Pharmacy and Homoeopathic Philosophy

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Pharmacy and Homoeopathic Philosophy

• Objectives
•  
• To review the literature related to Pharmacy
  from Hahnemannian writings
•  
• To evolve a teaching methodology to correlate
  with Organon of Medicine

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• Cardinal Principles of Homoeopathy
•  
• Law of Similars
• Theory of Vital Force
• Law of Simplex (Single, Simple Medicine)
• Law of Minimum Dose
• Doctrine of Drug Dynamization
• Doctrine of Drug Proving
• Theory of Chronic Diseases

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• Pharmacy involves the process of
• Drug Dynamization
• Drug Proving
• Medicine Administration

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DRUG DYNAMIZATION HISTORY
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• Hahnemann's early writings frequently advise the
  use of small doses of medicines, but say nothing
  about potencies or potentization.
• Hahnemann's writings imply that his aim was the
  reduction of the toxic effects from overdosing
  with medicines.
• This intention directed Hahnemann's work for
  several years.

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• Two closely related discoveries brought
  Hahnemann closer to the principle of dynamization
  
• One was the improved therapeutic effect of
  reducing the dosage of previously used medicines.
• The other finding was that substances such as
  salt or lycopodium, not previously identified as
  medicines became therapeutically active on
• undergoing this process.

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• So Hahnemann, setting out simply to reduce the
  quantity of his doses, discovered potentization,
  an entirely new principle in posology.
• This is the principle, which gives life and power
  to the system of medicine that Hahnemann
  Developed and is the third great step in the
  evolution of the law of cure.

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EVOLUTION OF THE CONCEPT OF POTENTIZATION

• Hahnemann's approach to potency was modified in
  each phase of his medical career.
• A point worth emphasising is that he was an
  experimenter and innovator, motivated more by
  practice than by theory.
• These phases can be discussed in detail along
  with the published works that Hahnemann was
  involved with at each stage.

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1784 1796 PRE HOMOEOPATHIC MEDICAL CAREER

• Before discovering the law of similars,
  Hahnemann's treatment of his patients differed
  very slightly from that of other physicians.
• His prescriptions corresponded in composition,
  weight and quantities with those of his
  contemporaries.

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• 1790 - Hahnemann translated Cullen's Materia
  Medica - historic discovery relating to Cinchona
  bark.
• Hahnemann wrote 'Surely toxicity is nothing but
  the violent manifestation of an extremely
  powerful agent applied in too high a dose and in
  the wrong place.'

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• 1796 - Hufeland's journal -
• Essay on a New Principle For ascertaining the
  Curative Powers
• of Drugs.
• In this essay he makes reference to
• the use of small doses, but does not clarify
  what he meant by "small".

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• The aggravation or the increase of disease
  symptoms following the administration of the
  homoeopathic remedy, induced him gradually to
  decrease the dose.
• But this diminution was not so swift and it was
  only by experiments and bedside experiences that
  the necessity was felt by him.

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1797 1800 FIRST HINTS OF DILUTION

• 1798 Some Kinds of Continued and Remittent
  Fevers. Here, he notes using Ignatia in doses of
  2 to 3 grains Opium in 1/5-1/2 grain doses
  Camphor 30-40 grains/day Ledum 6-7 grains.
• Although these are still crude doses, and
  rather large by later homoeopathic standards,
  they represent dramatic reductions from the
  allopathic doses of his contemporaries.

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• The first hints of dilutions are found in his
  Apothecaries Lexicon (1798), where
• he recommends Sabina in very small
• doses Stramonium at 1/100th or
• 1/1000th part of a grain. Hahnemann's
• experiments during this time led him to
• the use of even smaller doses, with those
• remedies he used commonly.
• Serial dilution in the preparation of
• remedies appears to have been
• introduced in 1799.

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1801 1813 DISPERSING THE SUBSTANCE WELL
THROUGHOUT DILUTION MEDIUM

• 1801 Cure and Prevention of Scarlet Fever.
• He offered exact details of the preparation
• and administration of Belladonna.
• He offers descriptions of mixing such as
• shaking the whole well and intimately mixed
• ... by shaking it for a minute that suggest an
• interest in dispersing the substance well
• throughout the dilution medium. He
• describes these preparations in terms as
• dilutions, attenuations or reduced doses.

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• Hahnemann wrote an article On the Power of Small
  Doses of Medicine in General, and of Belladonna
  in Particular, in Hufeland's Journal in 1801. He
  still understood the infinitesimal preparations
  to be dilutions or small doses.
• Up to 1813, nothing definite was written by
  Hahnemann. There appeared general remarks about
  dilution and reduction of size of doses.

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1813 - 1819 SEED OF DYNAMIZATION THEORY

• 1813 Spirit of the Homoeopathic Doctrine of
  Medicine - Drugs, besides their physico-chemical
  properties, possess another property by which
  they alter the qualitative state of the organism.
  More the materiality of a drug is reduced, by
  processes of dilution or trituration, greater
  the specific therapeutic quality lying dormant in
  the drug seemed to be unveiled.
• This is the seed of dynamization theory.

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• So it is dilution plus friction that liberates
  the pharmacodynamic properties of the drug.
• His observations had demonstrated that
• certain substances, ineffective in their
• natural form, as common salt, charcoal,
• lycopodium, silica, lime, etc. become
• available as an efficacious medicine only
• after prolonged trituration with milk sugar.

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• These discoveries are the reason why Hahnemann
  from that time onwards no longer designated the
  different degrees of his dosages as dilutions,
  but as
• 'power developments' or 'potencies'.

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1820 1828 DYNAMIZATIONS IMPORTANCE OF
FRICTION

• 1821 - Sixth volume of Materia Medica Pura,
  Hahnemann referred constantly to treating with
  "the smallest part of a drop".
• Hahnemann was then adopting the use of globules,
  whereby a fraction of a drop could be
  administered easily.

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• He now understood the idea of friction as
  bringing about the remarkable change in the
  activity of the drug.
• This is represented in his article
• How can Small Doses of such very Attenuated
  Medicine as Homoeopathy employs still possess
  great power
• in 1827.

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• Hahnemann used the terms 'dilution', 'diminish',
  'dynamization' / 'dynamic' / 'dynamized', and
  'potentization' / 'potency' to describe these
  various concepts.
• The term too-strong dose referred to
  prescriptions making a too-strong impression on
  the life force either by to being too large (in a
  material sense) or of too great a potency.

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1829 1837 STANDARD POTENCY 30C
OLFACTION

• Hahnemann felt in 1829, the urgent necessity of
  a limit in potentising and declared the ultimate
  degree of dilution to be the 30th centesimal
  potency.
• In 1832, Hahnemann began experimenting with
  olfaction of remedies.
• 5th edition of the Organon
• Hahnemann described the concept of potentization
  in 269.

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• Hahnemann also began experimenting with giving
  the dose in solution, rather than as a dry pellet
  on the tongue.
• In 1835 Hahnemann described split doses of a
  medicinal solution produced by dissolving a
  medicated centesimal pellet in a volume of water.
  This reduced dose allowed for more frequent
  repetition.

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1838 FINAL INSTRUCTIONS

• LM potency scale, which Hahnemann
• referred to as "medicaments au globule"
• as distinct from the centesimal
• medicaments a la goutte, was developed
• in 1838, 5 years before his death, with the
• intention of preparing remedies even better
• adapted for use in split dose in medicinal
• solution - 6th edition of the Organon (270).
• Intimately related to these new
• preparations, were new approaches
• to the repetition of dose.

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EVOLUTION OF CONCEPT OF TRITURATION AND
SUCCUSSION

• In 1814, in an essay entitled, A method of
  treating the currently epidemic typhus, he says
  shaken vigorously for 3 minutes.
• Volume 2 of Materia Medica Pura (1816) - Well
  shaken or accurately shaken.
• He almost always used fluids, shaking them,
  sometimes unsystematically, for minutes.
• 4th volume of Materia Medica Pura, 1818 - Aurum
  - first metal to be triturated.

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• Vol 6 of Materia Medica Pura (1821)
• bring down ten times, using full strength
• of the arm.
• 5th edition of Organon give only two
• succussions.
• 2nd edition of volume 3 of Chronic Diseases
• (1837) he changed his method again, going
• back to 10 succussion strokes.
• 2nd volume of Chronic Diseases metals
• triturated for a total of 3 hours, exactly 1
• hour per stage, were soluble in water.

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• One can therefore conclude
• that Hahnemann changed his
• views on potency mainly in the
• light of clinical experience
• rather than empty
• speculations and theories.

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Observations on the three current methods of
treatment ( 1809)
Treatment of the Name Interchangeable remedies,
Compound Prescriptions Treatment of the Symptom
General indications general remedies, Routine
remedies Treatment of the Cause ( internal
essence of disease) Material Cause , Immaterial
Dynamic Cause
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Examination of the sources of the common(
ordinary) materia medica ( 1817 )

• Guess work and fiction general therapeutic
  virtues of drugs Dioscorides resolving,
  dissiptating, diuretic,diaphoretic, emmenagogue,
  antispasmodic, cathartic
• Their sensible properties, from which their
  action may be inferred Signature Hypericum
  perforatum red juice injuries wounds
• Chemistry - Animal and plant
• Clinical and Special therapeutic indications for
  employment

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Pharmacy and Organon of Medicine
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20 Spirit like power to alter mans state of
health which lies hidden in the nature of
medicines Experience of the phenomena it
displays when acting on state of health
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31 Alteration in the state of health occurs
due to Susceptibility To the attack of the
morbific cause that may be present
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63 and 64 PRIMARY ACTION AND SECONDARY
ACTION
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Drug Proving Concept From 105 to 145
105 Acquiring a knowledge of the instruments
intended for the cure of the natural diseases
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106 Pathogenetic effects of the several
medicines must be known on healthy individual.
107 108 Proving on healthy individuals
F.N. 91 - Albrecht von Haller
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109 Homoeopathic employment of medicines cure
human maladies F.N.92 and F.N.93 Fragmenta De
viribus medicamentorum positivis sive in sano
corpore humano observatis 1805, Reine
Arzneimittellehre 1833, M.M.Pura 1827 and Die
chronischen Krankheiten 1828,1830 , Dresden bei
Arnold 1835,1839
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110 Poisonous substances and their curative
powers 
111 Based on Eternal Laws
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112 Primary and Secondary Action Concept
Allopathy and Homoeopathy   113 Exception
Narcotic Drugs   114 Observe only Primary
Actions except in Narcotic medicines
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115 Alternating actions of medicines -
Opposing symptoms in Primary Action   116
Appearance of Symptoms Frequent ( Many )
Rarely ( Few) and Very few
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117 Idiosyncrasies.   118 Peculiar
Action by every medicine  
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• 119
• Morphology of every substance varies
• The action of every medicine differs from that
  of every other.
• F.N. 98 No surrogates

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120 Value based knowledge of Action of
Medicines - Experiments on healthy body  
121 Power of medicine to be tested on Human
Body  
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122 Care in selecting the medicines Pure,
Genuine and energy assured   123 Mode of
Preparation of medicines. Indigenous plants,
Exotic vegetable substances, Salts and Gums  
124 Employment of medicines
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125 Diet to be followed F.N. 100 and
101   126 Qualities of a Prover Mind Factor
 
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127 Method of testing Male and Female
both   128 Not only crude medicines but
dilutions of 30 also are used for proving  
129 Start with small dose and then increasing  
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130 Response after administration of dose
Strong / Moderate   131 Repetition till the
full action of the medicine is known and
inferring Secondary / Alternating Action   132
Repetition not considering the sequential
order of symptoms / phenomena
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133 Modalities and Characteristic
expressions of medicine   134 Expectation of
all symptoms not in one prover but various
provers and at various times.   135 Numerous
observations on both sexes and various
constitutions Observation of same symptom to be
confirmed
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136 Similar medicine produces an artificial
state and also cures him of his original
malady   137 Recording the symptoms of
Primary Action of Moderate doses. Large doses
bring about Primary Action very fast and
overlapping. No observation   138 Previous
symptoms resurging / which also Primary Action
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139 Physician noting down the symptoms of
prover. Precise details to be elicited.
140 Mode of proceeding when we make trial of
them on other persons. If prover unable to
write, voluntary narration of the same must be
recorded as mentioned in CASE TAKING   141
The experiments of the healthy physician with
medicines upon himself are the best. F.N 103
Advantages
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142 The investigation of the pure
effects of medicines in diseases is
difficult.   143 True Materia Medica
Collection of all disease elements and symptoms,
real, pure, reliable modes of action   144
Pure language of nature Materia Medica
carefully and honestly interrogated   145
Superiority of Materia Medica and Homoeopathy
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196 205 External Application and their
disadvantage. F.N. 163 to 282 states that
Figwarts need external application of their
specific medicine as well as their Internal use
at the same time
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246, 247, 248 Successive dilutions for
higher attenuations
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267 Preparation of the most powerful and
most durable forms of medicines from fresh
plants.   268 Preparation of Dry vegetable
substances. Note- Preparation of powders so
that they shall keep. 
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269, 270, 271, 272 The mode of
preparing crude medicinal substances peculiar
to Homoeopathy, so as to develop their
curative powers to the utmost. 50 millessimal
potency F.N.150
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284, 285 Routes of administration of
medicine