Re: Understanding Homeopathy Potency
Posted: Sat Sep 22, 2007 10:32 pm
At 04:25 PM 9/22/2007 -0400, you wrote:
the
That's news to me............
Potency and dose vital - and its certainly not about starting high -
individualized................................
Lesson 26, Part 6 - Aphorisms 246, 247 and 248 of the 6th Organon.
(Aphorisms quoted at the end)
Dear students and colleagues,
The ghost of the mechanism continues to appear in the minds of some
persons. There are still too many persons that teach one can give the LM
potency daily for months in a mechanical fashion to every patient no matter
what the reaction the remedy produces. I have responded to this myth in
another medium so I thought I would share the post here. I bet some of you
are tried of hearing this from me! Nevertheless, there may be some parties
that have not read these details before. The following document is based on
Hahnemann's teachings contained in aphorism 246, 247 and 248 as translated
by W. Beoricke..
Aphorism 246
"Every perceptible progressive and strikingly increasing amelioration
during treatment is a condition which, as long as it lasts, completely
precludes every repetition of the administration of any medicine
whatsoever, because all the good the medicine taken continues to effect is
now hastening towards its completion."
1. Hahnemann clearly says that when there is a "perceptibly progressive
and strikingly increasing amelioration" is a condition that "COMPLETELY
PRECLUDES" any "REPETITION" of the remedy whatsoever. This is because the
good effect of the remedy is now "hastening" towards its completion.
Although single dose and infrequent dose cures are not the majority of
chronic cases but they do take place in a significant minority. This is
more often in very sensitive patients, in functional diseases and in the
early states of pathology. There are occasions, however, where advanced
pathological states of several years duration is cured by single doses or
infrequent repetitions of the LM potency. Under these condition the
repetition of the remedy is counter indicated because the remedy is already
heading for cure very quickly and the repetition of the remedy under these
conditions runs the risk of slowing down the cure and causing aggravations
and antagonistic counter actions of the vital force. When their is a
dramatically increasing amelioration it is always best to leave well enough
alone!
"This is not infrequently the case in acute diseases, but in more
chronic diseases, on the other hand, a single dose of an appropriately
selected Homoeopathic remedy will at times complete even with but slowly
progressive improvement and give the help which such a remedy in such a
case can accomplish naturally within 40, 50, 60, 100 days."
2. Single dose cures are often the case in acute diseases but in chronic
diseases a single dose usually only produces a "slowly progressive
improvement" that will accomplish what it can naturally within 40, 50, 60,
100 days. This is, however, but rarely the case; and besides, it must be a
matter of great importance to the physician as well as to the patient that
were it possible, this period should be diminished to one-half,
one-quarter, and even still less, so that a much more rapid cure might be
obtained."
There is a great difference between a "strikingly increasing
amelioration" and a "slowly progressive improvement". Hahnemann makes it
clear that "anytime" during treatment there is a strikingly increasing
amelioration. the remedy should be stopped as long as this lasts. This case
be caused by a single dose, short series of split-doses or after the remedy
has been repeated for some time. Hahnemann then takes up the discussion of
cases in which a single dose can only cause a "slowly progressive
improvement" that may take up to 100 days to show any significant
improvement. Under these conditions the remedy should be repeated at
suitable intervals to speed the cure to 1/2, 1/4 or less the time it would
take with the exclusive single dose wait and watch method. When using the
4th Organon dry dose method the remedy can not be repeat until the duration
of the remedy ceases and the patient relapses.
4. Now Hahnemann offers five conditions that must be met to speed the
cure of slowly progressing cases.
a. The remedy must be "perfectly homeopathic".
b. It must be highly potentized.
c. It must be dissolved in water.
d. It must be given in a proper small dose.
e. It must be repeated in definite intervals that experience has taught the
most suitable.
If the remedy is NOT perfectly homeopathic one best not repeat it. How
can you tell if the remedy is perfectly homeopathic if you don't carefully
test it at the start of treatment. The Paris casebooks show that it was
Hahnemann practice to give either a single dose (usually by olfaction) or
short series of 3 to 7 doses over a period of a week and had the patient
come back in 7 days. He never sent anyone off for 1 month at the start of a
case with a preconceived remedy schedule. He always checked his remedy very
carefully at the start of treatment to make sure it was not the wrong
remedy or a partial simillimum. Everything that Hahnemann says in aphorism
247 and 248 about speeding the cure is conditioned by his statements in
aphorism 246.
Aphorism 247
Aphorism 247 explains why one needs to use the medicinal solution that
is succussed prior to administration and given it in split-doses. He gives
the reasons why it is difficult to speed the cure with the unmodified dry
dose or unadjusted liquid dose. Then Hahnemann says:
"But if the succeeding dose is changed slightly every time, namely
potentized somewhat higher (pp. 269-270) then the vital principle may be
altered without difficulty by the same medicine (the sensation of natural
disease diminishing) and thus the cure brought nearer".
Aphorism 248
Aphorism 248 continues the theme that started in aphorism 246 where
Hahnemann taught when the single dose wait and watch method is appropriate
(in perceptively progressive and strikingly increasing ameliorations) and
where one should repeat the remedy at suitable intervals (case where a
single dose can only cause slowly progressive improvement). Aphorism 248
follows on the discussion of the five conditions for speeding the cure and
the need to adjust each dose so that patient never receives the exact same
potency twice in succession.
"For this purpose, we potentize anew the medicinal solution (with
perhaps 8, 10, 12 succussions) from which we give the patient one or
(increasingly) several teaspoonful doses, in long lasting diseases daily or
every second day, in acute diseases every two to six hours and in very
urgent cases every hour or oftener.
The "purpose" Hahnemann is speaking about how to adjust the potency
when repeating the remedy to speed the cure of cases that would only slowly
improve on a single dose or infrequent repetitions. This includes BOTH
acute and chronic diseases. For this purpose we potentize anew the
medicinal solution prior to the administration of each dose so that patient
never receives the exact same potency twice in succession. Then Hahnemann
offers a method for treating for long lasting protracted diseases where a
single dose can only produces a slow progressive improvement over 30 to 100
days at best and even this is rarely the case. it is more common for the
patient to relapse calling for repeated doses. Aphorism 248 teaches how to
speed the cure of resistant cases to 1/2, 1/4 or less the time it takes
with the exclusive single dose wait and watch method.
In protracted cases, the remedy may be repeated daily or on alternated
days if necessary as long as there are no aggravations or new symptoms. It
must also be noted that in sentence 1 of aphorism 246 Hahnemann says every
strikingly increasing amelioration "during treatment" is a state that
"precludes" the repetition of the remedy as long as it lasts. This means
that anytime during a series of split-doses there appears a dramatic
increasing amelioration the remedy should be stopped as long as this state
lasts. If one stops the remedy under these three conditions (aggravation,
new symptoms, dramatic increasing amelioration) over medication can be
avoided while the cure greatly speeded.
Hahnemann noted in aphorism 246 that acute diseases are often cured by
a single dose. When he speaks about giving the acute remedy every 6 hours
or less it means in resistant acute disorders that can not be cured by a
single dose. The same conditions apply. There is no need to repeat the dose
when there is a strikingly increasing amelioration in acute diseases any
more than in a chronic diseases. All the conditions discussed in the
aphorism 246 condition all the statement that follow in aphorism 248. If
one ignores the first sentence of aphorism 246 they leave out 1/2 of
Hahnemann's case management strategies that deals with strikingly
increasing ameliorations.
In the footnote to aphorism 246 Hahnemann says one can give the remedy
daily "WHEN NECESSARY". This same when necessary applies to the statements
on the daily dose in aphorism 248! It is amazing some persons can
completely ignore or change the meaning of everything Hahnemann says in
aphorism 246 and its footnote. Then they say Hahnemann only taught that one
should give everyone the remedy daily or on alternate days in chronic
diseases and every 6 hours or less in acute diseases no matter what. This
type selective amnesia takes a few words out of context with the rest of
the text and ignores hundreds of words that explain Hahnemann's complete
posology and case management strategy in detail. To say Hahnemann said
always give the daily dose for months and forget the "when necessary" a
grand misnomer that puts the patient in danger.
It is very difficult to learn how to use the LM potency properly just
by reading the 6th Organon. There was supposed to be a living lineage of
teachers that could clarify the points and add oral teachings that are not
contained in the 6th edition. Hahnemann was teaching Boenninghausen about
the LM method when he died. Melaine Hahnemann asked Boenninghausen not to
speak about the new methods in pubic until after she published the 6th
Organon. Unfortunately, this task was not accomplished before the Baron and
Melaine passed away. By the time the 6th edition was published in 1920 all
those with personal knowledge of the LM potency had died. This makes it
extremely difficult to put the entire LM method into perspective without
studying the Paris casebooks, the testimony of those with inside
information, and the eyewitness accounts of those who witnessed Hahnemann's
practice between1838 to 1843.
Hahnemann shared LM cases with Beonninghausen as he hoped the Baron
would someday pass on his teachings on the new method. These cases showed
how Hahnemann actually gave the LM potency in the clinic. This information
was complemented by the eyewitness account of Dr. Croserio, who worked
closely with Hahnemann in his last years. Dr. Croserio's letter to
Beonninghausen IHahnemann's Doses of Medicine, Lesser Writing,
Boenninghausen) shows that the Founder often gave single doses (usually by
olfaction) followed by at least one week of placebos while he waited and
watched. The Paris casebooks confirm that Hahnemann used this method quite
often in the 1840s. This proves that Hahnemann did NOT always give the
daily and alternate day dose to every patient. He often used single doses
usually by olfaction but not always.
Dr. Croserio's letter clearly points out that; "Even in acute diseases
it was a rare case to see him [Hahnemann] allow the patient to take more
than one spoonful in 24 hours". Dr.Croserio's eyewitness account proves
that Hahnemann did not always use the daily or alternate day dose or give
acute remedies every 6 hours or less. The rapid repetition of the remedy
was specific for the treatment of resistant acute and chronic disorders. In
aphorism 246 Hahnemann clearly states that acute diseases often are cured
by single doses in a striking manner! If one gives the remedy every 6 hours
in a mechanical fashion i n these cases the outcome would be aggravations,
accessory symptoms and antagonistic counter actions of the vital force.
Dr. Croserio also noted that anytime during treatment Hahnemann
observed strong medicinal actions he would reduce the dose or stop the
doses and give placebos while he waited and watched. This method has also
been confirmed by a study of the Paris casebooks. Hahnemann did not speak
about how much placebo he was using in the 1840s in the 6th Organon. That
would have alerted the general public to the fact that he was using almost
as much milk sugar in water as active medicine. The Founder rarely gave the
daily or alternate days dose for very long without placing the patient on
placebos for one or more weeks. I have not see one case in the entire Paris
casebooks where Hahnemann gave the daily or alternated day dose from months
on end without stopping the medicine and given 1, 2 even 3 weeks of
placebo. Hahnemann constantly used this "On again - off again" method
throughout his treatment. The idea that Hahnemann always gave the daily
dose or alternate day dose for months is a complete complete myth.
I have not written this discourse with the idea of proving a point to a
single party. I have written this post for the benefit of the Homoeopathic
community at large and for the good of their patients. The first
Hippocratic maxim is "Do no harm". Homeopathy is a very safe system when
one follows the basic checks and balances introduced by Samuel Hahnemann.
The biggest danger inherent in homeopathy is from over medication with
potentized remedies. This can cause remedy induced symptoms, medical
diseases, and antagonistic counter actions of the vital force. These
conditions can become very serious if the over medication is excessive.
None of this has to happen if one follows all the principles elucidated in
aphorism 246, 247 and 248 in a careful manner. If one just takes one or two
words out of context and ignores the rest they take the law in to their own
hands and are personally responsible for any suffering they cause.
Simila Minimus
Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."
Samuel Hahnemann
Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000
************
Aphorisms Below
http://homeoint.org/books/hahorgan/organ240.htm#P246E5
§ 246 Fifth Edition
On the other hand, the slowly progressive amelioration consequent on a very
minute dose, whose selection has been accurately homoeopathic, when it has
met with no hindrance to the duration of its action, sometimes accomplishes
all the good the remedy in question is capable from its nature of
performing in a given case, in periods of forty, fifty or a hundred days.
This is, however, but rarely the case; and besides, it must be a matter of
great importance to the physician as well as to the patient that were it
possible, this period should be diminished to one-half, one-quarter, and
even still less, so that a much more rapid cure might be obtained. And this
may be very happily affected, as recent and oft-repeated observations have
shown, under three conditions: firstly, if the medicine selected with the
utmost care was perfectly homoeopathic; secondly, if it was given in the
minutest dose, so as to produce the least possible excitation of the vital
force, and yet sufficient to effect the necessary change in it; and
thirdly, if this minutest yet powerful dose of the best selected medicine
be repeated at suitable intervals,1 which experience shall have pronounced
to be the best adapted for accelerating the cure to the utmost extent, yet
without the vital force, which it is sought to influence to the production
of a similar medicinal disease, being able to feel itself excited and
roused to adverse reactions.
1 In the former editions of the Organon I have advised that a single dose
of a well-selected homoeopathic medicine should always be allowed first
fully to expend its action before a new medicine is given or the same one
repeated - a doctrine which was the result of the positive experience that
neither by a larger dose of the remedy, which may have been well chosen (as
has been again recently proposed, but which would be very like a retrograde
movement), nor, what amounts to the same thing, by several doses of it
given in quick succession, can the greatest possible good be effected in
the treatment of diseases, more especially of chronic ones; and the reason
of this is, that by such a procedure the vital force dose not quietly adapt
itself to the transition from the natural disease to the similar medicinal
disease, but is usually so violently excited and disturbed by a larger
dose, or by smaller doses of even a homoeopathically chosen remedy given
rapidly one after the other, that in most cases its reaction will be
anything but salutary and will do more harm than good. As long as no more
efficacious mode of proceeding than that then taught by me was discovered,
the safe philanthropic maxim of sin non juvat, modo ne noceat, rendered it
imperative for the homoeopathic practitioner, for whom the weal of his
fellow-creatures was the highest object, to allow, as a general rule in
diseases, but a single dose at a time, and that the very smallest, of the
carefully selected remedy to act upon the patient and, moreover, to exhaust
its action. The very smallest, I repeat, for it holds good and will
continue to hold good as a homoeopathic therapeutic maxim not to be refuted
by any experience in the world, that the best doses of the properly
selected remedy is always the very smallest on in one of the high potencies
(X), as well for chronic as for acute as for acute diseases - a truth that
is the inestimable property of pure homoeopathy and which as long as
allopathy and the new mongrel sect, whose treatment is a mixture of
allopathic and homoeopathic processes is not much better continues to gnaw
like a cancer at the life of sick human beings, and to ruin them by large
and ever larger doses of drugs, will keep pure homoeopathy separated from
these spurious arts as by an impassable gulf.
On the other hand, however, practice shows us that though a single one of
these small doses may suffice to accomplish almost all that it was possible
for this medicine to do under the circumstances, in some, and especially in
slight cases of disease, particularly in those of young children and very
delicate and excitable adults, yet that in many, indeed in most cases, not
only of very chronic diseases that have already made great progress and
have frequently been aggravated by a previous employment of inappropriate
medicines, but also of serious acute diseases, one such smallest dose of
medicine in our highly potentized dynamization is evidently insufficient to
effect all the curative action that might be expected from that medicine,
for it may unquestionably be requisite to administer several of them, in
order that the vital force may be pathogenetically altered by them to such
a degree and its salutary reaction stimulated to such a height, as to
enable it to completely extinguish, by its reaction, the whole of that
portion of the original disease that it lay in the power of the
well-selected homoeopathic remedy to eradicate; the best chosen medicine in
such a small dose, given but once, might certainly be of some service, but
would not be nearly sufficient.
But the careful homoeopathic physician would not venture soon to repeat the
same dose of the same remedy again, as from such a practice he has
frequently experienced no advantage, but most frequently, on close
observation, decided disadvantage. He generally witnessed aggravation, from
even the smallest dose of the most suitable remedy, which he has given one
day, when he repeated the next day and the next.
Now, in cases where he was convinced of the correctness of his choice of
the homoeopathic medicine, in order to obtain more benefit for the patient
than he was able to get hitherto from prescribing a single small dose, the
idea often naturally struck him to increase the dose, since, for the reason
given above, one single dose only should be given; an, for instance, in
place of giving a single very minute globule moistened with the medicine in
the highest dynamization, to administer six, seven or eight of them at
once, and even a half or a whole drop. But the result was almost always
less favourable than it should have been; it was often actually
unfavourable, often even very bad - an injury that, in a patient so
treated, is difficult to repair.
The difficulty in this case is not solved by giving, instead, lower
dynamizations of the remedy in a large dose.
Thus, increasing the strength of the single doses of the homoeopathic
medicine with the view of effecting the degree of pathogenic excitation of
the vital force necessary to produce satisfactory salutary reaction, fails
altogether, as experience teaches, to accomplish the desired object. This
vital force is thereby too violent and too suddenly assailed and excited to
allow it time to exercise a gradual equable, salutary reaction, to adapt
itself to the modification effected in it; hence it strives to repel, as if
it were an enemy, the medicine attacking it in excessive force, by means of
vomiting, diarrhoea, fever, perspiration, and so forth, and thus in a great
measure it diverts and renders nugatory the aim of the incautious physician
- little or no good towards curing the disease will be thereby
accomplished; on the contrary, the patient will be thereby perceptibly
weakened and, for a long time, the administration of even the smallest dose
of the same remedy must not be thought of if we would not wish it to injure
the patient.
But it happens, moreover, that a number of the smallest doses given for the
same object in quick succession accumulate in the organism into a kind of
excessively large dose, with (a few cases excepted) similar bad results; in
this case the vital force, not being able to recover itself betwixt every
dose, though it be but small, becomes oppressed and overwhelmed, and thus
being incapable of reacting in a salutary manner, it is necessitated
passively to allow involuntary the continuance of the over-strong medicinal
disease that has thus been forced upon it, just in the same manner as we
may every day observe from the allopathic abuse of large cumulative doses
of one and the same medicine, to the lasting injury of the patient.
Now, therefore, in order, whilst avoiding the erroneous method I have here
pointed out, to attain the desired object more certainly than hitherto, and
to administer the medicine selected in such a manner that it must exercise
all its efficacy without injury to the patient, that it may effect all the
good it is capable of performing in a given case of disease, I have lately
adopted a particular method.
I perceived that, in order to discover this true middle path, we must be
guided as well by the nature of the different medicinal substances, as also
by the corporeal constitution of the patient and the magnitude of the
disease, so that - to give an example from the use of sulphur in chronic
(psoric) diseases - the smallest dose of it (tinct, sulph. X°) can seldom
be repeated with advantage, seen in the most robust patients and in fully
developed psora, oftener than every seven days, a period of time which must
be proportionally lengthened when we have to treat weaker and more
excitable patients of this kind; in such cases we would do well to give
such a dose only every nine, twelve, or fourteen days, and continue to
repeat the medicine until it ceases to be of service. We thus find (to
abide by the instance of sulphur) that in sporic diseases seldom fewer than
four, often however, six, eight and even ten doses (tinct. sulph. X°) are
required to be successively administered at these intervals for the
complete annihilation of the whole portion of the chronic disease that is
eradicated by sulphur - provided always there had been no previous
allopathic abuse of sulphur in the case. Thus even a (primary) scabious
eruption of recent origin, though it may have spread all over the body, may
be perfectly cured, in persons who are not too weakly, by a dose of tinct
sulph. X° given every seven days, in the course of from ten to twelve weeks
(accordingly with ten or twelve such globules), so that it will seldom be
necessary to aid the cure with a few doses of carb. veg. X° (also given at
the rate of one dose per week) without the slightest external treatment
besides frequent changes of linen and good regimen.
When for other serious chronic diseases also we may consider it requisite,
as far as we can calculate, to give eight, nine or ten doses of tinct.
sulph. (at X°) it is yet more expedient in such cases, instead of giving
them in uninterrupted succession, to interpose after every, or every second
or third dose, a dose of another medicine, which in this case is next in
point of homoeopathic suitableness to sulphur (usually hep. sulph.) and to
allow this likewise to act for eight, nine, twelve or fourteen days before
again commencing a course of three doses of sulphur.
But it not infrequently happens that the vital force refuses to permit
several doses of sulphur, even though they may be essential for the cure of
the chronic malady and are given at the intervals mentioned above, to act
quietly on itself; this refusal it reveals by some, though moderate,
sulphur symptoms, which it allows to appear in the patient during the
treatment. In such cases it is sometimes advisable to administer a small
dose of nux vom. X°, allowing it to act for eight or ten days, in order to
dispose the system again to allow succeeding doses of the sulphur to act
quietly and effectually upon it. In those cases for which it is adapted,
puls. X° is preferable.
But the vital force shows the greatest resistance to the salutary action
upon itself of the strongly indicated sulphur, and even exhibits manifest
aggravation of the chronic disease, though the sulphur be given in the very
smallest dose, though only a globule of the size of a mustard seed
moistened with tinct. sulph X° be smelt, if the sulphur have formerly (it
may be years since) been improperly given allopathically in large doses.
This is one lamentable circumstance that renders the best medical treatment
of chronic disease almost impossible among the many that the ordinary
bungling treatment of chronic diseases by the old school would leave us
nothing to do but to deplore, were there not some mode of getting over the
difficulty.
In such cases we have only to let the patient smell a single time strongly
at a globule the size of a mustard seed moistened with mercur metall. X,
and allow this olfaction to act for about nine days, in order to make the
vital force again disposed to permit the sulphur (at least the olfaction of
tinct. sulph. X°) to exercise a beneficial influence on itself - a
discovery for which we are indepted to Dr. Griesselich, of Carlsruhe.
§ 246 Sixth Edition
Every perceptibly progressive and strikingly increasing amelioration during
treatment is a condition which, as long as it lasts, completely precludes
every repetition of the administration of any medicine whatsoever, because
all the good the medicine taken continues to effect is now hastening
towards its completion. This is not infrequently the cause in acute
diseases, but in more chronic diseases, on the other hand, a single dose of
an appropriately selected homoeopathic remedy will at times complete even
with but slowly progressive improvement and give the help which such a
remedy in such a case can accomplish naturally within 40, 50, 60, 100 days.
This is, however, but rarely the case; and besides, it must be a matter of
great importance to the physician as well as to the patient that were it
possible, this period should be diminished to one-half, one-quarter, and
even still less, so that a much more rapid cure might be obtained. And this
may be very happily affected, as recent and oft-repeated observations have
taught me under the following conditions: firstly, if the medicine selected
with the utmost care was perfectly homoeopathic; secondly, if it is highly
potentized, dissolved in water and given in proper small dose that
experience has taught as the most suitable in definite intervals for the
quickest accomplishment of the cure but with the precaution, that the
degree of every dose deviate somewhat from the preceding and following in
order that the vital principle which is to be altered to a similar
medicinal disease be not aroused to untoward reactions and revolt as is
always the case1 with unmodified and especially rapidly repeated doses.
1 What I said in the fifth edition of the organon, in a long note to this
paragraph in order to prevent these undesirable reactions of the vital
energy, was all the experience I then had justified. But during the last
four or five years, however, all these difficulties are wholly solved by my
new altered but perfected method. The same carefully selected medicine may
now be given daily and for months, if necessary in this way, namely, after
the lower degree of potency has been used for one or two weeks in the
treatment of chronic disease, advance is made in the same way to higher
degrees, (beginning according to the new dynamization method, taught
herewith with the use of the lowest degrees).
§ 247 Fifth Edition
Under these conditions, the smallest doses of the best selected
homoeopathic medicine may be repeated with the best, often with incredible
results, at intervals of fourteen, twelve, ten, eight, seven days, and,
where rapidity is requisite, in chronic diseases resembling cases of acute
disease, at still shorter intervals, but in acute diseases at very much
shorter periods - every twenty - four, twelve, eight, four hours, in the
very acutest every hour, up to as often as every five minutes, - in ever
case in proportion to the more or less rapid course of the diseases and of
the action of the medicine employed, as is more distinctly explained in the
last note.
§ 247 Sixth Edition
It is impractical to repeat the same unchanged dose of a remedy once, not
to mention its frequent repetition (and at short intervals in order not to
delay the cure). The vital principle does not accept such unchanged doses
without resistance, that is, without other symptoms of the medicine to
manifest themselves than those similar to the disease to be cured, because
the former dose has already accomplished the expected change in the vital
principle and a second dynamically wholly similar, unchanged dose of the
same medicine no longer finds, therefore, the same conditions of the vital
force. The patient may indeed be made sick in another way by receiving
other such unchanged doses, even sicker than he was, for now only those
symptoms of the given remedy remain active which were not homoeopathic to
the original disease, hence no step towards cure can follow, only a true
aggravation of the condition of the patient. But if the succeeding dose is
changed slightly every time, namely potentized somewhat higher (§§ 269-270)
then the vital principle may be altered without difficulty by the same
medicine (the sensation of natural disease diminishing) and thus the cure
brought nearer.1
1 We ought not even with the best chosen homoeopathic medicine, for
instance one pellet of the same potency that was beneficial at first, to
let the patient have a second or third dose, taken dry. In the same way, if
the medicine was dissolved in water and the first dose proved beneficial, a
second or third and even smaller dose from the bottle standing undisturbed,
even in intervals of a few days, would prove no longer beneficial, even
though the original preparation had been potentized with ten succussions or
as I suggested later with but two succussions in order to obviate this
disadvantage and this according to above reasons. But through modification
of every dose in its dynamiztion degree, as I herewith teach, there exists
no offence, even if the doses be repeated more frequently, even if the
medicine be ever so highly potentized with ever so many succussions. It
almost seems as if the best selected homoeopathic remedy could best extract
the morbid disorder from the vital force and in chronic disease to
extinguish the same only if applied in several different forms.
§ 248 Fifth Edition
The dose of the same medicine may be repeated several times according to
circumstances, but only so long as until either recovery ensues, or the
same remedy ceases to do good and the rest of the disease, presenting a
different group of symptoms, demands a different homoeopathic remedy.
§ 248 Sixth Edition
For this purpose, we potentize anew the medicinal solution1 (with perhaps
8, 10, 12 succussions) from which we give the patient one or (increasingly)
several teaspoonful doses, in long lasting diseases daily or every second
day, in acute diseases every two to six hours and in very urgent cases
every hour or oftener. Thus in chronic diseases, every correctly chosen
homoeopathic medicine, even those whose action is of long duration, may be
repeated daily for months with ever increasing success. If the solution is
used up (in seven to fifteen days) it is necessary to add to the next
solution of the same medicine if still indicated one or (though rarely)
several pellets of a higher potency with which we continue so long as the
patient experiences continued improvement without encountering one or
another complaint that he never had before in his life. For if this
happens, if the balance of the disease appears in a group of altered
symptoms then another, one more homoeopathically related medicine must be
chosen in place of the last and administered in the same repeated doses,
mindful, however, of modifying the solution of every dose with thorough
vigorous succussions, thus changing its degree of potency and increasing it
somewhat. On the other hand, should there appear during almost daily
repetition of the well indicated homoeopathic remedy, towards the end of
the treatment of a chronic disease, so-called (§ 161) homoeopathic
aggravations by which the balance of the morbid symptoms seem to again
increase somewhat (the medicinal disease, similar to the original, now
alone persistently manifests itself). The doses in that case must then be
reduced still further and repeated in longer intervals and possibly stopped
several days, in order to see if the convalescence need no further
medicinal aid. The apparent symptoms (Schein - Symptome) caused by the
excess of the homoeopathic medicine will soon disappear and leave
undisturbed health in its wake. If only a small vial say a dram of dilute
alcohol is used in the treatment, in which is contained and dissolved
through succussion one globule of the medicine which is to be used by
olfaction every two, three or four days, this also must be thoroughly
succussed eight to ten times before each olfaction.
1 Made in 40, 30, 20, 15 or 8 tablespoons of water with the addition of
some alcohol or a piece of charcoal in order to preserve it. If charcoal is
used, it is suspended by means of a thread in the vial and is taken out
when the vial is succussed. The solution of the medicinal globule (and it
is rarely necessary to use more than one globule) of a thoroughly
potentized medicine in a large quantity of water can be obviated by making
a solution in only 7-8 tablespoons of water and after thorough succussion
of the vial take from it one tablespoon and put it in a glass of water
(containing about 7 to 8 spoonfuls), this stirred thoroughly and then given
a dose to the patient. If he is unusually excited and sensitive, a teaspoon
of this solution may be put in a second glass of water, thoroughly stirred
and teaspoonful doses or more be given. There are patients of so great
sensitiveness that a third or fourth glass, similarly prepared, may be
necessary. Each such prepared glass must be made fresh daily. the globule
of the high potency is best crushed in a few grains of sugar of milk which
the patient can put in the vial and be dissolved in the requisite quantity
of water.
----------------------------------------------------------------------
Sheri Nakken, R.N., MA, Hahnemannian Homeopath
Well Within & Earth Mysteries & Sacred Site Tours (worldwide)
Vaccination Information & Choice Network (new website)
http://www.wellwithin1.com/vaccine.htm
http://www.wellwithin1.com/homeo.htm
homeopathycures@tesco.net
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the
That's news to me............
Potency and dose vital - and its certainly not about starting high -
individualized................................
Lesson 26, Part 6 - Aphorisms 246, 247 and 248 of the 6th Organon.
(Aphorisms quoted at the end)
Dear students and colleagues,
The ghost of the mechanism continues to appear in the minds of some
persons. There are still too many persons that teach one can give the LM
potency daily for months in a mechanical fashion to every patient no matter
what the reaction the remedy produces. I have responded to this myth in
another medium so I thought I would share the post here. I bet some of you
are tried of hearing this from me! Nevertheless, there may be some parties
that have not read these details before. The following document is based on
Hahnemann's teachings contained in aphorism 246, 247 and 248 as translated
by W. Beoricke..
Aphorism 246
"Every perceptible progressive and strikingly increasing amelioration
during treatment is a condition which, as long as it lasts, completely
precludes every repetition of the administration of any medicine
whatsoever, because all the good the medicine taken continues to effect is
now hastening towards its completion."
1. Hahnemann clearly says that when there is a "perceptibly progressive
and strikingly increasing amelioration" is a condition that "COMPLETELY
PRECLUDES" any "REPETITION" of the remedy whatsoever. This is because the
good effect of the remedy is now "hastening" towards its completion.
Although single dose and infrequent dose cures are not the majority of
chronic cases but they do take place in a significant minority. This is
more often in very sensitive patients, in functional diseases and in the
early states of pathology. There are occasions, however, where advanced
pathological states of several years duration is cured by single doses or
infrequent repetitions of the LM potency. Under these condition the
repetition of the remedy is counter indicated because the remedy is already
heading for cure very quickly and the repetition of the remedy under these
conditions runs the risk of slowing down the cure and causing aggravations
and antagonistic counter actions of the vital force. When their is a
dramatically increasing amelioration it is always best to leave well enough
alone!
"This is not infrequently the case in acute diseases, but in more
chronic diseases, on the other hand, a single dose of an appropriately
selected Homoeopathic remedy will at times complete even with but slowly
progressive improvement and give the help which such a remedy in such a
case can accomplish naturally within 40, 50, 60, 100 days."
2. Single dose cures are often the case in acute diseases but in chronic
diseases a single dose usually only produces a "slowly progressive
improvement" that will accomplish what it can naturally within 40, 50, 60,
100 days. This is, however, but rarely the case; and besides, it must be a
matter of great importance to the physician as well as to the patient that
were it possible, this period should be diminished to one-half,
one-quarter, and even still less, so that a much more rapid cure might be
obtained."
There is a great difference between a "strikingly increasing
amelioration" and a "slowly progressive improvement". Hahnemann makes it
clear that "anytime" during treatment there is a strikingly increasing
amelioration. the remedy should be stopped as long as this lasts. This case
be caused by a single dose, short series of split-doses or after the remedy
has been repeated for some time. Hahnemann then takes up the discussion of
cases in which a single dose can only cause a "slowly progressive
improvement" that may take up to 100 days to show any significant
improvement. Under these conditions the remedy should be repeated at
suitable intervals to speed the cure to 1/2, 1/4 or less the time it would
take with the exclusive single dose wait and watch method. When using the
4th Organon dry dose method the remedy can not be repeat until the duration
of the remedy ceases and the patient relapses.
4. Now Hahnemann offers five conditions that must be met to speed the
cure of slowly progressing cases.
a. The remedy must be "perfectly homeopathic".
b. It must be highly potentized.
c. It must be dissolved in water.
d. It must be given in a proper small dose.
e. It must be repeated in definite intervals that experience has taught the
most suitable.
If the remedy is NOT perfectly homeopathic one best not repeat it. How
can you tell if the remedy is perfectly homeopathic if you don't carefully
test it at the start of treatment. The Paris casebooks show that it was
Hahnemann practice to give either a single dose (usually by olfaction) or
short series of 3 to 7 doses over a period of a week and had the patient
come back in 7 days. He never sent anyone off for 1 month at the start of a
case with a preconceived remedy schedule. He always checked his remedy very
carefully at the start of treatment to make sure it was not the wrong
remedy or a partial simillimum. Everything that Hahnemann says in aphorism
247 and 248 about speeding the cure is conditioned by his statements in
aphorism 246.
Aphorism 247
Aphorism 247 explains why one needs to use the medicinal solution that
is succussed prior to administration and given it in split-doses. He gives
the reasons why it is difficult to speed the cure with the unmodified dry
dose or unadjusted liquid dose. Then Hahnemann says:
"But if the succeeding dose is changed slightly every time, namely
potentized somewhat higher (pp. 269-270) then the vital principle may be
altered without difficulty by the same medicine (the sensation of natural
disease diminishing) and thus the cure brought nearer".
Aphorism 248
Aphorism 248 continues the theme that started in aphorism 246 where
Hahnemann taught when the single dose wait and watch method is appropriate
(in perceptively progressive and strikingly increasing ameliorations) and
where one should repeat the remedy at suitable intervals (case where a
single dose can only cause slowly progressive improvement). Aphorism 248
follows on the discussion of the five conditions for speeding the cure and
the need to adjust each dose so that patient never receives the exact same
potency twice in succession.
"For this purpose, we potentize anew the medicinal solution (with
perhaps 8, 10, 12 succussions) from which we give the patient one or
(increasingly) several teaspoonful doses, in long lasting diseases daily or
every second day, in acute diseases every two to six hours and in very
urgent cases every hour or oftener.
The "purpose" Hahnemann is speaking about how to adjust the potency
when repeating the remedy to speed the cure of cases that would only slowly
improve on a single dose or infrequent repetitions. This includes BOTH
acute and chronic diseases. For this purpose we potentize anew the
medicinal solution prior to the administration of each dose so that patient
never receives the exact same potency twice in succession. Then Hahnemann
offers a method for treating for long lasting protracted diseases where a
single dose can only produces a slow progressive improvement over 30 to 100
days at best and even this is rarely the case. it is more common for the
patient to relapse calling for repeated doses. Aphorism 248 teaches how to
speed the cure of resistant cases to 1/2, 1/4 or less the time it takes
with the exclusive single dose wait and watch method.
In protracted cases, the remedy may be repeated daily or on alternated
days if necessary as long as there are no aggravations or new symptoms. It
must also be noted that in sentence 1 of aphorism 246 Hahnemann says every
strikingly increasing amelioration "during treatment" is a state that
"precludes" the repetition of the remedy as long as it lasts. This means
that anytime during a series of split-doses there appears a dramatic
increasing amelioration the remedy should be stopped as long as this state
lasts. If one stops the remedy under these three conditions (aggravation,
new symptoms, dramatic increasing amelioration) over medication can be
avoided while the cure greatly speeded.
Hahnemann noted in aphorism 246 that acute diseases are often cured by
a single dose. When he speaks about giving the acute remedy every 6 hours
or less it means in resistant acute disorders that can not be cured by a
single dose. The same conditions apply. There is no need to repeat the dose
when there is a strikingly increasing amelioration in acute diseases any
more than in a chronic diseases. All the conditions discussed in the
aphorism 246 condition all the statement that follow in aphorism 248. If
one ignores the first sentence of aphorism 246 they leave out 1/2 of
Hahnemann's case management strategies that deals with strikingly
increasing ameliorations.
In the footnote to aphorism 246 Hahnemann says one can give the remedy
daily "WHEN NECESSARY". This same when necessary applies to the statements
on the daily dose in aphorism 248! It is amazing some persons can
completely ignore or change the meaning of everything Hahnemann says in
aphorism 246 and its footnote. Then they say Hahnemann only taught that one
should give everyone the remedy daily or on alternate days in chronic
diseases and every 6 hours or less in acute diseases no matter what. This
type selective amnesia takes a few words out of context with the rest of
the text and ignores hundreds of words that explain Hahnemann's complete
posology and case management strategy in detail. To say Hahnemann said
always give the daily dose for months and forget the "when necessary" a
grand misnomer that puts the patient in danger.
It is very difficult to learn how to use the LM potency properly just
by reading the 6th Organon. There was supposed to be a living lineage of
teachers that could clarify the points and add oral teachings that are not
contained in the 6th edition. Hahnemann was teaching Boenninghausen about
the LM method when he died. Melaine Hahnemann asked Boenninghausen not to
speak about the new methods in pubic until after she published the 6th
Organon. Unfortunately, this task was not accomplished before the Baron and
Melaine passed away. By the time the 6th edition was published in 1920 all
those with personal knowledge of the LM potency had died. This makes it
extremely difficult to put the entire LM method into perspective without
studying the Paris casebooks, the testimony of those with inside
information, and the eyewitness accounts of those who witnessed Hahnemann's
practice between1838 to 1843.
Hahnemann shared LM cases with Beonninghausen as he hoped the Baron
would someday pass on his teachings on the new method. These cases showed
how Hahnemann actually gave the LM potency in the clinic. This information
was complemented by the eyewitness account of Dr. Croserio, who worked
closely with Hahnemann in his last years. Dr. Croserio's letter to
Beonninghausen IHahnemann's Doses of Medicine, Lesser Writing,
Boenninghausen) shows that the Founder often gave single doses (usually by
olfaction) followed by at least one week of placebos while he waited and
watched. The Paris casebooks confirm that Hahnemann used this method quite
often in the 1840s. This proves that Hahnemann did NOT always give the
daily and alternate day dose to every patient. He often used single doses
usually by olfaction but not always.
Dr. Croserio's letter clearly points out that; "Even in acute diseases
it was a rare case to see him [Hahnemann] allow the patient to take more
than one spoonful in 24 hours". Dr.Croserio's eyewitness account proves
that Hahnemann did not always use the daily or alternate day dose or give
acute remedies every 6 hours or less. The rapid repetition of the remedy
was specific for the treatment of resistant acute and chronic disorders. In
aphorism 246 Hahnemann clearly states that acute diseases often are cured
by single doses in a striking manner! If one gives the remedy every 6 hours
in a mechanical fashion i n these cases the outcome would be aggravations,
accessory symptoms and antagonistic counter actions of the vital force.
Dr. Croserio also noted that anytime during treatment Hahnemann
observed strong medicinal actions he would reduce the dose or stop the
doses and give placebos while he waited and watched. This method has also
been confirmed by a study of the Paris casebooks. Hahnemann did not speak
about how much placebo he was using in the 1840s in the 6th Organon. That
would have alerted the general public to the fact that he was using almost
as much milk sugar in water as active medicine. The Founder rarely gave the
daily or alternate days dose for very long without placing the patient on
placebos for one or more weeks. I have not see one case in the entire Paris
casebooks where Hahnemann gave the daily or alternated day dose from months
on end without stopping the medicine and given 1, 2 even 3 weeks of
placebo. Hahnemann constantly used this "On again - off again" method
throughout his treatment. The idea that Hahnemann always gave the daily
dose or alternate day dose for months is a complete complete myth.
I have not written this discourse with the idea of proving a point to a
single party. I have written this post for the benefit of the Homoeopathic
community at large and for the good of their patients. The first
Hippocratic maxim is "Do no harm". Homeopathy is a very safe system when
one follows the basic checks and balances introduced by Samuel Hahnemann.
The biggest danger inherent in homeopathy is from over medication with
potentized remedies. This can cause remedy induced symptoms, medical
diseases, and antagonistic counter actions of the vital force. These
conditions can become very serious if the over medication is excessive.
None of this has to happen if one follows all the principles elucidated in
aphorism 246, 247 and 248 in a careful manner. If one just takes one or two
words out of context and ignores the rest they take the law in to their own
hands and are personally responsible for any suffering they cause.
Simila Minimus
Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."
Samuel Hahnemann
Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000
************
Aphorisms Below
http://homeoint.org/books/hahorgan/organ240.htm#P246E5
§ 246 Fifth Edition
On the other hand, the slowly progressive amelioration consequent on a very
minute dose, whose selection has been accurately homoeopathic, when it has
met with no hindrance to the duration of its action, sometimes accomplishes
all the good the remedy in question is capable from its nature of
performing in a given case, in periods of forty, fifty or a hundred days.
This is, however, but rarely the case; and besides, it must be a matter of
great importance to the physician as well as to the patient that were it
possible, this period should be diminished to one-half, one-quarter, and
even still less, so that a much more rapid cure might be obtained. And this
may be very happily affected, as recent and oft-repeated observations have
shown, under three conditions: firstly, if the medicine selected with the
utmost care was perfectly homoeopathic; secondly, if it was given in the
minutest dose, so as to produce the least possible excitation of the vital
force, and yet sufficient to effect the necessary change in it; and
thirdly, if this minutest yet powerful dose of the best selected medicine
be repeated at suitable intervals,1 which experience shall have pronounced
to be the best adapted for accelerating the cure to the utmost extent, yet
without the vital force, which it is sought to influence to the production
of a similar medicinal disease, being able to feel itself excited and
roused to adverse reactions.
1 In the former editions of the Organon I have advised that a single dose
of a well-selected homoeopathic medicine should always be allowed first
fully to expend its action before a new medicine is given or the same one
repeated - a doctrine which was the result of the positive experience that
neither by a larger dose of the remedy, which may have been well chosen (as
has been again recently proposed, but which would be very like a retrograde
movement), nor, what amounts to the same thing, by several doses of it
given in quick succession, can the greatest possible good be effected in
the treatment of diseases, more especially of chronic ones; and the reason
of this is, that by such a procedure the vital force dose not quietly adapt
itself to the transition from the natural disease to the similar medicinal
disease, but is usually so violently excited and disturbed by a larger
dose, or by smaller doses of even a homoeopathically chosen remedy given
rapidly one after the other, that in most cases its reaction will be
anything but salutary and will do more harm than good. As long as no more
efficacious mode of proceeding than that then taught by me was discovered,
the safe philanthropic maxim of sin non juvat, modo ne noceat, rendered it
imperative for the homoeopathic practitioner, for whom the weal of his
fellow-creatures was the highest object, to allow, as a general rule in
diseases, but a single dose at a time, and that the very smallest, of the
carefully selected remedy to act upon the patient and, moreover, to exhaust
its action. The very smallest, I repeat, for it holds good and will
continue to hold good as a homoeopathic therapeutic maxim not to be refuted
by any experience in the world, that the best doses of the properly
selected remedy is always the very smallest on in one of the high potencies
(X), as well for chronic as for acute as for acute diseases - a truth that
is the inestimable property of pure homoeopathy and which as long as
allopathy and the new mongrel sect, whose treatment is a mixture of
allopathic and homoeopathic processes is not much better continues to gnaw
like a cancer at the life of sick human beings, and to ruin them by large
and ever larger doses of drugs, will keep pure homoeopathy separated from
these spurious arts as by an impassable gulf.
On the other hand, however, practice shows us that though a single one of
these small doses may suffice to accomplish almost all that it was possible
for this medicine to do under the circumstances, in some, and especially in
slight cases of disease, particularly in those of young children and very
delicate and excitable adults, yet that in many, indeed in most cases, not
only of very chronic diseases that have already made great progress and
have frequently been aggravated by a previous employment of inappropriate
medicines, but also of serious acute diseases, one such smallest dose of
medicine in our highly potentized dynamization is evidently insufficient to
effect all the curative action that might be expected from that medicine,
for it may unquestionably be requisite to administer several of them, in
order that the vital force may be pathogenetically altered by them to such
a degree and its salutary reaction stimulated to such a height, as to
enable it to completely extinguish, by its reaction, the whole of that
portion of the original disease that it lay in the power of the
well-selected homoeopathic remedy to eradicate; the best chosen medicine in
such a small dose, given but once, might certainly be of some service, but
would not be nearly sufficient.
But the careful homoeopathic physician would not venture soon to repeat the
same dose of the same remedy again, as from such a practice he has
frequently experienced no advantage, but most frequently, on close
observation, decided disadvantage. He generally witnessed aggravation, from
even the smallest dose of the most suitable remedy, which he has given one
day, when he repeated the next day and the next.
Now, in cases where he was convinced of the correctness of his choice of
the homoeopathic medicine, in order to obtain more benefit for the patient
than he was able to get hitherto from prescribing a single small dose, the
idea often naturally struck him to increase the dose, since, for the reason
given above, one single dose only should be given; an, for instance, in
place of giving a single very minute globule moistened with the medicine in
the highest dynamization, to administer six, seven or eight of them at
once, and even a half or a whole drop. But the result was almost always
less favourable than it should have been; it was often actually
unfavourable, often even very bad - an injury that, in a patient so
treated, is difficult to repair.
The difficulty in this case is not solved by giving, instead, lower
dynamizations of the remedy in a large dose.
Thus, increasing the strength of the single doses of the homoeopathic
medicine with the view of effecting the degree of pathogenic excitation of
the vital force necessary to produce satisfactory salutary reaction, fails
altogether, as experience teaches, to accomplish the desired object. This
vital force is thereby too violent and too suddenly assailed and excited to
allow it time to exercise a gradual equable, salutary reaction, to adapt
itself to the modification effected in it; hence it strives to repel, as if
it were an enemy, the medicine attacking it in excessive force, by means of
vomiting, diarrhoea, fever, perspiration, and so forth, and thus in a great
measure it diverts and renders nugatory the aim of the incautious physician
- little or no good towards curing the disease will be thereby
accomplished; on the contrary, the patient will be thereby perceptibly
weakened and, for a long time, the administration of even the smallest dose
of the same remedy must not be thought of if we would not wish it to injure
the patient.
But it happens, moreover, that a number of the smallest doses given for the
same object in quick succession accumulate in the organism into a kind of
excessively large dose, with (a few cases excepted) similar bad results; in
this case the vital force, not being able to recover itself betwixt every
dose, though it be but small, becomes oppressed and overwhelmed, and thus
being incapable of reacting in a salutary manner, it is necessitated
passively to allow involuntary the continuance of the over-strong medicinal
disease that has thus been forced upon it, just in the same manner as we
may every day observe from the allopathic abuse of large cumulative doses
of one and the same medicine, to the lasting injury of the patient.
Now, therefore, in order, whilst avoiding the erroneous method I have here
pointed out, to attain the desired object more certainly than hitherto, and
to administer the medicine selected in such a manner that it must exercise
all its efficacy without injury to the patient, that it may effect all the
good it is capable of performing in a given case of disease, I have lately
adopted a particular method.
I perceived that, in order to discover this true middle path, we must be
guided as well by the nature of the different medicinal substances, as also
by the corporeal constitution of the patient and the magnitude of the
disease, so that - to give an example from the use of sulphur in chronic
(psoric) diseases - the smallest dose of it (tinct, sulph. X°) can seldom
be repeated with advantage, seen in the most robust patients and in fully
developed psora, oftener than every seven days, a period of time which must
be proportionally lengthened when we have to treat weaker and more
excitable patients of this kind; in such cases we would do well to give
such a dose only every nine, twelve, or fourteen days, and continue to
repeat the medicine until it ceases to be of service. We thus find (to
abide by the instance of sulphur) that in sporic diseases seldom fewer than
four, often however, six, eight and even ten doses (tinct. sulph. X°) are
required to be successively administered at these intervals for the
complete annihilation of the whole portion of the chronic disease that is
eradicated by sulphur - provided always there had been no previous
allopathic abuse of sulphur in the case. Thus even a (primary) scabious
eruption of recent origin, though it may have spread all over the body, may
be perfectly cured, in persons who are not too weakly, by a dose of tinct
sulph. X° given every seven days, in the course of from ten to twelve weeks
(accordingly with ten or twelve such globules), so that it will seldom be
necessary to aid the cure with a few doses of carb. veg. X° (also given at
the rate of one dose per week) without the slightest external treatment
besides frequent changes of linen and good regimen.
When for other serious chronic diseases also we may consider it requisite,
as far as we can calculate, to give eight, nine or ten doses of tinct.
sulph. (at X°) it is yet more expedient in such cases, instead of giving
them in uninterrupted succession, to interpose after every, or every second
or third dose, a dose of another medicine, which in this case is next in
point of homoeopathic suitableness to sulphur (usually hep. sulph.) and to
allow this likewise to act for eight, nine, twelve or fourteen days before
again commencing a course of three doses of sulphur.
But it not infrequently happens that the vital force refuses to permit
several doses of sulphur, even though they may be essential for the cure of
the chronic malady and are given at the intervals mentioned above, to act
quietly on itself; this refusal it reveals by some, though moderate,
sulphur symptoms, which it allows to appear in the patient during the
treatment. In such cases it is sometimes advisable to administer a small
dose of nux vom. X°, allowing it to act for eight or ten days, in order to
dispose the system again to allow succeeding doses of the sulphur to act
quietly and effectually upon it. In those cases for which it is adapted,
puls. X° is preferable.
But the vital force shows the greatest resistance to the salutary action
upon itself of the strongly indicated sulphur, and even exhibits manifest
aggravation of the chronic disease, though the sulphur be given in the very
smallest dose, though only a globule of the size of a mustard seed
moistened with tinct. sulph X° be smelt, if the sulphur have formerly (it
may be years since) been improperly given allopathically in large doses.
This is one lamentable circumstance that renders the best medical treatment
of chronic disease almost impossible among the many that the ordinary
bungling treatment of chronic diseases by the old school would leave us
nothing to do but to deplore, were there not some mode of getting over the
difficulty.
In such cases we have only to let the patient smell a single time strongly
at a globule the size of a mustard seed moistened with mercur metall. X,
and allow this olfaction to act for about nine days, in order to make the
vital force again disposed to permit the sulphur (at least the olfaction of
tinct. sulph. X°) to exercise a beneficial influence on itself - a
discovery for which we are indepted to Dr. Griesselich, of Carlsruhe.
§ 246 Sixth Edition
Every perceptibly progressive and strikingly increasing amelioration during
treatment is a condition which, as long as it lasts, completely precludes
every repetition of the administration of any medicine whatsoever, because
all the good the medicine taken continues to effect is now hastening
towards its completion. This is not infrequently the cause in acute
diseases, but in more chronic diseases, on the other hand, a single dose of
an appropriately selected homoeopathic remedy will at times complete even
with but slowly progressive improvement and give the help which such a
remedy in such a case can accomplish naturally within 40, 50, 60, 100 days.
This is, however, but rarely the case; and besides, it must be a matter of
great importance to the physician as well as to the patient that were it
possible, this period should be diminished to one-half, one-quarter, and
even still less, so that a much more rapid cure might be obtained. And this
may be very happily affected, as recent and oft-repeated observations have
taught me under the following conditions: firstly, if the medicine selected
with the utmost care was perfectly homoeopathic; secondly, if it is highly
potentized, dissolved in water and given in proper small dose that
experience has taught as the most suitable in definite intervals for the
quickest accomplishment of the cure but with the precaution, that the
degree of every dose deviate somewhat from the preceding and following in
order that the vital principle which is to be altered to a similar
medicinal disease be not aroused to untoward reactions and revolt as is
always the case1 with unmodified and especially rapidly repeated doses.
1 What I said in the fifth edition of the organon, in a long note to this
paragraph in order to prevent these undesirable reactions of the vital
energy, was all the experience I then had justified. But during the last
four or five years, however, all these difficulties are wholly solved by my
new altered but perfected method. The same carefully selected medicine may
now be given daily and for months, if necessary in this way, namely, after
the lower degree of potency has been used for one or two weeks in the
treatment of chronic disease, advance is made in the same way to higher
degrees, (beginning according to the new dynamization method, taught
herewith with the use of the lowest degrees).
§ 247 Fifth Edition
Under these conditions, the smallest doses of the best selected
homoeopathic medicine may be repeated with the best, often with incredible
results, at intervals of fourteen, twelve, ten, eight, seven days, and,
where rapidity is requisite, in chronic diseases resembling cases of acute
disease, at still shorter intervals, but in acute diseases at very much
shorter periods - every twenty - four, twelve, eight, four hours, in the
very acutest every hour, up to as often as every five minutes, - in ever
case in proportion to the more or less rapid course of the diseases and of
the action of the medicine employed, as is more distinctly explained in the
last note.
§ 247 Sixth Edition
It is impractical to repeat the same unchanged dose of a remedy once, not
to mention its frequent repetition (and at short intervals in order not to
delay the cure). The vital principle does not accept such unchanged doses
without resistance, that is, without other symptoms of the medicine to
manifest themselves than those similar to the disease to be cured, because
the former dose has already accomplished the expected change in the vital
principle and a second dynamically wholly similar, unchanged dose of the
same medicine no longer finds, therefore, the same conditions of the vital
force. The patient may indeed be made sick in another way by receiving
other such unchanged doses, even sicker than he was, for now only those
symptoms of the given remedy remain active which were not homoeopathic to
the original disease, hence no step towards cure can follow, only a true
aggravation of the condition of the patient. But if the succeeding dose is
changed slightly every time, namely potentized somewhat higher (§§ 269-270)
then the vital principle may be altered without difficulty by the same
medicine (the sensation of natural disease diminishing) and thus the cure
brought nearer.1
1 We ought not even with the best chosen homoeopathic medicine, for
instance one pellet of the same potency that was beneficial at first, to
let the patient have a second or third dose, taken dry. In the same way, if
the medicine was dissolved in water and the first dose proved beneficial, a
second or third and even smaller dose from the bottle standing undisturbed,
even in intervals of a few days, would prove no longer beneficial, even
though the original preparation had been potentized with ten succussions or
as I suggested later with but two succussions in order to obviate this
disadvantage and this according to above reasons. But through modification
of every dose in its dynamiztion degree, as I herewith teach, there exists
no offence, even if the doses be repeated more frequently, even if the
medicine be ever so highly potentized with ever so many succussions. It
almost seems as if the best selected homoeopathic remedy could best extract
the morbid disorder from the vital force and in chronic disease to
extinguish the same only if applied in several different forms.
§ 248 Fifth Edition
The dose of the same medicine may be repeated several times according to
circumstances, but only so long as until either recovery ensues, or the
same remedy ceases to do good and the rest of the disease, presenting a
different group of symptoms, demands a different homoeopathic remedy.
§ 248 Sixth Edition
For this purpose, we potentize anew the medicinal solution1 (with perhaps
8, 10, 12 succussions) from which we give the patient one or (increasingly)
several teaspoonful doses, in long lasting diseases daily or every second
day, in acute diseases every two to six hours and in very urgent cases
every hour or oftener. Thus in chronic diseases, every correctly chosen
homoeopathic medicine, even those whose action is of long duration, may be
repeated daily for months with ever increasing success. If the solution is
used up (in seven to fifteen days) it is necessary to add to the next
solution of the same medicine if still indicated one or (though rarely)
several pellets of a higher potency with which we continue so long as the
patient experiences continued improvement without encountering one or
another complaint that he never had before in his life. For if this
happens, if the balance of the disease appears in a group of altered
symptoms then another, one more homoeopathically related medicine must be
chosen in place of the last and administered in the same repeated doses,
mindful, however, of modifying the solution of every dose with thorough
vigorous succussions, thus changing its degree of potency and increasing it
somewhat. On the other hand, should there appear during almost daily
repetition of the well indicated homoeopathic remedy, towards the end of
the treatment of a chronic disease, so-called (§ 161) homoeopathic
aggravations by which the balance of the morbid symptoms seem to again
increase somewhat (the medicinal disease, similar to the original, now
alone persistently manifests itself). The doses in that case must then be
reduced still further and repeated in longer intervals and possibly stopped
several days, in order to see if the convalescence need no further
medicinal aid. The apparent symptoms (Schein - Symptome) caused by the
excess of the homoeopathic medicine will soon disappear and leave
undisturbed health in its wake. If only a small vial say a dram of dilute
alcohol is used in the treatment, in which is contained and dissolved
through succussion one globule of the medicine which is to be used by
olfaction every two, three or four days, this also must be thoroughly
succussed eight to ten times before each olfaction.
1 Made in 40, 30, 20, 15 or 8 tablespoons of water with the addition of
some alcohol or a piece of charcoal in order to preserve it. If charcoal is
used, it is suspended by means of a thread in the vial and is taken out
when the vial is succussed. The solution of the medicinal globule (and it
is rarely necessary to use more than one globule) of a thoroughly
potentized medicine in a large quantity of water can be obviated by making
a solution in only 7-8 tablespoons of water and after thorough succussion
of the vial take from it one tablespoon and put it in a glass of water
(containing about 7 to 8 spoonfuls), this stirred thoroughly and then given
a dose to the patient. If he is unusually excited and sensitive, a teaspoon
of this solution may be put in a second glass of water, thoroughly stirred
and teaspoonful doses or more be given. There are patients of so great
sensitiveness that a third or fourth glass, similarly prepared, may be
necessary. Each such prepared glass must be made fresh daily. the globule
of the high potency is best crushed in a few grains of sugar of milk which
the patient can put in the vial and be dissolved in the requisite quantity
of water.
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Sheri Nakken, R.N., MA, Hahnemannian Homeopath
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