The question of the homoeopathic dose is our next problem. We may make many mistakes in this case also. We should know the cases where high dilutions are to be used and where to apply the lower dilutions. We must also know how to repeat the homoeopathic doses. The repetition of doses is a very important problem.
The laws regarding the dilutions are not yet accepted by all homoeopaths. They should be considered with an open mind. However, most of the homoeopaths agree on the point that the lower dilutions act soon, superficially and for a short time; the high dilutions act slowly, deeply and for a long time. It seems that the laws relating to the homoeopathic dose are rather some corollaries of the law relating to the intensity of excitations caused in the living organism. In practice this is very important and should be considered with a supple mind because the excitation differ according to the remedies. But we must insist on the point that, while diluting the medicines the homoeopaths have discovered a capital principle which is the duration of the action of homoeopathic medicines. This is what makes homoeopaths far more superior to other therapeutists. We know at least approximately the duration of the action of our medicines. In general medicine one does not know it. Hahnemann has discovered that in diluting and in dynamising a substance, imparting to it some more medicinal energy, the duration of action is augmented, and in reading the works of Hahnemann we find that he proved as for example, Causticum is capable in high dilution to act from 60 to 100 days. When the dilutions are increased up to CM (Korsakow), or still higher, it may be active for a much longer duration. Every remedy has its duration of action but this duration of action may be increased in course of treatment. When you begin to treat a patient with a high dilution the duration of its action is not very long. Take for example: you administer Lachesis 200, to a patient who has never been treated or who is having homoeopathic treatment for the first time. In such a case the duration will not be more than 7 to 8 days. The negative phase is 24 hours; the positive phase begins on the 2nd day; amelioration continues for 6 days and from the 6th day the amelioration begins to fall and the patient feels less better. You repeat the dose and as gradually you go on repeating the dose even in the same dilution the duration of its action will increase. If instead of giving Lachesis 200, you apply 1,000, the duration of action will be 15 days of positive phase and next you will have one month with another dose of M and you will obtain a positive phase for 2 to 3 months with Lachesis 10,000 Korsakow.
The duration of action varies according as the patient has only begun the treatment or he is having a treatment for a long time. But there are such frequent exceptions to this rule that in reality it can only be learnt by individual practice.
Here we have an excellent argument for propaganda of Homoeopathy to other doctors who never busy themselves with the question of the duration of action of their medicines. The official school busy themselves only in case of preventive vaccinations as regards the duration of action.
As regards the lower dilutions, they are to be applied rather in acute cases because they act superficially and for a short duration. On the other hand for the drainage of a chronic case we will get a real hierarchy of actions by giving a high dilution which acts for a long time, followed by some functional remedies which are repeated every day or at an interval of two days for the reason that their action is short lasting.
Very recently Cahis of Barcelona and Dr. Nebel have used mixtures of dilutions and it has been seen that by mixing dilutions an action is obtained which is intermediary between the high and the low dilution, acting at the same time very rapidly (because there is a lower dilution) and that the duration of action is intermediary. The mixtures of dilutions act rapidly, deeply and their duration is medium.
In summary we may say : While the high dilutions have a negative phase of aggravation for one or two days followed by a slow amelioration continuing for a long time. The lower dilution acts for a short time. It acts superficially and it should be repeated. The mixture of the two kinds of dilutions give a result intermediary between the two.
In practice we have made some interesting mixtures for some remedies. Dr. Nebel often used to mix 30,200,500 or 30,200, 1,000. Cahis tried to obtain a violent reaction of the patient with these mixtures causing at the same time a fall of the potential. He used to give for example: Silicea 18, the next day a mixture of 300 dilutions from 4,700 to 5,0 0 of Silicea. He used to give in this way 300 dilutions, simultaneously. This was a work of considerable patience. Cahis of Barcelona had thousands of phials. He worked on Sundays to prepare the dilutions which he applied during the following week. He obtained very interesting results by alternating one very low dilution with a very high dilution. He did this for example for Thiosinamin.
(In my practice I have very often verified the rapid and sure action of a remedy by using two of its dilutions alternately. In chronic case I generally use a remedy in the following manner : 6,200; 200,1M; IM, 25M etc. applying the high dilution first following it with its corresponding lower one. The dilutions are repeated in an interval more or less according to the dilutions high or low. In neurotic patients this method of applying medicine is really marvellous).
According to the works of Berne, it seems that the dilutions always made in the same phial are but some mixtures of dilutions and the elements of depolymerisation corresponds to the high dilutions and the elements already polymerised to the lower and medium dilution. The superiority that is attributed to the Korsakowian dilutions, is perhaps due to the mixture of dilutions and to some physical phenomena which will result out of the mixtures.
There is also another law which has been equally formulated, but for which there are so many exceptions. It should be followed with great care. It is as follows:
When it is necessary to act on very subtle symptoms as for example mental or sympathetic or nervous. it is better to use high dilutions. When you descend to the materiality of morbid symptoms apply medium doses in lower dilutions. Such is the case for the diseases of digestive system. But to speak the truth. most of the gastro intestinal manifestations are neurodigestive syndromes. They are some phenomena which, though we believe to be purely material, are however of energetic order. This is really true for the stomach and for the caecum.
(It would not be simple to say that the pathogenesis of a given medicine is not the same when it has been studied in lower and in higher dilutions.)
It is evident.
(It is very difficult to get a pathogenesis of say Silicea M. It is quite different from that of Silicea 3x. Similar is the case with Sulphur and Hepar Sulphur.)
I think that Homoeopaths are very often haunted by their spirit of synthesis.
(It is easy to verify Dulcamara with 1x. But the case is different with Dulcamara 6 or 30).
As regards Phosphorus when you read the pathogenesis you find in a general way that the symptoms caused by the poisoning correspond to the acute stage of the disease. The symptoms produced by the high dilutions correspond to the chronic stage. In reality it is necessary that we should establish the pathogenesis of Phosphorus in different dilutions and to understand them well we must take into consideration the chronology of appearance of the symptoms. You will find this kind of chronology in the materia medica established by Hahnemann himself. You find, for example, that the patient of Lycopodium had such and such symptoms that appeared primarily and such other symptoms that appeared later on.
(It corresponds to the declining action of the high dilution. It is, therefore, necessary to prepare three or four pathogenesis because they are not the same.)
Some homoeopaths have acted thus. But the pathogenesis has not been established always according to these rules.
(However there is for each remedy an optimum dose).
In a general way, the symptoms that appeared in the beginning are the symptoms of acute stage, and the secondary symptoms are the symptoms of the chronic stage.
In ignoring the fact that the action of a remedy is different dilutions, the homoeopaths have ignored some very simple phenomena. The pathogenesis of Magnesia Muriaticum has been prepared with very high dilutions. Some aspects have been neglected and it has not been noticed that the disappearance of a wart may follow after absorption of Magnesium Chloride and corresponds to a very special sycotic state with the possibility of a secondary nephritis.
(It is necessary that first of all a pathogenesis of the tincture should be prepared, then we must proceed to the different dilutions).
Now we shall consider errors that we should try to avoid concerning repetition of dose, the intervals and the moment of application of remedies. Lastly we shall consider some particular cases for individual remedies.