One of the monumental mistakes happened to Hahnemann due to the primitive state of scientific knowledge available during his time was that potentized medicines act upon the body through “sentient” or sensory nerves.
In aphorism 16 of Sixth Edition of organon, he says:
“all such morbid derangements (diseases) cannot be removed from it by the physician in any other way than by the spirit-like (dynamically #your new , virtual) alterative powers of the serviceable medicines acting upon our spirit-like vital force, which perceives them through the medium of the sentient faculty of the nerves everywhere present in the organism”.
Here Hahnemann says that vital force “perceives” the “powers” of medicines through “sentient faculty of nerves”. According to this view, vital force is an intelligent conscious immaterial entity governing the living body and constantly “perceiving” through “faculty of sentient nerves” everything happening around. From modern scientific view, this idea is totally absurd and unscientific. Various in vivo studies have already proved that potentized homeopathic medicines can chemically interact with biological molecules even in the absence of vital force, sentient nerves or a brain to which the information are carried by “sensory nerves”. Actually, there does not exist any particular “power” in medicinal substances that could be “perceived by vital force”, but the medicinal properties of drug substances are nothing but their capacity to interact with specific targets in biological molecules in our body due to the peculiar structure and conformations of individual chemical molecules they contain. Chemical molecules cannot travel through sensory nerves to brain, but only sensory information is transmitted as electric impulses.
In aphorism 272 of Sixth Edition:
“placed dry upon the tongue, is one of the smallest doses for a moderate recent case of illness. Here but few nerves are touched by the medicine. A similar globule, crushed with some sugar of milk and dissolved in a good deal of water and stirred well before every administration will produce a far more powerful medicine for the use of several days. Every dose, no matter how minute, touches, on the contrary, many nerves.”
Here also, Hahnemann talks about the importance of medicinal substances direct “touching” the nerves as a pre-condition for eliciting a therapeutic action.
Again in aphorism 285 of Fifth Edition:
“nerves of the living organism can be touched, whereby the power of the medicine is certainly also communicated to the whole organism”
See aphorism 286 of Fifth Edition:
“when the medicine is taken, it comes in contact with a much larger surface of sensitive nerves responsive to the medicinal action. “
Aphorism 288 Fifth Edition:
The action of medicines in the liquid from upon the living human body takes place in such a penetrating manner, spreads out from the point of the sensitive fibers provided with nerves whereto the medicine is first applied with such inconceivable rapidity and so universally through all parts of the living body, that this action of the medicine must be denominated a spirit-like (a dynamic, virtual) action.
By this statement, Hahnemann has clearly demonstrated how much ignorant he is regarding the structure and functioning of nervous system. He seems to think that information can “spread out” to all parts of body “from the point of the sensitive fibers provided with nerves whereto the medicine is first applied”! Actually, each sensory nerve in any part of the body is connected only to brain, and information collected by nerve endings are transmitted directly to brain through system of electric impulses and neurotransmitters, where it initiates some bio molecular interactions . Sensory information is never “spread out” ‘‘from the point of the sensitive fibers provided with nerves whereto the medicine is first applied”.
Hahnemann continues in same aphorism as follows:
“In little children it may be applied close to their nostrils whilst they are asleep with the certainty of producing an effect. The medicinal aura thus inhaled comes in contact with the nerves in the walls of the spacious cavities it traverses without obstruction, and thus produces a salutary influence on the vital force”.
Everybody knows well how inhalation of toxic gases produce toxic effects upon the body. Molecules of toxic substances thus inhaled are always detectable in the blood samples of the individual, which clearly demonstrates that they enter the body through blood capillaries in the mucous membranes of upper and lower respiratory tract, and not through “sensory nerves”.
Hahnemann’s advice on another occasion regarding application of potentized medicines to infants through nursing mothers or wet nurses actually contradicts his theory that drugs act through “sentient nerves”. Medicines taken by nursing mother could be transferred to infant only though breast milk, which does not contain any “nerve fibre”!
From scientific point of view, molecular imprints contained in potentized drugs applied in mouth are absorbed into blood stream through capillaries in buccal mucosa.
Substances absorbed through the buccal mucosa will bypass gastrointestinal enzymatic degradation and the hepatic first-pass effect, since they are directly drained into systemic circulation through superior vena cava. The mouth has a relatively large area for drug application and good accessibility compared to the nose, rectum, and vagina. In particular, the sublingual and buccal mucosal regions are highly vascularized and, therefore, are useful for systemic drug delivery. Sublingual administration involves placing a drug under the tongue and buccal administration involves placing a drug between the gums and cheek. The sublingual and buccal routes are considered by modern medicine also as promising alternatives to the traditional oral and parenteral routes for drug delivery.
The oral cavity has a relatively neutral pH of approximately 6.2 to 7.4, and has limited enzymatic activity. The surface area of the oral mucosa is relatively small (100–200 cm2), with the sublingual and buccal regions having an estimated surface area of 26.5 ± 4.2 cm2 and 50.2 ± 2.9 cm2, respectively. These regions in the oral cavity are lined by non-keratinized, stratified squamous epithelium that is 100–200 µm and 8–12 cells thick in the sublingual region, and 500–800 µm and 40–50 cells thick in the buccal region. Components from the saliva also binds to the surface of the buccal and sublingual epithelium to create a mucus layer with an average thickness of 70–100 µm. Underneath the epithelium is the lamina propria and submucosa that consists of connective tissue with a network of blood vessels, lymphatic vessels and smooth muscles. Molecular imprints contained in potentized can be rapidly and directly absorbed into the systemic circulation via venous drainage to the superior vena cava.
The sublingual and buccal routes of administration have a number of advantages, for systemic drug delivery of modern medicines. In general, they produce faster onset of action compared to orally ingested drug formulations. Drug absorption is relatively faster across the sublingual mucosa compared to the buccal mucosa due to the thinner epithelium. In addition to rapid absorption, the portion of drug that is absorbed through the blood vessels directly enters the systemic circulation and bypasses hepatic first-pass metabolic processes. Therefore, this route is particularly useful for highly soluble drugs that undergo high hepatic clearance or decomposition in the gastrointestinal tract. The non-adherent saliva in the buccal and sublingual regions also contains less mucin and limited enzymes such as salivary amylase. Drugs may also be more stable owing to the pH in the mouth being relatively neutral compared to other parts of the gastrointestinal tract.
Absorption of potentized drugs from mouth cavity is highly dependent on the residence time of the drug in the sublingual and buccal area. This may vary considerably depending on the dispensing vehicle we use. The dispensing vehicle should be ideal for providing enough residence time to ensure optimal disintegration and drug absorption. In addition, the dispensing vehicle should increase the residence time of the formulation in the sublingual or buccal region to optimize drug permeability and systemic absorption. In addition, patients should avoid eating, drinking, chewing, or swallowing until the medication has been absorbed. Swallowing the medication will decrease the drug’s effectiveness.Holding the medicines in mouth without swallowing for some time will surely facilitate better absorption and drug action.
Potentized drugs are absorbed from baccal cavity very easily, since they have a good balance between hydrophilic and lipophilic properties, being constituted by water and alcohol molecules. That is, they are easily soluble in aqueous buccal fluids and also have high lipid solubility to be able to cross the epithelial membrane in these regions, which is usually by passive diffusion. Habit of smoking can decrease the sublingual or buccal absorption of medications due to vasoconstriction of the blood vessels.
The pH of the saliva is ideal for perfect absorption of potentized homeopathic drugs. Molecular imprints may undergo passive absorption pathways via transcellular diffusion or paracellular diffusion, depending on the size of molecular imprints. It should be noted that the pH of the saliva can be temporarily altered by environmental factors such as foods and drinks, or personal factors such as oral diseases, which can affect the sublingual and buccal absorption of drugs.
Saliva flow can influence buccal and sublingual drug delivery by altering the rate of disintegration of the formulation and dissolution of the drug. For example, if the mouth is dry, this can negatively affect drug absorption. Conversely, if saliva flow is considerable, this can lead to the drug being swallowed before absorption.