In homoeopathy “dose” can be defined as the very smallest possible quantity of medicine which has homoeopathicity to the patient in all respects to produce a perfect cure and the selection of which is based on the 3 cardinal principles SIMI, MINI, MONO.
According to our master, a single medicated globule of poppy seed size constitutes a dose, for patient. In the case of a hypersensitive subject, a single olfaction of one medicated globule is considered to be a dose.
Dr. L.H. Lutze mentions “When a homoeopathic physician gives tincture to all patients, it proves that he is a poor observer and does not notice the aggravations, or he be a poor prescriber and fails to find the indicated homoeopathic remedy or he even gives two or more remedies at a time.”
Therefore it is better to use a single globule instead of 4-5 of it for a dose, but when we need to bring about physiological proving action of medicine, we can use larger doses as done in proving. As an example for restoration of suppressed menses or for quick delivery we can use proving dose (i.e., large quantity of dose) of the selected medicine.
REPETITION OF DOSE
Repetition of dose is done to prolong or continue the rhythm (resonance) of the potency of the previous dose which is already in action with the rhythm of the affected vital force. Generally, after administering a dose one must wait and observe whether the action of the earlier dose of medicine can be given to continue the curative process.
Now the question is how long to wait. For this, a physician must have a thorough knowledge of the drug pathogenesis and nature of the disease; so that he can judge well the general condition of the patient and confirm whether he is improving. If you are confident of the selected medicine and the general condition of the patient and confirm whether he is improving. If you are confident of the selected medicine and the general condition of the patient does not grow worse, you wait till the earlier medicinal action is exhausted and he requires further doses to improve. If the patient is found improving mentally inspite of his physical sufferings, you can wait and no new dose is required.
As an example when we plant apple seed we wait for it to sprout and grow, we don’t grow around the next day and stick another seed in on top of the one we planted yesterday.
So we must learn how to wait patiently and see the improvement of the patient after the first prescription. But no where we see any rule how long to wait, how long to see, when to change the prescription. There may not be a fixed rule in this regard as we do not treat the disease, we treat the man and the reaction to a remedy varies from man to man. The rhythm of every individual differs from other. Therefore we cannot formulate a fixed formula of repetition. But we must be able to observe the overall improvement of the patient in the perspective of the total symptom picture.
According to Dr. Charles Dixon, the best way to avoid this mistake (repetition of dose ) is in taking exhaustive notes in your case taking and in reviewing them carefully before prescribing a second time.
Some doctors give 2-3 doses of medicine to be taken at 15 or 20 minutes interval, which is called multiple single dose. You will come across patients who came to you for medicine for themselves, while chewing betel leaf, tobacco, cardamom etc., In that case I ask the patient to get his mouth cleaned first before I administer him the indicated medicine. Even after cleaning the mouth the smell or taste of the above mentioned articles remain in his mouth in that case if you depend on the single dose.
Curing with a remedy that is capable of producing a similar trouble is entirely dependent on the quantity or dose administered. The larger the dose, the more will be the aggravation naturally. By carefully and systematically reducing or diluting the drug used, Hahnemann conquered this bug-bear and also discovered the tremendous powers of attenuation. It seemed to liberate unbelievable powers of quick and permanent healing and also brought out the medicinal values of so called inert substances like charcoal and lycopodium and many others. Common salt became a very powerful blood maker and body builder.
In spite of going to infinitesmal doses, Hahnemann still seemed to fear aggravation “From a bugger dose or a number globules per dose”. Minimum dose, for him was one pilule, the size of poppy seed. This was in the fifth edition of organon. In his sixth edition, which came to light much later, he had come to the still more delicate method of potentising on the fifty millesimal and that too in dilute solution of water.
Most of the then physicians never used more than one pellet, no. 10 size of any potency, which is packed in sugar of milk as a powder. It had been found any difference if added four or five pills, any upset or aggravation was not seen.
Such an aggravation depending on the size of the dose really happens. The actual drug is in a fraction , one upon one followed by sixty ( in 30C ), four hundred (200C ) or two thousand (1000C), would a change, say from one to even six in the numerator really make any change with in the quantum of the fraction, when the denominator is so large a figure?
Actually the dreaded aggravation is an extremely rare event and may occur only as a curative one.
Nowadays homoeopathic pharmacies are selling medicines in globules no. 20, 30, 40, etc., by kilos. Are those globules not working satisfactorily? Most probably the seat of action of an oral dose, pill or powder or liquid is the delicate membrane of the tongue with its extremely highly developed nerve system. Obviously the more area that is covered by the dose, the higher should be its effect. How many nerves can one globule touch, even if it gets spread by the dissolving action of saliva?
It is felt that we are making a lot of things ritualistic. Ordering a number of medicines, tablets A, B, C, D at certain fixed hours daily, at particular times, one hour before or after food etc., serves as a constant reminder to a patient that he is a patient. Perhaps the less a person thinks about his/her illness, the more he recovers fast.
Let us have not too much hair splitting about dosage or unnecessary thinking of aggravations.
Why not tell the patients about the wonderful advice of the famous Emil Coue, to stand before the mirror and assert to self “Every day, in every way. I am getting better and better.”