THE DOSE AND ITS REPETITION


Homoeopathy as practised by the best prescribers employs the single remedy in the single dose and usually in the centesimal scale of potency range. This combination is unique. The majority of physicians who represent themselves as homoeopathists would scarcely qualify on all three counts and yet the most consistently brilliant results are achieved by those who prescribe in this way.


Homoeopathy as practised by the best prescribers employs the single remedy in the single dose and usually in the centesimal scale of potency range. This combination is unique. The majority of physicians who represent themselves as homoeopathists would scarcely qualify on all three counts and yet the most consistently brilliant results are achieved by those who prescribe in this way.

The use of the single drug is in itself an incentive to accurate prescribing. Those who alternate remedies and give complex mixtures tend naturally to become careless and indifferent, for it is almost impossible to see or know what one is doing. If the Similimum should happen to be included in the prescription the physician will never actually know which medicine it was that turned the trick and so he sinks into deeper apathy and more profound lethargy. Such a physician needs a real Hahnemannian to prescribe for him and buck him up.

It is important to stress the fact that there can be but one remedy wholly and completely indicated. A different remedy picture may have been present a year ago or even yesterday and the similimum of today may not be that of tomorrow.

The majority of chronic conditions hold the same remedy indications much longer than do acute cases, and patients are occasionally seen who need the same medicine they should have had in early childhood, no matter how many years may have passed. This is often true of Calcarea and other carbonates and also of remedies like Natrum mur. and Silica. There is a vast difference in the action of a partially similar remedy from that of the exactly similar one. Nothing can be more obvious and satisfying to both physician and patient than the results of accurate prescribing.

Undoubtedly many so called homoeopathic prescriptions are only relatively similar to the symptom ensemble of the patient and the further we get away from the exact remedy the more indifferent and unsatisfactory must our therapeutic results be.

There is more than one natural law to be observed and compiled with in success homoeopathic practice. The law of similars is familiar to all and for our present purpose requires no discussion. Employment of the single dose has occasioned considerable ridicule and has sometimes been regarded with unreasonable skepticism. Nevertheless the single dose is as much in harmony with the law of cycles as the single remedy is with the law of similars.

A single dose of the homoeopathic remedy in suitable potency initiates a cycle of corrective or remedial action. If the disorder is confined to a merely functional disturbance no further medication may be required to complete the case. With our present knowledge it is exceedingly difficult to forecast the length of action of any remedy. The curative cycle is generally longer and more satisfactory with potencies above the 30th centesimal, but aside from the potency more depends upon the condition of the patient than upon any inherent peculiarity of the drug.

If more than two or three doses of medicine in moderately high potency are required to complete the cure of an acute illness the probabilities are that an incorrect remedy was prescribed. The only other explanation would be very poor case management, especially as regards over feeding.

In chronic work the length of the curative cycle depends upon the nature and extent of the pathology, the vitality of the patient and upon the degree to which all obstacles to recovery have been successfully removed. Structural changes and perpetuating factors of disease causation offer resistance to remedial action and may either shorten or divert the cycle.

The word cycle implies progression, whereas a circle brings one back to the original point of departure. If nature operated in circles instead of cycles evolution would be impossible and life would be devoid of all purpose and direction, a weary treadmill in every sense of the term. A cycle is like a spiral, it has direction, it gets somewhere. Although history repeats itself it never does so exactly or completely, there is always a difference and in that difference there resides an infinitude of possibilities.

In the absence of persisting disease causation when a curative cycle has run its course it should leave the patient, if not entirely well, at least on higher ground than that on which he began treatment. His case should be at least somewhat advanced toward recovery.

To repeat the remedy during the rise or culmination of the curative cycle is apt to weaken rather than strengthen the cycle. Sometimes it appears to cut or cancel it. At least there is often more or less interference just as there is on the radio when two equally powerful stations attempt to broadcast on the same frequency or wave length.

In acute conditions it is not difficult to know when to repeat the remedy. If the patient takes a turn for the worse repeat at once and if the case is at all alarming step up the potency, making certain that the symptoms of the remedy still match those of the patient.

In ambulatory chronic cases it is sometimes quite a problem to know just when to repeat. The general tendency undoubtedly is to repeat too soon.

Too early repetition causes less interference if the potency is raised but it is an unnecessary extravagance in slow-paced deep- rooted chronic cases requiring perhaps years of constitutional treatment. The element of time (chronos) cannot be ignored in the treatment of chronic disease and if the remedy is frequently repeated and the potency steeped up each time we may quite possibly arrive at the jumping-off place before the patient is cured. The billionth and ten billionth potencies will undoubtedly work but this is nevertheless getting somewhat beyond the range of practically.

If the curative cycle has run down before the remedy is repeated the same potency can be successfully employed at least from three to five times. If repeated in the identical potency during the active progress of the cycle the third or even the second dose may prove disappointing.

The question of when to repeat and when to raise the potency in chronic cases is further confused by the failure of many physicians to realize the natural rhythm or periodicity which is present both in sickness and in health. No one feels the same from day to day or from month to month. Each individual has his own rhythm and when there is constitutional derangement this flux and reflux of the vital energy becomes more or less exaggerated into periods of aggravation and amelioration. The diurnal periodicity is very marked in some cases and this is reflected in such remedies as Arsenicum, Kali carb., Lycopodium and Syphilinum, all of which have conspicuous time aggravations. China reflects a forty-eight hour and a seven day periodicity. Arsenicum often has a fourteen day rhythm. Tuberculinum twenty- one days, Nux vomica and Sepia twenty-eight days. The springtime aggravation of Lachesis and other snake venoms is well known.

Probably most of those present will recall the frequency with which old patients, those on the absent list, will return again for treatment at the same season of the year, often in the same month, and sometimes almost to the very anniversary of their first visit to the office. Arsenicum and Thuja have this annual periodicity to a marked degree.

In considering repetition or change of potency wait until the general direction of the case can be clearly seen. When the pick- up is definitely lost it is time to initiate a new cycle of curative action.

PHILADELPHIA, PENNA.

DISCUSSION.

DR. FARRINGTON: This paper deals with a subject that is always in our minds, one of the failures of homoeopathic technique which so few really understand or recognize. As the essayist so well says, it is often difficult, especially in chronic cases, to determine when to repeat the remedy. It is a fact that homoeopaths the world over, even those who are loyal and try to practice according to correct principles, find this difficulty. It is always surprising to me how a chronic case, or for that matter even an acute case, can improve and permanently recover when a remedy has been repeated day after day, and probably several times a day for a long period of time. I think it is only because when the remedy has acted, the patient established an immunity to its further action, or else I dont know how we could cure so many cases in this way.

It must be remembered, however, that all cases will not respond to higher potencies. We have to select as best we can the potency that seems best suited to the case. The periodicity that Dr. Underhill mentioned is also an interesting subject. He has mentioned several of the most prominent remedies of periodicity, among them the snake poisons. Snake poisons have a periodicity, some of them annual. There are many cases recorded in literature which show that symptoms return after the snake bite on the identical day of the year on which the bite occurred, both in human beings and in animals.

DR. BOGER: Some years ago I translated a paper on remedies written by Dr. Ide of Stettin. That was a very valuable paper, and ever since I did that work, the idea has been growing upon me. I have extended the paper now to quite a good-sized little book. Among the latest additions that I have made to that have been over 3,000 observations of successful prescriptions made and the days upon which they were made. In looking those cases up to find out what phase of the moon was present at that time, I find out several things. Of 134 observations on Phosphorus, but 53 prescriptions were made in the full moon week. That is only one example. Arsenicum I have carried on in the same way. The high percentage of successful Arsenicum prescriptions are made in the increase of the moon.

Eugene Underhill
Dr Eugene Underhill Jr. (1887-1968) was the son of Eugene and Minnie (Lewis) Underhill Sr. He was a graduate of Swarthmore College and the University of Pennsylvania Medical School. A homeopathic physician for over 50 years, he had offices in Philadelphia.

Eugene passed away at his country home on Spring Hill, Tuscarora Township, Bradford County, PA. He had been in ill health for several months. His wife, the former Caroline Davis, whom he had married in Philadelphia in 1910, had passed away in 1961. They spent most of their marriage lives in Swarthmore, PA.

Dr. Underhill was a member of the United Lodge of Theosophy, a member of the Philadelphia County Medical Society, and the Pennsylvania Medical Society. He was also the editor of the Homœopathic Recorder.