THE MINIMUM DOSE
The difficulty of the subject along with the vast number of opinions concerning the potency question make me timid in launching out upon this most important and, to some, irritating subject.
In all cases the minimum dose that will cure is to be employed, otherwise an aggravation of the existing diseased condition may be caused, or other symptoms of the administered drug be produced before reaction takes place. An among of medicine just sufficient to bring about this reaction, we believe, will cause the best results, for the primary action, which must be produced before reaction can take place, is of shorter duration, but the following cure or amelioration will be more permanent. No set attenuation can be established, but the smallest curative dose should be utilized, whether that is the tincture or the thousandth dilution, and nothing is to be more condemned, to my mind, than the frequent contention of the potency question among the members of our school. Some of the exclusive law potentists brand all those who use dilutions above the twelfth as “fanatics,” and accuse them of imagining all their cures; and, on the other hand some of the exclusive high potentists refer. To their low-dilution professional brothers a “mongrels,” and remark that they have not enough brains to prescribe homoeopathically. It is true that some high potentists may imagine that they have worked wonderful cures when they have not, and that some exclusive low potentists never give the indicated remedy except by accident, but it seems to me to be very poor logic to put the entire profession under the epithets of “fanatics” and “mongrels.”
It is not the belief in high dilutions that makes a physician faulty about his observations, nor the belief in low that makes a poor homoeopath. These men would be the same no matter what their creeds.
There are many of the so-called liberal homoeopaths with as highly developed power of imagining extraordinary results as that of any high dilutionist. And many close. Careful prescribes who usually resort to the lower potencies and who are always true to the homoeopathic law. It is not faith in a certain class of potencies that makes the true homoeopath, but his belief carried into practice in the similar and single remedy.
I believe that we should not be hide-bound to any potency and that the greatest latitude should be indulged in. Although I firmly think that in the majority of cases a reasonably high dilution acts better, I never hesitate to lower or raise the potency as I see fit.
Some of the objections against the use of high potencies are the following:
1. That no medicine can be detected by chemical analysis, the spectrum, or by the microscope in a potency above the twelfth.
2. That the saccharum lactis and alcohol used as media have a medicinal effect and modify or destroy the action of highly attenuated drugs.
3. That the mortars and pastels used for triturating cannot be perfectly cleaned, and always contain more foreign medicinal matter than exists in the high triturations.
4. That the water from the pipes used for the preparation of very high potencies contains more extraneous medicinal substances than the remedy being attenuated.
Because chemistry, the microscope or spectrum analysis cannot detect the presence of medicine in potency above the twelfth, are we to cast aside all our high dilutions and cry, “All hail to Science?”
Facts are proven in two ways: By the impressions they make upon our senses, if we do not have delusions and hallucinations, and through the intellect. I think that those familiar with the microscope will agree that it can play many tricks even upon the most expert. One of out departed great homoeopathic surgeons related a case in which some acetic fluid was sent to one of the leading microscopists for examination. There returned a report of a urinary analysis. He related other cases; and all those who know the microscope could and many more. I do not wish to underestimate the valve of microscopical examinations but often it is hard to tell just what we are looking at. I think that the facts proven to us through our intellect can be just as conclusive, if net more so, than those proven through the senses.
Many of the best provings were made with the thirtieth potency, and many evidences of cures with it and higher dilutions stand out, regardless of the non- acceptance of those who only think of a certain point and stop, as proof that there is medicine in dilutions above the twelfth. Aggravations have been caused by the thirtieth and higher potencies. Again, many of the presumed origins of our most virulent diseases have not been discovered and it is only recently that the small-pox germ came into view. Did anyone doubt it existence? Some years ago all the microbes were hidden from our sight because of the lack of power of the then existing optical instruments. According to these gentlemen, then, they did not exist until they were seen. The proof that there is medicine in dilutions above the twelfth lies in the fact that we get actions from them in both healthy and diseased bodies.
Not many will deny that Natrum mur. Will act in a potency above the twelfth. If it act medicine must be present.
At what potency, then, does the drug cease to exist? No mortal can tell; but it is present long after the exclusive low dilutionist would have us believe it were no more, simply because he could not see it.
The second objection: That the alcohol and Saccharum lactis destroy, more or less, the action of highly attenuated drugs, can not be accepted as a fact. They are simply the media and remain the same unit throughout; they are not potentized. That more medicine remains on the pestles and in the mortars than is contained in high triturations I deny.
First, they are washed thoroughly with boiling water; this, of course, is not sufficient to remove all the medicine formerly prepared therewith. This is not all that happens, however. Alcohol is then put in the mortars and on the pestles and lighted. Everyone knows that heat causes chemical action, and the then existing substance is destroyed as such. Nearly all passes off into the air. And if any remain behind, it becomes a new inert substance.
Separate mortars and pestles are used for low and high potencies. Often the mortars are pumice-stoned. The fact remains: that these triturations act, however, and that is all we care about.
That the water used for the preparation of very high dilutions contains more foreign medicinal material than the substance being potentized is next contended by the pessimists. If these gentlemen cannot understand the difference between a potentized remedy and a crude substance, their ability to heal the sick is very materially hampered. There is not the least doubt about the fact that inert substances become valuable remedies when potentized. Remember that sea-water contains more gold than aurum thirtieth and an egg more sulphur than a high potency of that substance: that we get more common salt in out food than there is in Nat.Mur. In a reasonably high dilution, and that there is more silicea dissolved from the vial than exists in the higher attenuation.
The recent discoveries pertaining to radium seem to give some explanation as to why an inert substance becomes medicinal when potentized. Sir William Ramsey has discovered that the gaseous emanation given off from radium changes of its own accord into helium. If this be true, the transmutation of elements is feasible and it is possible for salt, sand, etc., when potentized, to change into new substances differing widely from the old. If also admits of a scientific explanation if we adhere to older, recognized chemical laws. Chemically, the diamond, graphite and lamp black are identical, but the relation between the atoms in the molecule differs in each substance. It is not unreasonable to believe that the same condition exists between common salt and any Natrum mur. Etc. If you think a diamond and graphite the same because chemically alike, present your wife or sweetheart with a piece of graphite out of your pencil for a diamond, and see what happens. It does not make the slightest difference whether we accept or reject this, the vibratory, the ion theory, or other attempted explanations, the fact stands forth proven by many and repeated observations that inert substances can be made active by potentization. An apple falls to the ground. Why does it fall? Gravitation causes it to fall. What is gravitation? The attraction between masses of matter. What is that attraction? No one knows. We know that the apple falls; we are sure of that. We know that potentized drugs act.
Scarcely anyone can be satisfied enough to put aside all the facts presented by the provings and by clinical experience with inert substances which are developed into wonderful remedies by potentization, but there are some who do not doubt. There is a tendency for these men, if they find a believer in the potentized remedy mistaken in his observations in a single instance, to class him as well as his followers or associates as dreamers. Such logic would have killed Aristotle. We simply ask these men if they have ever been mistaken, if they have ever made faulty observations, or if they have ever imagined that they have worked great good when they have not. Until they can do so, their comments are unwarranted. Every man is human, every man makes faulty observations, every man has imagination, but the sum total of evidence offered by many competent learned men as to the results of their observations, admitting that there are times when these observations are incorrect, is ample proof to the unprejudiced that potentized drugs can and do act.
Admitting then that the minimum dose that will cure should be given, whether it be high or low, how are we going to tell which is the minimum dose, and if we give the thirtieth or two-hundredth, how do we know that the thousandth will not cure? If any mortal can answer this question, he had better pass right on to the next world; he is to wise for this. All that we can hope to do is to give him what we consider, from our experience, to be about the minimum dose. This can only be approximately known. We have to begin somewhere; a good rule is to start with the thirtieth potency, thus leaving room above and below to work as we consider necessary.
Sometime it may be well to give at once a higher or a lower potency, depending on the clearness of the indications, susceptibility of the patient to drug action in general, or to an individual drug, on the particular diseased condition we have to treat, and on thee drug administered. These are questions that each physician must decide for himself, and his success scientifically depends upon how well we can answer them.
Begin with the general, not absolute, rule that I accept at present.
Some give the credit of curing to everything but the action of the drug: nature, diet, hygiene and suggestion. Although we should admit all these have their influences and that mistakes regarding cures have occurred, nevertheless, we can prove by elimination that the cure of many cases must be due to the remedy and to the remedy alone.
The part which diet and hygiene play can easily be settled by not altering the habits or diet of the patient; not that hygiene and diet are of any benefit, but in many cases they are not necessary.
There now remain suggestion and coincidence: that is nature curing when we think that the drug is doing the work. Admitting that suggestion is a strong therapeutic agent, I cannot comprehend how anyone can possibly attribute all our cures to its influence. Often we give the wrong drug and get no results.
Now, if suggestion were doing the work we would get our result in spite of the faulty prescription, we study out our case again mo more carefully and give some other remedy which cures. In the second case the patient has lost some of the faith he or she had at first and the therapeutic efficiency of suggestion is correspondingly lessened. Again, can suggestion be used in the case of a newly-born infant or unconscious person? I think not, for I believe it to be auto. A well known homoeopath had a friend who always said that homoeopathy was suggestion and nothing more. He came to the doctor complaining that if something were not done his horse would die. He had tried “all known therapeutic means” (all but the right one, he should have said), and all had failed. He asked the doctor if his “little pills” could do any good that he was willing to have his horse cured even by homoeopathy. The doctor cured the horse. In reply to the gentleman’s question as to what drug he gave, “When that horse saw me coming through the door his faith was so strong that he got well right away.”
There now remains only the question of coincidence: that is, nature righting herself at the same time as we give the remedy. It is mightily strange how often nature just gets ready to fix things the right way, after years of idleness coincidentally with the administration of the indicated drug.
It is infinitely harder to believe that such coincidences can occur repeatedly than to attribute the cure to the medicine. We admit that such instances do occur, but it is inconceivable that this is always the case. There never seems to be any doubt of the action of a strong compound tablet and nature is not given much credit. We believe that she cannot claim much for she is never given an opportunity to bring about a cure which is retarded by faulty methods. Speaking of compound tablets: an insistent agent selling this alleged easy, lazy method came to my office. After telling him I was a Hahnemann homoeopath he remarked that life was too short to convince me of my faulty ways. He seemed to be looking for an opening, so I showed him the door.
Mistaken diagnosis is also a cry when a cure is claimed. The following history, as an illustration, is worth relating: An eminent New York surgeon called one of the recognized greatest authorities on diagnosis in consultation upon a case of pernicious anaemia. They both after careful physical and microscopical examination decided it to be a true case of this dreaded disease. Two other “old school” physicians had made the same diagnosis. After considerable treatment, in which they had exhausted all their therapeutic agencies, he was told that there was absolutely no hope for him – which he must die. Of course, he could not attend to business, in truth he could hardly move from the weakness, yet he did not lose hope. He next consulted one of the greatest of homoeopathic prescribers. The man was cured and resumed his business in a few months. All the medicine he received was three dose of Kali carb. c. m. After each dose a blood examination was made showing continued improvement, finally it became normal.
To what is this result to be attributed – faulty diagnosis or coincidence? Who is ready to question the diagnosis of such men, or if they are to be doubted, who can be relied on?
If on the other hand, nature just gets ready to cure such cases coincidentally with the giving of the homoeopathically indicated drug, there is sufficient reason for the administration of a remedy.
We agree that nature just gets ready, but she is made to get ready by the action of the medicine. It is like a disorderly person being forcibly rejected from a place when he is on the side-walk, he “was about to leave anyhow.” No one wishes to deny that there are times when coincidences happen, but to apply this old threadbare argument to every case of cure is absurd.
It has been remarked that there is no such thing as genius in medicine, and that work is the factor that counts. We admit that work does count, but that one man has more native talent in specific lines cannot be denied. No amount of industry can make every man a prescriber of the first rank, yet any man can improve himself in any line; all can become better prescribers with such books as Hahnemann’s, T.F. Allen’s. Herring’s, Farrington’s, Nash’s, H.C. Allen’s, and other well-known classics on Materia Medica. All singers do not reach the galaxy of operatic stars, all pianists cannot become world-famous, though all can learn to a greater or less degree to sing and play, so all can learn to prescribe. With this in view I work on. Hoping that I may some day reflect, as a hand-mirror does the sun, perhaps, some of the light given to the world by the immortal Hahnemann.
Closing, permit me to repeat that the smallest dose that will cure, whether high or low, is to be employed and that I do not wish to pose as a high, medium or low dilutionist, notwithstanding that I may have a preference usually, but not always, for the reasonably high potencies.
It is claimed by some that there is a tendency among the younger men towards the so-called “common sense” methods in homoeopathy; that they are physicians and stand ready to use any method to cure their patients.
My experience and observations so far (I humbly concede that I am young) convince me that there is no system so effective as true Hahnemannian Homoeopathy. Being brought up in the “old school” and knowing its methods comparisons are inevitable. Despite any opposition, many young men are loyally allegiant to their colors. We cannot but deduce that if there exists a tendency for a number of recent graduates to join the ranks of the so-called “liberalists” it is due to faulty teaching. Some said that it would be impossible to practice pure Homoeopathy. That one would be obliged to resort to compound tablets, astringents, cathartics, etc., in order to make a living.
I believe that the public is capable of understanding Homoeopathy in its true form, and it is my experience, so far, gained in a thickly populated section of New York with rich and poor in close proximity that the laity are beginning to demand Homoeopathy in its strictest sense.
We should consider that all men have brains and understanding and always explain the true homoeopathic principles to any patient who is interested or in doubt. I recall one patent whose first question was: “To what school do you belong?” “I am a homoeopath,” I answered. “Great Lord,” he said, “There are four or five different kinds of homoeopaths. What I want is one that is sure of his own system.” He continued that he was tired of paying for cathartics, compounds, etc., when he called or thought that he called a homoeopathist and that if I were not what I professed to be he would bid me good day. The gentleman was well educated, a banker and a broker. This experience has been repeated. It is not only among the higher educated that is found this tendency to demand the true treatment they pay for, but among the poorer classes also. There is among all classes a growing habit to treat with greater respect and confidence the physicians who are true to the banner under which they walk.
More time cannot now be spent in discussing this subject, but if any are under the impression that Hahnemannian Homoeopathy is dying and that all the younger generation are eclectic, let these look into the matter more intimately. Daniel E. S. Coleman, Ph. B., M.D., New York