An 1837 case from Hahnemann's paris journals

- Following in hahnemann's footsteps : the the definitive years 1833-1843 (D. Little) Most of the symptoms of the Paris casebooks are recorded in Melanie's handwriting, although Samuel wrote all the prescriptions and repertory insertions. The following case is from the same year that he introduced the split-dose of the medicinal solution to the Paris edition of the Chronic Diseases. [Samuel Hahnemann, Krankenjournal, DF-5, 1837- 1842, Karl F. Haug Verlag, Heidelberg, Germany, lower page number, 521. Research on the French documents by David and Jill Little and Gamberra, who also compared it with the German translation.

 The client was Duke Valmy, an unmarried man aged 35 years old. Valmy's case history is suggestive of venereal miasms, suppression, and mercury poisoning. He visited the good doctor complaining of throat pain, loose teeth, bleeding, pus of the gums, ulcers, and apthae. These symptoms began after taking a sea journey at the age of 25. His throat pains were treated with bleeding by leeches. Fourteen days before his visit to Hahnemann, he suffered a relapse of the pain, but it passed off naturally. He was constipated and needed to take enemas of water to pass stool. For three years he suffered arthritic pains and edema of the left knee, which was worse when fatigued by walking. Duke Valmy was also treated with mercury for blood of the urethra, although the date is not given.
 Complex diseases involving miasms, suppression, and drug poisoning are the most difficult to cure. In the 1st edition of the Chronic Diseases [1828], the Founder wrote that the treatment of the venereal miasms by allopathic mercury often caused a flare-up of latent Psora, producing an obstructive layer. For this reason, he used Sulphur and other anti-psoric remedies in many of his suppressed venereal disease cases. By removing the Psora and the suppression, the venereal disease would then surface unmasked. The Paris casebooks are full of patients with infectious itch miasm, sycosis, syphilis, and tuberculosis mistreated by the crudest allopathy imaginable. "Gay Paree" was reeling under the influence of many acute and chronic miasms, as well as faulty medical practice. The following is Hahnemann's July 26 prescription for the Duke:
 Rx: Sulphur, 1 pill, 30C, in 500 drops of mixture.
 1 drop in 6 tablespoons of water
 Take one tablespoon every morning.
 This is an example of a miniature solution made with 1 pill in 500 drops of 50% brandy and water. After succussing this bottle, the patient was instructed to place one drop of solution into six tablespoons of water in a glass. The water in the glass was then stirred and one tablespoon was given as a dose. This technique is called a split dose instead of a multiple dose, because it only uses one pill to make an aqueous solution that is then "split" over several days, weeks, or months. In this way, it is possible to take "one pill many times." This keeps the amount of the dose very small, allowing for the repetition of the remedy to speed the cure if and when necessary. Hahnemann referred to this method in the Paris edition of the Chronic Diseases.
 On September 12, it is reported that Valmy was aggravated by Sulphur 24C in 15 tablespoons of water and was given placebo. But Valmy misunderstood the instructions and continued to take the remedy as well. When the Duke returned on September 20, Hahnemann gave Valmy Sulphur in alternation with a placebo according to his symptoms. Then, on October 23, Hahnemann prescribed a series of placebos without Sulphur.
 Note that, in this case, the good doctor used both the small dropper bottle dose and the larger tablespoon solution.
 In the year 1837, Hahnemann was still facing several limitations in his therapeutic system, especially in cases like Duke de Valmy. He was working with around 100 remedies in potencies mostly below 30C. Although he spoke of potencies above 30C in the 5th Organon, in 1837 he mostly used 60c, 30C, 24C, 18C, 12C, and 6C. It is only in 1839 that his journals show him regularly administering the 198c, 199c, or 200C potencies. By 1840, we find him using a full range of C potencies side by side with his new LM potencies 0/1 to 0/10. The increased remedial powers of the high potency C remedies [200-1M] and LM potencies [0/1-0/30] were critical to the development of the complete homoeopathic paradigm.