Pharmacy is the art of preparing drugs for use and dispensing them as medicines. Although accuracy is the basis of every method, it is doubly important in Homoeopathic pharmacy whose distinctive feature is simplicity. The United States Homoeopathic Pharmacopoeia deals with the preparation of Homoeopathic drugs and corresponds to the United States Pharmacopoeia. (Regular.) A new edition of the former book is in process of preparation and in this English edition an effort will be made to standardize pharmaceutical processes so it will no longer the necessary to have different homoeopathic pharmacopoeias for different countries. At present, there are three : British, German, and American.
Essentials of Homoeopathic Pharmacy – The pharmacy of medicine for homoeopathic use differs in many essential details from other and older methods. Cleanliness as required by Homoeopathy differs as much from that of the older pharmacy as the cleanliness of modern surgery differs from the practice of surgery before the days of our aseptic methods. It involves the most conscientious care in handling drugs of different kinds and in keeping them from contact with each other, in storing them so as to protect them from vapors, odors and deterioration from physical agents.
Drugs for homoeopathic use are taken from the three kingdoms of nature. In order to convert these substances into Homoeopathic medicines in such a state as will secure the ready and complete absorption we choose one of two processes (solution or trituration) such choice being determined by the physical state of the substance. Such a preliminary substance is the basis of our Homoeopathic potencies hence the necessity for starting with pure and active preparations. A discussion of potencies is reserved for a later paragraph.
The Menstrua used in Homoeopathic Pharmacy
Sugar of milk (lactose, saccharum lactis) is the menstruum used for triturations and tablets. It is pure white, slightly sweetish and non-hygroscopic. The selection of this substance by Hahnemann as a general menstrua was a most happy one as the sharp flinty crystals are capable of reducing even hard mineral substances to an extremely fine powder.
Alcohol (Pure Ethyl) is the most important menstruum used in Homoeopathic pharmacy and must be of absolute purity. Evaporation should be immediate, leaving neither stain nor odor.Mixed with pure water in any proportion it should remain clear. Official or dispensing alcohol is used for making the liquid potencies and is best adapted for medicating disks or pellets. It contains 88 per cent by volume of ethyl alcohol.
Distilled Water – This is most essential because it is used as a solvent for many chemical substances and also for converting triturations into liquid preparations.
The Unit of Medicinal Strength – The dry, crude drug is the unit of medicinal strength. It is a starting point from whence to calculate the strength of every preparation (tincture or solution). In making triturations or solutions of chemical substances, the matter is very simple. The first potency or tincture being 1/10 of the crude drug. In case of tinctures from plants, the dry drug also is a unit of drug power but as this is soluble in varying proportions in different plants the drug power of tinctures must first be calculated. (See paragraph on Tinctures.)
Some Homoeopathic solutions are subject to deterioration. The chemical salts should be made fresh. An example of this is ammonia carbonate, silver nitrate, etc.
Tinctures – These are made from plants and other substances wholly or partially soluble in alcohol. A few are extracted by other more suitable means. The chief source of Homoeopathic tinctures is the fresh plant, also barks, roots, seeds, etc. When made from plants it is essential to obtain the fresh, flowering plant, the dried article being inferior, often inert.
For this reason, Homoeopathic tinctures must be imported from the country where the plants grow and in no case will it answer to substitute the tincture made from the dry plant or worse still from a fluid extract. In order to have uniform strength, in spite of the different water content of plants (some being more succulent than others) the dried crude drug is taken as a starting point from whence to calculate the strength of the tincture.
This is readily ascertained by taking a suitable quantity of the fresh plant and weighing it, then drying and weighing again. The difference in weight will indicate the amount of water contained in the plant for which allowance is to be made in the use of the menstrua. It should be remembered, however, that while a dry crude plant is taken as a unit of strength the fresh green plant is to be used in the preparation of the tincture.
Triturations – A trituration is a preparation made by taking a given quantity of a drug and grinding it up in a mortar and pestle with a definite proportion of sugar of milk. Each potency calls for a separate and distinct triturating process. At least four hours should be consumed to make the first step and some drugs in the first trituration require a much longer time. All mineral substances, most chemical salts, animal substances, and certain vegetable drugs are thus prepared. Triturating them up to the sixth decimal potency makes possible liquid preparations as follows:
Conversion of Triturations into Liquid Potencies – Hahnemann proved conclusively and clinical experience has verified that beyond the sixth potency all medicines yield up their medicinal virtues to water and alcohol and can thus be prepared in a liquid state. In other words, this is such a fine suspension that even solid substances are practically dissolved. In this way wall Homoeopathic medicines made from minerals may be converted into liquid preparations above the 6x. Since it is obvious that better mixture may be obtained in liquid than by means of a mortar and pestle it follows that when prescribing drugs above the 6x we should use a liquid preparation. The first step after the 6x of this process is accomplished by using a mixture of water and alcohol since sugar of milk is not soluble in alcohol. In succeeding steps dispensing alcohol may be used.
Liquid Preparations or Potencies– These have several different names but none of them convey a true idea of their composition. Thus, they are also spoken of as: “Attenuations,” dilutions,” decimals,” “potencies,” and “expansions.” The last is, in our opinion, most suitable since it conveys the idea of increasing power by an altered physical state.
In practice such preparations are expressed by the letter “x” with the proper coefficient. Thus, Bryonia 3x would mean the third expansion of this drug and, of course, we would designate whether we wanted it a dry preparation (trituration) or a liquid (potency). Nowadays Homoeopathic potencies and triturations are prepared on the decimal scale, in the proportion of one to nine, which makes each successive dilution or trituration contained just 1/10 as much of the drug substance as the preceding one.
The first potency is always the tincture and therefore has a drug strength of 1/10. To make the 2x we take one part of the tincture (if we a dealing with liquids) and add nine parts of alcohol. The resulting mixture contains 1/10 the amount of the 1x preparation or actually 1/100 of the original crude drug. Proceeding the this manner the 3x would contain 1/1000 and the 6x one to a million.
These preparations are more then mere dilutions, however. It is an absolute prerequisite to go through the steps leading to a certain potency and thoroughly success or triturate each intermediate process. It is only in this way that the individual medicinal force is developed. Hahnemann called this process dynamization and perhaps ” dynamic energy” is still the best way to consider this intangible property of Homoeopathy potencies. That it exists there can be no question of doubt and to the practical physician this is enough. Let us assume that we deal with medicinal energy instead of a medicinal substance.
This is not a fantastic speculation, since no one knows just how drugs influence cell life. Why should we not control this energy and adapt it to our needs ? There is certainly ample clinical proof that our potencies have a very special effect on living tissue. It would also seem that successive dilution and agitation are practically calculated to augment this energy, so far as we can judge from therapeutic effects. We have no right to speak of a powerful or weak dose of medicine unless we indicate what kind of power.
Thus in ordinary medicine we speak of power to purge, power to sweat, power to slow the heart. In Homoeopathy we speak of power to nullify a certain symptom group, power to aggravate, power to modify a certain constitution. Both medicines may be powerful in their ability to accomplish their object yet not necessarily powerful in amount of dose.
A very large dose would be powerless to accomplish one of the above homoeopathic objectives, and likewise a Homoeopathic dose would be quite incapable of producing such physiological effects. Yet both have power in their own way. When we speak of the “power of potencies” we refer to the possible biologic effects which has no direct relation to the dose.