The main points which I wish to raise here are either entirely new and somewhat revolutionary when compared with accepted notions, divulged and applied in the five earlier editions of the Organon, or points already stated but redrafted and re-examined. They are, as a rule, badly known or not known or not known at all by homoeopaths. I shall therefore endeavour to extract them, as gold and diamonds are extracted from a mine, and let them sparkle in the sunshine of truth. I shall not proceed paragraph by paragraph but by order of importance.
The paragraphs I shall consider first are those at practical interest and afterwards I shall take such paragraphs as are interesting from a theoretical point of view.
Medicamental repetition is undoubtedly a question of great interest to all medical men, but it is more particularly so for homoeopaths who are more specially trained to observe individual reactions. The paragraphs contained in the Organon on this subject are the outcome of numerous experiments repeated in the course of Hahnemanns professional activity, that is, over 50 years practical experience.
In aphorism 246, he repeats the statement included in the five earlier editions:
Any clearly defined improvement showing obvious progress is a state in which-as long as it lasts-the repeated administration of any medicine whatsoever is to be strictly forbidden, as the remedy previously taken by the patients still producing its beneficial effect and this is no rare occurrence in acute disorders.
Such is the well-known and much quoted paragraph which Hahnemanns and Kents disciples observe most reverently and to which they owe such excellent results. The words “this is no rare occurrence …” remained one that, though this is fairly frequent, there are a good many cases in which no progress is detected and where it will be necessary to repeat. We shall see later no how this is to be done; but we must bear in mind that Hahnemann never says anything which has not been duly considered and thought out and that all his words should be weighed with the utmost care. He goes on to say,
On the other hand, in chronic disorders which have not reached an advanced stage.
(mark the words “not reached an advanced stage”!) the improvement may last from 40 to 60 or even 100 days. This is, however, very rare and, besides, it is important for both physician and patient to reduce the period in order to effect a speedier cure.
This may be achieved provided the following conditions are observed:
The choice of the remedy shall be strictly determined in accordance with the Law of Similars. It shall be administered potency.
(I insist upon “potency” as the word “dose” implies quantity whereas potency or dynamization refers to quality) after being extensively diluted and highly potentized, absorbed dissolved in water, administered in general in very small quantities (1 coffee-spoonful), repeated at intervals which experience has proved suitable to effect as speedy a cure as possible, taking great care, however, in repeating, to vary the degree of potency so that each dose should differ slightly from those preceding and following.
Where he is at variance with the notions hitherto accepted is in the following recommendations:
2) The absorption of any homoeopathic remedy to be repeated shall henceforth be exclusively in liquid form. A new factor in the preparation of remedies is the suppression of attenuations from mother tinctures. All remedies, to whichever natural kingdom they may belong, whether derived from mother tinctures or substance solutions, Hahnemann rejects granules, tables and trituration (aphorism 246).
b) In acute cases, where no improvement is observed, the dose is to be repeated and-this is quite new-in chronic diseases where the treatment has proved effective, the remedy, in order to speed up the cure, may be given daily and for months, if necessary.
In aphorism 247. Hahnemann stressed the danger of repeating the remedy with the same degree of potency, which he defines as “in- opportune and unwarranted repetition of an unmodified dose liable to provoke an absolutely unnecessary morbid addition”. It is detrimental to the patient (aphorism 247a) to repeat the same remedy on the plea that it has done him good in globules with the same potency.
It is also detrimental to the patient if repeated because it has done him good in liquid form with the same potency.
It is detrimental, too, if repeated with the same attenuation, even if t he original preparation has been shaken on each occasion 10 times or only twice, because the remedy newly administered is unchanged as regards potency and liable to occasion what is known as therapeutic saturation.
In fact, after the first dose of a medicine which has proved efficacious, the patient will be a little less ill. The second dose must consequently be adapted to a less morbid condition, or rather to disease in a more dynamized stage. The patient has been saturated in the first stage, thanks to a remedy in a suitable dose. Consequently, Hahnemann recommends giving the same remedy, but more highly dynamized, the disease having been partially subdued under is influence. The remedy is thus to be administered in varying forms as the cure proceeds so as to be constantly adapted to the disease.
Hahnemann combines two factors in an entirely new form. Apparently the remedy was to be given in diluted any dynamized from only, but a motions of quantity was added in order that no confusion should arise as to the notions of dosing, frequency and potency.
Dosage implies capacity: 1,2,3 small, middle-sized or large spoonfuls, i.e notion of quantity. Frequency is implied by repetition of the dose once, twice, 3 times, etc. Potency or dynamization, produced by shaking the dilution a certain number of times, implies quality.
Hahnemann now defines quantity ( 275, 281) i.e. posology, even with high potency, in the form of a single globule of poppy seed size ( 270of, 272, 275). Pharmacopollaxy Must Be Ascendant
For the first time in his professional life, Hahnemann lays stress upon the importance of increasing the race of potency in former editions. It is contained in the footnote to aphorisms 246 as well as in aphorism 248, 270 of, 280 and 281, and worded as follows:
The remedy is to be administered at a low rate of potency, proceeding according to the technique and, after exhaustion of the solution, repeating at a higher rate of power. Finally. he insists upon the danger of repeating with the same potency, even only once, this being detrimental and even liable to lead to incurability. It is even more harmful than it would be with an equal dose of an allopathic remedy, as such repetition, through unwarranted dosage, might bring about chronic drug dyscrasia, a king of drug miasma. This may also occur when the dosage is too high.
(i.e. when a mouthful or a tablespoonful is given instead of a teaspoonful. In this connection, see aphorism 276 and footnote to aphorism 282).
I shall not comment on the results f this new practice, nor compare it with Kents ascendant Pharmacopollaxy, as it would lead me too far. However, there is every important exception to which I wish to call your attention, in the footnote to aphorism 282, with regard to the doses in the treatment of the three great diatheses during the period of their first cutaneous manifestations, namely: (1) recent scabietic dermatosis in psora, (2) untreated primary chancre, wherever located, in syphilis, (3) condylomata in sycosis:
These localized diseases (and not local, I insist upon it) do not only tolerate, but demand immediate administration of large doses. (large tablespoonfuls or even mouthfuls) repeated daily and even several times a day, of their specific remedies in ascending repetition. In chronic illnesses, the doses should at first as first be as small as possible.
(a teaspoonful only).
In such cases particularly, no objective localization should be suppressed and nothing ought to be removed by external applications, for the disappearance f such objective manifestations, which the physician cannot fail to notice, enable him to ascertain that the remedy hitherto administered is no longer necessary.
Hahnemann adds however that.
….experience has shown that itch, like syphilitic canker can and must be treated only exceptionally through external channels, but that in the case of sycotic condylomata, internal administration combined with simultaneous external application in direct contact with the lesions may prove necessary (Footnote to 282).
The homoeopath never tries to deceive patients by purely superficial success which, though it may be gratifying at first, is always harmful in the long run.
The volume of the remedy, i.e. the quantity, according to Hahnemanns experience, must therefore be taken into account.