Minutus

Dear List,

I have not had formal instruction on the use of LM potencies. Often I use them for myself and my family. I like the fact that they only have to be taken at most once a day. My teacher,Tom Heard, a low potency prescriber, so I can't ask him. I usually review case problems with Tom. I would like to know if those of you who have experience with LM management think I am approaching the following case in a reasonable manner.

I have a friend/patient who has been taking progressively 4-2 dilutions of LM 1 ARS over 2 months. I spent about 3 hours taking his case and he was excellent because he is so conscious of his symptoms. I have done one full followup with him and check in with him regularily.

Since childhood suppressions of an ear infection, he has suffered from food allergies causing sinus and digestive symptoms. He has gone through most of his typical symptoms along with intense Arsenicum dreams that his loved ones are being attacked and will not be able to protect him. (He's actually a great leader and protector of others). He is a portrait artist and his work in the studio has become very intense. In general, his aggravations have been severe but short, which I take to be normal. He has experienced a steady flow of ameliorations. This week-end he reached into the childhood fear that he could not leave his house because his bowel movements would not stop. He stopped taking the remedy on his own because of fear that he would not be able to work. Today he is feeling much better but I don't know if he means better than he has felt in general or better than he felt during the last aggravation. I asked him to take a week off and then I will re-evaluate.

Reading David Little on LM aggravations, I understand that LM potencies will aggravate and when they do you should go on to the next potency if the problem is ameliorated by the remedy. He was decreasing the dilutions and he has yet not arrived at LM 1 without dilution. I imagine a decrease in the dilution to be similar to an increase from LM 1 to LM 2.

Am I misunderstanding anything here? I think that my choices are to either increase the dilution and slow down or to look for an herb similar to Ars that will be less intense. Then go back to the Ars later if there is a need. I will probably take the first choice if he is getting a lot of ameliorations despite the severity of his aggravations. That has been the rationale so far.

Blessings,
Ellen Madono
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Dear Ellen

I use LMs in my practice; but, before I can comment on this could you please
explain just exactly what you mean by "taking progressively 4-2 dilutions
over 2 months"?

thanks
Patricia Hatherly

Greetings Patricia,

What do I mean my 2 through 4 dilutions in 2.5 months? Sorry, very unclear wording. At first he diluted 4 times. Then several weeks later he diluted 3 times and so on until he was diluting 2 times after taking the remedy for 2.5 months.

David Little says to put the pellet in about 4 oz. of water. Prepare another 4 oz of water. Place 1 tablespoon of water in that cup. That is one dilution. 4 dilutions repeats that process 4 times. The dilutions avoid aggravations while getting ameliorations.

I hope I am getting this all correct because as I say, I have not been taught LM's formally.

Blessings,
Ellen Madono
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Hi Ellen,

Decreasing the number of dilutions makes the impact of the dose stronger on
the individual, it is NOT the same as moving up the scale of potency from
one to the next.
We should always seek to find the minimum dosage necessary to make a clear
impact, but this does not mean lowering the number of dulution cups back to
one or no dilution cups.
In one Asperger's case, for example, there are 8 dilutions necessary to
avoid unnecessary aggravations with each dose. This rate of dilution has
remained the same from LM 01 to LM03 of the same remedy. Needless to say,
this patient is in the high sensitivity ratio.
There are two important points to consider with LM administration:
It is NOT necessary to dose every day with LM's if the patient is showing
signs of improvement. If a reaction is produced by the dose, wait and see
the effect - whether it is positive or negative, and how long the overall
effect lasts. It could be one day, it could be several days, it could be a
month. Take note of this time frame before repeating another dose. Why
overstimulate the Vital Force if it is not necessary, or in fact,
counter-productive? Please note, Hahnemann said the LM potency could be
repeated daily IF NECESSARY, and this always depends on the nature of the
disease and the patient who suffers the disease.
Another method of reducing the aggravation in sensitive individuals is to
place the LM remedy in a 8 oz bottle.

Chris.

Hi, Ellen.

Just out of curiosity, was there some reason you expected this patient to be unusually sensitive to potential aggravations? In my experience, most patients do fine without multiple dilutions of LM potencies, although occasionally someone is very sensitive and needs the potency to be tempered in some way.

Very sensitive patients often do well with olfaction, starting with a quick breath with the solution held at arm's length, and then, with repeated doses, moving it closer and breathing more deeply until they've found their comfort level.

In any case, you can almost always move up from LM1 to 2 to 3, etc... every month to six weeks, and get more definite results from these changes.

Someone with a strong vital force and no deep pathology may do well starting with LM2 rather than 1, and going LM2, 4, 6... Rajan Sankaran correlates the starting potency with the level at which the symptoms are most strongly felt -- physical, mental, emotional, sensation, spiritual, etc... I've never started as high as he suggests starting for patients whose main focus is at the deeper levels, but then most patients really do start out at the physical and/or mental level rather than at a level of higher concern for universal energy or moral dilemmas.

The art is in finding the balance point for each individual, accommodating what their vital force requires while also getting results as quickly as possible. Very sensitive patients are, in my experience, able to tell you that as soon as they grasp the remedy bottle, or even before, if they've used homeopathic treatment previously. I find it's a good idea to accommodate absolutely whatever people tell me in that regard.

Unless your patient is unusually sensitive, however, you may find in future that you don't need to be so tentative in introducing a remedy in LM potency, and can start with LM1 with the patient taking a few drops of the first solution of 1 pellet in 4 ounces of water. I have patients take 1-4 drops from a dropper at whatever interval is comfortable for them, telling them to experiment and be aware of what happens to their energy when they take the remedy. They start daily --as Hahnemann described in the 6th Organon--, and some continue daily, while others find every 2, 3, 4... days, or simply taking a drop or a sniff whenever they feel they need it, works best -- depending on their degree of sensitivity to remedies and to their internal state.

The school I attended, in California, simply told patients to take a daily dose, and used LM potencies almost exclusively. I've found patients are more variable in what works best for them, and that they can generally quickly tell what's best.

It will be interesting to read others' experiences in using LMs, and I'm sure that the methods will be as varied as the number of individuals who address the topic. One of the marvels of homeopathy, I think, is that it seems to work with a wide variety of potencies and doses, accommodating many sorts of both patients and practitioners.

Rosemary

At 9:28 PM -0700 4/28/04, Rosemary C Hyde PhD wrote:

[snip]
[snip]
I must beg to differ.
Para 246 says:
"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."

and later:

"Give a dose of the solution at intervals that experience has shown
to be the most distinctly appropriate for the best possible
acceleration of treatment."

The big advantage of the Q (misnamed LM) potencies is that the *can*
be repeated *if needed.*

I have seen and heard of too many people giving daily doses of Q
potencies when it is NOT needed.
Hahneman does NOT say "start daily." He says, as I read it, "give a
dose and then see IF if needs repetition" and the repetition is
determined by the experience of the practitioner AND the patient.
You give ONE dose of a Q potency and see what happens.
Each case is treated individually.
Repetition is NOT needed if an action is seen.

Too many people think that the routine administration of Q potencies
is the norm, and this should NOT be the case. NOTHING in homeopathy
is routine!

Give the dose (as you do with a centesimal potency) and see what happens.
THEN decide how to proceed.

JW

At 8:57 AM +0300 4/29/04, yerewan wrote:

Ah! A really good dumb question!

Long answer:

Your question comes about, in some way, because of the historical
mis-naming of the Fifty-Millesimal potencies as "LM."

In the preparation of remedies on the centesimal scale (as Hahnemann
began), each part is diluted to 1:100. So in each 100 drops there is
ONE drop of the previous dilution. Although Hahnemann did this up to
a 30c, there were, by the time of his death, others going up to a
200c and higher.
When potencies started to go above a dilution of 1:100 taken 1000
times, the people preparing them began to use Roman Numerals to
indicate the number of the dilutions done at the 1:100 ratio. Thus, a
1,000c potency becomes a 1M ("M" being 1,000). I have even seen many
of the older potencies labelled "2C" (where "C" is taken as "100")
i.e., a 200 centesimal.
Generally the potency nomenclature uses the arabic numeral for the
1st figure, and a Roman numeral for the second-- so we have 30, 200,
1M (1,000), 10M (10,000), 50M (50,000) and CM (100,000).
This was all done prior to people knowing that Hahnemann developed
another system which he called the "fifty millesimal".
These potencies are made in a totally different way.
First-- they are started as triturations-- not tinctures. The
substance is triturated 1:100 through three steps-- and the beginning
point of these new potencies is a 3c trit.
As I just outlined in another topic, it looks like this:
1. Dissolve 1 gr. of the trit powder in 500 drops of a mixture that
is 1 part alcohol and 4 parts distilled water.
2. Place a single drop of this mixture in a vial.
3. add 100 drops of alcohol to the vial."

But that's not the end....
You take 500 poppyseed sized granules, put them in a "thimble with
holes" and pour in the alcoholic solution from step 3. This saturates
the granules. Then, take the granules out and dry them off. Now THIS
is the key:
Each granule has absorbed a specific amount of liquid.
To make the next potency, you take 1 granule in 100 drops, and THIS
again will yield a dilution of 1:50,000. You use that to moisten 500
more granules, and you're off.

So a 50M remedy is a dilution ratio of 1:100 serially diluted and
succussed 50,000 times, and a Q (for quinquagintamillesimal) is in
the ratio of 1:50,000 ONCE.

Quinquagintamillesimal is the correct nomenclature for this dilution ratio.
"LM" is NOT. In fact, if we look at Roman numerals, L (50) before M
(1000) would be 950 and not 50,000.

Short answer: They are prepared differently.

Does that answer it?

JW

Good morning Julian, Chris and Rosemary,
My teacher, Tom Heard, does low potency prescribing. In general, I like the results, but I do get aggravations even when starting with 6c once a day. Tom likes to keep the pressure up when possible and has the patient continue taking the remedy regularly if possible. I says that if they quit stop the remedy because of the aggravation, they will also be afraid to begin the remedy again. They will not notice that they are getting a mild amelioration because their attention is absorbed by the aggravation. In your experience does taking the remedy when the amelioration wears down work with low potency prescribing as well? How do you handle this psychological problem that Tom describes and I have also observed many times.

The ars. patient that I described could take the remedy as required rather than regularly. He is a true blood ars so he has that sensitivity. I remember David Little's article pointing out that aggravations can be decreased by taking remedies as needed. I guess it did not stick in my mind because I have had so many experiences with patients who 1.) do not notice what their remedy is doing. After careful questioning, I find that they are getting a subtle amelioration or nothing is happening, but they notice nothing except strong aggravations and provings. So, to them, take a their remedy as required would be meaningless as a form of instruction. 2.) Taking the remedy everyday is easy to put into the routine of a busy life. I know if I was supposed to take a remedy every 3rd day, someone would have to call me to make me remember. If I were also unaware of changes in my state of being, instructions such as "take when needed" would be carried out as take when problems hit you over the head with a sledge hammer. I don't have a solution for this except, stick to low potency prescribing for these types and frequent telephone calls.

Chris, this idea of keeping the remedy at the same level as the original dilution is revolutionary to me (As I am in a low state of ignorance this says little). I am not understanding the logic: "More dilution is more potent (stronger)." Then why do fewer dilutions not aggravate? I thought too much potency over-stimulated the vital force and aggravations resulted. Or perhaps you are suggesting that I should decrease the dilutions and at a point I find that fewer dilutions will aggravate, I should stay at that dilution. After all, telling the patient to take x dilutions is arbitrary at my low level of experience. I have had another case that was tied up with aggravation amid ameliorations and I just gave up on the deep acting remedy and switched to an herb. But the ameliorations were better with the original Q remedy. So, you are saying that when the patient taking the Q remedy severely aggravates, just bump up the potency by one Q at the non-aggravating dilution. That is very helpful. Whew! Thank-you. Please tell me if I am incorrect.

Rosemary, Vermeulen did not give the rationale, but said in his taped lecture (Dana has it), "Interviewing a Substance" that some people do better with odd number Q potencies and others with even number Q potency. So don't give up when they do not react to 1Q.

David Little (website) described a case where the patient was a drug abuser and his spiritual life was very coarse. So, he opened the case with a 4Q. The logic being that the vital force would not be stimulated by a lower potency.

Julian, Thank-you so much for clearing up the LM vs Q mystery. I like Q so much better because I can easily imagine me picking up a 1M and using it as if it were a 1Q. I am going to re-label all Q bottles with a feeling of authority.

Rosemary and Chris, you say that I should not be so afraid of aggravations from Q's. My teacher had so many bad experience with them and he fills us full of his horror stories. I personally liked the Q's so I have been very adventurous. They are quick, and easy for me personally to manage. I know that they are supposed to be good for people on lots of meds. In our clinical class we use 6c with them and at this point I don't want to work on them without Tom's direct supervision. So, I reserve Q's for clean eaters and people who can clearly describe their symptoms to me and have an fairly good idea of what I am thinking about the management of the remedy. I wish someday to go beyond my teacher's limitations.
Thank-you all for your help. I feel much clearer.

Blessings,
Ellen Madono

Hi All,

Three more beginner questions about LM aggravations and aggravations in general. Please tell me if I am asking too many questions.

1.) A friend was treated by a homeopath using a Q remedy. When she aggravated, she was told to take 30 c for the acute aggravation. She was told that the Q potency would continue working and she was to continue taking it at the prescribed rate (everyday in this case). My friend said that after several weeks, the remedy did bring out the next layer and the the chief complaint was cured. Does anyone have experience with this way of handling acute aggravations during a chronic case treating with Q remedies?

2.) Also, my friend said that the aggravations should come about 10 days after the daily Q remedy. This last case came 2 days after begining. He was very sick with his chief complaint. He got worse then much better in two days. My teacher, Tom, said that low dose prescribers expect aggravations within a week. Is there a similar time frame of expectation for aggravations with Q remedies?

3.) What do you call the continued problems that occur after that timeframe when patients are having aggravations they have experienced before (not provings). If they are also getting ameliorations, it is not the wrong remedy. But what is it? I feel inadaquate explaining this to the patient because I sympathize with their discomfort. Only the ameliorations make the discomfort worthwhile. Sometimes, the ameliorations are small compared to the discomfort.

Blessings,
Ellen Madono
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Hi Rosemary,

Is Sankaran saying something like the c-scale advice "use higher potencies for more mental diseases and lower potencies for more physical diseases"? Where does he write about this? I think David Little is not saying that. He is responding to a low vital force (a vital force that has been lowered by drug and sex abuse) that will not pick up on the lower potency Q remedy. So, he choses a higher Q potency for that case.

What do you mean they are "able to tell" as soon as they grasp the bottle. "Tell" that they will aggravate? Or tell that the level of dilution is correct? My Ars patient can probably do both evaluations. I just have not tried him out. He had never used homeopathy successfully before. I knew that he would be sensitive because he is sensitive to all stimuli. Yoga and meditation have been great medicine for him. He recited his symptoms with such ease and detail that I had to ask very few questions during the interview (I ask way too many questions in general).

Maybe just as an experiment, I will try the olfaction with him. I know he would cooperate.

What is your experience with how to instruct different kinds of learners and different levels of self-control? Do you have patients who simply cannot self adjust the dosage? If you do, how do you treat them?

Blessings,
Ellen Madono