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OF TERMS WHICH, IN GERMAN, HAVE A MORE OR LESS TECHNICAL MEANING, AND FOR WHICH THE ENGLISH LANGUAGE HAS NO STRICTLY COR
Eingenommenheit.This expression has been rendered by "dulness" of the head. It conveys an idea of tightness, of want of clearness, of 'fulness and heaviness.
Boll, Bollheit. This expression has been rendered by "pithy, pithiness." The literal sense corresponds exactly to the English, "pithy" as used of radishes, etc. The figurative sense conveys an idea of deadness, numbness, insensibility..
Reissend. This has been rendered by "tearing," tearing pain, meaning a sort of violent rheumatic pain, striking from one part to another.
Zwangend, has been rendered by "dragging;" literally the term conveys an idea of forcing, or driving one body (a wedge, for instance) into or through another.
Herz. This word is frequently used in common parlance for "pit of the stomach." "Herzweh is frequently used to convey the idea of "sickness at the stomach." "Schmerz am Herzen," in common conversation means a pain.
in the pit of the stomach."
Jochbein.-This has been translated by "malar bone." Klamm, Klemmender Schmerz, has been rendered by cramp, cramp-pain, crampy feeling or sensation; "Krampf" has been rendered by "spasm?
Drohnend has been rendered by the literally corresponding expression, "groaning." "Drohnender Schmerz," means a sort of painful vibratory sensation in a part, with or without numbness, sensation as if the part would go to sleep, etc.
The question of doses has not yet been settled upon a scientific basis. Some use the lower, some the middle and higher, others again both orders of preparations. The latter is undoubtedly the wisest course.
For the benefit of those who have not determined for themselves what course they ought to pursue in reference to the magnitude and repetition of the dose, we will transfer to this place the two paragraphs from Jahr's old Manual bearing upon that subject.
ON THE USE OF THE HOMEOPATHIC DOSES.
Beside the pathogenesis and resumé of clinical cases, some remarks upon the doses used and the duration of their action, may be found at the head of each medicine.—In regard to the doses, we have selected them as found in authors, regarding them only as historical authority, but in no respect as absolute rules. The question of dilution must always be secondary, relatively to that of the medicine. HAHNEMANN employs the thirtieth in preference, others such as they find in the pharmacopæias, and others pass from one dilution to another, especially in cases of repetition. Dr. MURE, in an article inserted in the Bibliothèque de Genève, prefers the use of the first (low) attenuations in acute diseases, and those of the last (high) in chronic maladies. We ourselves, in the preface to our first edition, (Paris translation of 1833,) expressed similar opinions regarding the different dilutions, and virtually retain the same up to the present time in this form: that if any distinction is to be maintained for prac tice, we think that the first attenuations generally answer the best for maladies whose progress is rapid, while the last accord with those whose progress is tedious. But another question arises for information: whether, in cases where the low dilutions seem to be required (such as some primitive forms of syphilis, gonorrhoea, &c.), a desirable result cannot be attained by administering the last dilutions in reiterated doses, and especially by spoonful doses of a watery solution? For whatever may be the increase of strength which the remedies may acquire by trituration or shaking, it is not the less true that there follows at the same time a loss of power, inasmuch as any quantity of the thirtieth dilution will always prove more feeble than an equal volume of the first. The thing is perfectly evident, if we compare the effects which ten drops of the crude tincture of Arsenic will produce, with those which result from ten drops of the thirtieth. The observation is equally applicable to those substances which are called inert in their natural state, in this, that if we take a grain of Lycopodium, or of pure Carbon, but sufficiently triturated to become active, this grain will act more than an equal volume of the thirtieth dilution of these substances. But on the other hand, it is ascertained that by these dilutions the body of the substance has been dilated or expanded in its surface; and, in this manner, not
only affects a greater number of our organs, when taken, but also developes all its atoms, which remain inactive in the compact state, and by consequence, allows a display of their entire action. For example, a hundred drops of the first dilution will produce, together, an effect infinitely more decided than can be obtained by a single drop of the crude tincture; yet in the hundred drops of the first dilution there is not in reality any more medicinal matter than existed in the single drop of the crude tincture. Whence it appears that, while a single drop of the thirtieth in itself, may be more feeble than a drop of the first, a certain number of drops may constitute a dose, which, by the extension of its active atoms, will not only prove equal, but even surpass the power of the first dilutions.
This is not the appropriate place to treat of the preparation of doses, which justly belongs to the pharmacopæias; notwithstanding, we will propose this question: For the development of the dynamic virtue of a medicine, will it answer to move the atoms of substances, either by shaking or trituration, or will it not be preferable to advance from dilution to dilution to reach the greatest extension possible of the atoms as to surface? We have seen the ingenious instrument of trituration, invented by MURE, and the really powerful machine with which he effects the dilutions of his medicines; we have used the medicines prepared by these means, and must confess that, in respect to activity, they absolutely leave nothing to be desired, unless that their effects are sometimes in direct proportion to the increased number of shakings they may have received. The essential requisite is, that the mixture shall be as intimate as possible; and to produce this result it is necessary that the substances be agitated up to a certain point; but, for a medicine mixed with alcohol in the proportion of 1 to 100, it is probable that after 50 or 100 shakings, the combination of all the atoms will be effected as completely as possible. The palpable advantage which a machine offers for shaking, appears in the power of preparing medicines in the proportion of 1 to 1000, and perhaps, also, of 1 to 10,000, advancing even up to the thirtieth. Through a mechanism which will.conveniently allow agitation in so large proportions, we can obtain all that is to be coveted in relation to the development of the virtue of medicines.
ON THE REPETITION OF DOSES.
We have treated, at length, of the dilution to be employed, in a separate article, feeling that this question appeared less important for practice than that of the multiplication of doses, or of the repetition according to the occasion. Give, if you please, during a certain time, 10, 12, or 15 globules to the sick, and also one entire drop of the first dilutions: and on abstaining from the repetition of the dose until a new indication supervenes, you will not perceive a more unpleasant aggravation than if you had administered some globules of the last dilutions; and in this case, the difference will be, by no means, in proportion to the relative volume of the medicinal substance taken.
Change your experiment, on the contrary: take a single globule of any dilution, whether of the first or of the thirtieth, and dissolve it in 10, 12, or 15 spoonfuls of water, and give the solution to the sick by spoonfuls; the aggravations that will follow in particular cases, especially in some chronic affections, will be much more violent, and much less easy to combat, than those which appear in consequence of one entire drop, also of the first dilution, when it has been taken at a single time. We have remarked this fact more than a hundred times in the course of our observations; and HAHNEMANN himself has given it as his opinion, that one or two globules taken at a single time form a feeble and
most gentle dose; while the same globules dissolved in a quantity of water and taken in repeated spoonfuls, have a much more decided action upon the organism. Frequently, it is true, a patient may take a spoonful of a like solution for a fortnight, every evening or every morning, without any misadventure; but it is not less frequently the case that, after the use of the solution, an aggravation arises proportionately more violent than the state of the patient had been satisfactory during the taking of the medicament, an aggravation which, in many cases, does not yield to a new dose of the solution, but to return, in consequence, with renewed intensity, resembling in action the relief afforded by palliatives. On this account, however salutary and however preferable this mode of administering medicines in repeated doses may be in many cases, it is nevertheless not always applicable, and demands for its successful employment to be based on fixed principles and rules. These rules, we very well know, cannot be established with any certainty but by comparing a great number of the most contradictory observations; and, if we here essay to express our opinion on this subject, it is only with the intention of presenting some ideas for a more extended examination in the solution of this important question. Our ideas, in other respects, are the same as those we have expressed in our first edition, but more matured.
The principle which, according to our views, and conformably to the basis of our science, should lead to a view of the question in its true aspect is, that true, durable and radical cures are never effected by the direct action of a medicine, BUT BY A REACTION OF NATURE EXCITED BY IT; whence there follows as a first general consequence, that every repetition of doses is at least superfluous, EXCEPT ENTIRELY DISPLACED, whilst this reaction follows its course. Thus we observe in a large number of functional lesions not very inveterate, often the single taking of an appropriate medicine an amelioration established, which, with very unimportant interruptions, continues in general up to the entire cessation of suffering. To administer reiterated doses immediately after, in such cases, or to renew the first taken upon a slight and sudden diminution, that this amelioration may undergo, would be opposing nature in her efforts, and most certainly retard the cure. Also in some recent and trifling organic lesions a cure may be frequently obtained much more promptly by the administration of a single dose. But it is quite the contrary in all very severe cases of organic lesions, especially those which result from the energetic action of some poison, miasm, or medicinal substance. In such instances the disease appears to have its own peculiar vital power, which controls the vital force of the organization, and obstructs or promptly neutralizes the reaction, which requires for its support a new and constant activity sufficient to triumph over the disease. Here we can administer repeated doses, in solutions, with the greatest success, whether the solutions be the first or last, provided they are only continued to the necessary point for establishing the victorious reaction of the vital principle. The same rule applies to all the organic lesions, which, from their nature, maintain a continual focus of irritation in the parts affected, such as inflammations with suppuration, ulcers, some forms of disorganizations, &c.
In some cases of chronic diseases, characterized by a kind of inertness and want of reaction, we may have similar recourse to reiterated doses of globules dissolved in water; but this depends upon another reason and in regard to a design quite different from that of the preceding cases. For whilst we struggle to combat the violence of the disease which triumphs over the reaction, we will also endeavour to aggravate the malady, so to speak, before arousing it from its inertness, and thus elicit the reaction of the vitality of the organism. Never
theless these trials are not always without danger, and it is necessary to proceed with much caution, lest the aggravation, on developing itself, may be so violent as to render insufficient the reaction of the vital force. Therefore in similar cases we must most cautiously administer the repeated doses at intervals as short as possible, and arrest them on witnessing the supervention of the first signs of an aggravation.
Finally, there is another case in which we may repeat the doses: it is when, after a time more or less prolonged, the disease improves, and yet the symptoms indicate the same medicine more than any other. But these cases seldom occur, except we have given a single dose one time for all, or many spoonfuls to the point of aggravation, the effects of which we await without further action; and then it is essential that we should be certain of the cessation of the tion before we have recourse to a repetition.
ON THE DURATION OF THE ACTION OF MEDICINES.
What we have said regarding the period when the repetition of a single dose should seem to be indicated, applies equally to the choice of a new medicine. For every aggravation, after an appropriate time, is not always a natural aggravation of the disease; frequently, on the contrary, it is dependent upon a new excitement provoked by the medicine, which continues to act; and here nothing better can be done than to wait, since it will generally subside in a few days and give place to a much more decided expression. We frequently witness this development, especially in chronic diseases, after the administration of a single dose, one time for all. Frequently the two and three first days are good; then follows a light aggravation, which disappears and renews itself occasionally for some time; so that generally in the first fortnight, and especially during the third week, the number of bad days exceed those of the good, while a change finally takes place at the conclusion of the month; the favourable days now exceeding the bad, a durable benefit is established and continues to the seventh and eighth weeks, an epoch in which the relics of the disease, which have not been completely destroyed, commence their reappearance.In the mean time, there is a case where the aggravation is only the last effort of the action of the medicine, an effort that does not fail to subside in several days, leaving the disease, if not entirely cured, at least in such a state that no other means offer a more favourable issue. To apply a new medicine in such a case without knowing what might be developed, must frequently annul the whole treatment; while by carefully watching and understanding the progress of the vital reaction, we may frequently obtain in two months, with a single dose of a single medicine, an acceleration of cure, which could not be done in two years by a continual change of medicines, or by an inappropriate multiplication of doses. Such is our oftrepeated experience in following out the precepts HAHNEMANN gives on this subject in his Orgonon, and in the first volume on Chronic Maladies; and to it we seriously call the attention of every Homoeopathic physician. It is never necessary, in any chronic disease, to change the medicine without having observed, at least during five or six days, the aggravation which seemed to demand it; and, likewise, those which sometimes occur after the cessation of a medicine administered by spoonfuls, ought to be treated after the same manner, that is to say, to allow the medicine to act so long as there is any room to hope for improvement.
Notwithstanding the indispensable rule that a salutary remedy shall be allowed to expend its entire action, including the occasional momentary aggravation, we must not hesitate to interfere with the medicine we have chosen.-1. When