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Organon by Hahnemann, aphorisms 236 - 252
"Doses, repetition and Acutes"

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Organon aphorism §236

The most appropriate and efficacious time for administering the medicine in these cases is immediately or very soon after the termination of the paroxysm, as soon as the patient has in some degree recovered from its effects; it has then time to effect all the changes in the organism requisite for the restoration of health, without any great disturbance or violent commotion; whereas the action of a medicine, be it ever so specifically appropriate, if given immediately before the paroxysm, coincides with the natural recurrence of the disease and causes such a reaction in the organism, such a violent contention, that an attack of that nature produces at the very least a great loss of strength, if it do not endanger life.(130) But if the medicine be given immediately after the termination of the fit, that is to say, at the period when the apyretic interval has commenced and a long time before there are any preparations for the next paroxysm, then the vital force of the organism is in the best possible condition to allow itself to be quietly altered by the remedy, and thus restored to the healthy state.

Organon aphorism §237

But if the stage of apyrexia be very short, as happens in some very bad fevers, or if it be disturbed by some of the after sufferings of the previous paroxysm, the dose of the homeopathic medicine should be administered when the perspiration begins to abate, or the other subsequent phenomena of the expiring paroxysm begin to diminish.

Organon aphorism §238

Not infrequently, the suitable medicine has with a single dose destroyed several attacks and brought about the return of health, but in the majority of cases, another dose must be administered after each attack. Better still, however, when the character of the symptoms has not changed, doses of the same medicine given according to the newer discovery of repetition of doses (see note to (§ 270)), may be given without difficulty by dynamizing each successive dose with 10-12 succussions of the vial containing the medicinal substance. Nevertheless, there are at times cases, though seldom, where the intermittent fever returns after several days' well being. This return of the same fever after a healthy interval is only possible when the noxious principle that first caused the fever, is still acting upon the convalescent, as is the case in marshy regions. Here a permanent restoration can often take place only by getting away from this causative factor, as is possible by seeking a mountainous retreat, if the cause was a marshy fever.

Organon aphorism §239

As almost every medicine causes in its pure action a special peculiar fever, and even a kind of intermittent fever with its alternating states, differing from all other fevers that are caused by other medicines, homeopathic remedies may be found in the extensive domain of medicines for all the numerous varieties of natural intermittent fevers and, for a great many of such fevers, even in the moderate collection of medicines already proved on the healthy individual.

Organon aphorism §240

But if the remedy found to be the homeopathic specific for a prevalent epidemic of intermittent fever do not effect a perfect cure in some one or other patient, if it be not the influence of a marshy district that prevents the cure, it must always be the psoric miasm in the background, in which case antipsoric medicines must be employed until complete relief is obtained.

Organon aphorism §241

Epidemics of intermittent fever in situations where none are endemic, are of the nature of chronic diseases, composed of single acute paroxysms; each single epidemy is of a peculiar, uniform character common to all the individuals attacked, and when this character is found in the totality of the symptoms common to all, it guides us to the discovery of the homeopathic (specific) remedy suitable for all the cases, which is almost universally serviceable in those patients who enjoyed tolerable health before the occurrence of the epidemy, that is to say, who were not chronic sufferers from developed psora.

Organon aphorism §242

If, however, in such an epidemic intermittent fever the first paroxysms have been left uncured, or if the patients have been weakened by improper allopathic treatment; then the inherent psora that exists, alas! in so many persons, although in a latent state, becomes developed, takes on the type of the intermittent fever, and to all appearances continues to play the part of the epidemic intermittent fever, so that the medicine, which would have been useful in the first paroxysms (rarely an antipsoric), is now no longer suitable and cannot be of any service. We have now to do with a psoric intermittent fever only, and this will generally be subdued by minute and rarely repeated doses of sulphur or hepar sulphuris in a high potency.

Organon aphorism §243

In those often very pernicious intermittent fevers which attack a single person, not residing in a marshy district, we must also AT FIRST, as in the case of acute diseases generally, which they resemble in respect to their psoric origin, employ for some days, to render what service it may, a homeopathic remedy selected for the special case from the other class of proved (not antipsoric) medicines; but if, notwithstanding this procedure the recovery is deferred, we know that we have to do with psora on the point of its development, and that in this case antipsoric medicines alone can effect a radical cure.

Organon aphorism §244

The intermittent fevers endemic in marshy districts and tracts of country frequently exposed to inundations, give a great deal of work to physicians of the old school, and yet a healthy man may in his youth become habituated even to marshy districts and remain in good health, provided he preserves a faultless regimen and his system is not lowered by want, fatigue or pernicious passions. The intermittent fevers endemic there would at the most only attack him on his first arrival; but one or two very small doses of a highly potentized solution of cinchona bark would, conjointly with the well-regulated mode of living just alluded to, speedily free him from the disease. But persons who, while taking sufficient corporeal exercise and pursuing a healthy system of intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever by one or a few of such small doses of cinchona—in such persons psora, striving to develop itself, always lies at the root of their malady, and their intermittent fever cannot be cured in the marshy district without antipsoric treatment.(131) It sometimes happens that when these patients exchange, without delay, the marshy district for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if they be not yet deeply sunk in disease, that is to say, if the psora was not completely developed in them and can consequently return to its latent state; but they will never regain perfect health without antipsoric treatment.

Organon aphorism §245

Having thus seen what attention should, in the homeopathic treatment, be paid to the chief varieties of diseases and to the peculiar circumstances connected with them, we now pass on to what we have to say respecting the remedies and the mode of employing them, together with the regimen to be observed during their use.

Organon aphorism §246

Every perceptibly progressive and strikingly increasing amelioration during treatment is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever, because all the good the medicine taken continues to effect is now hastening towards its completion. This is not infrequently the case in acute diseases, but in more chronic diseases, on the other hand, a single dose of an appropriately selected homeopathic remedy will at times complete even with but slowly progressive improvement and give the help which such a remedy in such a case can accomplish naturally within 40, 50, 60, 100 days. This is, however, but rarely the case; and besides, it must be a matter of great importance to the physician as well as to the patient that were it possible, this period should be diminished to one-half, one-quarter, and even still less, so that a much more rapid cure might be obtained. And this may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions: firstly, if the medicine selected with the utmost care was perfectly homeopathic; secondly, if it is highly potentized, dissolved in water and given in proper small dose that experience has taught as the most suitable in definite intervals for the quickest accomplishment of the cure but with the precaution, THAT THE DEGREE OF EVERY DOSE DEVIATE SOMEWHAT FROM THE PRECEDING AND FOLLOWING in order that the vital principle which is to be altered to a similar medicinal disease be not aroused to untoward reactions and revolt as is always the case(132) with unmodified and especially rapidly repeated doses.

Organon aphorism §247

It is impractical to repeat the same unchanged dose of a remedy once, not to mention its frequent repetition (and at short inervals in order not to delay the cure). The vital principle does not accept such unchanged doses without resistance, that is, without other symptoms of the medicine to manifest themselves than those similar to the disease to be cured, because the former dose has already accomplished the expected change in the vital principle and a second dynamically wholly similar, unchanged dose of the same medicine no longer finds, therefore, the same conditions of the vital force. The patient may indeed be made sick in another way by receiving other such unchanged doses, even sicker than he was, for now only those symptoms of the given remedy remain active which were not homeopathic to the original disease, hence no step towards cure can follow, only a true aggravation of the condition of the patient. But if the succeeding dose is changed slightly every time, namely potentized somewhat higher (pp. 269-270)) then the vital principle may be altered without difficulty by the same medicine (the sensation of natural disease diminishing) and thus the cure brought nearer.(133)

Organon aphorism §248

For this purpose, we potentize anew the medicinal solution(134) (with perhaps 8, 10, 12 succussions) from which we give the patient one or (increasingly) several teaspoonful doses, in long lasting diseases daily or every second day, in acute diseases every two to six hours and in very urgent cases every hour or oftener. Thus in chronic diseases, every correctly chosen homeopathic medicine, even those whose action is of long duration, may be repeated daily for months with ever increasing success. If the solution is used up (in seven to fifteen days) it is necessary to add to the next solution of the same medicine if still indicated one or (though rarely) several pellets of a higher potency with which we continue so long as the patient experiences continued improvement without encountering one or another complaint that he never had before in his life. For if this happens, if the balance of the disease appears in a group of ALTERED symptoms then ANOTHER, ONE MORE HOMEOPATHICALLY RELATED MEDICINE MUST BE CHOSEN IN PLACE OF THE LAST AND ADMINISTERED IN THE SAME REPEATED DOSES, mindful, however, of modifying the solution of every dose with thorough vigorous succussions, thus changing its degree of potency and increasing it somewhat. On the other hand, should there appear during almost daily repetition of the well indicated homeopathic remedy, towards the end of the treatment of a chronic disease, SO-CALLED HOMEOPATHIC AGGRAVATIONS (§ 161) by which the balance of the morbid symptoms seem to again increase somewhat (the medicinal disease, similar to the original, now alone persistently manifests itself). The doses in that case must then be reduced still further and repeated in longer intervals and possibly stopped several days, in order to see if the convalescence need no further medicinal aid. The apparent symptoms (Schein-Symptome) caused by the excess of the homeopathic medicine will soon disappear and leave undisturbed health in its wake. If only a small vial say a dram of dilute alcohol is used in the treatment, in which is contained and dissolved through succussion one globule of the medicine which is to be used by olfaction every two, three or four days, this also must be thoroughly succussed eight to ten times before each olfaction.

Organon aphorism §249

Every medicine prescribed for a case of disease which, in the course of its action, produces new and troublesome symptoms not appertaining to the disease to be cured, is not capable of effecting real improvement,(135) and cannot be considered as homeopathically selected; it must, therefore, either, if the aggravation be considerable, be first partially neutralized as soon as possible by an antidote before giving the next remedy chosen more accurately according to similarity of action; or if the troublesome symptoms be not very violent, the next remedy must be given immediately, in order to take the place of the improperly selected one.(136)

Organon aphorism §250

When, to the observant practitioner who accurately investigates the state of the disease, it is evident, in urgent cases after the lapse of only six, eight or twelve hours that he has made a bad selection in the medicine last given, in that the patient's state is growing perceptibly, however slightly, worse from hour to hour, by the occurrence of new symptoms and sufferings, it is not only allowable for him, but it is his duty to remedy his mistake, by the selection and administration of a homeopathic medicine not merely tolerably suitable, but the most appropriate possible for the existing state of the disease (§ 167).

Organon aphorism §251

There are some medicines (E. G., ignatia, also bryonia and rhus, and sometimes belladonna) whose power of altering man's health consists chiefly in alternating actions—a kind of primary-action symptoms that are in part opposed to each other. Should the practitioner find, on prescribing one of these, selected on strict homeopathic principles, that no improvement follows, he will in most cases soon effect his object by giving (in acute diseases, even within a few hours) a fresh and equally small dose of the same medicine.(137)

Organon aphorism §252

But should we find, during the employment of the other medicines in chronic (psoric) diseases, that the best selected homeopathic (antipsoric) medicine in the suitable (minutest) dose does not effect an improvement, this is a SURE sign that the cause that keeps up the disease still persists, and that there is some circumstance in the mode of life of the patient or in the situation in which he is placed, that must be removed in order that a permanent cure may ensue.

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Organon notes and explanatory remarks

--- 236 Organon aphorism ---

[130] This is observed in the fatal cases, by no means rare, in which a moderate dose of opium given during the cold stage quickly deprived the patients of life.

--- 244 Organon aphorism ---

[131] Large, oft-repeated doses of cinchona bark, as also concentrated cinchonic remedies, such as the SULPHATE OF QUININE, have certainly the power of freeing such patients from the periodical fits of the marsh ague; but those thus deceived into the belief that they are cured remain diseased in another way, frequently with an incurable Quinin intoxication. (See § 276 note.)

--- 246 Organon aphorism ---

[132] What I said in the fifth edition of the ORGANON, in a long note to this paragraph in order to prevent these undesirable reactions of the vital energy, was all that the experience I then had justified. But during the last four or five years, however, all these difficulties are wholly solved by my new altered but perfected method. The same carefully selected medicine may now be given daily and for months, if necessary in this way, namely, after the lower degree of potency has been used for one or two weeks in the treatment of chronic disease, advance is made in the same way to higher degrees, (beginning according to the new dynamization method, taught herewith with the use of the lowest degrees).

--- 247 Organon aphorism ---

[133] We ought not even with the best chosen homceopathic medicine, for instance one pellet of the same potency that was beneficial at first, to let the patient have a second or third dose, taken dry. In the same way, if the medicine was dissolved in water and the first dose proved beneficial, a second or third and even smaller dose from the bottle STANDING UNDISTURBED, even in intervals of a few days, would prove no longer beneficial, even though the original preparation had been potentized with ten succussions or as I suggested later with but two succussions in order to obviate this disadvantage and this according to above reasons. BUT THROUGH MODIFICATION OF EVERY DOSE IN ITS DYNAMIZA-TION DEGREE, as I herewith teach, there exists no offense, even if the doses be repeated more frequently, even if the medicine be ever so highly potentized with ever so many succussions. It almost seems as if the best selected homeopathic remedy could best extract the morbid disorder from the vital force and in chronic ' diseases to extinguish the same only IF APPLIED IN SEVERAL DIFFERENT FORMS.

--- 248 Organon aphorism ---

[134] Made in 40, 30, 20, IS or 8 tablespoonfuls of water with the addition of some alcohol or a piece of charcoal in order to preserve it. If charcoal is used, it is suspended by means of a thread in the vial and is taken out when the vial is succussed. The solution of the medicinal globule (and it is rarely necessary to use more than one globule) of a thoroughly potentized medicine in a large quantity of water can be obviated by making a solution in only 7-8 tablespoonfuls of water and AFTER THOROUGH SUCCUSSION OF THE VIAL take from it one tablespoonful and put it in a glass of water (containing about 7 to 8 spoonfuls), this STIRRED THOROUGHLY and then give a dose to the patient. If fie is unusually excited and sensitive, a teaspoonful of this solution may be put in a second glass of water, thoroughly stirred and teaspoonful doses or more be given. There are patients of so great sensitiveness that a third or fourth glass, similarly prepared, may be necessary. Each such prepared glass must be made fresh daily. The globule of the high potency is best crushed in a few grains of sugar of milk which the patient can put in the vial and be dissolved in the requisite quantity of water.

--- 249 Organon aphorism ---

[135] As all experience shows that the dose of the specially suited homeopathic medicine can scarcely be prepared too small to effect perceptible amelioration in the disease for which it is appropriate (§§275-278), we should act injudiciously and hurtfully were we when no improvement, or some, though it be even slight, aggravation ensues, to repeat or even INCREASE THE DOSE of the same medicine, as is done in the old system, under the delusion that it was not efficacious on account of its small quantity (its too small dose). EVERY AGGRAVATION BY THE PRODUCTION OF NEW SYMPTOMS—when nothing untoward has occurred in the mental or physical regimen —INVARIABLY PROVES UNSUITABLENESS ON THE PART OF THE MEDICINE FORMERLY GIVEN in the case of disease before us, BUT NEVER INDICATES THAT THE DOSE HAS BEEN TOO WEAK.

[136] The well informed and conscientiously careful physician will never be in a position to require an antidote in his practice if he will begin, as he should, to give the selected medicine in the smallest possible dose. A like minute dose of a better chosen remedy will re-establish order throughout.

--- 251 Organon aphorism ---

[137] As I have more particularly described in the introduction to "Ignatia" (in the first volume of the MATERIA MEDICA PURA).


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