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Guidelines in 4th Edition of Organon of Medicine (1929)
All emphasis (bold/italic/underline) and summary notes by Dr. Manish Bhatia
§ 248. The dose of the same medicine should be repeated until a cure is effected, or until it ceases any longer to afford relief; in the latter alternative, the remnant of the disease, with its altered group of symptoms, will require another homoeopathic remedy.
- The same medicine should be repeated till a cure is affected or it ceases to act.
- Find another remedy for the remaining symptoms.
§ 249. Every medicine which, in the course of its operation, produces new symptoms that do not appertain to the disease to be cured, and that are annoying, is incapable of procuring real amendment,* and cannot be considered as homoeopathically chosen. If the deterioration of symptoms be important, the effect of the medicine must be extinguished, in part, without delay, by means of an antidote, before another and more homoeopathic remedy is given, or if the new symptoms be not violent, the other remedy must be immediately given, to take the place of that which has been so unfitly chosen.
* All experience teaches us, that scarcely any homoeopathic medicine can be prepared in too minute a dose to produce perceptible benefit in a disease to which it is adapted (§ 161. 279). Hence it would be an improper and injurious practice, when the medicine produces no good effect, or an inconsiderable exacerbation of the symptoms, after the manner of the old school, to repeat or increase the dose under the idea that it cannot prove serviceable on account of its minuteness. Every exacerbation caused by new symptoms, when nothing injurious has occurred with regard to diet or mental impressions, always proves the unsuitableness of the medicine previously given, but never indicates the weakness of the dose.
- If a remedy produces new symptoms during treatment, it can not be considered the simillimum.
- If the new symptoms are mild, reasess the case and give the right remedy immediately.
- If the new symptoms are severe, first antidote the wrong remedy and then reasess the case and give the right remedy.
§ 250. When in urgent cases, after the lapse of six, eight, to twelve hours, it becomes manifest to the observant physician who has accurately investigated the character of the disease, that he has made a false selection of the remedy last administered, when, during the appearance of new symptoms, the disease becomes, though slightly, yet evidently worse from hour to hour, it is not only admissible, but duty renders it imperative on him to rectify the mistake he has made, and administer another homoeopathic remedy not only tolerably, but the best possibly adapted to the morbid condition at the time (§ 167).
- In emergency cases or in cases regressing rapidly, the physician should not wait even if new symptoms have appeared. he should reasess the case and give the right remedy immediately without waiting.
§ 251. There are some medicines, for example, ignatia amara, bryonia, rhus, and sometimes belladonna, whose power of changing the human economy chiefly consists in the production of alternate effects—a kind of primary symptoms, partly in opposition to each other. If the physician find no improvement after the strict homoeopathic selection and administration of one of these remedies (in acute cases, after a few hours), then by repeating it in the same dilution, he will quickly obtain the desired effect.*
* As I have explained more circumstantially in the introduction to the article ignatia (Mat. Med. vol. ii.)
- If you are very sure of your remedy selection but the patient does not react to your first dose, repeat the same medicine in the same dose again and you will most likley see a positive reaction, esp. when your remedy has some alternating action.
§ 252. But if in a chronic disease (psoric) the most homoeopathic remedy (anti-psoric), administered in the smallest and most suitable dose, does not produce an amendment, it is a sure sign that the cause which keeps up the disease still exists, and that there is something either in the regimen or condition of the patient that must be first altered before a permanent cure can be effected.
- But if you still fail to produce a positive reaction from the right remedy in a chronic case, look for a maintaining case which might be working as an obstruction to cure.
§ 253. In all diseases, particularly those which are acute, the state of mind and general demeanour of the patient are among the first and most certain of the symptoms (which are not perceived by every one) that announce the beginning of any slight amendment or augmentation of the malady. If the disease begins to improve, though in ever so slight a degree, the patient feels more at ease, he is more tranquil, his mind is less restrained, his spirits revive, and all his conduct is, so to express it, more natural. The very reverse takes place where there is only a slight increase; an embarrassment and helplessness, which call for commiseration, are observable in the mind and temper of the patient, as well as in all his actions, gestures, and postures—something both remarkable and peculiar which cannot escape the eye of an attentive observer, but which it would be difficult to describe in words.*
* In order to have a determinate rule for the moderate developement of power of the fluid medicines, multiplied experience and observation have led me to retain two shakes for every vial, in preference to a greater number, which had previously been used, but which developed the energy in too great a degree. On the contrary, there are homoeopathists who, in their visits to the sick, carry about their persons the medicines in a fluid state, which, they nevertheless affirm, do not in time become increased in energy by the frequent agitation to which they are thus subjected. This declaration, however, betrays on their part the want of a talent for accurate observation. I dissolved a grain of natron in half an ounce of a mixture of water and a little alcohol, poured the solution into a vial, which was thereby filled two-thirds, and shook it uninterruptedly for half an hour. By this agitation, the fluid attained an energy equal to that of the thirtieth dilution.
- In all disease, but especially in acutes, after the administration of the right remedy, the first change that will be noticed is that the energy levels of the patient will increase and the patient will feel more relaxed, more at peace and less anxious.
- Hahnemann though that 10 or more strokes/succussions between each dilution raises the potency too much and he settled at two strokes between each dilution.
§ 270. If two drops of a mixture of equal parts of alcohol and the recent juice of any medicinal plant (see § 267) be diluted with ninety-eight drops of alcohol in a vial capable of containing one hundred and thirty drops, and the whole twice shaken together, the medicine becomes exalted in energy (potenzirt) to the first developement of power, or, as it may be denominated, the first potence. The process is to be continued through twenty-nine additional vials, each of equal capacity with the first, and each containing ninety-nine drops of spirits of wine; so that every successive vial, after the first, being furnished with one drop from the vial or dilution immediately preceding (which had just been twice shaken), is, in its turn, to be shaken twice," remembering to number the dilution of each vial upon the cork as the operation proceeds. These manipulations are to be conducted thus through all the vials, from the first up to the thirtieth or decillionth developement of power (potenzirte Decillion-Verdünnung, X.), which is the one in most general use.
- Two strokes are to be used to prepare each potency in centesimal scale.
- 10C was the potency that he most often used at this time..
§ 272. In no instance is it requisite to employ more than one simple medicinal substance at a time.*
* have been made by some homoeopathists in cases where, imagining that one part of the symptoms of a disease required one remedy, and that another remedy was more suitable to the other part, they have given both remedies at the same time, or nearly so; but I earnestly caution all my adherents against such a hazardous practice, which never will be necessary, though, in some instances, it may appear serviceable.
- Give a single remedy at any given time.
§ 275. The appropriation of a medicine to any given case of disease does not depend solely upon the circumstance of its being perfectly homoeopathic, but also upon the minute quantity of the dose in which it is administered. If too strong a dose of a remedy, that is even entirely homoeopathic, be given, it will infallibly injure the patient, though the medicinal substance be of ever so salutary a nature; the impression it makes is felt more sensibly, because, in virtue of its homoeopathic character, the remedy acts precisely on those parts of the organism which have already been most exposed to the attacks of time natural disease.
- A medicine become the simillimum for a case not just by covering the symptoms of the case but also when given in thr right dose(potency and quantity).
- Even a right remedy, given in too high a dose will harm the patient.
§ 276. Even a homoeopathic medicine is, on this account, always injurious when given in too large a dose, and hurtful to the patient in proportion to the extent of the quantity administered. But the increase of the dose itself is also prejudicial in the same degree as the remedy is more homoeopathic; and a strong dose of such a medicine would do more harm than the dose of all alloeopathic medicinal substance (which bears no analogy whatever to the disease) of equal strength; for, in that case, the homoeopathic aggravation (5 157-160)—that is to say, the artificial malady, which is very analogous to the natural one excited by the remedy in the most suffering parts of the organism—is carried to a height that is injurious (§ 246, note); whereas, if it had been confined within proper limits, it would have effected a gentle, prompt, and certain cure. It is true the patient no longer suffers from the primitive malady which has been homoeopathically destroyed, but he suffers so much more from the medicinal one which was much too powerful, and from unnecessary debility.
- If the right medicine is given in a very large dose(potency or quantity), it will create strong homeopathic aggravation.
§ 281. All diseases have an extraordinary tendency to undergo a change when operated upon by the influence of homogeneous medicinal agents. There is no patient, however robust his constitution may be, who, if attacked merely by a chronic disease, or by what is called a local malady, does not speedily experience a favourable change in the suffering parts after having taken the appropriate homoeopathic remedy in the smallest dose possible. In short, the effects of this substance will make a greater impression on him than they would upon a healthy child twenty-four hours after its birth. How insignificant and ridiculous is mere theoretic incredulity, when opposed to the infallible evidence of facts!
§ 282. However feeble the dose of a remedy may be, provided it can in the slightest degree aggravate the state of the patient homoeopathically provided it has the power of exciting symptoms similar to those of the primitive disease, but rather more intense, it will, in preference, and almost exclusively, affect those parts of the organism that are already in a state of suffering, and which are strongly irritated and predisposed to receive any irritation analogous to their own. Thus an artificial disease rather more intense is substituted in the place of the natural one. The organism no longer suffers but from the former affection, which, by reason of its nature, and the minuteness of the dose by which it was produced, soon yields to the efforts of the vital force to restore the normal state, and thus leaves the body (if the disease was an acute one) free from suffering—that is to say, in a healthy condition.
§ 283. To proceed, therefore, in a manlier conformable to nature, the true physician will only administer a homoeopathic remedy in the precise dose necessary to exceed and destroy the disease to which it is opposed, so that if by one of those errors, pardonable to human frailty, he had made choice of a remedy that was inappropriate, the injury that might result from it would be so slight that the developement of the vital force, and the administration of the smallest close of another remedy more homoeopathic, would suffice to repair it.
§ 284. The effects of a dose are by no means diminished in the same proportion as the quantity of the medicinal substance is attenuated in the homoeopathic practice. Eight drops of a tincture taken at once do not produce upon the human body four limes the effect of a dose of two drops ; they merely produce one that is nearly double. In the same manner the single drop of a mixture, composed of one drop of a tincture and ten of a liquid void of all medicinal properties, does not produce ten limes the effect that a drop ten times more attenuated would produce, but merely an effect that is scarcely double. The progression continues according to this law, so that a single drop of a dilution, attenuated in the highest degree, ought, and does in fact, produce a very considerable effect.*
* Suppose, for example, that one drop of a mixture containing the tenth of a grain of any medicinal substance produces art effect = a; a drop of another mixture containing merely a hundredth part of a grain of this same substance will only produce an effect= a/2; if it contains a ten thousandth part of a grain of medicine, the effect will be = a/4; if a millionth, it will be = ; and so on progressively, to an equal volume of the doses, the effects of the remedy on the body will merely be diminished about one half each time that the quantity is reduced nine tenths of what it was before. I have often seen a drop of the tincture of nux vomica at the decillionth degree of dilution, produce exactly half the effect of another at the quintillionth degree, when I administered both one and the other to the same individual, and under the same circumstances.
§ 285. By diminishing the volume of the dose, the power of it is also diminished—that is to say, when instead of one entire drop of attenuated tincture merely a fraction of this drop be administered,* the object of rendering the effect less powerful. is then very perfectly attained. The reason of this may be easily conceived: the volume of the dose being diminished it must necessarily follow that it will touch a less number of the nerves of the living organism, by contact with which, it is true, the power of the medicine is communicated to the whole body, but it is transmitted in a smaller degree.
* The best mode of administration is to make use of small globules of sugar, the size of a mustard seed ; one of these globules having imbibed the medicine, and being introduced into the vehicle, forms a close containing about the three hundredth part of a drop, for three hundred of such globules will imbibe one drop of alcohol ; by placing one of those on the tongue, and not drinking any thing after it, the dose is considerably diminished. But if the patient is very sensitive, and it is necessary to employ the smallest dose possible, and attain at the same time the most speedy results, it will be sufficient to let him smell once. (See § 288, note).
- Small, musturd seed size sugar pills are the best mode for administering a remedy.
- One such globule will comprise one dose.
- If the patient is oversensitive, he can just smell one such globule.
§ 286. For the same reason, the effect of a homoeopathic dose is increased when we augment the quantity of the liquid in which it is dissolved to administer it to the patient ; but then the remedy comes in contact with a much more extended surface, and the nerves that feel its effects are far more numerous. Although theorists have asserted that the extension of a medicine in liquid weakens its action, experience proves the reverse, at least as far as regards homoeopathic remedies.*
* Only wine and alcohol, which are the most simple of all excitants, lose a portion of their heating and exciting power when they are attenuated in a large quantity of water.
- The quality of the homeopathic medicine increases with the dilution.
Footnote to Aph 246 in 5th ed
1 In the former editions of the Organon I have advised that a single dose of a well-selected homoeopathic medicine should always be allowed first fully to expend its action before a new medicine is given or the same one repeated - a doctrine which was the result of the positive experience that neither by a larger dose of the remedy, which may have been well chosen (as has been again recently proposed, but which would be very like a retrograde movement), nor, what amounts to the same thing, by several doses of it given in quick succession, can the greatest possible good be effected in the treatment of diseases, more especially of chronic ones; and the reason of this is, that by such a procedure the vital force dose not quietly adapt itself to the transition from the natural disease to the similar medicinal disease, but is usually so violently excited and disturbed by a larger dose, or by smaller doses of even a homoeopathically chosen remedy given rapidly one after the other, that in most cases its reaction will be anything but salutary and will do more harm than good. As long as no more efficacious mode of proceeding than that then taught by me was discovered, the safe philanthropic maxim of sin non juvat, modo ne noceat, rendered it imperative for the homoeopathic practitioner, for whom the weal of his fellow-creatures was the highest object, to allow, as a general rule in diseases, but a single dose at a time, and that the very smallest, of the carefully selected remedy to act upon the patient and, moreover, to exhaust its action.
- Give a single dose of the well selected remedy as a single dose.
- Do not repeat till the first dose exhausts its action.
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