LM question 3
Posted: Sat Apr 26, 2003 6:25 pm
Dear Minutus,
There are those who suggest using the LM potency of the 6th Organon in
the exact same manner as the dry dose C wait and watch of the 4th Organon.
They suggest this to avoid some of the strong aggravations that have been
caused by the LM potency in some cases. The LMs are very powerful remedies
that must be treated with great respect. Some are giving the LMs in a
mechanical fashion daily or on alternate days to every patient. This has
led to many unneeded strong aggravations. This has given the LM potency a
bad reputation in some circles. This mechanistic method comes from not
understanding what is written in the Organon.
Nevertheless, to suggest that the LM potency should be used in the
exact same fashion as the dry dose of the C potency is also missing the
point. Using the LM potency by the methods of the 4th Organon and the 1820s
does not utilized the all advantages of the new methods Hahnemann
introduced between 1838 and 1843. What Hahnemann suggests in aphorism 246
is a middle path between the single dose wait and watch method and the
automatic repetition of a remedy. This important idea takes a little more
explanation:
Aphorism 246 of the 6th Organon on Case Management
Aphorism 246 of the 6th edition is based on a synthesis of the ideas
introduced in aphorisms 245 and 246 of the 5th edition with the addition of
five new conditions to speeding the cure. The first topic taken up is when
a single dose of the LM potency produces a strikingly progressive
improvement in the patient’s symptoms.
"During treatment, every noticeably progressing and conspicuously
increasing improvement is a state which, as long as it persists, generally
excludes any repetition of the medicine being used because all the good
being produced by the medicine is still hastening towards completion. This
is not seldom the case in acute diseases"
Organon of the Medical Art, Hahnemann, O’Reilly 6th Edition, Aphorism 246.
When a single dose of the LM potency produces an obvious
progressively increasing amelioration the remedy should NOT be repeated.
This is because the simillimum is already hastening toward cure at the
fastest rate possible. Such a response is usually noticed within the period
of 4, 7 to 14 days. A strikingly increasing amelioration is one in which
the patient feels better day by day as the symptoms are rapidly reduced and
the vitality increases. The repetition of the LM potency under this
condition will cause aggravations or a relapse of the symptoms or just slow
down the cure.
Dr. Croserio wrote that Hahnemann either reduced the doses or stopped
the remedy whenever there was a strong medical action. Anytime during
treatment there is suddenly a progressive improvement the repetition remedy
should be stopped and the reaction observed. My research of Hahnemann's
Paris casebooks shows that Hahnemann often gave placebo and waited and
watched. He did this when there was an aggravation, confusion about the
nature of the symptoms, or a sudden improvement.
Hahnemann never gave the daily dose for weeks, months and years on end
without interspersing placebo and periods of observation. These last points
are noted in the Paris casebooks and eyewitness accounts but do not come
across that well in the 6th Organon. Hahnemann gave a great amount of
placebo. Most of what some observers thought were second remedies was in
truth only sugar in medicinal solution. When he gave doses by olfaction
they were usually repeated no sooner than in 7 days or longer. Hahnemann's
most popular "alternation" was a remedy and placebo!
Single dose cures with the LM potency are somewhat common in acute
diseases but there are also chronic patients that only need a single dose
or infrequent repetitions. For the above reasons, I usually give my
patients a single test dose of the chosen remedy at the start of the
treatment and wait and watch. On very rare occasions, I may give a patient
a series of three test doses with the instructions to stop the remedy
immediately if there is any aggravation or striking amelioration. I only
use this triple-split dose on those patients that appear hyposensitive when
they cannot return for a quick follow up assessment. This triple test dose
is almost NEVER a daily or alternative day dose. I never give more than 3
doses before checking the patient. The patients are instructed to stop the
dose immediately if the is any aggravation or a strong improvement. Now
let's look careful at part two of aphorism 246.
"On the other hand, with somewhat chronic diseases, there are, to be
sure, some cases that have slow, continuous improvement based on one dose
of an aptly selected homeopathic medicine (taking 40, 50, 60, 100 days to
complete the cure, depending on the nature of the medicine) but this is
very seldom the case. Also, it must be a matter of great importance, to the
physician as well as to the patient, to foreshorten this period, if
possible, by half, three-quarters, indeed even more, in order that a far
more rapid cure might be attained. The most recent and frequently repeated
experiences have taught me that such rapid cures can be favorably carried
out under the following conditions:
1. Select with all circumspection, the aptly homeopathic medicine.
2. Use a highly potentized [fifty-millesimal] dose, dissolved in water.
3. Administer a properly small dose of this to the patient.
4. Give a dose of the solution at intervals that experience has shown to be
the most distinctly appropriate for the best possible acceleration of the
treatment.
5. Prior to each administration of a dose of the solution, alter the degree
of potency of the dose. It is very important that the degree of potency of
each dose deviate somewhat from the previous and subsequent ones. This is
so that the life principle, whose tunement is to be altered to that of the
similar medicinal disease, may never feel itself agitated to adverse
counter-actions and enraged, as happens when repeated, unmodified doses are
given, especially when such doses are rapidly repeated one after another."
Organon: of the Medical Art, Hahnemann, O’Reilly 6th Edition, Aphorism 246.
Many individuals read the above paragraph but fail to note that
Hahnemann makes a grand differentiation between two fundamental types of
remedy reactions. In the first part of aphorism 246 the Founder describes
the reaction as a ****noticeably progressing and conspicuously increasing
improvement”*** This strikingly progressive increasing amelioration is a
reaction that is enhanced day by day. Under such conditions the repetition
of the LM potency is normally “excluded” because the first single dose is
already moving the patient toward cure at the fastest possible rate. In the
second section of aphorism 246 the Founder states there are cases where a
single dose only causes a ****slow, continuous improvement*** that may take
50, 60, or 100 days to show any significant amelioration. There is a vast
difference between a rapid improvement where the patient feels much better
every day and a slow improvement where the patient barely notices any
changes for months! It is only for these slower moving cases that aphorism
246 suggests the repetition of the LM potency at suitable intervals to
speed the cure.
Sometimes a single dose will slowly accomplish a complete cure over a
period of several months. Under these conditions the homœopath and sufferer
must demonstrate very great patience. Days, weeks and months pass where the
individual only experiences the slightest amelioration degree by degree.
According to the rules of the 4th Organon, and the dry dose, nothing can be
done to advance this situation. All one can do is wait and watch until
there is a complete cure or a definite relapse. Even these very gradually
progressing single dose cures are rather rare in chronic diseases. Sooner
or later most of these slow moving cases relapse calling for the repetition
of the remedy. It is in these time consuming cases that Hahnemann claims
his new method can speed the cure to one half, one quarter, or less the
time it takes with the single dry dose wait and watch method. This may be
accomplished by repeating the split-dose of the medicinal solution at the
proper times in the proper manner.
To speed the cure of long-drawn-out cases Hahnemann suggests five
specific conditions that must be met. The first condition Hahnemann places
on repeating the remedy to speed the cure is that the chosen remedy is a
true simillimum. How can one know this if one does not test the remedy with
a single dose or a short series of three test doses? What if the first dose
causes a strikingly progressive amelioration? What if the first dose causes
a strong aggravation? How do we know if we have the correct potency and
adjustments of the dose if we don't test them first? What if we are giving
the wrong remedy that has the potential to cause harm? None of this can be
told in advance. Therefore, it is very important to test the suitability of
the chosen remedy at the start of its administration. The other conditions
must also be met in full. This means the remedy must be given in a very
small dose of the medicinal solution succuss prior to administration. He
also says that the remedy should be repeated by intervals that "experience
has shown" to be the most suitable. So one must use their experience to
judge how long to wait and when to repeat a remedy.
When there is a marked, progressive amelioration of the patient’s
symptoms on the single test dose, I do not repeat the remedy. I very
carefully observe the number of days that this increasing amelioration
lasts. This offers the homœopath insights into the duration of the remedy
and reveals what a suitable interval might be for the patient. If the
striking response lasts forever one does not need to repeat the remedy. If
the markedly progressive improvement lasts for 1, 2, 3, 4, 5, or 6 days,
the remedy is only given every 1, 2, 3, 4, 5, or 6 days respectively. If
the increasing amelioration lasts 1, 2, or 3 weeks, the remedy may be
repeated every 1, 2, or 3 weeks. If the increasing amelioration lasts 1, 2,
or 3 months, the remedy may be repeated every 1, 2, or 3 months. If it
lasts 1, 2, or 3 years, give the remedy every 1, 2, or 3 years, etc.
Anytime there is an improvement in the symptoms the intervals between doses
should be lengthened. There are a few very hypersensitive patients that do
better when the remedy energy is allowed to slow down a bit before
repetition, but even in these rare cases, one does not have to wait for a
full relapse of symptoms.
When Necessary!
All of the statements about repeating the dose to speed the cure
relate only to protracted cases that demonstrate a slow amelioration. This
circumstance conditions all the following statements Hahnemann made about
the use of daily and alternate day doses in aphorism 248. If the patient is
doing very well on a single dose, or infrequent repetition, suggestions
about rapid repetitions do not apply. There are homœopaths who mechanically
administer the LM potency daily for days, weeks and months on end to every
patient. Sooner or later this method leads to over medication, aggravations
and relapses. They have not yet understood the fine print in the footnote
to aphorism 246. In this footnote the Founder explains why he made changes
in the 6th Organon and when the daily dose is applicable.
"What I said in a long footnote to this paragraph in the fifth
edition of The Organon of the Medical Art was all that my experience
allowed me to say at the time. It was written with the purpose of
preventing these adverse reactions of the life principle. However, during
the last four to five years, all such difficulties have been fully lifted
through the modifications I have made since then, resulting in my new,
perfected procedure [for fiftly-millesimal potency medicines]. The same
well-chosen medicine can now be given daily, even for months when
necessary. In the treatment of chronic diseases, after the lowest degree of
potency has been used up (in one or two weeks) one proceeds in the same way
to higher degrees of potency (for in the new [fifty-millesimal] manner of
dynamization, use begins with the lowest degrees, as is taught in the
following paragraphs)."
Organon: of the Medical Art, Hahnemann, O’Reilly 6th Edition, footnote,
Aphorism 246.
In the footnote to aphorism 246 Hahnemann suggests that a well chosen
remedy (not a poorly chosen one) may be given daily WHEN NECESSARY. Theh
late great Dr. M. Choudhury (who used the LM for 30 years), said that in
the beginning he tried to give the LM potencies daily or every other day
mechanically but found this aggravated far too many patients. Then he read
the fine print in the above footnote and saw the words, “when necessary”.
When the repetition of the remedy is not necessary the LM potency will
cause strong aggravations, unproductive accessory symptoms, and only slow
down the cure. Unneeded repetition can make a patient too hypersensitive or
make their vital force non reactive due to over exposure. Hahnemann’s new
posology method spans the single unit dose in striking responses and the
repetition of remedies at suitable intervals to speed the cure when
necessary. In this way, the posology strategy can be tailored to a great
variety of patients and conditions.
I hope this sort review makes the essential difference between the 4th
Organon method of the 1820s, and the methods Hahnemann introduced in the
1830s for the Cs, and 1840s for the LM potency. In his last 5 years (1838
to 1843) Hahnemann used the low and high potency Cs and LM potency side by
side in the medicinal solution and in the split-dose if and when necessary.
The way to compensate for the aggravations caused by the LM potency done
wrongly is not to prescribe them like the single dry dose wait and watch
method of the 4th Organon. The way forward is to correct these errors by
using the LM potency in the right manner! If the Cs and LMs are used
correctly in the medicinal solution in accordance with aphorism 246 and its
conditions - there will be no serious aggravations. I have not had a
serious aggravation with the LM potency in many, many years. What
aggravations do appear have been relatively mild and easy to manage.
Hahnemann's final method may truly be called a middle path that avoids
all extremes. It utilizes the single dose wait and watch method where
appropriate but will also repeat the remedy to speed the cure if and when
necessary. To utilize this advanced method the differential assessment of
remedy reactions of aphorism 246 must be understood and its five conditions
must be met in full. This method individualizes the case management to suit
the circumstances.
Similia Minimus
Sincerely yours,
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
There are those who suggest using the LM potency of the 6th Organon in
the exact same manner as the dry dose C wait and watch of the 4th Organon.
They suggest this to avoid some of the strong aggravations that have been
caused by the LM potency in some cases. The LMs are very powerful remedies
that must be treated with great respect. Some are giving the LMs in a
mechanical fashion daily or on alternate days to every patient. This has
led to many unneeded strong aggravations. This has given the LM potency a
bad reputation in some circles. This mechanistic method comes from not
understanding what is written in the Organon.
Nevertheless, to suggest that the LM potency should be used in the
exact same fashion as the dry dose of the C potency is also missing the
point. Using the LM potency by the methods of the 4th Organon and the 1820s
does not utilized the all advantages of the new methods Hahnemann
introduced between 1838 and 1843. What Hahnemann suggests in aphorism 246
is a middle path between the single dose wait and watch method and the
automatic repetition of a remedy. This important idea takes a little more
explanation:
Aphorism 246 of the 6th Organon on Case Management
Aphorism 246 of the 6th edition is based on a synthesis of the ideas
introduced in aphorisms 245 and 246 of the 5th edition with the addition of
five new conditions to speeding the cure. The first topic taken up is when
a single dose of the LM potency produces a strikingly progressive
improvement in the patient’s symptoms.
"During treatment, every noticeably progressing and conspicuously
increasing improvement is a state which, as long as it persists, generally
excludes any repetition of the medicine being used because all the good
being produced by the medicine is still hastening towards completion. This
is not seldom the case in acute diseases"
Organon of the Medical Art, Hahnemann, O’Reilly 6th Edition, Aphorism 246.
When a single dose of the LM potency produces an obvious
progressively increasing amelioration the remedy should NOT be repeated.
This is because the simillimum is already hastening toward cure at the
fastest rate possible. Such a response is usually noticed within the period
of 4, 7 to 14 days. A strikingly increasing amelioration is one in which
the patient feels better day by day as the symptoms are rapidly reduced and
the vitality increases. The repetition of the LM potency under this
condition will cause aggravations or a relapse of the symptoms or just slow
down the cure.
Dr. Croserio wrote that Hahnemann either reduced the doses or stopped
the remedy whenever there was a strong medical action. Anytime during
treatment there is suddenly a progressive improvement the repetition remedy
should be stopped and the reaction observed. My research of Hahnemann's
Paris casebooks shows that Hahnemann often gave placebo and waited and
watched. He did this when there was an aggravation, confusion about the
nature of the symptoms, or a sudden improvement.
Hahnemann never gave the daily dose for weeks, months and years on end
without interspersing placebo and periods of observation. These last points
are noted in the Paris casebooks and eyewitness accounts but do not come
across that well in the 6th Organon. Hahnemann gave a great amount of
placebo. Most of what some observers thought were second remedies was in
truth only sugar in medicinal solution. When he gave doses by olfaction
they were usually repeated no sooner than in 7 days or longer. Hahnemann's
most popular "alternation" was a remedy and placebo!
Single dose cures with the LM potency are somewhat common in acute
diseases but there are also chronic patients that only need a single dose
or infrequent repetitions. For the above reasons, I usually give my
patients a single test dose of the chosen remedy at the start of the
treatment and wait and watch. On very rare occasions, I may give a patient
a series of three test doses with the instructions to stop the remedy
immediately if there is any aggravation or striking amelioration. I only
use this triple-split dose on those patients that appear hyposensitive when
they cannot return for a quick follow up assessment. This triple test dose
is almost NEVER a daily or alternative day dose. I never give more than 3
doses before checking the patient. The patients are instructed to stop the
dose immediately if the is any aggravation or a strong improvement. Now
let's look careful at part two of aphorism 246.
"On the other hand, with somewhat chronic diseases, there are, to be
sure, some cases that have slow, continuous improvement based on one dose
of an aptly selected homeopathic medicine (taking 40, 50, 60, 100 days to
complete the cure, depending on the nature of the medicine) but this is
very seldom the case. Also, it must be a matter of great importance, to the
physician as well as to the patient, to foreshorten this period, if
possible, by half, three-quarters, indeed even more, in order that a far
more rapid cure might be attained. The most recent and frequently repeated
experiences have taught me that such rapid cures can be favorably carried
out under the following conditions:
1. Select with all circumspection, the aptly homeopathic medicine.
2. Use a highly potentized [fifty-millesimal] dose, dissolved in water.
3. Administer a properly small dose of this to the patient.
4. Give a dose of the solution at intervals that experience has shown to be
the most distinctly appropriate for the best possible acceleration of the
treatment.
5. Prior to each administration of a dose of the solution, alter the degree
of potency of the dose. It is very important that the degree of potency of
each dose deviate somewhat from the previous and subsequent ones. This is
so that the life principle, whose tunement is to be altered to that of the
similar medicinal disease, may never feel itself agitated to adverse
counter-actions and enraged, as happens when repeated, unmodified doses are
given, especially when such doses are rapidly repeated one after another."
Organon: of the Medical Art, Hahnemann, O’Reilly 6th Edition, Aphorism 246.
Many individuals read the above paragraph but fail to note that
Hahnemann makes a grand differentiation between two fundamental types of
remedy reactions. In the first part of aphorism 246 the Founder describes
the reaction as a ****noticeably progressing and conspicuously increasing
improvement”*** This strikingly progressive increasing amelioration is a
reaction that is enhanced day by day. Under such conditions the repetition
of the LM potency is normally “excluded” because the first single dose is
already moving the patient toward cure at the fastest possible rate. In the
second section of aphorism 246 the Founder states there are cases where a
single dose only causes a ****slow, continuous improvement*** that may take
50, 60, or 100 days to show any significant amelioration. There is a vast
difference between a rapid improvement where the patient feels much better
every day and a slow improvement where the patient barely notices any
changes for months! It is only for these slower moving cases that aphorism
246 suggests the repetition of the LM potency at suitable intervals to
speed the cure.
Sometimes a single dose will slowly accomplish a complete cure over a
period of several months. Under these conditions the homœopath and sufferer
must demonstrate very great patience. Days, weeks and months pass where the
individual only experiences the slightest amelioration degree by degree.
According to the rules of the 4th Organon, and the dry dose, nothing can be
done to advance this situation. All one can do is wait and watch until
there is a complete cure or a definite relapse. Even these very gradually
progressing single dose cures are rather rare in chronic diseases. Sooner
or later most of these slow moving cases relapse calling for the repetition
of the remedy. It is in these time consuming cases that Hahnemann claims
his new method can speed the cure to one half, one quarter, or less the
time it takes with the single dry dose wait and watch method. This may be
accomplished by repeating the split-dose of the medicinal solution at the
proper times in the proper manner.
To speed the cure of long-drawn-out cases Hahnemann suggests five
specific conditions that must be met. The first condition Hahnemann places
on repeating the remedy to speed the cure is that the chosen remedy is a
true simillimum. How can one know this if one does not test the remedy with
a single dose or a short series of three test doses? What if the first dose
causes a strikingly progressive amelioration? What if the first dose causes
a strong aggravation? How do we know if we have the correct potency and
adjustments of the dose if we don't test them first? What if we are giving
the wrong remedy that has the potential to cause harm? None of this can be
told in advance. Therefore, it is very important to test the suitability of
the chosen remedy at the start of its administration. The other conditions
must also be met in full. This means the remedy must be given in a very
small dose of the medicinal solution succuss prior to administration. He
also says that the remedy should be repeated by intervals that "experience
has shown" to be the most suitable. So one must use their experience to
judge how long to wait and when to repeat a remedy.
When there is a marked, progressive amelioration of the patient’s
symptoms on the single test dose, I do not repeat the remedy. I very
carefully observe the number of days that this increasing amelioration
lasts. This offers the homœopath insights into the duration of the remedy
and reveals what a suitable interval might be for the patient. If the
striking response lasts forever one does not need to repeat the remedy. If
the markedly progressive improvement lasts for 1, 2, 3, 4, 5, or 6 days,
the remedy is only given every 1, 2, 3, 4, 5, or 6 days respectively. If
the increasing amelioration lasts 1, 2, or 3 weeks, the remedy may be
repeated every 1, 2, or 3 weeks. If the increasing amelioration lasts 1, 2,
or 3 months, the remedy may be repeated every 1, 2, or 3 months. If it
lasts 1, 2, or 3 years, give the remedy every 1, 2, or 3 years, etc.
Anytime there is an improvement in the symptoms the intervals between doses
should be lengthened. There are a few very hypersensitive patients that do
better when the remedy energy is allowed to slow down a bit before
repetition, but even in these rare cases, one does not have to wait for a
full relapse of symptoms.
When Necessary!
All of the statements about repeating the dose to speed the cure
relate only to protracted cases that demonstrate a slow amelioration. This
circumstance conditions all the following statements Hahnemann made about
the use of daily and alternate day doses in aphorism 248. If the patient is
doing very well on a single dose, or infrequent repetition, suggestions
about rapid repetitions do not apply. There are homœopaths who mechanically
administer the LM potency daily for days, weeks and months on end to every
patient. Sooner or later this method leads to over medication, aggravations
and relapses. They have not yet understood the fine print in the footnote
to aphorism 246. In this footnote the Founder explains why he made changes
in the 6th Organon and when the daily dose is applicable.
"What I said in a long footnote to this paragraph in the fifth
edition of The Organon of the Medical Art was all that my experience
allowed me to say at the time. It was written with the purpose of
preventing these adverse reactions of the life principle. However, during
the last four to five years, all such difficulties have been fully lifted
through the modifications I have made since then, resulting in my new,
perfected procedure [for fiftly-millesimal potency medicines]. The same
well-chosen medicine can now be given daily, even for months when
necessary. In the treatment of chronic diseases, after the lowest degree of
potency has been used up (in one or two weeks) one proceeds in the same way
to higher degrees of potency (for in the new [fifty-millesimal] manner of
dynamization, use begins with the lowest degrees, as is taught in the
following paragraphs)."
Organon: of the Medical Art, Hahnemann, O’Reilly 6th Edition, footnote,
Aphorism 246.
In the footnote to aphorism 246 Hahnemann suggests that a well chosen
remedy (not a poorly chosen one) may be given daily WHEN NECESSARY. Theh
late great Dr. M. Choudhury (who used the LM for 30 years), said that in
the beginning he tried to give the LM potencies daily or every other day
mechanically but found this aggravated far too many patients. Then he read
the fine print in the above footnote and saw the words, “when necessary”.
When the repetition of the remedy is not necessary the LM potency will
cause strong aggravations, unproductive accessory symptoms, and only slow
down the cure. Unneeded repetition can make a patient too hypersensitive or
make their vital force non reactive due to over exposure. Hahnemann’s new
posology method spans the single unit dose in striking responses and the
repetition of remedies at suitable intervals to speed the cure when
necessary. In this way, the posology strategy can be tailored to a great
variety of patients and conditions.
I hope this sort review makes the essential difference between the 4th
Organon method of the 1820s, and the methods Hahnemann introduced in the
1830s for the Cs, and 1840s for the LM potency. In his last 5 years (1838
to 1843) Hahnemann used the low and high potency Cs and LM potency side by
side in the medicinal solution and in the split-dose if and when necessary.
The way to compensate for the aggravations caused by the LM potency done
wrongly is not to prescribe them like the single dry dose wait and watch
method of the 4th Organon. The way forward is to correct these errors by
using the LM potency in the right manner! If the Cs and LMs are used
correctly in the medicinal solution in accordance with aphorism 246 and its
conditions - there will be no serious aggravations. I have not had a
serious aggravation with the LM potency in many, many years. What
aggravations do appear have been relatively mild and easy to manage.
Hahnemann's final method may truly be called a middle path that avoids
all extremes. It utilizes the single dose wait and watch method where
appropriate but will also repeat the remedy to speed the cure if and when
necessary. To utilize this advanced method the differential assessment of
remedy reactions of aphorism 246 must be understood and its five conditions
must be met in full. This method individualizes the case management to suit
the circumstances.
Similia Minimus
Sincerely yours,
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