Having been honored by the President of the Society’ with an appointment to report on the use of High Potencies in Chronic Diseases, I trust it may not be considered an unwarrantable presumption if, for the following reasons, I venture to modify, to a slight extent, the theme assigned to me.
First. The subject contemplates a report of a practical nature. But from the stand-point of practice, I think that a clear and well-defined distinction between acute and chronic diseases is not possible. If we attempt to base such a distinction upon the element of time alone, paying regard only to the duration of the disease, it cannot be made at the beginning of the treatment, and cannot therefore be of any practical value in determining the potency to be used.
If we base the distinction upon a pathological conception- that is, upon the presumed existence in the patient of some dyscrasia, diathesis or miasm- it is equally impossible, at least in very many instances, to make it at the commencement of an illness.
It is a matter of common remark that cases which begin without any sign of miasmatic or dyscratic complication often develop in their course unequivocal evidence of such complication, so that a case which would, in the outset, have been regarded as, in this sense, unquestionably acute, proves in its course to be unmistakably chronic.
Second. Furthermore, the subject as stated, involved a kind of petitio principii. To require a report on the “Use of the High Potencies in Chronic Diseases” is in some sort to imply that these potencies are especially useful and appropriate, if at all, in the treatment of chronic diseases as distinguished from acute diseases-an implication which it is true corresponds to a very widely received opinion among those physicians who have but little practical acquaintance with the action of the high potencies, but which, as we shall see, is not supported by the results of experiment.
By the kind indulgence of the Society, then, I shall beg leave to report on the “Use of High Potencies in the Treatment of the Sick.”
No question connected with Homoeopathy has given rise to more vigorous controversy or to more earnest partisan feeling than that concerning the infinitesimal dose. The most bitter opposition of the Old School to Hahnemann was based on this question. It has been also the chief ground of division and contention among homoeopathists themselves.
After an animated disputation covering a period of more than fifty years, there seems now, however, to be a cessation of hostilities between the advocates and opponents of the higher potencies. There seems to be a mutual disposition to suspend the discussion hitherto maintained chiefly on hypothetical grounds, and to appeal in good faith to the “ultima ratio-experiment. The times are favorable, therefore, for a quite survey of the field and for a dispassionate estimate of the experimental knowledge of which the practical labors of our colleagues have put us in possession.
It is probable that Hahnemann was never what could be called an “heroic prescriber.” In his work on The Venereal Disease, published 1789, before he had discovered the homoeopathic law of cure, he portrays the evil effects of excessive doses of mercurial preparations, and speaks of radically curing some cases of syphilis by the use of a single grain of Mercurius solubilis in divided doses; and says that eight grains thus administered will often be sufficient to cure “very severe cases of syphilis.” Compared with the practice of his contemporaries, these are almost infinitesimal prescriptions.
In his first essays upon the homoeopathic law, Hahnemann advises the administration of doses but little, if any, smaller than those he had previously used. We first meet with the recommendation to use infinitesimal doses in the essays on “scarlet Fever,” published in 1801, but referring to cases treated in 1799. He here advises Belladonna and Chamomilla to be given in preparations which correspond pretty nearly to the third centesimal dilution.
It pleases Dr. Dudgeon to suppose that “this sudden change,” as he calls it, from material to infinitesimal doses, was a matter of expediency and policy rather than of conviction on the part of Hahnemann, inasmuch as it coincided in point of time with the prosecutions of Hahnemann by the apothecaries.
But there is no evidence that the change was so very sudden as to require such an explanation. Even so short a period as one year spent in constant practice might be sufficient to satisfy so acute an observer as Hahnemann, that remedies given according to the homoeopathic law must be given in very small doses.
The whole career of Hahnemann is a consistent protest against the adoption or renunciation of any procedure connected with the practice of medicine, on grounds of mere policy or expediency. Hahnemann’s long life was a continual sacrifice of ease and prosperity and highly prized friendships to his convictions of truth. While therefore, during a period of twenty years he submitted to be driven from city to city rather than renounce the right of dispensing his own medicines, is it at all probable that he devised the method of diluting or potentizing remedies and insisted on the superiority of potentized remedies, simply, or in any degree from motives of expediency?
In subsequent essays Hahnemann advises still more distinctly the administration of potentized remedies, and in the first edition of the Organon, published in 1810, he says: “Scarcely any dose of the homoeopathically selected remedy can be so small as not to be stronger than the natural disease and not capable of overcoming it.” About the same period he advise the use of the ninth dilution of Nux vomica and the eighteenth of Arsenic.
In the earlier volumes and editions of the Materia Medica Pura, Hahnemann recommends a particular dose for each remedy. Some remedies are to be given in the first dilution, some in the third, some in the ninth, some in he fifteenth, some in he twenty-fourth, some in the thirtieth.
In subsequent editions of the Materia Medica and in the work on Chronic Diseases, Hahnemann, as is well known, advises that all remedies be given in a uniform dose-the thirtieth dilution.
In the latter years of his life he speaks of using with great success the sixtieth, one hundred and fiftieth and three hundredth dilutions, and it is well known that during these years he did not confine himself to a uniform dose, but used in some case the lower potencies, and in some the very highest.
It is not unworthy of remarks that as Hahnemann’s practical experience in the treatment of disease increased, so did his estimate of the advantage and necessity of using higher dilutions, in a least many cases, likewise increase.
The promulgation of the dynamization theory by Hahnemann, and his adoption of the practice of giving infinitesimal doses, were the occasion of the most violent denunciation of Homoeopathy by his professional opponents. Indeed, to this day, this really subordinate department of the method is regarded by allopaths as the essential feature of the method is regarded by allopaths as the essential feature of Homoeopathy; and to a superficial observer it would seem as if the infinitesimal dose were almost the only obstacle to a blending of Homoeopathy and the so-called Physiological School of Medicine.
The progressive advocacy by Hahnemann of the higher dilutions, and especially the introduction by Korsakoff of what are technically known as the “high potencies” (the one hundred to fifteen hundredth) gave rise, as has been said, to a lively and bitter and decidedly personal controversy among homoeopathists.
In every party or school which is still a minority, there are always Conservatives, who regret the necessity which compelled a separation from the party or school of the majority; who strive to make that separation as little decisive and marked as may be; who stoutly oppose any measure which would tend to increase the division or to make it irremediable; and who hail with delight almost any project of compromise or reunion. There are also Radicals, whose turbulent nature revels in the sensation of opposition; whose tendency it is lay more stress on points of difference than on points of coincidence; who, having once separated from the majority, will not only entertain no thought of a reunion with them, but consider that fidelity to the principle on which their separation was based, requires that the separating chasm should be made continually wider. they seem to glory, not so much in the truth for the sake of which they separated, as in the mere fact of separation.
These two classes are necessary in every progressive school. The Radicals furnish the propelling force- the steam. The Conservatives supply the restraining and moderating influence -the fly-wheel.
Among the followers of Hahnemann, the Radicals and the Conservatives were the respective parties to the contest about the potentization theory; and in weighting the arguments which each side brought forward, we must not lose sight of the respective tendencies of these two parties.
Dr. Dunham graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. His works include 'Lectures on Materia Medica' and 'Homoeopathy - Science of Therapeutics'.