied, and I will stick to it”.

DR. GRIMMER: Really, this paper should serve as a text to any of us. He has very tersely and epigrammatically brought the essentials of homoeopathic philosophy to us, especially in the rhythm of health and of disease and the cycles that we all know exist and the tremendous length of time that remedies will act curatively if permitted.

There is just one little point in summing up the action of remedies, one little point that confuses us at times that we lose sight of in this day of drug slugging, in this day where the patient frequently takes crude remedies without the consent or knowledge of the homoeopathic prescriber, such as aspirin and cathartics, the contact of camphorated substances in the form of balms, and things of that kind. We all know that deleterious effects camphor has an our homoeopathic potencies and our patient come in contact with that very much more frequently than we realize, and that will sometimes cut the action of deep potencies; if it doesnt entirely eradicate their action it will at least dampen it, and the progress of recovery is often interfered with.

That may necessitate a more frequent repetition of remedies than would ordinarily be the case under this beautiful picture that Dr. Underhill has brought to us. It is true that these observations have been confirmed by a great many of our best men. It is purely Hahnemannian in essence. It embodies everything that is in the philosophy, and I think with just remembering this other thing about the effects of camphorated and mentholated preparations, if we study the Doctors paper very carefully and take it to heart, we will be able to do much better prescribing than we have done before.

Eugene Underhill
Dr Eugene Underhill Jr. (1887-1968) was the son of Eugene and Minnie (Lewis) Underhill Sr. He was a graduate of Swarthmore College and the University of Pennsylvania Medical School. A homeopathic physician for over 50 years, he had offices in Philadelphia.

Eugene passed away at his country home on Spring Hill, Tuscarora Township, Bradford County, PA. He had been in ill health for several months. His wife, the former Caroline Davis, whom he had married in Philadelphia in 1910, had passed away in 1961. They spent most of their marriage lives in Swarthmore, PA.

Dr. Underhill was a member of the United Lodge of Theosophy, a member of the Philadelphia County Medical Society, and the Pennsylvania Medical Society. He was also the editor of the Homœopathic Recorder.