The single
dose.
By William A. Yingling, M. D.
Presented by Sylvain Cazalet
Dr William A.
Yingling
After properly
“taking the case”, and the selection of the simillimum, the
true Hahnemannian, holds in importance the exhibition of the remedy.
Shall the remedy be given, in a single dose or, without reason, in a
multitude of repetitions ? That is a most important consideration
whether the potency be low or high, as either the high or low potency
will cure, or do great injury when improperly administered. Its
determination will materially influence the curative action of the
remedy- From this reason the question of dose should occupy a higher
plane in the minds of all prescribers, and be determined with care and
reason.There is a
misapprehension on the part of many regarding the exhibition of single
dose. Some suppose it to mean that each individual patient is to receive
one, and only dose of the given remedy, and no more. This is erroneous.
The single dose does not apply to the case alone, but directly to the
prescription. Each prescription is to be of a single dose, unless there
are very strong reasons for a repetition arising out of the nature of
the acute case, or the similarity of the remedy, which will be but
seldom with careful prescribers, and then only until the drug shows an
action. If a well selected drug does not show an action within a
reasonable time, reason tells us to repeat it. But under such a
circumstance the reasoning would be the same as a new prescription, and
the repetition upon reason would be the same as a single dose with each
prescription. To repeat without reason would be guessing, and hence
censurable if not criminal. With but very few patients can the
repetition be submitted to their judgements. If you say. Repeat
till better, then stop, the patient will reason that if one
dose does good, another will do more good, and hence will continue to
repeat to the detriment of the case. It is seldom that more than one
dose is needed in a single prescription, occasionally two or even three
doses may be required to effect the vital force, and make a change in
the case. Following this, the next dose may be of an entirely different
remedy. To give a remedy when another is indicated may do harm and
complicate matters to such an extent that great trouble, even danger to
the patient’s life may arise. The only safe plan is to follow the
directions of the Master.This plan is not
incompatible with a large practice, as our remedies act for hours and
days in acute diseases and for weeks and months in chronic cases. A very
critical case necessarily must be seen frequently, and in such a case it
would be the height of folly to submit the all-important question of
repetition to the judgement and decision of the panic-stricken friends
or to the incompetency of the nurse. To return in six or twelve hours
would be wiser and safer than to repeat on a guess without reason. In
emergency cases, like hæmorrhage, convulsions, etc.. the physician is
expected to remain till the remedy shows an ameliorative action, and
then to see or to hear from the case within a reasonable time.In chronic cases there
is no danger in writing on a single dose, and it frequently requires
days, or even weeks before a change may be noticed ; but when
undisturbed, always followed by a happy action of the true remedy. In
chronic cases the skill of the physician is gauged to a very large
extent by his ability to intelligently wait on the action of the remedy.
He must know the nature of the disease and the indications of the
favorable action of his remedy. If the disease goes from within outward,
from above downward, from the more important to the less important
organs, he may rest assured that his remedy is favorably acting and that
a repetition of the dose is not called for.There are persons so
constituted as to be uninfluenced by a single dose of remedy, but I feel
free to say that the vast majority of such uninfluenced cases arise from
a wrong selection of the remedy. It is plain to be seen that a similar
remedy will require more repetition than the simillimum. There may be
several similar remedies to a given case, but there can be but one
simillimum. The similar will lack something, thus not striking the vital
force properly and requiring a repetition and more time to effect a
cure.The simillimum exactly
fits the case, its action goes right to the centre of the mark, and the
cure is the most speedy, pleasant and effective. The simillimum seldom
needs repetition ; the similar most always needs it, and the
farther it is from the one simillimum the more need there will be for
the repetition. Either may cure ; only the simillimum is sure of a
cure in all curable cases. I believe that if a simillimum to the entire
state of the patient is found, one dose of a high potency is sufficient,
either in chronic or acute cases’, but when the medicine does not fully
correspond as may often happen through the deficiencies of even our
large Materia Medica, the dose may have to be repeated, the want of a
complete similarity hindering the curative action of the drug, and in
these cases the more acute the disease the more frequent must be the
repetition, because the action of the drug then becomes more speedily
exhausted, unless it is sufficiently homœopathic to subdue the disease
at once. This view is in accordance with the teaching of Hahnemann. One
thing is certain, that when the curative effect has set in we should let
the medicine act undisturbed till its effect has entirely ceased.
Dr A. LippeAgain, in certain cases
a frequent repetition may be needed to effect a cure. This applies to
those cases where several doses have been given of the same remedy ;
the symptoms remaining the same ; each dose has had a favorable
result, but with a lessening effect. Then a lower potency should be
given in water and frequently repeated till a very decided result has
been obtained. Or as Dr. Ad. Lippe remarks, “If a dose administered
has acted for a long time, in acute diseases, for days in chronic
diseases for weeks or months, we may reasonably judge that it would be
best to again administer one more single dose ; but if the action
of the dose lasted only a comparatively short time, has been rapidly
exhausted, especially in acute diseases, and a repetition appears still
advisable, then it would almost always be better to dissolve a single
dose of the remedy now to be repeated in some few ounces of water and
continue its administration in broken doses till it becomes evident that
the action of the dose in this manner administered has fully set in, and
the symptoms for which it was given are yielding to it, becoming
lessened in every respect. The greatest care should be taken never to
repeat the dose, or administer another remedy till the effects of the
dose last taken have been exhausted.”The rule should be to
carefully “take the case”, by comparison select the remedy,
covering the totality of the symptoms, the simillimum, and then exhibit
it in a single dose of some potency whether high or low, according to
the faith and practice of the prescriber.The single dose is no
new doctrine, but one as old as the school of Homœopathy. This may be
seen from a careful study of the Organon
and other writing of Hahnemann. He says in article 158 of the Organon :
“This slight homœopathic aggravation during the first hours, is
quite in order and in case of an acute diseases, generally serves as an
excellent indication that it will yield to the very first dose.
“Also in his remarks upon article 246 he elaborately elucidates
this subject. Among other things he says, “In the former edition of
the Organon. I have recommended that
a single dose of a well selected Homœopathic remedy should be allowed
to terminate its operation before the same or a new remedy is repeated,
a doctrine derived from the same certain experience that the greatest
amount of good can scarcely ever be accomplished, particularly in
chronic diseases, by a large dose of medicine (a retrogressive measure
recently proposed) however well selected, or what amounts to the same
thing, by several small doses administered in rapid succession, because
a procedure of this kind, will not permit the vital force to undergo
imperceptibly the change from the natural disease to the similar drug
disease.On the contrary, it is
usually excited to violent repulsive action by one large dose, or by the
quick succession of a several smaller doses, so that the reaction of the
vital force, in most cases, is anything but beneficial, doing more harm
than good. Therefore, while it was impossible to discover a more
salutary method than the one proposed by me, it was necessary to obey
the philanthropic rule of precaution : “Sinon
juvat modo se noceat” in accordance with which maxim,
the homœopathic physician considering human welfare to be his highest
aim, was to administer but one most minute dose at a time, of a
carefully selected medicine in a case of disease to allow this dose to
act upon the patient and to terminate its action. I say most minute,
since it holds good, and will continue to hold good as an
incontrovertible homœopathic rule of cure that the best dose of
correctly selected medicine will always be the smallest in one of the
high potencies for chronic as well as for acute diseases.“A quick number of
small doses, repeated for the same purpose in quick succession will
accumulate in the organism till they constitute as it were, one large
dose, and will produce the same evil result, except in some rare
instances. The vital force, unable to recover during the interval even
between small doses, is over tasked and overpowered, incapacitated to
begin curative reaction and compelled to continue passively the
predominant drug disease forced upon it. This process is similar to that
produced by the large and accumulating allopathic doses of the drug,
resulting in protracted injury to the patient, an event we are called
upon daily to witness.”
Dr J. C. BurnettThe following letter
from Hahnemann to a patient is to be the point. This letter is in the
possession of Dr. J. C. Burnett :“My dear Post
Master, … You have done well to inquire of me whether, in case of
obvious (striking) amelioration of your salivary fistula, you should
nevertheless take a new medicament ? I answer No. Continue so long
entirely without medicine, living regularly, until the gland has been
again getting worse for seven days. Then only begin with the new
medicine.“It is impossible
in the various constitutions of the body to determine how long a given
anti-psoric drug may continue to act. This much, however, is certain,
that its action lasts as long as it does good, and the disease does not
again continuously increase”Now that you may
plainly see that Hahnemann and his coadjutors relied on the single dose,
I have every hope that you wilt also put to test Hahnemann’s golden
rules and enjoy the best results !Copyright © Sylvain
Cazalet 2001
