Correspondence - The questions contained in the following letter, recently received, represent a class of queries that are frequently propounded both orally and in correspondence. It has appeared not inappropriate to publish a general reply to these and similar questions: “ October, 1864.
“Dear Sir: I recently had brought to my notice your two articles on “The Use of High Potencies in the Treatment of the Sick, which appeared in the American Homoeopath Review, for December, 1863, and January, 1864.
“Since rending your articles, however, which I did with great pleasure, and, I trust, profit, I have fully determined to give the high potencies fair trial; in fact I cannot do otherwise when I behold such powerful testimony in their favor. Now allow me to ask you:
“6. Do you believe that the high potencies, from your own experience in the use of them and from what you have beheld in the practice of others, are far superior, in all respects, to the low preparations as remedial agent?”
“Some of these questions may seem in themselves to be insignificant, but I do not consider them so, for in making my first trial I wished to start right, that the experiment may be made fairly, with a sincere desire to know the truth, the whole truth and nothing but the truth.”
We heartily respect our correspondent's earnest desire to get at the “whole truth,” and to “start fair” in his experiment; and we respect his hesitation to use the high potencies until he should have a reasonable assurance that, in so doing he would not be hazarding the interests of his patients. We take this public manner of replying to his questions, partly with a view of convincing him that we have no wish that our “answers to this communication” should be “kept strictly private.” On the contrary we should be glad to have “publicity (as coming from us) given them.” For they are expressions of our honest convictions, the result of as careful observations and as cautious and complete experiments as we have up to the present time been capable of making. They express our present opinion, those views in accordance with which we shape our daily practice.
But we hold ourselves bound by them only so long as they shall continue to be our honest convictions. Should further observation and more extended experience satisfy us that any or our present positions are untenable we shall gladly abandon them for others, and shall then, likewise, be not only willing but anxious to have “publicity (as coming from us) given” to these new views. The object of our professional life is to find out the truth and to shape our practice accordingly. Consistency to this object is true consistency - while consistency to any form of opinion or doctrine that may at one time have been supposed to be the truth and proclaimed by us as such-consistently to such opinion merely because we may have once publicly uttered it, this is the basest and most ignoble bigotry and cowardice.
In the articles to which our correspondent refers we had no object but to express frankly and plainly the views which govern us in the practice of medicine. We would call his attention to the fact that the greater part of the articles, consisted of citations of the opinions and experiences of other practitioners whose conclusions were but corroborated by our own. .
As a matter of fact, we use them In the form of pellets. As a matter faith, we know no difference between pellets, pills, triturations or liquids. The pellet is merely a convenient means for dividing a drop of liquid into a number of equal parts, and it is for this object that we use them. We have been in the habit of buying unmedicated pellets or globules at Smith's Pharmacy, and medicating them with liquid potencies of our own preparation. Pellets thus medicated we find retain their remedial powers for several years at least, - exactly how long we cannot say. They are so much more portable and more convenient to administer than liquids, that this furnishes us a sufficient reason for preferring them to the liquid form of prescriptions. A writer in the British Journal of Homoeopathy, some years ago, published an essay on the Globule versus the Pillule, making out a very bad case for the unlucky globule as calculated to bring Homoeopathy into contempt in the eyes of persons not indoctrinated. There is something laughable, if it were not deplorable, in this argument, the pith of which is this: “We give small doses to be sure, but let us not, by using the pellet, appear to give small ones; let us use as big a pill as anybody that we may not seem to give a small dose, and may not rudely Jostle the prejudices of our patients.” But surely, if contempt would have damaged Homoeopathy, this luckless science, despised, scorned, ridiculed and, scores. of times, extinguished by Homeric laughter, should have been done for long ago! To adopt and defend this much contemned science, and yet to shrink from the obviously smallness of a pellet-dose - is not this “to strain at a gnat and swallow a camel.”
Nothing will gain confidence of a patient so surely as success! His confidence, once gained by success, cannot be shaken by the form of your dose! Yes, it may though! If he sees that while your doctrines require you to give small doses, you yet dissemble and juggle, and, by using large pills and lozenges and mixtures, try to make it appear that you are giving as large doses as your old school neighbor, he will suspect that your faith in the system you profess is not really strong, and he will have doubts of both you and your system. The sick man who feels that you are curing him cares not a straw for the logical improbabilities of your doctrines, nor for the scientific difficulties attending the explanation of the action of your little dose. Large or small - much or nothing - if, under your auspices, his health return, he will have faith equally in yourself And in your methods.
We have been amazed at much that has been said and written on this subject. Our own patients have rarely remarked upon the pellet. One, Who had never seen them before, once said to us, “Do you really hope to cure me with those tiny pills? “Yes, certainly.” “I should not believe they could possibly have any power.” “Why? Because they are so fine and small for pills? ” “Yes.” “Then, my dear Sir, instead of regarding them as 'fine pills,' consider them to be very coarse granular powder, and you cannot fail to be impressed, a priori, with their immense power!” He perceived the absurdity of his objection, which was to the outward form and not to the inherent power. The success of the prescription satisfied him of the virtue of little pills.
Another patient objected to the very small vials of my pocket case. I replied, they were a matter of convenience to me, but if he would be better satisfied I would, next day, bring his dose in a quart bottle and pour out the same quantity (pellets). He also perceived that his objection was frivolous and was content.
2. Do you use the decimal or centesimal scale in the preparation of the high Potencies? As a matter of a fact, we used the centesimal scale in preparing the high potencies and all the potencies which we use, and have used since we began to practise medicine. As a matter of opinion we see no reason to prefer the decimal. It does not ensure a more uniform gradation as has been claimed. The use of it leads to confusion and is to be regretted. We prefer adhering to Hahnemann's scale. It is easy to convert the one into the other in reporting cases or in reading reports. If our correspondent will refer to the articles which prompted his letter, he will note that in the treatment of pneumonia, Wurmb and Eidherr used potencies prepared on the decimal scale, which fact we there stated and we reduced their numbers to the corresponding ones of the centesimal scale. In general in this country where the facts are not specifically stated, it is understood that the centesimal or Hahnemannian scale is intended.
Our own preparations were made in strict accordance with Hahnemann's Directions and so are the high potencies of Lehrmann, as we have learned from Dr.von Boenninghausen, who directed their preparation, and from Lehrmann himself.
How shall such a knotty question be unrivalled? It involves two assumptions two beggings of the question, viz.: 1. That we do repeat the low potencies in rapid succession in acute diseases; and, second, that we make any such distinction between acute and chronic disease, as to admit of a radical difference in our principle of prescribing.
1. We recognize but one rule touching the repetition of the dose. It was laid down by Hahnemann and is as follows: Do not repeat the dose of the remedy given until the effects of the previous dose shall have ceased to be evident. Our most grievous failures have come from a violation of this rule. — Our most brilliant and complete success have coincided with a strict observance of it. If we are sure that our remedy has been rightly selected, we sometimes direct, particularly in cases that have been actively treated by allopathic physicians before we were called and in which we apprehend a sluggish response to remedies, repetition of the dose every few hours, until some amelioration or decided aggravation appear, but we always order a suspension of the remedy as soon as either is manifest.
2. We know of no clear distinction between acute and chronic diseases on which to base a difference in treatment. Indeed no difference whatever, unless it be one analogous to that which Hahnemann hid down, viz.: that chronic diseases are based on the awakening of miasms that had hitherto lain dormant in the system.
For instance, is scarlatina an acute disease? Assuredly it is so regarded. Yet, on the third day, scarlatina often shows that it has awakened and engrafted itself upon the scrofulous (or psoric?) taint in the patient's constitution and then, surely, it becomes typically chronic. This is an example of what we see happen in all forms of disease. It prevents an available distinction between acute and chronic diseases.
We can assure our correspondent that it is safe and advantageous to strictly follow the Hahnemannian rule about the repetition of the dose in acute no less than in chronic diseases. But let us anticipate a possible confusion in his mind. Some writers, Dr. Drysdale we are surprised to see among them, seem to think that Hahnemann, when he said, “wait till the first dose shall have exhausted its action,” meant to say “do not repeat the dose until that period shall have elapsed which I have indicated in the Materia Medica, as the duration of action of each drug.” This period for some drugs is several days, for others several weeks or even months. We do not so understand him. The duration of action of a remedy on the healthy subject (prover) furnishes no criterion of the duration or its action on the sick. Again, the duration of its action on one sick person furnishes no criterion of the duration of its action on another sick person. Surely the vital processes are much more rapid in acute pneumonia than they are in tuberculosis. Is it not probably that the duration of action of a dose of medicine would be shorter in the former than in the latter?
We suppose Hahnemann meant as follows: “If amelioration follows a dose of medicine, do not repeat the dose until the amelioration ceases to progress, then, if the symptoms be the same as before, though mitigated in severity, repeat the dose. If the symptoms be different, study the case anew and make another selection of remedy. It is in the sense that we have understood and that we apply Hahnemann's rule. Not pretending that we do not often, through errors of judgment, infringe it, we are sure that whenever we do so, misfortune follows, and that in proportion to our faithfulness, so is our success.
In respect of the repetition of doses, as well as of the form of the prescription, we have no difficulty with our patients. Patients are like soldiers, they believe in a man who believes in himself. We say this in all humility, for, in a matter of science, belief in oneself is faith in the laws one has undertaken to carry out in practice. And if the physician shows confidence in his methods, his patients will yield themselves implicitly to his guidance. The prejudice in favor of large and many doses is a relic of past ages, when the practitioner was paid, not for his skill and personal services, but for the medicines he furnished, a barbarous usage which, along with slavery, we received from our British progenitors. Unlike them, we have discarded the former but not the latter.
And, how many constitute a dose? If properly medicated, one is as good as one hundred. As there is a possibility that, in medicating several thousand at one operation, a pellet here and there may fail to get saturated, we usually give about four to six. We use the smallest pellets as most easily and surely medicated.
5. Do you alternate the high potencies or do you rely upon the single remedy? Here again our friend confounds a principle and quantity. If it be right and advantageous to alternate the low, it is right and advantageous to alternate the high potencies. But, in fact, we do not alternate at all. We always rely on the single remedy at one time. Dr. Drysdale says that everybody alternates and, therefore, there must be some necessity for the practice. But his illustrations are so far-fetched, and his definition of alternation is so contrary to the conceptions which all other Homoeopathicians, from Hahnemann down, have had on the subject, that, notwithstanding our respect for Dr. Drysdale, we must repeat, in the very face of his learned paper, that we do not alternate.
We are opposed to it in theory and we abjure it in practice. It is on abominable heresy. As a shot-gun maims, where the rifle would kill, so alternation may change and modify and maim the disease, but it never does nor can affect the clean, direct and perfect cure that a single remedy, exactly homoeopathic, will accomplish. As a relic of the polypharmacy which has been the stumbling block of the old school, we loath it. As a refuge of the careless prescriber, and slothful student, we despise it. As an anomaly in homoeopathic practice, a fatal obstacle to progress in the clinical portion of our Materia Medica, we deplore it.
6. Do you believe that the high potencies, from your own experience in the use of them, and from what you have beheld in the practice of others are far superior in all respects to the low preparation as remedial agents?
An affirmative answer is involved in the statement that we use the high in preference to the low preparations. For details we refer again to the articles which prompted our correspondent's letter. Personally we have suffered and do now suffer from chronic organic disease and from occasional very violent acute attacks. We always use the high potencies in these cases, preferring them to the low. We use them in our family and among our friends. We use them in general practice. Many of our friends and patients, non-professional persons, know the fact and freely say that they and their children are more speedily cured by the high than by the low potencies.
N.B. The imaginations of our friends aforesaid are not more lively than those of, the average of other people. Indeed, they are plain matter of fact persons, possessing much common sense but, for the most part, no genius. — They prefer high potencies.
To change the aspect of a case, to cause the original symptoms to be supplanted by other symptoms, this is no more a cure than ”a strategic change of base” is a “victorious campaign”. Yet this may be effected by repeated doses of a drug in a low potency, whether the drug be strictly homoeopathic to the case or not. And a succession of such changes and supplantings may be effected, day after day, until finally the patient gets well or nearly so. Meanwhile the patient may be amused by the varieties which each day brings forth, and if he know nothing of a true homoeopathic cure but have heretofore had only the heroic treatment, he may fancy he has been doing finely.
Not so if he use the high potencies. With these no change is effected in the case unless the remedy have been strictly homoeopathic to the case. They are like the rifle ball - if they hit, they kill - if not, there is no record of the shot. There can be no good luck from scattering.
Now it will be perceived that the question of cures with high and low potencies is not merely a question of potencies and our friend's trial will not be a fair one unless he make sure that his selection of the remedy in each case in which he tries the high potencies, is strictly homoeopathic. If he make sure of this and be correct in it, then let him go on in confidence with his experiment. We bid him God speed. D.
|The American Homoeopathic Review Vol. 04 No. 04, 1864, pages 233-238
|Administration of High Potencies.
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