Minutus

Dear Colleagues,

There are many who say that Hahnemann gave his patients the LM
potency daily. There are even pharmacies that are suggesting that the LM
potency should be given daily in there informations packages. Too many
persons are telling their patients to take the LM potency daily for 1 month
before returning for a follow up. Is this the way Hahnemann prescribed the
LM potency? I have personally studied 100s of Hahnemann's cases in the
microfiches of the Paris casebooks and this is NOT the way the Founder
practiced! The idea that Hahnemann gave the LM potency daily for weeks,
months and years on end is a complete myth.

Hahnemann begins his discourse on using the LM potency in aphorism 246
and aphorism 248 of the 6th Organon. 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 conditions for speeding the cure.
The first topic taken up is when a single dose of the LM potency produces a
strikingly progressive and increasing 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; S. Hahnemann (O’Reilly 6th Edition),
Aphorism 246.

In first half of aphorism 246 Hahnemann speaks of a *noticeably
progressive and conspicuously increasing improvement".Does he say to repeat
the dose daily or on alternate days under these conditions? NO, he does
not! He says that such a state, as long as it exists, excludes any
repetition of the medicine. When a single dose, or a short series of doses,
causes a strikingly progress increasing improvement the remedy should NOT
be repeated. I have personally seen several single dose LM cures in acute
and chronic diseases. I have also seen many cases where the patient only
needed infrequent doses like every week, every fortnight, every month, or
even longer to progress rapidly to cure. Those who give the LM daily will
never see these fantastic cures because these are the very cases that are
easy spoiled by rapid repetitions. Instead of a miracle cure these are
often the cases that become extremely complex and confused by overmedication.

After speaking of strikingly increasing ameliorations in the first
part of aphorism 246 Hahnemann goes on to speak about those protracted
cases that do not improve on a single dose.

"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; S. 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 fundamentally different
remedy reactions*. In the first part of aphorism 246 the Founder describes
the remedy reaction as a “NOTICEABLY PROGRESSIVE AND CONSPICUOUSLY
INCREASING IMPROVEMENT" In the second section of aphorism 246 the Founder
speaks of cases where the 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 better and better every day and a slow improvement where
the patient barely notices any changes! It is ONLY for these slower moving
cases that aphorism 246 suggests repeating the remedy suitable intervals
speed the cure. This paragraph say say nothing about repeating the remedy
daily and ask homeopaths to use there "experience" to choose the proper
remedy schedule.

Hahnemann's statements about SLOW IMPROVEMENTS condition all the
following remarks he made about using daily and alternate day doses in
"protracted diseases" aphorism 248. If the patient is quickly getting
better on a single dose, or infrequent repetition, suggestions about rapid
repetitions do not apply. There are homœopaths who try to mechanically
administer the LM potency daily for days, weeks and months on end to every
patient. They have not yet understood the true essence of aphorism 246 nor
its footnote. Hahnemann is suggesting the individualization of the
treatment according to the time and circumstances.

In the footnote to aphorism 246 Hahnemann says that a well chosen
remedy (not a poorly chosen one) may be given daily WHEN NECESSARY. When
repetition of the remedy is not necessary the LM potency will cause strong
aggravations, accessory symptoms, relapses and only slow down the cure.
Over medication can make a patient overly hypersensitive to remedies or
make their vital force non reactive due to over exposure. The same
principles apply when using the C potency in a medicinal solution. From
1838 to 1843 Hahnemann gave his C and LM potency in medicinal solutions in
the same manner. .

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 slow moving cases. The homoeopath does not need to
speed the cure when it is already taking place in a rapid manner. Here one
only needs to wait and watch the cure unfold. Hahnemann stated that when
all five conditions are met the time of cure of *slowly improving cases*
can be reduced to 1/2, 1/3 or less the time it takes with the single dry
dose. To do this the homeopath must met the following five conditions.

1. The first condition for repeating the dose to speed the cure is the
selection of a good simillimum! How can one know if they have the correct
remedy if one doesn't test it with a single dose or short series of test
doses first? If we don't test the dose first how to we know if there will
be a strikingly increasing response to the single dose or short test
series? I normally give a single dose first and then wait and watch to see
what happens. If there is a strikingly increasing amelioration I do not
repeat the dose as longs as this rapid improvement lasts. If there is no
change or only slow improvement on a single dose I use my experience to
individualize a test series of doses at intervals that seem suitable for
the patient and their condition. Then I act accordingly.

2. Use a properly potentized remedy. Ms. O' Reilly has written the
[fifty-millesimal] in brackets but it is not in the German text. Hahnemann
used the exact same method with the C and LM potency from 1838 to 1843.

3. Administer the proper small sized dose. Here he means the amount of
the remedy, i.e. 1 or 2 small poppy seed size pills in a minimum of a 7
tablespoon medicinal solution with the addition of the dilution glass of 8
to 10 tablespoons. When the dose is too large it is very difficult to
repeat the dose without producing aggravations, accessory symptoms and
antagonistic secondary reactions of the vital force. When Hahnemann is
speaking of the proper small size dose he is NOT speaking of the
infinitesimal amount of medicine found in a potentized medicine. He already
spoke of the potency factor in condition 2. The idea that the size of the
dose makes no difference in the action of a remedy was the mistaken idea of
James Kent. I respect Kent for all his good work but he had this one wrong.

4. Repeat the *split-dose* of the medicinal solution at the proper
intervals to speed the cure of slow moving cases. These repetition must be
individualized according to one's experience. These repetitions could be
daily, alternate days, every third day, every fourth day, once a week, etc..

5. The medicinal solution should be sucussed just prior to
administration so that the vital force never receives the same exact
potency twice in succession. This also helps to prevent the antagonistic
counter actions of the vital force sometimes witness with the repetition of
the dry dose. The small dose and succussing the solution are very important
as they make the remedy more acceptable to the vital force.

Once all these five conditions are met it is possible to speed the cure
of protracted cases that only slowly improve on a single dose or a short
series of three doses. In this way, the Hahnemann advanced posology
strategy can be tailored to a great variety of patients and conditions.

Boenninghausen sought detailed information about how Hahnemann
administered his medicines in his last years from Dr. Croserio, a close
colleague of the Founder in Paris. In Hahnemann’s Doses of Medicine in The
Lesser Writings, Croserio said that Hahnemann would "diminish the dose or
stop the medicine" as soon as he observed medicinal action. He also noted
that Hahnemann often gave single dose of olfactions followed by at least
one week of placebos. Single dose olfactions are very common in the Paris
casebooks right up Hahnemann's death in 1843. In my review of the
microfiches of the Paris casebooks I found that the Founder often stopped
his medicines, gave placebos, and waited and watched for one or two weeks.
In some cases he even waited even longer before giving a remedy again.

THE PARIS CASEBOOKS SHOW THAT HAHNEMANN TENDED TO GIVE SINGLE DOSE
OLFACTIONS FOLLOWED BY PLACEBOS OR A SHORT SERIES OF DOSES OF THE ORAL
SOLUTION INTERSPERSED WITH OR FOLLOWED BY PLACEBOS. The most common
"alteration" and "second remedy" Hahnemann used was a placebo. In the
Chronic Diseases he wrote "I considered the sugar of milk thus used an
invaluable gift of God." The placebo was Hahnemann's "secret simillimum"
which he used to "please" the patient and control the case. Hahnemann saw
most of his patients at least every week or two and constantly alternated
between medicinal doses and placebos.

Hahnemann often gave a series of doses for one or two weeks and then he
gave a series of placebos and waited and watched for some time. I could not
find one case in the Paris casebooks where Hahnemann gave the LM potency
daily for weeks, months and years! Hahnemann used almost as much placebo
as medicine. This is a fact that is not explained in the 6th Organon. When
this omission is combined with a superficial reading of aphorism 246 and
248 the outcome is over medication on a grand scale.This is a grand
mistake. Hahnemann individualized all his treatments and adjusted his
remedy schedules to suit the time and circumstances. These are the
historical facts.

There is a tendency for individuals to fall into extremes in posology.
On the one hand there are those who always give the single dose and wait
and watch even if the patient is only slowly improving and those who are
repeating the remedy daily no matter what the reaction. Hahnemann's
advanced methods are a perfect balance between knowing how to wait and
watch during a strikingly increasing improvement and when to act and
observe by repeating the remedy at suitable intervals to speed the cure of
a slow moving case. This is the middle path that transcends the extremes of
the exclusive single dose and the mechanical repetition of remedies.
Individualization provides the best of both worlds. I would recommend that
those using the C and LM potency in medicinal solution experiment in the
proper manner and let the results speak for themselves.

Similia Minimus
Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

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David Little © 2000