gunter's case 30c/200c/1M (not)

[Dave Hartley]

I remember a conversation or two about 30c/200c/1M in quick succession..
One person thought it had originated with a prescriber who was uncertain of
the efficacy of h/ir potencies .. &/or who may not have been uncertain, but
who may've recieved a goodly number of improperly prepared "dud" remedies.

There are several reasons that I would never prescribe in this way.

First and easiest to point to- is one of homeopathy's basic cornerstones:
Similia Minimus, minimum dose.

Second is the deductive logic which dictates that this would effectively
eliminate the ability to see exactly what-the-heck a 30c dose was doing, or
200c. One of the dictums by which I learned homeopathy and by which I
practice is "Watch and Wait" after single test dose of any newly given Rx...
otherwise it is really impossible for me to follow the case according to
what I know to be prudent case management.

How would I know if there were (aphorism 246) "perceptible progressive and
strikingly increasing amelioration during treatment which condition, as long
as it lasts, precludes every reptition of the administration of any medicine
whatsoever..."

Quite a lot is said about this in the Organon, Footnote to Aphorism 246:
" 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 small 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 does 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 si 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 dose of the
properly selected remedy is always by very smallest one in one of the high
potencies (X), as well for chronic 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 reawakening, 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 narly sufficient. But
the careful homoeopathic physician would not venture soon to repeat the same
dose of the same remedy again and 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 had given one
day, when 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 reasons given above, one
single dose only should be given; and, 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, it 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 pathogenetic 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
violently 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 rare 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 latterly adopted a peculiar 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 his disease, so that - to give an example
from the use of sulphur in chronic (psoric) diseases - the smallest dose of
it (tinct. sulph. Xo) can seldom be repeated with advantage, even in 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."
(continues)
Dave Hartley
http://www.localcomputermart.com
Santa Cruz, CA (831)423-4284
Asheville Computer (N. Carolina) (828)285-0240

[Rochelle]

Hi Dave,
I think the 30/200/1M thing is quite British!! It is not an uncommon
prescribing method here. Some do it 1M/200/30 but I really can't see the
point of this as to me you are just bringing the potency down. I think the
reason we were told at college for this is that it is a gentler way of going
to 1M without agg. Now I know all about trying to find the silmilimum and
you can quote the Organon (which I have read) until you are blue in the face
but I believe - and this is my own opinion- that it is sooo difficult to
find the similimum these days when we have been subjected to vaccinations,
pollution
from the food we eat and stress etc. Therefore I attempt to find the
similimum but it is more likely to be a best fit remedy prescribing on what
is there at this moment and what the patient wants cured at this moment.

I do give one remedy , minimum dose!! The 30/200/1M in 24 hours was called
AN ascending split dose at college. When that has done its job I see what
comes up or what is left and prescribe on that. Call it zig zagging or
layers I don't care, as long as the patient is becoming more healthy with an
increased energy that seems to be fine for me and my patients. The one I
haven't prescribed for because I can't see a remedy I am happy with is the
case I put on this site last week and only Joyce I think tried to have a go
at it. I would be willing to put it on again , or send to you privately if
you reckon you could find a similimum!!! I am only in my 3rd year of
practice and know I have a lot to learn and sometimes I don't feel competent
enough to reply to posts on this site with so many experienced homeopaths
and this is the first time I have dared put my sort of philosophy on paper
as it were so please don't hang me for it. I should also point out that I
really only do the 30/200/1M dose for Carc. and that is something I have
learnt to do through clinical practise of having agg with 30 and 200. Oh yes
were also taught to give 30 and 200 in a split dose night, morning , night,
at college and you will find that most British homeopaths prescribe this
way. Personally I always do this with a 30, sometimes with 200 and never
with 1M although my homeopath gives 2 doses with the 1M. (of which I used
to take just the one!!!)

Regards,
Rochelle (RSHom)

www.rochellemarsden.co.uk
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[Soroush Ebrahimi]

Dear Rochelle

Not all colleges in UK teach this technique. I think LCH is probably the
leader in this method of prescribing and I am yet to find someone who can
justify it properly.

It saddens me GREATLY that when you have been asked a question to justify
your techniques and you are quoted the Master - you are happy to ignore this
good advice and say you can do this until you are blue in the face!
Is this logic?
Is this scientific?

Hn and Kent have both advised against this. You are just muddying the water
in this way of treatment. I agree that we have a much difficult cases to
resolve than 200 years ago, but why go and muddy the water even more?

Do you think that Hn's and Kent's advice/instruction that one single dose of
a remedy to be prescribed and then WAIT is based on just a few year's
experiences or a life time of work and treating more patients than perhaps
we have?

I would like you to offer proper evidence that if you prescribe based on the
split dose technique you completely avoided agg and if you prescribe a
single dose the pt experiences agg? (In fact GV uses a consider amount of
his book just explaining the post-remedy outcomes and what they mean). We
know that Hn went over to liquid remedies and to LMs to avoid agg, but this
was his PERFECTED technique, not the split dose!

I await your comments and SCIENTIFIC justifications.

Soroush

[Rochelle]

Dear Soroush,
My evidence is clinical experience. As a former science specialist I am
aware that there is no way I can prove this. I am hardly likely to give a
patient a split 200 - see an agg and then give 30/200/1M in the same potency
to the same patient. Everyone is an individual anyway and therefore every
reaction is individual. All I can say is that when giving Carc. I am getting
a gentler reaction from giving 30/200/1M than I got giving 30 - split and
200- split. Now ofcause you could argue that is because I was giving them as
a split dose rather than just the one dose but I have no problem giving any
other remedy like this.

I do always tell the patient to phone me if they have any reaction from any
of the doses before taking the next and if they do I tell them not to take
the next. BTW I am not into LM's but do use WP succussed if I feel I want to
take that sort of route i.e. if there is a maintaining cause such as
continual allopathic medication.

Regards,
Rochelle

the
this
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[Soroush Ebrahimi]

Thanks for sharing this.

Please try a single dose for while and just see!

LM's are BEAUTIFUL. Just try them. They give you so much control
especially when the pt has skin problems.
Rgds
Soroush

[Rochelle]

I don't trend to get skin problems homing in on me. I get IBS and stress!!!

Rochelle
www.rochellemarsden.co.uk

[Soroush Ebrahimi]

Try LMs with IBS!!! Coz there is all sorts going on there

Good luck
Soroush

[Dave Hartley]

Hi Rochelle,

Thanks for your explanation, and the information that you are taught this at
college (which college ?)

I'll make more or less point-by-point comment, which I hope won't seem like
anyone's trying to hang anyone.

Seems the British to tend to hang on to "traditional ways"

Hahnemann and many others have experimented with moving potency up OR down
as case management technique IN THE EVENT OF (not as propylaxis of)
aggravation.

Since the 5th edition of Organon, there has been MASSIVE intellectual
capital available for practically ELIMINATING aggravation in most cases.
This
distilled essence of the culmination of Hahnemann's genius is called liquid
posology. If you haven't studied it and used it Please Consider reading
"Hahnemann's Advanced Methods" -which is a concise explanation that has
helped Many homeopaths (some very well experienced) who previously were
unaware of liquid posology to understand and implement this Quanum Leap in
case management. This was first made widely available on the Internet about
7 or 8
yrs ago.
http://www.simillimum.com/Thelittlelibr ... s/HAM.html

I'm familiar with the idea that "people these days" have terrible diet or
WhatEver; in actual point of fact, the people of Hahnemann's time probably
suffered Much Worse from poor nutrition (no refrigerators, don'cha know) and
poor sanitation (open sewers) .. so I can't personally give any credence to
the litany of reasons it's difficult to find the Similimum. It *IS*
difficult, but that is just the way it is; homeopathy is Simple, but Not
Easy.

Being Overly Influenced by "what the patient/client wants cured" is becoming
entrapped by sympathy as opposed to exercising compassion of the
discriminating healer.

Aphorism 2:
The highest ideal of cure is rapid, gentle and permanent restoration of the
health, or removal and annihilation of the disease in its whole extent, in
the shortest, most reliable, and most harmless way, on easily comprehensible
principles. (read Aphorism 3 also in this regard- if you don't have it
handy check out Homeoint.org's new high-speed server:
http://209.249.65.150/books/hahorgan/organ001.htm#P1 )

It is up to the homeopath to discern what needs to be cured in the case;
this is h/ir "sacred trust."

Taking the case in such a way as to have the information necessary to locate
the Simillimum is the most important, and one of the more difficult- things
in Homeopathy.

Send your case notes on the one you mention if you like,
mailto:dave@localcomputermart.com
I'll see if anything strikes me or if I can give you some input on where to
dig a little more.

best,
Dave Hartley
http://www.localcomputermart.com
Santa Cruz, CA (831)423-4284
Asheville Computer (N. Carolina) (828)285-0240