THE DOSAGE USED BY HAHNEMANN

  When from time to time at the Hahnemannian School the question of posology comes back for discussion, the Master’s way is frequently mentioned by someone, but whatever is stated by one person is often contradicted by someone else; so that utter confusion reigns on the subject.

  It occurred to me that this controversy could be finally settled if a chronological report was given based on the original documents of all of HAHNEMANN’s writings on the question from his first publication until the end of his life.

  I am well aware of the value of the material gathered by Dr. DUDGEON on the Hahnemannian posology in his Lectures on Homœopathy.  However, it is certain that, at that time, this esteemed authority lacked some very important information on the subject.

  I am referring to HAHNEMANN’s first edition of his Materia Medica Pura, of his “Chronic Diseases”, and to the second edition of the first and second volumes of this work, as well as to the valuable compilation made by Dr. Richard HUGHES  in 1878 which has been published in the British Journal of Homoeopathy. Through this source of information I was able to remedy certain lapses and make a complete expose of facts on the Hahnemannian posology from 1796 until HAHNEMANN’s death in 1843.  So here comes the sequence:

  1796-1798: In 1796 HAHNEMANN stated for the first time, in the second volume of “Hufeland’s Journal”, the homœopathic doctrine in a paper entitled: “Essay on a New Principle to Discover the Curative Virtues of Medicinal substances, Followed by Some Remarks on the Principles Accepted since Then.”

  In this work he mentions several times the word “small doses”, necessary when one prescribes drugs having similar action; but the context showed (and sometimes proved) that he thought the doses were so weak as to be unable to produce physiological effects with the substance used.

  During the next two years it is clear that for the majority of the drugs used in his practice “small doses” never meant their use in fractionated parts.  In 1797 he reported a case of colic for which he prescribed Veratrum album at a dose of 4 grains, i.e., 26 centigrams (1 grain = 0.065 centigrams) and a case of asthma treated with the same amount.  In 1798 he reported a series of cases of fever, steady and remittent, which occurred that year and for which he prescribed Arnica (a few grains of the root, i.e. 15-30 centigrams.); Ignatia: for children seven to 12 years of age (2 to 3 grains, i.e. 12 to 18 centigrams);  Opium (1/5 to 1/2 grain, i.e., 1 to 3 centigrams); Camphora ( 2 to 3 grains, i.e., 20 to 40 centigrams);  Ledum (6 to 7 grains, i.e., 39 to 40 centigrams).

  In another work published the same year, “On a Few Periodical disease of the Daily Type,” he mentions giving 8 grains, i.e., 52 centigrams, of Ignatia and doses of 1/2 to 1 drachm of Cinchona i.e., 2 to 4 grams of the raw substance.

  So in the beginning HAHNEMANN used substancial material doses, corresponding approximately to those used in minimal doses by traditional medicine.

  1799: This was the year of the sudden and unexplained introduction of what we now call “infinitesimal doses.”  In a publication “On the Care and Prevention of Scarlatina” (1801) HAHNEMANN mentions his treatment of an epidemic of this disease which occurred in the summer of 1799 and the use of our remedies: Ipecac, Opium, Belladonna, and Chamomilla, and speaks of each one prescribed in doses of a minuteness unknown in medical practice to that day.

  His tincture of Ipecacuanha, for example, was made of one part of the drug to 2,000 parts of alcohol.  Of this dilution only 1 to 10 drops were to be administered depending on the age of the patient.

  Opium was diluted to such an extent that 1 drop was equivalent to 5 millionths of a grain (of about 6 centigrams).  For children under four years of age this dose was to be further diluted to correspond to the 6X.

  Belladonna was administered at a dose equivalent to the 432,000 part of a grain (i.e. 6 centigrams) of the extract, therefore approximately the 7th decimal dilution.  As a prophylactic, a solution was prepared containing only 1/24 millionth part of a grain, of which 1 to 40 drops were prescribed depending on the age, and only every third day (i.e. about the 9th decimal dilution.)

  Chamomilla tincture contained the 800th part of a grain of the dry extract, and only 1, 2 or more, drops were to be administered.

  1801:  In the second part of “Hufeland’s Journal” for that year HAHNEMANN no longer needed to be defended on the question raised by his article:  “What could be the effects of such minute doses of Belladonna?”  But we should note that he mentions several times the effects of the millionth part of the ordinary dose, i.e. the 6th decimal or the 3rd centesimal:

  “Those who are satisfied with these general indications will believe me when I state that I have cured various paralytic conditions by the administration for several weeks of a highly diluted solution of Belladonna.  For the whole treatment I needed less than a 100 thousandth part of a grain of the extract, i.e. a 5th centesimal dilution or 10X.  I also succeeded in curing several periodical nervous syndromes, furunculosis and its prevention, etc...  with less than one millionth of a grain, i.e. a 6th CH for the whole treatment.”

  1806:  HAHNEMANN says nothing more regarding the homeo posology, not even in his Fragmenta de Viribus Medicamentorum Positivis published in 1805, until his publication of Medicine of Experience in 1806 in Hufeland’s Journal.  Anyway, he does not go beyond the position he took in 1799 and even until 1801.  He speaks of “the smallest possible sufficient dose,” the exact number being of little importance; when referring to particular cases he mentions only 100th, 1,000th, one millionth of an ordinary dose, i.e., the 1st, 2nd, 3rd centesimal dilutions with which we are already familiar.

  1809:  I haven’t been able to find anything regarding posology until 1809 aside from the general advice regarding the minuteness cited above.

  In a study of more than 40 pages entitled: “Reflections on the Three Methods Accredited for Treating Diseases,” published in Hufeland’s Journal for that year, we find a paragraph stipulating that in certain circumstances of so-called “bilious states” one single unique dose of the tincture of Arnica root will suppress often within a few hours all fever, the bilious taste, and all the “intestinal storms.”  The tongue clears up and all vigor is restored before night.

  However, in another communication published that year we note that regarding two violent poisons, HAHNEMANN dilutes much more and much further than in the preceding three years.

  For a fever that had lasted well over a year in Germany and described in the “Allgemeine Anzeiger der Deutschen” of 1809, he mentions Nux vomica and Arsenicum, according to the indicating symptoms, and recommends giving the first in the 3 millionth and the second in the 6 millionth of a grain, respectively in the 4th and 3rd centesimal dilutions.

  1810:  This is the historical year when the first edition of the Organon was published, and it is natural that we expect to find in the paragraphs devoted to posology a whole series of extra details regarding the homoeo dilutions.  However, there is very little else said aside from what was reported in his Medicine of Experience of 1805.

  In a note which I have been able to trace in the Organon paragraph 247 HAHNEMANN writes (according to R.HUGHES):  “When I speak of the dose prescribed in homeo practice as being the smallest possible, I do not intend - because of the difference in pharmacological power - to give a precise table of the volume and weights of each drug.”

  1814: in an article on the “Treatment of Typhus and the Nervous Hospital Fever spreading Now.” (it was the time of Germany’s insurrection against Napoleon following his retreat from Russia) in 1814 we have a new glimpse of HAHNEMANN’s Posology.

  The drugs he recommended, according to the symptomatology, were Bryonia, Rhus-tox, and Hyoscyamus.  He suggested the administration of the first two in the 12th dilution, the third in the 8th dilution, however on a different scale of the centesimal, which was his usual practice and in which 6 drachms, i.e., 1,000 drops instead of 100 drops of alcohol, had to be used in each progression of the dynamisation.

  This would correspond, according to Dr. DUDGEON, to the 12th dilution being equivalent to our 15th to 16th dilution; and the 8th, to our 10th approximately.

  Spiritus nitri dulcis was indicated in certain circumstances, and 1 drop had to be succussed in 30 cc. of water and the mixture consumed in 24 hours.

  1816:  This year is outstanding in the history of Hahnemannian posology, at least from my knowledge of books.

  In the first volume of Materia Medica Pura, published in 1811, HAHNEMANN fails to give any details in his preliminary remarks to the many pathogeneses regarding the dose of the drugs he found to be particularly indicated.

  We know nothing of his views at that time regarding the dosage of Belladonna, Dulcamara, Cina, Cannabis, Cocculus, Nux vomica, Opium, Moschus, Oleander, Mercurius, Aconite and Arnica.

  Now, however, in the second volume, published in 1816, and in the next two, the best dose of each drug is indicated.

  For Causticum, for example, 1 drop of the original preparation corresponds to one dose.

  Arsenicum is to be administered at the 12th, 18th, or at the 30th dilution, and preferably the 30th.

  For Ferrum the 100th, the 10,000th, and the 50,000th part of a grain is advised as the best dose.

  Ignatia is recommended at the 9th or at the 12th dynamisation, and Rheum, in acute cases, at the 9th.

  For Pulsatilla, Rhus-tox, and Bryonia the same doses are indicated:

  If the patient is robust and his disease is of some duration, 1 drop of the pure juice of the plant is the best dose.  But in delicate patients and for acute conditions the dose is to be smaller: for Pulsatilla, the 12th; for Rhus-tox, the 12th or the 15th dilution; and forBryonia, the 18th dilution.

  These ideas are perfectly illustrated in two famous cases published at that time by HAHNEMANN as examples of homœtherapeutics, as cited in the preface of that volume.

  The first case involved a gastralgia with gastrosuccorrhoea of three weeks’ duration in a robust woman with otherwise good health.

  As predicted by HAHNEMANN, she was cured in less than 24 hours by a single drop of the root of Bryonia, as verified by one of his friends.

  The second case was an acute gastritis of five days’ duration in a pale and weak man of 42 years of age.  His remedy was 1/2 drop of the 12th dilution of Pulsatilla.  The next day good digestion was restored, and a week later, when HAHNEMANN checked him, the cure was well maintained.

  These two cases were treated at the end of 1815.

  Furthermore, HAHNEMANN was then 60 years of age.  In the same preface we learn that he had now adopted the centesimal scale, the greatest care to be taken so that each dynamization would be exactly what it was supposed to be; but, alas, the pharmacists failed to follow his instructions.

  The dried plants are to be treated with 20 parts of alcohol. Each drop of that mother tincture is estimated as containing 1/20th part of the medicinal power (Arzneikraft) of that preparation.  The tinctures prepared with fresh plants by mixing the expressed juice with equal parts of alcohol, are to be considered as titrated at 50 %.  Therefore 2 drops will be added to 98 drops of alcohol to obtain the 1st centesimal dilution.

(Translated by Roger A. SCHMIDT, M.D. from Groupement Hahnemannian de Lyon, 9th series, No.1, 1972, p.35-41).

SOURCE OF THE ARTICLES

1. THE HAHNEMANNIAN GLEANINGS, VOL. XLVI, JAN. 1979.

2. THE HAHNEMANNIAN GLEANINGS, VOL. XIVI, AUG. 1979.

3. THE HAHNEMANNIAN GLEANINGS, VOL. XLVII, APR. 1980.

4. THE HAHNEMANNIAN GLEANINGS, VOL. XXXIX, MARCH 1972.

5. THE HOMŒOPATHIC RECORDER, NOV. 1929, CURRENT HOMŒOPATHIC PERIODICALS

6. THE HAHNEMANNIAN GLEANINGS,  VOL. XL, APRIL 1973.

7. THE HAHNEMANNIAN GLEANINGS, VOL. XLI, MARCH 1974

8. THE HAHNEMANNIAN GLEANINGS, VOL.XLIV,  DEC. 1977.

9. ZEITSCHRIFT FÜR KLASSISCHE HOMÖOPATHIE, 2, 1964.

10. THE HAHNEMANNIAN GLEANINGS, VOL. XLIV, JAN, 1977.

11. THE HOMŒOPATHIC HERITAGE, VOL. III, APRIL AND MAY 1978.

12. THE HOMŒOPATHIC HERITAGE,  VOL. III, FEBRUARY 1978.

13. ZEITSCHRIFT FÜR KLASSISCHE HOMÖOPATHIE, BAND 29, 1985.

14. THE HOMŒOPATHIC HERITAGE, JAN. 1978.

15. JOURNAL OF AMERICAN INSTITUTE HOMŒOPATHY, JUNE 1974.

[1] When they were not caused by an important error in regimen, a violent emotion, or a tumultuous revolution in the organism, such as the occurrence or cessation of the menses, conception, childbirth and so forth.”

[2] “In cases where the patient (which, rarely happens in chronic, but not infrequently in acute diseases)  feels very ill, although his symptoms are very distinct, so that this state may be attributed more to the benumbed state of the nerve, which does not permit the patient’s pains and sufferings to be distinctly perceived, this torpor of the internal sensibility is removed by Opium, and in its secondary action the symptoms of the disease become distinctly apparent”.

[3] See page 84.

[4] “One of the many great and pernicious blunders of the old school.”

[5]  In the Introduction to the Organon I (1810) HAHNEMANN says, “….. In this investigation I found the way to the truth, but I had to tread it alone.  …..  the farther I advanced from truth to truth  ……”  in a Note dated 12^th March 1843 HAHNEMANN wrote “I sought truth earnestly and found it.” = KSS.

[6]  Kent: Lectures on Homœopathic Philosophy; Lecture V

[7]  Poincaré, H.: La Valeur de la Science.

[8]  Larousse: Encyclopaedia

[9]  Regnualt: Precis de logique evolutionniste. Bib.phil. p.118.

[10]  Boutroux: Loc.cit.

[11]  Littré. Dictionary of Medicine, Art: Law.

[12] It is also very useful in fractures when small bone chips remain in the wound.  The Silica patient is always very chilly, mostly in the head, and shows frequent little white spots on the nails, called ‘flores unguis’ or leukonychia striata.  (Repertory p.1191, Extremities, spotted nails.)