Posology is the study of Law of Dosage. Dose is defined as the least quantity of substance required to effect a change in nature. A well selected remedy may fail utterly, or even do injury, because of wrong dosage. Hahnemann himself at one time in despair bought his followers to an agreement on the subject to treat all cases with the thirtieth potency. Following this suggestion others tacitly adopted a dosage confined to one, or a very limited range of potencies.
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Posology is the study of Law of Dosage. Dose is defined as the least quantity of substance required to effect a change in nature. A well selected remedy may fail utterly, or even do injury, because of wrong dosage. Hahnemann himself at one time in despair bought his followers to an agreement on the subject to treat all cases with the thirtieth potency.
Following this suggestion others tacitly adopted a dosage confined to one, or a very limited range of potencies. The materialistically minded restricted themselves to the crude tinctures and triturations, or the very low dilutions, ranging from 1x to 6x. Such a state of affairs is unfortunate. Assuming that there is a difference in the action of the various doses of medicines, and that a series of potencies or preparations of the different medicines has been available for use; it follows that the entire series should be open to every practitioner, and that each man should be competent, willing and ready to use any potency or preparation of the remedy indicated in a given case, without prejudice.
If he confines himself to one or two potencies, be they low, medium, or high, he is limiting his own usefulness and depriving his patient of valuable means of relief and cure. It is as unreasonable to expect to cure all cases with any two or three potencies as it is to expect to cure all cases with any two or three remedies. In either case, those who follow such a course are governed more by the love of ease and their prejudices than they are by their desire for efficiency.
Closely allied to this is the so-called primary and secondary action of drugs, in, which we see many drugs, in the first or primary stage of their action producing one group of symptoms, and in the second stage a directly opposite set of phenomena; as when the deep sleep of the primary action of Opium is followed by a much longer lasting wakefulness; or where the diarrhea induced by a cathartic is followed by a longer lasting constipation.
Its use tends to obscure, or keep in the background, the fact that the kind of drug action so designated is essentially a toxic action and therefore really painful and injurious. Is it a alternative ,sustitute. The action of the physiological dose and the purpose for which it is given is avowedly to produce drug symptoms, in, a direct and positive manner, that fact should be clearly expressed in order that there may be no misunderstanding. 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. Pathogenetic doses may be given, however, for experimental purposes to a healthy person, in making what are called provings.
By means of the similar remedy in the minimum dose it is possible to do this in a direct manner without producing symptoms. Only the similar remedy, in the. Infinitesimal doses are not capable of producing symptoms in healthy susceptible persons it is not true.
Infinitesimal doses will produce symptoms in certain highly sensitive persons, and many of our most valuable provings have been made with more or less highly potentised medicines. Indeed, no remedy can be regarded as having been thoroughly proven until it has been proven in the potencies as well as in crude form. A Physiological dose means a dose of a drug, empirically selected, of sufficient quantity and strength to produce a definite, predetermined effect or group of symptoms.
Practically it amounts to the maximum dose consistent with safety. A physiological dose of Atropine or Belladonna, for example, is one sufficient to produce dilatation of the pupils, dryness of the mucous membranes and flushing or turgescence of the skin.
The action of the drug is carried to this point irrespective of any accessory symptoms that may be produced, or as to whether it is curative or otherwise.
No other kind of action is looked for or expected and, as a rule, it is not recognized if it occurs. The intent is to produce a direct definite drug effect. In attempting to predetermine arbitrarily the size and strength of the physiological dose, allowance is made only for difference in the age of the patients, who are roughly divided into two classes, infants and adults.
If a patient is unable to take the established or usual doses without serious results, it is considered to be a case of idiosyncrasy or hypersensitiveness and some other drug is substituted.
From this point of view such symptoms, so long as they are not serious, are of no importance and have no use. In considering the reasons why the dose of the medicine chosen homeopathically is necessarily smaller than the physiological dose of antipathic or allopathic prescription, we meet first the fact of organic resistance.
Every living organism is endowed with an inherent, automatic power of reaction to stimuli. By means of this power the organism offers resistance to everything which tends to injure or destroy its integrity or disturb its normal functioning.
Resistance is manifested by suffering pain, fever, inflammation, changed secretions and excretions, etc. This power is displayed when drugs are administered because drugs are inimical to health, in proportion to their power and the size of the dose. In order for a dissimilar drug to produce its so-called physiological effect, therefore, the dose must be large enough to overcome first, this bodily resistance; and second, to produce its characteristic symptoms.
The affected organs or tissues are open to attacks from without. Susceptibility to the similar drug is therefore greatly increased. In order that the suffering of the affected organs may not be increased and the patient injured, a much smaller dose must be given. The homeopathic 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. Another reason for the small dose lies in the fact that disease renders the affected parts abnormally sensitive, as we see in an inflamed eye, which is painfully sensitive to a degree of light to which it reacts, normally in health.
A third reason is that the homeopathic drug is always given singly, so that its action is complete and unmodified by other drugs. This statement is qualified by laying down three, necessary requirements for such action:.
Force, to be effective, must be supplied not only in proper amount, but in the proper direction and at the proper time. The proper amount of a drug to be administered in a given case can never be settled by a priori reasoning, but only by experience; and thus it has been settled. It cannot be thought of as nothing. The smallest possible portion of a substance, is it not an integral part of the whole?
Were it to be divided and redivided even to the limits of infinity, would there not still remain something,-something substantial, — a part of the whole, let it be ever so minute?
What man in his senses would deny it? And if this be in reality an integral part of the divided substance, which no man in his senses can doubt, why should this minute portion, as it is certainly something, be inactive, while the whole acted with so much violence?
His discovery of the principle of potentization came about gradually as he experimented in the reduction of his doses, in order to arrive at a point where severe aggravations would not occur. Gradually, by experience, he learned that the latent powers of drugs were released or developed by trituration, dilution and succussion. Thus he arrived at his final conclusion that the proper dose is always the least possible dose which will effect a cure.
For the greater part of his life Hahnemann had only what we now call the lower potencies; namely from the first to the thirtieth; although in his later years he was enabled to procure and use some of the higher potencies. It was repeatedly stated that Hahnemann would deal with this subject in the forthcoming sixth edition of the Organon, a work which unfortunately never saw the light until Men with the confidence, courage and zeal to experiment with these altitudinous preparations and publish their results have not been lacking.
Physicians of unquestioned honesty, ability and experience have testified that, they obtained curative results from the use even of the very highest potencies. In the light of experience and of recent revelations in other departments of science of the power of the infinitesimal, there is nothing inherently improbable about it, and it is unquestionably to our advantage to have as large an armamentarium as possible.
Five considerations influence us in the choice of the dose: There are little teachings but many opinions which will help us to choose the best potency for a given case. Practitioners who publicly boast of their liberality on this subject, will too often be found, on more intimate acquaintance, to practice an obstinate exclusivism in the use of some particular potency, generally a very low or a very high one; and to harshly criticize those who differ with them.
This is unfortunate, because such practitioners undoubtedly deprive themselves and their patients of many agents of cure which are easily within their reach. 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.
Susceptibility of the Patient. Susceptibility to medicinal action is only a part or phase of the general susceptibility of the organism to all stimuli. By analogy, as well as by experience, we are led to a consideration of the main factors -which modify and express susceptibility in general.
Susceptibility varies in different individuals according to age, temperament, constitution, habits, character of diseases and environment. The susceptibility of an individual to a remedy at, different times also varies.
Idiosyncrasy may exist as a modifying factor. Homeopathicity must always be considered. The more similar the remedy, the more clearly and positively the symptoms of the patient take on the peculiar and characteristic form of the remedy, the greater the susceptibility to that remedy, and the higher the-potency required. Kent was not only an exponent of medium and high potencies but was also the preceptor of a generation of high potencists. It was because of his students that high potencies came into vogue in England.
Kent is still considered the person who has influenced the use of high potencies the most among the homeopathic community. If the remedy is only partially similar, it will act in one or two potencies and then the symptoms will change and a new remedy will be required. He remarks an essential difference between the action of the low and high potencies, which consists, not in their strength or weakness, but in the development of, the peculiarities of the remedy, as we rise in the scale of potencies.
This is based on the well known fact that provings of the tincture and lowest potencies of a drug produce only the more common and general symptoms of the drug, not very sharply differentiated from other drugs of its class. It is in the provings of the medium and higher potencies that the special and peculiar character of the drug is revealed by its finer and most characteristic symptoms.
All narcotics, like Bell, Stram or Opium, for example, in crude and massive doses act in a manner equally stupefying, causing death by apoplexy or paralysis; all drastics produce vomiting and purging, etc. It is only in small or potentiated doses that their most characteristic differences of action become apparent. The practical bearing of this on the selection of the potency or dose, according to Jahr, is as follows: — In a given case, where the symptoms are not clearly developed and there is an absence or scarcity of characteristic features; or where two or three remedies seem about equally indicated, susceptibility and reaction may be regarded as low.
We give, therefore, the remedy which seems most similar, in a low third to twelfth potency. But, when most symptoms of a case clearly indicate one remedy, whose characteristic symptoms correspond closely to the characteristic symptoms of the case, we give the high potencies — thirtieth, two hundredth, thousandth, or higher. Susceptibility is Modified by Age.
Children are particularly sensitive during development, and the most sensitive organs are those which are being developed. Therefore the medicines which have a peculiar affinity for those organs should be given in the medium or higher potencies.
Susceptibility is Modified by Constitution and Temperament. Lower potencies and larger and more frequent doses correspond better to torpid and phlegmatic individuals, dull of comprehension and slow to act; to coarse fibered, sluggish individuals of gross habits; to those who possess great muscular power but who require a powerful stimulus to excite them. Such persons can take with seeming impunity large amounts of stimulants like whiskey, and show little effect from it.
When ill they often require low potencies, or even sometimes, material doses. Susceptibility is Modified by Habit and Environment. Such persons require high potencies. Susceptibility is Modified by Pathological Conditions. A common example of this is seen in certain terminal conditions of valvular heart disease, where Digitalis is the indicated remedy, but no effect is produced by any potency.
The patient will respond, however, to tangible doses of the pure tincture or, a fresh infusion of Digitalis and sometimes make a good recovery from a condition that seems hopeless. The form of the reaction complies perfectly with the requirements of cure as to order and direction of the disappearance of the symptoms and nature of the result.
EVOLUTION OF HOMOEOPATHIC POSOLOGY
Background: Nowadays, conducting valid provings is one of the most important research topics in homeopathy. Consequently, many proving methodologies are continually being proposed. Results: In Hahnemann's provings several symptoms were included, deriving from material doses, such as grain doses, scruple doses, tinctures, the seeds or the root of the plant and from potentised doses, such as the 1st trituration, 9th dilution, 30th dilution, 3rd trituration and the 18th dilution. Thus, we don't know whether such symptoms are the reaction of the organism and hence secondary action, or an alternating action of this medicine. In this case the genius of the symptoms can be seen due to the clear distinction between the primary effects those most important and the after-effects secondary. Conclusion: Hahnemann, in his conclusion, experimented using varying amounts in his provings. Vithoulkas and Herscu propose a novel approach to proving's posology according to Hahnemann's concept of the prover's individual predisposition-idiosyncrasy-sensitivity.
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