Homoeopathic posology

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• In the homoeopathic medical language the idea
of dose differs diametrically from that which the
word implies in ordinary medical language.
• While the latter expresses a quantitatve
concept, for the former it is solely cumulative.
• A proper understanding of the dynamic concept
of disease, of susceptibility and of remedy
reaction is essential for an intelligent
grasp of this most important aspect of
homoeopathic practice.

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The three essential elements of the system are
the principle, the remedy and the dose

The ever changing kaleidoscopic piture

presented by homoeopathic posology
contrasts well with the firm application of law
of similars.

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• Hahnemann during the last five years of his
active professional life he discovered that the
centismal scale which he favoured as the best
method of potentisation, carrying out each
preparation with two successions, did not
seem to develop the latent power in the
desired attenuation ,although on the other
hand, if he followed with the ten or more
successions, then their action turned out to be
so violent that their use on supersensitive
organisms might be dangerous

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• In Hahnemann's earlier essay on his new
therapeutic principle we do not, however, find
that he carried out the principle he had in his
allopathic days laid down with respect to the
administration of mercury in syphilis to other
medicaments and other diseases.
• - On the contrary, we find that his doses, even
after his recognition of the great principle with
which his name is for ever connected, differed
little, if at all, from those in common use.

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• In his essay On the cure and Prevention of
Scarlet Fever, * published in 1801, but
referring to his treatment in 1799, we have
the first indications of the infinitesimal
posology which is now vulgarly looked upon as
forming an essential part of the homoeopathic
system.

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• Introduction of higher potencies:
he first tried 60 C potency in 1826, but it was
around 1830 that he really began to use high
potencies

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• We cannot fail to be struck with the sudden
transition from the massive doses he
prescribed in 1798 to the unheard-of
minuteness of his doses only one year later,
and we can but guess the causes for this
sudden and extreme change.
• - He nowhere assigns any reasons for this
abrupt transition, and still less does he give us
any details respecting the steps by which he
descended from the massive doses we saw
him administering in 1798 to the real
infinitesimals of 1799.
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These reason Dr. Dudgeon conceive to be as follows :
• - 1. An observation of the greater power of a
medicine when given in solution than when taken in
the dry state.
• - 2. An observation of the greater power of a certain
quantity of medicine when given in divided doses
than all at once.
• - 3. An observation of the greater susceptibility of
the diseased organism for the medicine having a
special or homoeopathic relation to the affected part
of parts.
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• - 4. Some still obscure notion with regard to the
increase in power of a medicine by through
admixture of it with a non-medicinal vehicle, by
means of succussion-a foreshadowing of the
dynamization-theory.
• - 5. A desire to avoid aggravation of the disease by
the larger doses; for he says, if any aggravations
occur during the use of a small dose they will not last
long, and are easily removable by some antidote.
• - 6. A desire to evade the persecutions of the
apothecaries, who had begun to institute legal
proceedings against him for infringing on their
privileges by dispensing his own medicaments
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• The rules laid down at this period are, we see, as follows :-
• - 1. In the most acute disease, and in chronic disease
combined with debility, in which the general derangement
of the organism is obvious, the smallest doses are to be
given.
• - 2. These smallest doses are equivalent, in the amount of
medicinal substance they contain, to the 2nd and 3rd
dilutions of the ordinary or centesimal scale.
• - 3. In what are called local diseases-those chronic
diseases, to wit, where the morbid affection is localized and
the general system does not seem to be much implicated-
the doses must be gradually increased in strength.
• .

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• - 4. It does not appear what Hahnemann understood by
these stronger doses, but as he wrote for the ordinary
practitioners, in a journal of general medicine, I presume he
meant by this expression such doses as were commonly in
use.
• - 5. It is evident that at this time he did not contemplate
the exclusive treatment of disease by means of specific or
homoeopathic medicines, but that he admitted the
propriety of the palliative or antipathic treatment in certain
cases, and that for such treatment he considered the very
largest doses used in ordinary practice to be necessary

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• The last edition of the first and second volumes was
published after the invention of the psora-theory, which we
shall presently find had a revolutionary effect on
Hahnemann's posology.
• - In the third and fourth volumes, published in 1825, the
following are the doses prescribed of the medicines
contained in these volumes :-
• - Digitalis is directed to be given in the 15th or 30th
dilution.
• - Ledum in the 15th dilution.
• - Cham., chin., verat., hyos., aurum, in the 12th dilution.
• - Stramonium in the 9th dilution.
•
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• - ipecacuanha in the 3rd dilution.
• - Hepar sulphuris in the 3rd trituration.
• - Sulphur and argentum in the 2nd dilution.
• - Squilla in the 1st dilution.
• - Guaiac and sarsaparilla in the mother-
tincture.
• - Camphor in doses of one-eighth of grain, at
short intervals.
• - The doses for hellebore, conium, and
chelidonium are not indicated; probably the
mother-tincture of these was employed.
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• In the first edition of the Chronic Diseases he remarks that
thousands of warning experiments had at length convinced
him that these very minute doses were the most
appropriate, and at the same time he denies the utility of
larger doses, and states that he never had obtained the
true curative effect of the medicine until he arrived at this
diminution of the dose.
• Nevertheless, in the same volume he states* that though
he had cured recent itch sometimes with one small dose of
sulphur, yet he had once occasion to give half a grain of the
3rd trituration of carbo vegetabilis, in a family consisting of
seven persons, and three times a similar preparation of
sepia; these doses, he states, were "quite efficacious."

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Dr. J. E. Veith * acknowledges the
perfect necessity of the dilutions
and triturations; the appropriate
remedy, when minutely
subdivided, acts much more
excellently and is much more
suitable to the functions of the
capillary and nervous systems than
the medicine in the grosser
material forms.
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Dr.Trink has determined :-
• - 1. Acute diseases require the lower and middle
attenuations.
• - 2. Chronic diseases require higher and often the highest
attenuations, because they generally need for their cure
such medicines as only attain their full development of
power of mean of repeated subdivision.
• - 3. There are many exceptions to this-many chronic
diseases requiring low dilutions, and even the mother-
tincture.
• - 4. Many observations go to prove that the higher
dilutions are of use in disease, no only of a purely dynamic
but also of a material or organic character.

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• - 5. Many medicines appear only to develop
their full powers by long-continued trituration
and succussion.
• - 6. Many other medicines seem to possess
their full powers in the original tincture or
crude state, and all the subsequent processes
to which they are subjected seem but to
diminish those powers.

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The proper dose must be determined-

• By the peculiar nature and essential character of the medicines.

• The individuality of the patient.
• The constitution.
• The sex.
• The female is most susceptible, and therefore requires the smallest
doses.
• The temperament.The melancholic, sanguine, and choleric
temperaments display the greatest susceptibility, the lymphatic least.
• The manner of life of the patient.
• His idiosyncrasies.
• The epidemic and endemic influences.
• The influences of climate.
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 Helbing speaks still more decidedly on this point.
- By smallest dose he understands the 30th dilutions, and he
alleges that he has found arsenicum, belladonna, aconite,
nux vomica, and other medicines still possessing power in
these exalted preparations, but he says that the general or
exclusive employment of such high dilutions is "a
stupidity";
he has almost entirely abandoned them, because in so many
cases they are utterly destitute of power, where the lower
dilutions and the pure tincture still act most favourably, and
because the lower dilutions are more easily prepared, and
we can be more certain of their genuineness.

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• Dr. Lietzau says that the employment of the very
smallest doses was a mere caprice on the part of
Hahnemann.
• - Some powerful substances, which are very
inimical to the human body-as, for example,
arsenic-appear to be capable of acting when very
highly diluted; but, as regards most medicines, he
thinks that the pure tincture is the most
appropriate preparation, and the so-called
homoeopathic aggravation is but very rarely met
with from its use.

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• Dr. Kamper
The apparent paradox that medicinal aggravations
are whereas none occur from the employment of
large doses, he seeks to explain by this maxim: that
the same medicine in the same dose can, under
different circumstances in the same disease,
produce quite different, even opposite, effects, and
in very different doses exactly the same effect.

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• He thus acknowledges himself in some degree
an advocate for the higher dilutions; still he
declares that it so much more frequently
happens that such small doses of very high
dilutions have no effect, or but a very feeble
action, where larger doses of lower dilutions
have a sure and powerful action without any
consequent bad effect,

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• Dr. Attomyr- on the provimg of medicines.
Medicines show a quantitatively different action
on the healthy and the sick when given in the
same dose, and a qualitatively different action,
as regards the amount of the dose, on the
healthy certainly, on the sick most probably.
- From the difference of the qualitative action he
draws the inference that large doses act more
quickly, more transiently, more intensively;
small doses, on the other hand, act more
slowly, more permanently, more extensively

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• from this he lays down the following practical rules
:-
• - a. If it is necessary to give transient relief, we
must give large doses; if not, small.
• - b. If it is necessary to give transient relief, we
must give large doses; if not, small.
• - c. If it is requisite to afford intensive relief we
must give large doses, if extensive, small doses;
hence acute diseases demand large, chronic
diseases small doses; the principle of similarity
demands this.

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 Dr. Hering of Philadelphia
• In proving medicines in larger doses, there occur first
the primary violent effects of the medicine, and
afterwards a series of symptoms are observed that
last for a long time, as long as weeks or months, and
gradually diminish in number and intensity.
• - These secondary symptoms are often the very
opposite of the primary ones.
• - When medicines are proved in the higher
potencies, only these latter, the secondary
symptoms, are observed, and there is no opposition
perceptible betwixt the symptoms produced during
the last and the first days of the medicine's action.
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• The practical rule he deduces from these
remarks is as follows :-"Have we chosen our
remedy from the symptoms of a case of
disease on account of the perfect
correspondence of the chief characteristics in
disease and remedy, we have only to note
whether the symptoms of the case correspond
with the primary action of the drug, when we
give the lower dilutions, or with the secondary
symptoms, that is, with those got from the
provings with higher potencies, in which case
we give the higher."
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• Now, in order that this rule should have any
practical value, we should require to know
what symptoms are primary, what secondary
in the Materia Medica, which I have on a
former occasion shown we do not, or at least,
what symptoms were produced by stronger,
what by weaker preparations of the
medicines, which we must ever remain
ignorant of as far as Hahnemann's provings
are concerned.

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• Dr. Mure * of Rio de Janen though full of
extravagances on many points, and of the most
consummate vanity, allows occasionally a glimpse
of good sense to gleam through the clouds of
bombast and absurdity that abound in all his
writings.
• That he was the first who, in 1837, pointed out
that the lower dilutions were more suitable for
acute, the higher for chronic disease, and that all
those who have expressed the same opinion sine
that time are his unblushing plagiarists, he does
not inform us what he is with respect to those
who professed the same belief long before 1837.
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• In very acute diseases he employs the 2nd and
3rd dilutions; in less acute but still acute diseases,
he uses the 5th, 6th, 7th, and 8th, dilution.
• - In chronic cases he commences with the 9th
and goes up to the 100th.
• - He has little confidence in the 1000th or
10,000th.
• The lower dilutions are best adapted to the
infantile age, because their disease are almost all
acute; the higher to the diseases of old age, as
these are always complicated with chronic
maladies.

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• The male sex demands the lower dilutions,
the female the higher.
• - The sanguine temperament demands the
lowest dilutions, after that comes the bilious,
then the lymphatic temperament, and the
nervous temperament requires the highest
dynamizations.

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• - As regards the tissues or systems of the
organism, and the doses their diseases require,
he gives the following list-the first requiring the
lowest, the last the highest dilutions :-
• - 1. Cellular tissue.
• - 2. Muscular system.
• - 3. Osseous system.
• - 4. Joints, cartilages.
• - 5. Vascular system.
• - 6. Glandular system.
• - 7. Cutaenous and mucous tissues.
• - 8. Nervous system.
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• As regards the organs, the following is the
order in which dilutions are required from the
lower to the higher :-
• - 1. Locomotive apparatus.
• - 2. Circulatory apparatus.
• - 3. Digestive apparatus.
• - 4. genito-urinary apparatus.
• - 5. Respiratory apparatus.
• - 6. Nervous apparatus.

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• Dr. Nunez of Madrid :

1. All dilutions, from 0 to 2000, may in certain cases be

of use; it rests with the feelings and the tact of the
physician to choose the appropriate one for each
case.
2. In general the most appropriate dose for the
treatment of acute disease must be sought for in the
dilutions from 2000 upwards

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3. Chronic diseases may generally be treated
with the 2000th potency, but in most cases it
will be best to select a higher dose.
4. Chronic diseases, combined with organic
alterations, are always aggravated by the
2000th potency, nor does the reaction on the
vital force suffice to remove entirely the
aggravation so produced, and hence they
require much higher doses.“
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• Dr. CruxentI of Mataro,
The dose of the medicine, says he, must be
proportioned to the duration of the disease.
If the disease has lasted less than one day, give the
mother-tincture ; if it has lasted one day, give the 1st
dilution; if two, the 2nd dilution; if three, the 3rd; if
ten, the 10th; if a hundred, the 100th; if a year, the
365th; or in what the almanacs call the bissextile or
leap-year, the 366th; if ten years, the 3650th .
And yet who would have dreamt of this wonderful
connection of the revolutions of the earth on its axis
and the homoeopathist's dilution bottles-this
sympathetic alliance of the great and the small ?
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• - Dr. Scott
• The potency to be chosen is determined by
the character of the disease, combined with
the completeness or incompleteness of its
remissions.
• - (This requires some explanation.
• - Dr. Scott considers that where the vital
action is exaggerated, a greater amount of
medicinal power, in other words, a lower
dilution, is requisite than in opposite
circumstances, viz., when there is depressed
vital action.
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• - Again, most, if not all, acute diseases have
intermissions, or at least remissions.
• - He argues that the more complete the
intermission or remission is, the larger should
be the dose administered, and the smaller, the
less perfect the remission, and the nearer the
disease approaches to the purely continued
character); 4, that the repetition of the
medicines is determined by the duration and
completeness of the intermission or remission
of the disease, and by the activity of the
system principally affected by the disease
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• This experience seems to show that the more
material doses, or the lower dilutions of
medicines, have a more rapid and intense
action, and are best adapted to disease of
rapid course and considerable violence, and
that the higher dilutions have a more
continued and profound action, and are
therefore better adapted to diseases of a
more chronic character; but there are many
exceptions to this.

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• Dose and amount of the prescribed remedy in
kentian homoeopathy:
kent was follower of the philsopher, Emanuel
Swedenberg one of the greatest scientist of
that day. In his chapter simple substance he
writes as follows;
quantity cannot be predicted of a simple
substance, only quality in degrees of
fineness.that energy is based on the fourth
state of matter called the simple substance.

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• Kent does not accept hahnemann’s vision that
pure energy without material basis exists.

He says it never matters whether the remedy is

given in water in spoonful doses or given in a
few pellets dry on the tongue the result is the
same. Thus kent was a fourth edition organon
prescriber contadictory to aphorism 275, 277

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• $ 277
“For the same reason, and because a medicine,
provided the dose of it was sufficiently small, is
all the more salutary and almost marvellously
efficacious the more accurately homoeopathic its
selection has been, a medicine whose selection
has been accurately homoeopathic must be all
the more salutary the more its dose is reduced to
the degree of minuteness appropriate for a
gentle remedial effect.”

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• In chronic diseases hahnemann tells us to
succuss the bottle each time before the next
dose until we see a similar aggravation
occurring.
• when I was still giving the medicines in
undivided portions, each with some water at a
time, I often found that the potentising in
atteuating glasses effected by ten shakes was
too strong….

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And I therefore advised only two
succussions.but during the last years, since I
have been giving every dose of medicine,
divided over 15,20,30 days,no potentising in
an attenuation vial is found too strong, and
again use ten strokes with each. So I herewith
take back what I wrote on this subject three
years ago in the first volume of this book .

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• Though the 6th edition of organon was
published in the year 1920 it took until 1950
for LM potencies to be discovered by Dr.
Charles Pahud of france and by the famous
Swiss homoeopath, Pierre Schmidt in 154 who
published a small booklet, hidden tresures of
the 6th edition of the organon.

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• The principle which holds is that “ the high
number of dilutions makemthe power of the
remedy very high, while the relatively low
number of succussions keeps the aggravations
low.

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• Stuart close words……………..:
The homoeopathic doctrine of dosage,
like the law of cure, was based upon the
discovery of the opposite action of large and
small doses of medicine. It is another
application in medicine of the Law of Mutual
Action-the third Newtonian law of motion-
"Action and Reaction are Equal and Opposite."

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• Although the physiological antagonism
between large and small doses is an
illustration of the homoeopathic law of
posology, the use of drugs in "physiological
doses" has nothing to do with their
homoeopathic use, because homoeopathic
remedies are never used in "physiological
doses." This statement is true, even in those
cases where the low reacting power of the
patient sometimes requires material doses of
the homoeopathic remedy. It would be more
accurate to say that homoeopathic medicines
are never used for their "physiological effect."
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• Therapeutic means curative, healing,
alleviating. A pathogenetic action is never
curative. The action of a drug may be
pathogenetic (toxic), or therapeutic (curative),
depending upon the size and strength of the
dose, the susceptibility of the patient and the
principle upon which it is given.

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• The homoeopathic dose, therefore, is always a
sub-physiological or sub-pathogenetic dose;
that is, a dose so small as not to produce
pathogenetic symptoms; for we desire, not to
produce more symptoms, but only to remove
and obliterate symptoms already existing. It
must also be given in a dose so small as not to
produce a severe aggravation of the already
existing symptoms.

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• In general it may be stated that any curable
diseases may be cured by any potency, when the
indicated remedy is administered; but that the
cure may be much accelerated by selecting the
potency or dose appropriate to the individual
case.
• Five considerations influence us in the choice of
the dose:
1. The susceptibility of the patient.
2. The seat of the disease.
3. The nature and intensity of the disease.
4. The stage and duration of the disease.
5. The previous treatment of the disease.
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• One of the most difficult things is to learn to
wait. Three things are necessary; wisdom,
courage and patience. "Strong doses" and
frequent repetition will not avail if the remedy
is not right.
• In Par. 245 Hahnemann gives this general
rule: "Perceptible and continued progress of
improvement in an acute or chronic disease, is
a condition which, as long as it lasts, invariably
counter-indicates the repetition of any
medicine whatever, because the beneficial
effect which the medicine continues to exert is
rapidly approaching its perfection.
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• The single dose of the indicated remedy,
repeated whenever improvement ceases, as
long as new or changed symptoms do not
indicate a change of remedy, is adapted to all
cases, but especially to chronic cases and to
such acute cases as can be seen frequently
and watched closely. The nature and progress
of the disease will determine, under this rule,
how often the dose is to be repeated.

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• Hahnemann finishes by warning us that the “
almost spiritual action of the remedies attains its
objective not by a quantitative, but a qualitative
effect of dynamic action” so that “the
homoeopathic physician who thinks of the
remedies only in terms of quantity fails to
comprehend the whole truth of homoeopathy.”

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• Now the the most widely followed are the
conclusions made by Dr. M L Dhawale on the
dynamic action of drugs, the potency
selection and their proper repetition. These
guidelines seems to show considerable
constructive changes in the field of
Homoeopathy.

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