Dose could be
defined as the least quantity of any substance required to
affect a change in nature. The science or doctrine of dosage is
called is called posology.
In Greek posos
=how much ) .
In medical parlance dose could be defined as the quantity of a
particular medicine administered to an individual at a time .
Doses can be
1) Physiological dose
A dose of drug empirically selected of sufficient quantity and
strength to produce definite pre-determined effect or a group of
symptoms.
For eg physiological dose of belladonna is one which is
sufficient to produce dialatation of pupil, dryness of mucus
membrane and flushing and turgescence of skin. This is the
quantity of medicine which could be administered with safety.
2) Pathological dose
Quantity of medicine capable of producing pathological changes
in the tissues of the organisum. i.e. biochemical changes, bio
physical changes .
3) Toxic dose
Dose which produces toxic effects upon the organisum.
4) Lethal dose
Dose which produces deletrious effects upon the organisum even
death.
5) Therapeutic dose
Least quantity of medicine required to effect a cure or a
palliation.
In homoeopathy therapeutic dose is the infinitesimal dose or the
minimum dose or the sub- physiological dose .
5) Minimum dose
In $ 280 minimum dose is defined as the quantity of medicine
required to produce a scarcely perceptible homoeopathic
aggravation.
According to Stuart Close minimum dose is a dose which is not
capable of producing symptoms when used therapeutically Minimum
dose is otherwise known as sub physiological dose or
homoeopathic dose.
Evolution of the concept of minimum dose by Hahnemann
Time period through which the concept of minimum dose evolved in
Hahnemann ’s mind could be separated into three phases .
Period - (1779 to 1799 )
Hahnemann was disappointed and disgusted by the practice of
applying large and heroic doses of medicine which he found was
only destroying the health .He raised his voice against the
existing dosage of medicine in his article on the treatment of
veneral disease
Mercurius was given at that time 1 to 5 grams according to the
severity of the disease .Hahnemann advised against this and said
that only ¼ to 1 grain is sufficient for the treatment of the
same.
In the cure and prevention of scarlet fever Hahnemann speaks
about the dose of opium to be given . He advises 1 part of opium
to be taken in 20 parts of weak alcohol and keep it for one day
, then one drop of it is taken and dissolved in 500 drops of
alcohol and one drop of it could be given for children and 2
drops for persons above 10 years of age . (dose is 1/ 20 x 500 )
. Here we can see that a reduction of dose was insisted by
Hahnemann.
Period ( 1799 to 1827 )
It was a time period in which Hahnemann was treating some cases
homoeopathically and some cases according to old system of
medicine . In a\c and c\c cases Hahnemann shifted to the
smallest doses which were of the second and third dilution .In
medicine of experience he says that the dose must be small in
accordance to the disease , so looking at the nature of the
disease dose has to be determined .
Period ( 1828 onwards )
This third period dawns with the arrival of Hahnemann’s chronic
disease . Hahnemann became assured of the efficacy of minimum
doses in treatment of disease . He fixes the dose as a globule
not bigger than that of a poppy seed . In the 5th edition of
organon he says that a dose could be as minimum as 1/ 200 of a
grain . In olfaction 1/400 of a grain should be used .
Observations of Hahnemann that lead to the derivation of the
concept of minimum dose
Dr Dudgeon in his Lectures and practice of homoeopathy says
that in deriving the concept of minimum dose -
a) Hahnemann observed that medicines exhibited greater strength
when given in dilutions than in dry state .
b) He observed the greater power of medicine when given in
divided doses than given at once .
c) He observed the greater susceptibility of disease organisum
for the medicines having a specific homoeopathic relation to the
affected parts .
d) He observed an increasing power of medicine by a thorough
admixture of vehicle by means of succusion .
e) Desire to evade persecussion of apothecaries who tried legal
proceedings against Hahnemann for invading upon their privileges
for dispensing medicine .
f) To avoid aggravation of disease when given in large doses .
Why dose should be minimum
1) When the disease attacks the body , it overcomes the
body resistance . Now the body becomes vulnerable to the action
of a similarly acting disease producing agent . So this disease
producing agent viz the drug need only be applied in a minimum
dose just sufficient to produce a cure .
2) Disease has already rendered the parts abnormally sensitive ,
so only a slight stimuli need be applied in order to reduce
aggravation
3) According to Arnold - Schutz minimum dose stimulates , medium
inhibits and maximum destroys .
GUIDELINES BY
DIFFERENT AUTHORS
Hahnemann
In his organon of
medicine he says
$279 The dose of homoeopathically selected remedy can never be
prepared so small that it shall not be stronger than natural
disease .
$280 fn
Let them learn from the mathematicians how true it is that a
substance divided into so many parts still contains its smallest
part and the smallest part dose not cease to have some substance
$ 281
Every patient ever so robust will be effected by small
conceivable dose .
An exception to infintesimal dose is given
In $ 282 fn there is an exception in the treatment of
three great miasm while they still efflorescence on the skin ie
recently erupted itch ,the untouched chancre and the fig warts .
These not only tolerate , but indeed require from the very
beginning large doses of their specific remedies of ever higher
and higher dynamisation daily
Stuart close -
According to Stuart Close there are 3 necessary requirements for
the action of infinitesimal dose .
1) The development of special virtues of medicine by the process
of potentisation .
2) The increased susceptibility to medicinal impression produced
by the disease .
3) The selection of symptomatically similar remedy .
H.A. Robert
According to H A Roberts the law of dosage could be summarized
from 3 fundamental laws .
1) Law of least action and quantity
The quantity of action necessary to effect any change in nature
is least possible . The decisive amount is always the minimum ie
an infinitesimal
2) Law of quantity and dose
The quantity of drug required is inverse ratio to its similarity
.
3) Law of quality
The quality of action of homoeopathic medicines is determined by
its quantity in its inverse ratio .
H A Roberts in The principles and art of cure of homoeopathy
says that infinitesimial dose is one which is so small as not to
produce too much aggravation of the symptoms already present and
never large enough to produce new symptoms .
Carrol Dunham
In his Science of therapeutics he says that the most
vigorous opposition from old school as well as chief ground of
division among the homoeopaths was upon the question of
infinitesimal dose .Dunham says that the question of minimum
dose is manifestly an open one .He states in favour of
infinitesimal dose and concludes that there are many evidences
in chronic disease that many medicines have acted in very large
doses .
Richard Hughs
Richard Hughs based his infinitesimal in those doses which which
could be considered as very large .
Ref books :
1) The genius of homoeopathy - Stuart Close
2)The principles and art of cure by homoeopathy – H A Roberts
3)The science of therapeutics - Caroll Dunham
4) Lectures on the theory and practice of homoeopathy - R E
Dudgeon
5) Organon of Medicine
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