Development of Approaches to the Repetition

of Dose in Hahnemann's Homoeopathy

By: VitalityLink Finder Wednesday, 25 January 2012 10:44
Modalities: Homeopathy
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Conditions: chronic disease or illness

The issue of repetition of dose is intimitely tied up with the related issues of dose and potency.
This essay is intended to be read alongside its sister-essay, The Development of Dose and
Potency in the History of Homoeopathy.

In the early years of homoeopathy, we find little written about the issue of repetition of dose.
Undoubtedly Hahnemann was experimenting widely, and he likely viewed the issue of repetition
similarly to the manner in which he viewed dose at this time (see the accompanying essay
re dose and potency) - as a variable to be determined individually for each of the various
medicinal substances he employed, guided by an evolving recognition of the general significance
of the minimum dose. It was not until 1825 (year 29*), with the recognition of the principle of
dynamization, that Hahnemann broke from materialistic perspectives re dose, and began to see
dose as an issue that transcended the physical properties of the particular medicinal substance in
question.

From this early period we have only a few glimpses at Hahnemann's practices re repetition.

In his booklet Cure and Prevention of Scarlet Fever (1801; year 6*) (discussing the use of poppy
in treating the active acute illness): "It is unnecessary to repeat these doses oftener than every
four or eight hours, in some cases not more than every twenty-four hours, and that sometimes
only a couple of times thoughout the whole fever, for which the more frequent or more rare
ocurrence of these symptoms must be our guide". In the treatment of the desquamation following
difficult cases, he dosed chamomilla daily.

In Treatment of the Typhus or Hospital Fever at Present Prevailing (Allgem. Anzeig. der
Deutschen, 1814; year 19) (discussing the use of Bryonia in the active acute illness): "and as
long as the improvement goes on, we give him no other medicine, nor even repeat the same one;
for none of the medicines here recommended can be used oftener than once (in the dose of a
drop) - seldom can they be given a second time with advantage."

The issue of repetition of dose began to receive understandably greater attention in the context of
treating chronic disease.

It was in 1829 that Hahnemann proposed the standardized use of the 30th centisimal potency,
and this was his prefered preparation when he wrote part 1 of Chronic Diseases in 1828 (year
32). His posology in treating chronic disease is detailed on pp. 119-129, & p. 137 (in the Jain
edition). The carefully chosen dose & potency (most usually a single 30C pellet, dry or
moistened) was allowed to act until the dose had exhausted its favorable action, with no other
prescription to be considered so long as the improvement continued. Repetition or change of
remedy was considered only when the old symptoms, which had been eradicated or very much
diminished by the previous dose, commenced to rise again for a few days; discernment of the
time to consider a second prescription required experience and careful observation.

Hahnemann suggested that the "third leading mistake" in treating chronic disease was in not
waiting until the dose had exhausted its action; that this might require 30, 40, even 50 or more
days, but could not be predicted ahead of clinical observation of the progress of the case. He
suggested that practicioners "scrupulous on the wrong occasion" mitigate their own and their
patients' impatience by giving milk sugar (sac lac) as a placebo during this period of observant
waiting.

The only exception to patient waiting for such extended periods, was when the initial dose
exhausted its action unexpectedly soon. He suggested it was then best to repeat, but if the same
remedy was indicated, to repeat it at an altered potency. This could involve moving either up or
down in the potency scale - e.g., from 30C to 24C, 18C to 24C, etc.

There is some heralding of his later use of split doses in medicinal solution, in his advice that to
allow the dose to act more strongly, it could be given in water, divided over 2-3 days (not
longer), stirred each time to modify the potency.

Hahnemann also introduced in this work the administration of remedies by olfaction, which he
elaborated on later in 1832-1833; and he later introduced administration by application to the
(healthy) external skin. As the issues of dose and repetition of dose are relatively independent of
the method of administration, I will not go into greater detail on these topics now, but will rather
cover them in a separate essay.

The 4th edition of the Organon, published the following year (1829), similarly 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".

Constantine Hering left Germany for Surinam in 1827, and was shipwrecked off Martha's
Vineyard on his attempt to return home in 1833. He settled in Philadelphia well-practiced in the
methods of the 4th edition of the Organon & the 1st edition of Chronic Diseases, and rooted the
development of homoeopathy in North America strongly this "wait & watch" methodology. Kent
later provided perhaps the most eloquent and detailed description of this approach in his Lecture
on the Second Prescription, read before the International Hahnemannian Association at Niagara
Falls in 1888.

Between 1829 and 1833 (years 33-37), Hahnemann's focus was very much on the treatment of
chronic disease, and overcoming the obstacles presented to its most rapid and gentle cure. He
experienced difficulties using the "wait & watch" approach, which he described in the note to
246 of the 5th edition of the Organon: "...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". This difficulty led him into exploring the dosing
alternatives described below, introduced to practice between 1833 and 1838 (years 37-42).

When Hahnemann published the 5th edition of the Organon in 1833 (year 37), he introduced an
option he felt preferable to this "wait & watch" approach, suggesting that a more rapid cure could
be had by repeating a dose at "suitable intervals which experience has proved to be best adapted"
, guided by the "nature of the medicinal substance, the corporeal constitution of the patient, and
the magnitude of the disease". He suggested repeating dry or moistened 30C globules (in
Hahnemann's notation, X, refering to the decillionth dilution) at an unaltered dose & potency.
Dosing frequency might range from every 7 to 14 days in a chronic illness of slow pace, to every
five minutes in an acute illness of rapid pace, guided by clinical experience and observation of
the progress of the case. This approach often required that an "intercurrent" remedy be given
after several doses; a precaution that was reversed with the later introduction of gradual
ascending potencies. He modified the preparation of his centisimal potencies when intended to
be used in this manner, reducing the number of succussions at each dilutional step from 10 to 2.

Four years later, in the Preface to part 3 of Chronic Diseases (1837, year 41), Hahnemann
described a major refinement of this repeated-dose approach, noting: "Experience has shown me,
as it has no doubt also shown to most of my followers, that it is most useful in diseases of any
magnitude (not excepting even the most acute, and still more so in the half-acute, in the tedious
and most tedious) to give to the patient the powerful homoeopathic pellet or pellets only in
solution, and this solution in divided doses." Repeated doses of the medicine were considered
"indispensible to secure the cure of a serious, chronic disease". He provides directions to dissolve
one or more pellets (centisimal pellets, usually 30C [X in Hahnemann's notation, for the
decillionth dilution]) in 7-20 tablespoons of water, and to give portions of this solution (1
tablespoon, or a small part of a tablespoon in more sensitive patients) in acute illness "every 6, 4
or 2 hours; when very urgent, even every hour or 1/2 hour", and in chronic diseases, "a dose
(e.g., a spoonful) every two days, more usually every day". Each subsequent dose was to be
modified "only a little in its degree of dynamizaton so the vital force will calmly receive the
same medicine", by shaking the solution 5-6 times. After the solution was used up in this
manner, if a subsequent bottle of the same remedy was required, he suggested either (1)preparing
the 2nd bottle with one or two pellets of the same medicine in a lower potency (e.g., 30C ->
24C); or, (2)if the same potency were desired, to make it up in the manner the first bottle, but
prior to the first dose, to give it as many shakes plus a few more as the previous bottle had
received during the entire time of its use.

He described an alternative "small bottle" method of making up the medicinal solution, using
200, 300 or 400 drops of water & brandy to half-fill a small vial, into which one or more pellets
were dissolved, and briskly shaken 5-6 times before each dose. According to the vitality &
sensitivity of the patient, 1, 2, 3 or several drops were removed to a cup containing a spoonful of
water, to be stirred, and the contents (or a portion of the contents) to be taken for a dose.

In 1838 (year 42), Hahnemann developed his new potencies, his "medicaments au globule" (the
LM or Q or 50-millesimal potencies), which were intended to optimize the medicinal solution
dosing approach described above. He shared his experience with these only with
Boenninghausen, and first wrote about them in the 6th edition of the Organon, the year prior to
his death (1842), but which was only made available to the homoeopathic community 80 years
later, in 1921. Directions for the preparation of LMs are provided in the 6th edition of the
Organon, in 270; and for their use in s245-248 and 280-282. Choudhury's book Fifty
Millesimal Potency - Theory and Practice is an excellent resource for this method; the best
writings I've seen on this approach are the series of articles titled Hahnemann's Advanced
Methods available on David Little's website. I'll outline the basics of this approach below, but
refer practitioners to the resources above (& particularly to David Little's writings) as guides to
actual application of this approach.

In the 6th edition of the Organon, Hahnemann states (246):

"Every perceptibly progressive and strikingly increasing amelioration in a transient (acute) or
persistent (chronic) disease, 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 new hastening towards its completion. Every new dose of any
medicine whatsoever, even of the one last administered, that has hitherto shown itself to be
salutary, would in this case disturb the work of amelioration".

However, in gradual amelioration, he suggests that one can ensure and hasten cure if one repeats
the dose in medicinal solution with modification of potency each time by succussion. He
provided much more explicit instructions for this approach than for the methods that led up to its
development. Most importantly, it is important that the degree of potency deviate somewhat
from the previous and subsequent ones, in order to avoid the development of accessory
symptoms (symptoms of the similar medicinal disease that are not part of, & therefore are not
homoeopathic to, the original natural disease of the patient). In order to hasten cure, one may
also gradually increase the size of the dose, but not so aggressively as to result in a homoeopathic
aggravation. Repetition of the dose in this manner was to be carried on until eradication of the
disease, or until the picture of the disease-gestalt changed to one demanding a different remedy
(248)

The actual potency selected to begin treatment, the size of the dose(s) given, and the frequency
of repetition of the dose were variables to be determined individually for each case. Hahnemann
does provide some general guidelines for consideration, outlined below.

He suggested 2 options for making up the medicinal solution ( 248, note). The first involves
using one or (rarely) more pellets in 40, 30, 20, 15 or 8 tblsp water (4 - 20 oz), adding alcohol or
a piece of charcoal to keep the solution from spoiling. This would be succussed about 8, 10 or 12
times before each dose, and a dose would consist of one or several teaspoons.

The second option uses one or (rarely) more pellets in 7-8 tblsp (~4oz) water, preserved with
alcohol or charcoal. After succussing as above, one tablespoon of this solution would be stirred
vigorously into a dilution glass containing 8-10 tblsp (4-5oz) water, and a portion of this would
be given for a dose. In sensitive patients, a tsp of this dilution would be stirred into a second
dilution glass, and this might be carried through a third or even a fourth dilution glass to create
an appropriately small dose.
Repetition was recommended (246 & 248) "at intervals that experience has shown to be the
most distinctly appropriate for the best possible acceleration of treatment"; in chronic diseases of
slow pace, this might be daily or every second day; in acute diseases, it might be every 6, 4, 3, or
2 hrs; in urgent cases, it could be hourly or even more frequently.

If a second or subsequent bottle of the same remedy is required, this should be made up with a
pellet of higher potency. Over the course of treatment, it is likely that the size of the dose would
need to be increased to ensure progress in the case, but this should be done only gradually to
avoid creating aggravation, and particularly to avoid the production of accessory symptoms by
the repeated doses.

Any "perceptibly progressive and strikingly increasing amelioration" would preclude continued
repetition (246), as would any aggravation (282). As the natural disease of the patient lessens
in intensity towards the end of treatment, symptoms of the medicinal disease resembling those of
the original natural disease of the patient might appear; this would occasion a reduction in the
size of the dose and/or the dosing frequency, or a brief suspension of dosing to assess the status
of the remnants of the natural disease prior to proceeding (248 &s280-281).

Although Hahnemann did share some of his early experiences with giving centisimal remedies in
split dose in medicinal solution in an 1835 letter to Hering; and although Hahnemann was
certainly familiar with the experiences of Hering (and others) in using high potencies according
to the 4th-edition "wait and watch" methodology (and in fact, as the note to 246 in the 5th
edition of the Organon reveals, had made his own observations on this method); these two
approaches to dosing continued to develop rather independently in the Hahnemannian and
Hering-Kentian lineages of 19th century homoeopathy. It is important to recognize that they each
have their own set of safeguards, principally from the risk of producing non-homoeopathic
aggravation or accessory symptoms of medicinal disease that could be obstructive of cure. These
are outlined in the careful methodologies of use, perhaps described best, respectively, (1)in the
6th edition of the Organon, s245-248 and 280-282, in Choudhury's book Fifty Millesimal
Potency - Theory and Practice, and in David Little's series of articles on Hahnemann's Advanced
Methods; and (2)in Kent's Lecture on the Second Prescription.

Perhaps it is a gift that difficulties in trans-Atlantic communication, and the delayed publication
of the 6th edtion of the Organon, permitted these posologies to each develop to their current
fruition. Today we can learn from both approaches, and select that which appears to be optimal
for each case that sits before us.

*As in previous essays, I've adopted a chronology dating from Hahnemann's publication
of Essay on a New Principal for Ascertaining the Curative Power of Drugs, establishing 1796 as
the "birth" of homoeopathy. This is done purely to simplify the picture of the developmental
chronology of our art. To those who might quibble and ask that the translation of Cullen's
Materia Medica be used as a landmark (1790), I might suggest that we call this the date of
conception, followed by a 6-year gestation.

1998, Will Taylor, MD

The Second Prescription
James Tyler Kent
paper read before the International Hahnemannian Association
at Niagara Falls, 1888

What is more beautiful to look upon than the bud during its hourly changes to the rose in its
bloom. This evolution has so often come to my mind when patiently awaiting the return of
symptoms after the first prescription has exhausted its curative power. The return symptom-
image unfolds the knowledge by which we know whether the first prescription was the specific
or the palliative, i.e., we may know whether the remedy was deep enough to cure all the
deranged vital wrong or simply a superficially acting remedy, capable of only a temporary effect.
The many things learned by the action of the first remedy determine the kind of demand made
upon the physician for the second prescription.

Many problems come up to be solved that must be solved, or failure may follow.

How long shall I watch and wait? Is a question frequently asked but seldom answered.

Is the remedy still acting? Is the vital reaction still affected by the impulse of the remedy?

If the symptoms are returning, how long shall they be watched before it is necessary to act or
give medicine?

Is the disease acute or chronic?

Why is the second prescription so much more difficult than the first?

Why is it that so many patients are benefited when first going to the physician and thereafter
derive no benefit?

I presume that most good prescribers will say: "We have often acted too soon, but never waited
too long." Many physicians fail because of not waiting, and yet the waiting must be governed by
knowledge. Knowledge must be had, but where can it be obtained? To know that this waiting is
right is quite different from waiting without a fixed purpose. This knowledge cannot be found
where its existence is denied; it is not found with unbelievers and agnostics.

When the first prescription has been made and the remedy has been similar enough to change the
existing image, we have but to wait for results. The manner of change taking place in the totality
of symptoms signifies everything, yet the manner of the return of the image, provided it has
disappeared, signifies more.

First. If aggravation of symptoms follow;

Second. If amelioration of symptoms follow;
1. Aggravation of exiting symptoms may come on with general improvement of the patient,
which means well; but --

If aggravation of the symptoms is attended with decline of the patient the cure is doubtful, and
the case must be handled with extreme care, as it is seldom that such patients recover perfectly.

2. If amelioration follow the prescription, to what does the amelioration apply?

It may apply to the general state or but to the few symptoms. If the patient does not feel the
elasticity of life returning, the improved symptoms are the facts upon which to doubt recovery.

The knowledge that the disease is incurable often is obtained only in this way. In such cases
every remedy may palliate his sufferings, but cure does not come. The symptoms that are the
expressions of the debility are there, and hence the totality of the symptoms is not removed.

After the curative impulse has entirely subsided, the symptoms will appear one by one, falling
into place to arrange an image of the disease before the intelligent physician for the purpose of
cure.

If the first prescription has been continuously given, there has been but little if any chance of a
pure returning image of the disease, therefore this image must be very unreliable.

When the remedy has been fully exhausted, then, and only then, can we trust the symptoms
constituting the picture.

If the first prescription was the similimum, the symptoms will return - and when they return -
asking for the same remedy.

Too often the remedy has been only similar enough to the superficial symptoms to change the
totality and the image comes back altered, therefore resembling another remedy, which must
always be regarded as a misfortune, by which the case is sometimes spoiled, and the hand of the
master may fail to correct the wrong done.

Whenever the symptoms return the same image, calling for the same remedy, then it is that we
have demonstrated, that - for a time, if the disease be chronic - we can but recommend the range
of dynamics to cure this case. This rule is almost free from exceptions if the remedy is an
antipsoric.

What must the physician do who has not the knowledge of dynamic medicines? He must
sometimes see sick images come back without change of symptoms, though I believe it is
seldom.

The symptoms may call for Phosphorus as strongly as when he began, and Phosphorus 6x has
served and no longer cures. What can he do but change his remedy?
Can it be possible that man can be so ignorant of how to cure as to give a drug that is not
indicated because the one that is indicated does not cure?

These ignorant mortals condemn the system of Homoeopathy and feel that they have performed
their duty to the sick, forgetting that ignorance was the culprit.

I have observed in cases where a low potency had been administered in frequently repeated
doses, that some time must elapse before a perfect action will follow the higher potency; but
where the dose had not been repeated after its action was first observed, the new and higher
potency will act promptly.

When the symptoms come back - after prudent waiting - unchanged, the selection was correct,
and if the same potency fail to act a higher one will generally do so quite promptly, as did the
lower one first. When the picture comes back unaltered except by the absence of some one or
more symptoms, the remedy should never be changed until a still higher potency has been fully
tested, as no harm can come to the case from giving a single dose of a medicine that has
exhausted its curative powers. It is even negligence not to do such a thing.

Proper Time to Change

When the demonstration is clear that the present remedy has done all it is capable of doing - and
this demonstration can not be made until much higher potencies than usually made have been
tried - then the time is present for the next prescription.

To change to the next remedy becomes a ponderous problem, and what shall it be?

The last appearing symptom shall be the guide to the next remedy. This is so whenever the image
has been permitted to settle by watching and waiting for the shaping of the returning symptom-
picture. Long have I waited after exhausting the power of a remedy, while observing a few of the
old symptoms returning; finally a new symptom appears. This latest symptom will appear in the
anamnesis as best related to some medicine having it as a characteristic which most likely have
all the rest of the symptoms.

It is not supposed that this later appearing symptom is an old symptom on its way to final
departure, for so long as old symptoms re-appear and disappear it is granted that no medicine is
to be thought of.

It is an error to think of a medicine when a symptom-image is changing. The physician must wait
for permanency or firmness in the relations of the image before making a prescription.

Some say, "I must give the patient medicine or he will go and see someone else." I have only to
say that it were better had all sick folks gone somewhere else, for these doctors seldom cure but
often complicate the sickness.
The acute expressions of a chronic disease have a different management from the acute disease,
e.g., a child suffers from bronchitis in every change of weather. It may grow worse if treated
with the remedy for the acute symptoms.

The miasm that predisposes the child to recurrent attacks must be considered.

One recently under my care had received Antimonium tart., Calcarea, Sulphur, Lycopodium,
etc., in such indiscriminate confusion that the child was not cured. The waiting on Sac.-lac.
through several attacks permitted the drug-effects to pass off, and the true image of the sickness
was permitted to express itself through several of the exacerbations taken as a whole.

When western ague is complicated with a miasm, a single paroxysm does not fully express the
totality, but several must be grouped and the true image will be discovered. If the acute disease
be complicated with a miasm the indicated remedy will wipe it out "cito, tuto et jucunde."

Avoid Haste

All things oppose haste in prescribing. In very grave diseases haste is a common error, more
frequently with the second prescription than the first. Many doctors suppose that a diphtheria
demands a medicine immediately because "something must be done." This is an error; many a
life has been saved by waiting and waiting.

For example:

A little girl was suffering from a severe attack of diphtheria and the mother had treated it four
days with Mercurius 3x, and Kali bich. 3x, in alternation. She was poor, and therefore I did not
refuse to take the case which was then in a very bad state: nose, mouth and larynx full of
exudate.

After a long study the child received Lycopodium cm., one dose, dry, which cleared out the
exudate from nose and fauces, but did not touch the larynx.

I dare not tell you how long I watched that child before I saw an indication for the second
remedy which it would have needed had the Lycopodium been given when the child first took
sick. I waited until the poor child was threatening dissolution when I saw a little tough yellow
mucus in the mouth. Kali bich., cm., one dose, cleared the larynx in one day and there was no
further medication necessary.

The first prescription is made with the entire image of the sickness formed. (People usually send
for the doctor after there can be no doubt of the sickness to be treated.)

The doctor watches the improvement of the patient and the corresponding disappearance of the
symptoms under the first prescription, and when the case comes to a standstill he is uneasy, and
with increasing fidgetiness he awaits the coming indication for the next dose of medicine.
The fidgetiness which comes from a lack of knowledge unfits the physician as an observer and
judge of symptoms; hence we see the doctor usually failing to cure his own children. He cannot
wait and reason clearly over the returning symptoms.

While watching the prescriptions of beginners, I have observed very often the proper results of
the first prescription. The patient has improved for a time, the ceased to respond to any remedy.

Close investigation generally reveals that this patient improved after the first dose of medicine,
that the symptoms changed slightly without new symptoms, and the new "photo" seemed to call
for some other remedy, when, of course, the remedy was changed and trouble began. Constant
changing of remedies followed until all the antipsorics in the Chronic Diseases had been given
on flitting symptom-images, and the patient is yet sick. This is the common experience of young
Hahnemannians trying to find the right way. Some of experience make lesser blunders and some
make few, but how many have made none? All of these blunders I have made, as I had no
teacher, until I blundered upon the works of the great Master.

Wait and Observe

The first prescription may not have been well chosen medicine, and then it becomes necessary to
make a second effort.

As time brings about the re-examination of the patient, new facts are brought out in relation to
the image of the sickness, indicating that the first medicine had not been suitable; perhaps several
weeks have passed and the re-examination finds no change in the symptoms.

Shall I compare all the facts in the case to reassure myself of the correctness of the first
prescription, or shall I wait longer?

Yes, to the former, of course, and if the remedy is still the most similar to all the symptoms, wait,
and watch, and study the patient for a new light on his feelings to which he has become so
accustomed he has not observed.

Commonly the new study of the case will reveal the reason why the first prescription has not
cured: it was not appropriate.

If it still appears to be the most similar remedy the question arises: "How long shall I wait?"

At this point it should be duly appreciated that the length of time is not so important as being on
the safe side, and "wait" is the only safe thing to do. It may have been many days, but that
matters not, wait longer.

The finest curative action I ever observed was begun sixty days after the administration of a
single dose.
The curative action may begin as late as a long-acting drug can produce symptoms on a healthy
body. This guide has never been thought of by our writers, but it is well to be considered. Why
not?

It is the practice for some to go lower if a high potency has failed.

This method has but few recorded successes but should not be ignored.

The question next to be considered is the giving of a dose of medicine in water and divided
doses. This has at times seemed to have favor over the single dry dose. This is open for
discussion, requiring the testimony of the many, not of few, to give weight. The best reports are
made from both methods, and both are in harmony with correct practice.

Improper Action

The next important step to be considered is when the first prescription has acted improperly, or
without curative results. Then it becomes necessary to consider a second prescription. The first
prescription sometimes changes the symptoms that are harmless and painless into symptoms that
are dangerous and painful.

If a rheumatism of the knee goes to the heart under a remedy prescribed for the one symptom,
the remedy has done harm. It is an unfortunate prescription and must be antidoted. In incurable
diseases when a remedy has set up destructive symptoms, an antidote must be considered.

If the remedy changes the general symptom-image, and the general state of the patient is growing
worse, the question then comes up, was the prescription only similar to a part of the image, or is
the disease incurable? Knowledge of disease may settle this question. If the disease is incurable,
the action of the remedy was not expected to do more than to change the sufferings into peaceful
symptoms, and the second prescription is to be considered only when new sufferings demand a
remedy.

But suppose such a change of suffering comes after the first prescription and the disease is
undoubtedly curable, then the conclusion must be that the first prescription was not the true
specific, and that the true image has not been seen.

Wait until the old image has fully returned is all there is to do.

It is hazardous practice to follow up rapidly all the changing symptoms in any sickness, with
remedies that simply for the moment seem similar to the symptoms present. The observing
physician will know by the symptoms and their directions, whether the patient is growing better
or worse, even though he appear to the contrary to himself and his friends.

The complaints of patient or friends constitute no ground for a second prescription.

The greatest sufferings may intervene in the change of symptoms during progress of permanent
recovery, and if such symptoms are disturbed by a new prescription or palliated by inappropriate
medicine, the patient may never be cured.

The object of the first prescription is to arrange the vital current or motion in a direction
favorable to equilibrium, and when this is attained it must not be disturbed by a new interference.
Ignorance in this sphere has cost millions of lives.

When will the medical world be willing to learn these principles so well that they can cure
speedily, gently and permanently?

There can be no fixed time for making the second prescription; it may be many months.

The second prescription must be one that has a friendly relation to the last one or the preceding.
No intelligent prescription can be made without knowing the last remedy. Concordances in
Boenninghausen must not be ignored. The new remedy should sustain a complementary to the
former.

Remedies Suitable to Follow

In managing a chronic sickness the remedy that conforms to an acute experience of the illness is
worth knowing, as very often its chronic may be just the one that conforms to its symptoms.

Calcarea is the natural chronic of Belladonna and Rhus;

Natrum mur. sustains the same relation to Apis and Ignatia;

Silicea to Pulsatilla;

Sulphur to Aconite;

When Pulsatilla has been of great service in a given case and finally cures no more, while the
symptoms now point to Silicea, the latter will be given with confidence as its complementary
relation has long been established.

On the other hand Causticum and Phosphorus do not like to work after each other, nor will Apis
do well after Rhus.

How physicians can make the second prescription without regard to the experience of nearly a
century, is more than man can know.

These things are not written to instruct men of experience in the right way, but for the young
men who have asked so often for the above notes of our present practice.

I am told almost daily that this kind of practice is splitting hairs, but I am convinced of the
necessity of obeying every injunction.
 Careful Records

You should have no confidence in the experience of men who do not write out faithfully all the
symptoms of the patient treated, and note carefully the remedy, and how given. Especially is this
necessary in patients likely to need a second prescription.

The physician who has in his case-book the notes of every illness of his patients has wonderful
hold of any community. He has the old symptoms and the remedies noted that cured, and he can
make indirect inquiry after all the old symptoms long ago removed.

The pleasure is not small found in consulting such a case-book.

Experience soon leads the close prescriber to note all the peculiar symptoms and to omit the
nondescript wanderings indulged in by sick people; however, it is important to be correct in
judgment.

Many physicians make a correct first prescription and the patient does well and cheers up for a
while, but finally the test is made for the second and then all is lost. Homoeopathy is nothing if
not true and, if true, the greatest accuracy of detail and method should be followed. It is fortunate
that the physicians who repeat while the remedy is acting are such poor prescribers or their
death-list would be enormous.

An Interview with Dr.Luc:

Getting started with Homeopathy and FAQ's

You were trained as a Western medical

doctor. What made you turn to homeopathy?
When I was a young doctor fresh out of medical
school in Belgium, I thought I knew everything.
But then I started seeing patients whom Western
medicine just couldnt help. One young girl of 15
got headaches every time the weather changed
and in Belgium the weather changes three times a
day! She had everything in Western medicine
you can dream of, but nothing helped. Another lady, I will never forget
it, she came in my office absolutely dripping with sweat. The sweat was
pouring off her and dripping onto the floor. Western medicine could do
nothing for her. Another lady could not speak. There was nothing
physically wrong with her. Her family said she had not spoken a word
since looking out the window and seeing a funeral processionwith her
best friends husband walking behind the hearse. The sudden shock of
her best friends death made her mute. I wanted to do something for
these patients, but my Western medical training gave me no answers. So
I went to a bookstore to look up alternative medicine and found a book
on homeopathy. I wish these patients would walk through my door
today, because these would all be easy cases for homeopathy.

What would you suggest for someone who wants to get started with
homeopathy
but feels bewildered by all the different remedies?
Get to know one or two remedies and all the different things they can be
used for. Arnica would be my first choiceits king of the trauma
remedies and king of the sports remedies. Arnica is good for the whole
family for bumps, bruises, pulled muscles, and overuse of muscles, like
someone who has a desk job and then gets 14 days vacation and wants to
be a hero playing sports with his kids. Its even good for elderly people
who get spontaneous bruises, because as we get older the capillaries
become fragile and burst easily. Some lesser known uses of Arnica
include overworry, overuse of the voice when someone is speaking all
day, and for the flu, especially when there is a bruised feeling. Arnica is
for bruises in general, and for illnesses with a bruised feeling, like when
you feel as though a tank just ran over you and everything is sore, you
dont want to be touched.

Arnica is also a great absorber of blood. For example, my patients have

had amazing experiences with their kids who bump their heads and get a
big egg on their forehead, which of course means there is a hematoma, a
leakage of blood. With Arnica the swelling goes right down and then
they dont have to take their kids to the emergency room.

Any other favorite remedies?

Arsenicum would be my second choice, especially for traveling. Never
leave home without it! Its the top remedy for travelers diarrhea and for
food poisoning. Some people get diarrhea just from the change of diet
when they travel. Arsenicum has rescued many, many a vacation,
especially in the Middle East, China and South America where the water
can be contaminated. Arsenicum is also great for the first stages of a cold
or flu, when you are just getting a scratchy throat and your nose is
running like a faucet with a clear, watery discharge. Arsenicum will nip
it in the bud. Arsenicum is one of the top remedies for asthma and for
shortness of breath in general, especially when you feel as though you
are going to die because you cant catch your breath. And its one of the
best remedies for people who wake up after midnight, anxious and
restless and unable to get back to sleep. But in both these cases people
shouldnt diagnose themselves. For example, in homeopathy we have so
many remedies for anxiety. The remedies are so precise, depending on
whether the patient has fear for the future, fear of death, of disease, of
failure, of flying, of taking exams, and so on. This is the kind of thing we
will teach in our school.
Whats the best way to take the remedies?
This is one of homeopathys best-kept secrets: take the remedies in
water. When you buy a little tube in the store with 80 pellets, the label
says to take 3 pellets 3 to 5 times a day under the tongue. (There is no
secret door under the tongue!) But it will work much better and much
faster for acute problems if you take one pellet and dissolve it in 4 to 8
ounces of water. Take one teaspoon as neededas often as every 20 to
30 minutes in acute cases such as high fevers and accidents. One cup
will is good for 24 hours. If you need the remedy again the next day,
make another cup. If after 2-3 doses you are not experiencing any
change, you can put a couple of pellets in 8 oz of water (put in a water
bottle with some room at the top), pound it several times and take one tsp
directly from the bottle. Putting it in water makes it reach more nerve
endings. As soon as it touches the mucous membranes it starts to work.
If someone cant swallow, you can even swab it on their skin.

What if you run out the same day, can you make another cup?
You could but you shouldnt need to, because as you start to feel better
you slow down and take a teaspoon only maybe every hour or two. If
you dont see any improvement by the time you finish the cup, it
probably means you have the wrong remedy. (It could also mean the
potency is too low, but this is something you will learn from experience.)
If one is not improving, it is a good to consult a homeopath.

So why dont they say this on the label?

Maybe because they can sell more tubes this way! Or maybe because
they just dont know. Hahnemann, the founder of homeopathy,
developed this method of taking the remedies in water at the very end of
his life, and the manuscript in which he described it was lost for nearly
100 years. Even now it is not well known. The people who work in the
pharmaceutical companies have probably never read it.

Are there any situations when its better to take the remedy dry?
Only if its impractical to take it in water. When I play tennis I keep
Arnica and Rhus tox. in my pockets in case I sprain my ankle. I can take
some pellets and keep on playing, then as soon as I have a chance I put
them in water. Heres another secret: if you are going to be out all day,
driving around in the car, put the remedy in a water bottle and take it
with you. Then each time you take the remedy you can succuss it (give it
a hard thwack, a slam-dunk). This gradually increases the potency of
the remedy and it will work even better this way.

How many pellets, say for a typical 16 oz. spring water bottle?
Just one, but you can put two pellets in to make sure, as very rarely,
some pellets are not "impregnated" with the solution. You dont need
four pellets, just because there is four times as much water. We are
dealing with energy, not with molecules. Its a little more dilute this way,
but succussing it will keep increasing the potency of the remedy.

Should you reduce the dosage for kids?

Not at all! In fact kids need higher potencies than adults. Never hesitate
to give a child a higher potency. Its the opposite of Western medicine,
where our dosages are based on bodyweight. In homeopathy, the dosage
is based on the vital energy of the patient, and kids usually have much
stronger vital energy than adults. Look at how fast a child can spike a
fever. That shows how strong the vital energy is.

Lets say someone looks up in a homeopathy book and figures out that
Lachesis is the best remedy for her left-sided headache, but when she
goes to the store to buy it, the tube says its for hot flashes. Why is that?
Each of the major remedies (the polycrests) has many, many different
indications or uses. The pharmaceutical company can only fit one or two
of them on the label. The good thing is that they have the freedom to do
that, unlike vitamin companies, because homeopathic remedies are under
a different law and the FDA allows this kind of labeling.

Do the remedies have side effects?

No, again because we are talking energy, not molecules. When you use
potencies over 24c there is not even one molecule of the original
substance left, and then when you put it in water it is even more dilute.
You can get what we call a similar aggravation, though, if you take too
much. An aggravation is a temporary intensification of the symptoms.
Its unlikely to happen in acute cases, because you are using up the
remedy so fast. You would have to really take a lot, to get this kind of
reaction. If you do get an aggravation, just stop taking the remedy and
your body will use up the excess. Its like speeding in a car. Its not a
bad car, just a bad driver! You need to get used to the car. As you get
experience using the remedies, you will get to know how fast you can
take repeated doses.

Some people say you have to go through an aggravation to be cured

with homeopathy. Would you agree with that?
Not at all! Hahnemann developed the water method to save people from
the discomfort of aggravations.

Can you be allergic to the remedies?

No, for the same reason. Sometimes my patients say they cant take
Sulphur as a remedy because they are allergic to sulfa drugs. An allergy
to sulfa drugs is actually a good indication that the patient needs
Sulphur!
What if someone is allergic to lactose, can they have a reaction to the
lactose the pills are made from?
Not usually, but if they are extremely sensitive they could have a
reaction if they take the pills dry. Its another good reason to take the
remedies in water.

Can you develop a tolerance to the remedies the way you can to a drug?
As long as you need the remedy, it will continue to work. If your baby is
learning to walk, all the time falling and smacking his head, you can give
Arnica every day and it will continue to work. If a remedy stops
working, it means you no longer need it.

Can the remedies be addictive? There is not one patient in a Betty Ford
center
addicted to homeopathic remedies!
Whereas there are many treatment centers and detox centers for people
addicted to Western drugs. Its scary how easy it is for people to and get
addicted. All it takes is one hospitalization, and they give you painkillers
sleeping pills without your knowledge or your permission. Before you
know it youre addicted. I have seen it many times in my practice.

What do the numbers mean6c, 30c, 200c?

They represent the successive dilutions the remedies go through. C
stands for centesimal and it means a dilution of 1 part of the remedy to
99 parts of alcohol at each stage. The remedy is succussed, or shaken,
100 times at each stage so that the energy of the remedy is imparted to
the liquid. The higher the number, the higher the dilutionwhich in
homeopathy means a more powerful remedy, because the vibrational
energy is higher.

Usually in health food stores you find 6c, 12c and 30c potencies.
Whats the difference in how they are used?
I would rather see 30c and 200c in stores for acute situations. I
encourage my students to get 200c kits once they are familiar with the
remedies. 30c is better when you are first starting out because if you take
the wrong remedy in a 200c, you could get an aggravation. 6c and 12c
are too low to do any good for acute situations. 6c and 12c are only
indicated for more chronic diseases, and people should definitely not
diagnose or treat themselves for chronic diseases. Only a professional
homeopath can do that.

Is that because 6c and 12c could be dangerous?

Not at all. Its because a layperson could not prescribe the right remedy
for a chronic situation, in which the choice of remedy depends on the
totality of symptoms of the physical, the mental and the emotional
symptoms, as well as the onset of the disease. For example, if I have four
patients with chronic fatigue, one may be never well since taking birth
control pills, another never well since overwork and over-worry, another
never well since multiple operations, and the fourth never well since
heartbreak. They may all have the exact same physical symptoms and
the same diagnosis in Western medicine, but they each get a different
remedy from me, because homeopathy is so individualized to the patient.

What do you mean by acute and chronic?

Acute is something that just happened within the last day or two, within
the last several weeks at most, that is self-limiting (it will go away by
itself). In an acute disease, the vital energy of the patient is usually
strong enough to overcome it. If not, it can turn into a chronic condition,
one that develops over a long period of time and does not go away by
itself. In a chronic condition there can be a steady overall downfall of the
patients health unless it is opposed by the right remedy. Other times
there can be acute symptoms of a chronic state of imbalance or disorder
in the system, such as PMS. A woman can have acute symptoms each
month which can be treated with acute over-the-counter remedies each
timebut if her overall constitution is treated by a professional
homeopath, her symptoms will not recur. I have seen this many times in
my practiceI do not even address the patients PMS symptoms directly
because they go away automatically with the well-chosen remedy.

A lot of times health food stores have combinations that have 6 or 8

different
remedies. Wouldnt that be better than a single remedy, since you would
be sure to cover your bases?
Actually, no, because the remedies can cancel each other out. I would
rather see people become familiar with the single remedies. For example,
Ive seen a combination for Grief that has one remedy, Pulsatilla, for
people who are very clingy and needy of consolation, and another, Nat-
mur., for people who just want to be left alone in their grief. How can
one person possibly need both?

Many homeopaths say you cant use mint, camphor or coffee when you
are taking remedies. Would you agree?
Coffee is the only one I put the accent on in my own practice. If
someone is drinking more than one cup a day, I get them off the coffee
first (with Chamomilla, Nux vomica or Coffea). Decaffeinated coffee
and other caffeine-containing foods like chocolate and cola are okay (not
in other ways but in terms of canceling the remedy!) Mint and camphor
are only important for the high potencies used by certain professional
homeopaths, the Kentian prescribers. They wont make much difference
in acute situations where you are repeating the doses frequently.

Some homeopaths tell their patients not to do acupuncture or polarity or

take vitamins while on a remedy. Why is that?
I tell my patients to do anything they can to support their vital energy
while they are healing. Any healing modality such as acupuncture that
follows the same natural laws as homeopathy will do nothing but help.
The only thing is, they shouldnt start doing these things the same week
they start the remedy. That will muddy the picture. Then if they have a
reaction, its not clear what they are reacting to.

Ive heard that remedies are prescribed based on the symptoms present.
So does that mean the remedies cant be used preventively?
No, in fact heres another little-known tip. They can be used ahead of
time if you know you are going to need them, but in this case make up
your 4 oz stock bottle: take 1 tsp from the stock bottle into a 4 oz cup,
stir and take 1 tsp. For example, Arnica should be taken before and after
strenuous sports for someone who is not in shape, or for weightlifters,
football players, soccer players and others who are likely to get pulled
muscles or bruises. And if one person in the family comes down with a
flu or cold, everyone else in the family can take the same remedy. If you
know there is a flu coming to your area, before it even hits you can start
the entire family taking Arsenicum, the best preventive flu remedy. Use
30c in a 4 oz stock bottle--take one tsp from the stock, into a 4 oz cup,
stir and take one tsp once Weekly.

Whats your basic approach in finding a remedy for your patients?

I have them make a timeline with all the major traumas in their life,
whether mental, emotional, physical, financial, or whatever. Any event
that causes lasting symptoms will need to be treated eventually. We call
it a layer. We start with the most recent layer first and work backwards,
every time treating the Never Well Since (usually a mental or emotional
trauma that triggered the onset of symptoms).

You are both a homeopath and an acupuncturist. What do you see

as the connection between these two healing modalities?
They both work with the healing energy or vital qi, and they both follow
the same natural laws of healing. For example, we know the patient is
healing if the disease goes from the inside to the outside. Also both
disciplines accent the mental and emotional origins of disease (unless
there is a direct physical trauma like a cut, blow or burn). In both, each
organ has certain emotions associated with it, like the liver and anger.
Each of the main homeopathic remedies has a place on the Star of the
Five Elements in Traditional Chinese Medicine. Homeopathy is so
similar to acupuncture that Hahnemann must have read the acupuncture
texts that were available to him in translation.

Does someone have to be a medical doctor to practice homeopathy?

In terms of licensing, it varies from state to state. In terms of knowledge,
many of the greatest homeopaths of the past have been lay-people!

Can you share one last secret with us?

Heres a great one for sports injuries: if youre a basically healthy person
and have a serious acute injury, like a pulled muscle, take in water: 1 tsp
from 4 oz cup (4 oz stock bottle) Arnica 30c, then 200c, then 1M, each, 4
hours apart. I did this once when I pulled my thigh muscle while playing
soccer. The muscle swelled up and turned hard as a rock. By the time I
was through the Arnica it was back to normal again! I learned this tip
from a Swiss-French homeopath and very few people in this country
know about it.

How do I find out more about Homeopathy?

I have a good book on acute prescribing called Peoples Repertory (link),
as well as more advanced books. Other places for beginning books to
start on your path to deeper understanding of Homeopathy and research
are Mimimum.com. WholeHealthNow.com, Educational Services.

The People's Repertory (a how-to guide to homeopathy) and Human

Condition Critical (an introduction to the laws and principles of
homeopathy in chronic diseases) are excellent books for furthering your
knowledge.

Hahnemann's Advanced Methods

You are: / Home / Education / Little Library /

David Little 1996-2007, all rights reserved.

Table of Contents
Part 1: Hahnemannian Homoeopathy
Part 2: The Medicinal Solution
Part 3: Managing the Case
Part 4: The LM Potency
Part 5: Speeding the Cure
Part 6: Preparing the Medicinal Solution
Part 7: Administering the Dose
Part 8: A Comparison of the Centesimal and LM Potency

Tools: Printable Version

Part 1: Hahnemannian Homoeopathy

Preface:

Hahnemann's Advanced Methods is an introduction to the

revolutionary works of Samuel Hahnemann's last 10 years (1833-
1843). This text supplies all the essential information for using the
techniques of the medicinal solutions for the C and LM potencies.
This treatise is directed at homoeopaths who wish to deepen their
study of Homoeopathy.

Hahnemann's Advanced Methods is a premier article on the

methods of the 4th, 5th and 6th Organon, the medicinal solutions,
and the C and LM potency. After reviewing the Principles of
Hahnemannian Homoeopathy it is time to study Hahnemann's
advanced posology methods. This work introduces the fundamental
philosophy of the new methods and provides a basis for clinical
trials. Such an undertaking, of course, can only be carried out by
those trained in Homoeopathy. A working knowledge of this article
is very important for putting the medicinal solutions and the
methods of speeding the cure into practice. Take your time, print
out and read this document well.

Homoeopathy

Homoeopathy is based on the teachings of Samuel Hahnemann as

presented in The Organon of the Healing Art. This masterpiece
expounds the four cardinal maxims of Homoeopathy: Likes Cure
Likes, the Single Remedy, the Minimal Dose and the Potentized
Remedy. These principles form a system of checks and balances
which makes the Doctrine of Similars a safe and effective modus
operandi. Even in the first comprehensive work on the new method,
The Medicine of Experience (1805), these four golden rules were
present. This is the essence of Homoeopathy.

The first edition of The Organon of the Healing Art appeared in

1810, and in order to update this material, Hahnemann published
subsequent editions in 1818, 1824, 1829 and 1833. The 6th and final
edition was completed shortly before Hahnemann's death in 1843,
but unfortunately, it remained unpublished until the German edition
of 1920 and the English version of 1921. These documents record
the evolution of Homoeopathy through 7 levels of development.
This is one of the reasons why so many conflicting statements are
attributed to Samuel Hahnemann. It is only through a careful study
of the historical development of Homoeopathy that these apparent
contradictions can be resolved.

The 4th Organon and the 1st Chronic Diseases

Homoeopathy as commonly practiced was established in the late

1820s. These were watershed years for Homoeopathy as they
represent the beginning of the most productive period of
Hahnemann's career. The Chronic Diseases, Their Peculiar Nature
and Their Homoeopathic Cure. was published in 1828. This work
contained new material on the pathogenesis of chronic diseases, the
materia medica and case management. The Chronic Diseases was
quickly followed by the publication of the 4th Organon (1829)
which further elucidated homoeopathic philosophy, case taking and
methodology.

In these foundation works Hahnemann introduced the theory of the

vital force, the doctrine of the chronic miasms, and the immaterial
30c potency. The Hofrath lectured on our spiritual nature and the
dynamics of the vital force, while at the same time, refuting the tolle
causum (one-sided causation) and materia peccans (materialistic
basis of disease) of the orthodox schools. In his new healing system
psychological and constitutional factors, the complete aetiological
constellation, and the signs and symptoms are used as a guide to the
choice of curative remedies.

The Single Unit Dose

Over the following fifteen years Homoeopathy went through a

tremendous transformation as Hahnemann sought to consummate
his system. During these years four new editions of The Chronic
Disease (1830, 1835, 1837 and 1839) and the 5th (1833) and 6th (c.
1842) editions of the Organon were written. During this period the
Master Homoeopath introduced several new innovations that
brought Homoeopathy closer to perfection. The 1st Chronic
Diseases and the 4th Organon are companion volumes in which
Hahnemann taught the administration of a single unit dose of one or
two poppy seed size pellets.

Vide the aphorism 242 of the 4th Organon.

"As long, therefore, as the progressive improvement continues from

the medicine administered, so long we can take for granted that the
duration of the action of the helpful medicine, in this case at least,
continues, and hence all repetition of any dose of medicine is
forbidden [DL]. "
The same point is also stressed in Aphorism 245.

"Even one dose of the same medicine which has up to now proved
beneficial, if repeated before the improvement has begun to stand
still in every direction, [DL] will, like an untimely interference,
only aggravate the state..."

Hahnemann again reminds us at the end of this paragraph:

"In one word, we disturb the amelioration affected, and still to be

expected from the first dose, if we give a second dose of the same
originally well chosen remedy before the expiry of the period of
action of the first; at all events, we thereby delay the recovery
[DL]. "

The Single Dose Wait and Watch Method

These aphorisms introduce the "wait and watch" philosophy which

is a manifestation of the principle of minimal intervention, another
important aspect of the maxim of the minimal dose. If the sufferer is
improving after the administration of the first dose of a remedy, all
repetitions of the dose are completely counter indicated. It is only
when there is a clear relapse of the symptoms that a second dose of
a remedy may be administered. This injunction was introduced to
prevent disruption of the healing process by the premature repetition
of the remedy.

Hahnemann noticed that premature repetition of a dose often caused

a relapse of symptoms as well as accessory symptoms (side-actions)
of the remedy to appear. This mixture of natural and remedial
symptoms confuses the picture and slows down the cure. This is
why classical homoeopaths are very conservative about the
repetition of the remedy before there is a definite relapse of the
symptoms. This demands great patience because even during a slow
amelioration the sufferer must wait for a relapse of symptoms
before they may take another dose. The 30c potency had shortened
the time of cure but the entire process was still taking too long.

Some of Hahnemann's more enthusiastic disciples took it on

themselves to begin experimenting with potencies well above the
level he introduced. The advocates of the new higher potencies
included Dr. Schreter, General Korsakoff of Russia, and Jenichen of
Wismar. The Father of Homoeopathy was concerned that their
unorthodox methods of remedy preparation would destroy the
pharmaceutical standards he introduced in 1828. For this reason he
wrote letters to Schreter and Korsakoff recommending that all
homoeopathic remedies be made by the methods introduced in the
Organon and called for a limit on potency at 30c.

Two of his closest disciples, Dr. Stapf and Gross, were supporters of
the new high potency movement and they quietly lobbied the Old
Doctor to perform his own experiments. The era of the 4th Organon
may be called "The Limit Maker" because Hahnemann sought to
control the rapidly expanding power of his homoeopathic system.
As he raised the potencies he simultaneously reduced the size of the
dose from 1 drop of the stock bottle to only 1 or 2 poppy seed sized
pellets. After reducing the size of the dose he also limited the
posology to the single unit dose and cautioned against any
premature repetition of the remedy. Finally, he suggested a limit on
the potency at 30c level made by his pharmaceutical methods. All of
these rules were safety measures Hahnemann introduced while he
sought to overcome the difficulties that still remained in his system.

The New Posology

Hahnemann was not completely satisfied with the posology

methods and case management he developed in the late 1820s. He
wanted to improve the single unit dose "wait and watch" method,
especially in resistant chronic diseases. The old master felt there
must be a more efficient way of administering his remedies so he
began a new set of posology experiments. As early as the First
Provers Union he used aqueous solutions to dilute remedies to
control their powers during provings. With this in mind he decided
to run trials on the action of the remedies in aqueous solution and
compare the results with the single unit dry dose.

Samuel Hahnemann published the 5th edition of the Organon in the

year 1833. This was followed by the publication of the 3rd, 4th and
5th editions of The Chronic Diseases in 1835, 1837 and 1839
respectively. In these twin manuscripts he developed the sixth level
of the homoeopathic system. In aphorisms 285, 286, 287 and 288 he
clearly states his view that the aqueous solution is far superior in
every way to the use of dry pellets. This is the final outcome of
many years of experimentation with both methods.

Vide aphorism 286.

"For the same reason the effect of a homoeopathic dose of medicine

increases the greater the quantity of fluid in which it is dissolved
when administered to the patient [DL] although the actual
amount of medicine it contains remains the same. For in this case,
when the medicine is taken, it comes in contact with a much larger
surface of sensitive nerves responsive to the medicinal action.
Although theorist may imagine there should be a weakening of the
action of the dose of medicine by its dilution with a large quantity
of liquid, experience asserts exactly the opposite, at all events when
the medicines are employed homoeopathically."

At the same time, Hahnemann offered one more critical detail in the
note to aphorism 287 which is essential to the new methods. This is
the importance of succussing the remedy solution immediately
before administration in the same manner as one succussed the
homoeopathic dynamization when preparing the stock potencies. In
the note to this aphorism Hahnemann points out that anywhere from
1, 2, 3, to 10 or more succussions will progressively increase the
potency of the aqueous remedy solution.

From this solution one or more teaspoons are given to the patient as
a dose whenever necessary. In this way the homoeopath makes a
more powerful solution that penetrates deeper than the dry dose, yet
at the same time, the remedy acts more gently on the vital force.
this is one of the major methods of adjusting the dose to suit the
sensitivity of the constitution.

Hahnemann pointed the way forward in aphorism 287 when he asks

homoeopaths to use their own experience to guide them in adjusting
the dose to suit the patient.

Vide Organon,

"...everyone will be able to judge for himself how to proceed with

regulation of the homoeopathic medicinal doses when desiring to
diminish their medicinal action as much as possible, in order to
make them suitable for the most sensitive patients."

The remedy solution must be succussed an appropriate number of

times just before ingestion to make it harmonic to the sensitivity of
the patient. The most sensitive constitutions may only need 1 or 2
succussions, whereas in the less sensitive types, 10 or more may be
necessary to get a response. The average number of succussions
suggested in Hahnemann's The Chronic Diseases is 5 or 6. In this
way the dose and potency may be tuned to suit the sensitivity of the
constitution. This method is called adjusting the dose and is one of
the greatest gifts of the 5th Organon.

Hahnemann Revises his Views

Hahnemann's experiments with the medicinal solution led to a

review of the 30c limit he set on potency in his letters of 1829 and
1832. He knew through his own experiments that the high potency
remedies were very powerful, but at the same time, he worried
about the aggravations they could cause. He was also concerned
about a loss of homoeopathic pharmaceutical standards making
uniform results difficult. Some of Hahnemann's closest disciples
were disappointed and spoke to him about their experiences with the
higher potencies. They discussed the pros and cons of the potency
question and its potential effects on the future of homoeopathic
practice and pharmacy.

After deep consideration Dr. Hahnemann decided to publicly

support the high potency movement, but with certain cautions
concerning their usage. In the 5th edition of The Organon
Hahnemann publicly supported the high potency movement. In the
footnote to aphorism 287 he recorded his own experiences of the
use of the 60th, 150th and 300th centesimal potencies. The fact that
the medicinal solution and the use of high potencies are introduced
together in the Organon shows that Hahnemann was working hard
to perfect the homoeopathic system. With the medicinal solution he
felt he now had the means to control the power of the ultra high
potencies.

The Middle Path

Another important feature of the 5th Organon is Hahnemann's

revision of his views on the repetition of the dose. In the 4th edition
he outlined the single unit dose and the philosophy of the "wait and
watch" method which was also in the first edition of The Chronic
Diseases. In the aphorisms 245, 246 and 247 of the 5th Organon
Hahnemann introduces what he calls the middle path concerning the
methods of repeating the remedies. Hahnemann begins his discourse
on posology by clarifying the proper view of the single unit dose
and when it is applicable in treatment. He begins his new review in
aphorism 245.

"Every perceptibly progressive and strikingly increasing

amelioration [DL] in a transient (acute) or persistent (chronic)
disease, is a condition which, as long as it lasts, completely
precludes every repetition of the administration of any medicine
whatsoever, because all the good of the medicine taken continues to
effect, is now hastening toward its completion. Every new dose of
any medicine whatsoever, even of the one last administered, that has
hitherto shown itself to be salutary would in this case disturb the
work of amelioration."
Notice the words strikingly increasing amelioration. Anytime
there is a dramatic reaction to the first dose of a homoeopathic
remedy there is no need for repetition as long as this dynamic affect
is progressing. If the dose is repeated under these circumstances it
will interfere with the dynamic reaction of the vital force and
disrupt the cure. Unfortunately, such marvelous cures are not that
common, especially in chronic complex diseases. Many chronic
patients only slowly improve over a period of months to years under
the influence of a constitutional remedy. What should we do to
speed the cure? Hahnemann sheds light on the situation in aphorism
246. Vide Organon.

"One the other hand, the slowly progressive amelioration [DL]

consequent on a very minute dose, whose selection has been
accurately homoeopathic, when it meets with no hindrance to the
duration of its action, sometimes accomplishes all the good the
remedy in question is capable of performing by its nature in a given
case, in a period of forty, fifty or a hundred days. This is however,
rarely the case, and besides, it must be a matter of great importance
to the physician as well as the patient that were it possible, this
period be diminished to one-half, one quarter, and even still less,
which many often repeated observations have shown under three
conditions.

Firstly, the correct homoeopathic remedy must be chosen by the

totality of the symptoms.

Secondly, the remedy is to be given in the minimal dose so as not to

overexcite the vital force. [The remedy is to be prepared with one,
rarely two pills in an aqueous solution. Vide aphorisms 285, 286,
287 and 288. DL]

Thirdly, the remedy may be repeated at suitable intervals to speed

the cure, if necessary, without producing aggravations."

Hahnemann was frustrated by cases which demonstrated only a

slow improvement, as by the rules of the 4th Organon, there was no
way to speed the cure. He was not happy with having to wait for the
relapse of symptoms before repeating the remedy in a slow moving
case. This was making the cure take too long. This led the good
doctor to perform countless experiments as he knew there must be a
better way.

The Master Homoeopath began a set of experiments with the aim of

overcoming the obstacles in the way of a rapid, gentle and
permanent cure. In the note to aphorism 246 Hahnemann calls his
method the "middle path" because it represents the balance point
between the exclusive single dose and the routine repetition of the
remedies. The new posology maxim states that anytime the first
dose produces a striking amelioration no more medicine is
needed for the time being. If, on the other hand, the first dose only
produces a slow amelioration the remedy may be repeated at
suitable intervals to speed the cure.

This new methodology can only be carried out if the remedy is

prepared in a medicinal solution and given in a "split-dose". If
the homoeopath is still using the dry pellet dose then they must
follow the rules as given in the 4th Organon. This means the
homoeopath can only repeat a remedy when there is a definite
relapse of the symptoms even if the person is only slowly
improving.

With the medicinal solution, however, the remedy may be

repeated at suitable intervals as long as the patient is improving
without any aggravations. This is how the cure can be reduced to
one half or less the time it takes with the ordinary dry dose method.
These are some of the directions contained in the 5th Organon on
the advanced methods of using the centesimal potencies. This
methodology led the way to the methods of the 6th Organon and the
LM potency.

A review of Hahnemann's writings shows that it is important to

understand three factors to safely repeat the dose. These are the
nature of the remedy, the nature of the constitution, and the nature
of the disease.

1. The nature of the remedy. The homoeopath should study the

patterns of remedy activity, duration, and depth of action. In
general, non-toxic plant remedies have shorter duration and a more
gentle action. Mineral remedies tend to act more deeply and possess
a longer duration of activity. The nutritional minerals tend to be
relatively more gentle than the toxic mineral elements. Toxic plants,
minerals, and nosodes tend to need more care in their usage and the
homoeopath should be more conservative in both potency and
repetition.

2. The nature of the constitution. The homoeopath must study the

physical constitution and psychological temperament of the patient
and their susceptibility factors. The quick moving, nervous,
allergenic and emotionally unstable types are usually more sensitive
then those of a slower moving, calm, and generally more tolerant
nature. The state of the constitutional sensitivity should be analyzed
 if the homoeopath is to prevent aggravations and complications.

3. The nature of the disease. The homoeopath must perceive the

nature of the acute and chronic diseases and their cycles. In general,
disorders that involve rapid development, hyperactive tendencies,
allergenic responses, and nervous irritability are more reactive than
those of a slow, progressive, and insidious nature. Those with
advanced pathology and weakened vitality are often more sensitive
to remedies than those with functional disorders and average
general health.

If the homoeopath understands these three areas it becomes easier to

safely repeat the homoeopathic remedies if and when needed.

Therefore, Hahnemann introduced three new revelations in the 5th

edition; the introduction of the higher potencies, the use of the
medic 8inal solution and the repetition of remedies at suitable
intervals when needed. In this way the 5th Organon can be truly
called "The Limit Breaker" as Hahnemann removed the 30c ceiling
on potency, overcame the obstacles associated with the dry dose,
and removed the restriction on the repetition of the remedy when it
was necessary to speed the cure.
Next: Part 2: The Medicinal Solution

Part 2: The Medicinal Solution

The Limitations of the Dry Dose

The next major renovations in the practice of Hahnemannian

Homoeopathy appear in the second part of the 1837 edition of The
Chronic Diseases in the article called Concerning the Technical Part
of Homoeopathy. This is a very valuable article as it acts as the
technical complement to the methods he introduced in the 1833
edition of the 5th Organon. Hahnemann intended that the various
editions of Organon and The Chronic Diseases should be read
together as they form a complete picture of the latest developments in
Homoeopathy.

These techniques not only brought the centesimal system of

Homoeopathy closer to perfection, but also pointed out the direction it
would be taking in the future. In the 1837 commentary Hahnemann
begins by assessing his experience of the dosing procedures that he
used during the late 1820s and shares the outcome of his latest
research in Homoeopathy. He says:
"Since I last addressed the public concerning our healing art I have
had among other things also the opportunity to gain experience as to
the best possible mode of administering the dose of the medicines to
the patients, and I herewith communicate what I have found best in
this respect.

A small pellet of one of the highest dynamizations of a medicine laid

dry upon the tongue, or the moderate smelling of an open vial where
one or more such pellets are contained proves itself the smallest and
weakest dose with shortest period of duration of its effects."

Due to the great diversity of age, predispositions, sensitivities,

physical constitutions, mental temperaments, reserves of vital powers,
and environmental factors, etc., a homoeopath needs a flexible dosage
system that allows for the adjustment of the remedy for each
individual case. This is something that the medicinal solution supplies.
Vide Concerning the Technical Part of Homoeopathy.

"Nevertheless the incredible variety among patients as to their

sensitivity, their age, their spiritual and bodily development, their vital
powers, and especially in the nature of their disease necessitates a
great variety in their treatment, and also in the administration to them
of the doses of medicine."

The best way to adjust each individual dose of a remedy to the

sensitivity of the individual constitution is to use the medicinal
solution. This is because the aqueous solution is far more flexible than
the dosage of the dry pills. Also of great importance is the following
revelation that tells us why the untimely repetition of an unadjusted
dose causes complications and explains the reason homoeopaths
disagree so much about the repetition of doses.

"Before proceeding, it is important to observe, that our vital principle

cannot bear well that the same unchanged dose of medicine be given
even twice in succession, much less more frequently to a patient. For
by this the good effect of the former dose of medicine is either
neutralized in part, or new symptoms proper to the medicine,
symptoms which have never before been present in the disease appear,
impeding the cure. Thus even a well selected homoeopathic medicine
produces ill effects and attains its purpose imperfectly or not at all.
Thence come the many contradictions of homoeopathic physicians
with respect to the repetition of doses."

The fact that the vital force cannot adapt to the repetition of an
unadjusted dose is the conclusion of around 40 years of
experimentation and should not be taken lightly. In the 6th Organon
Hahnemann adds that even with the perfect remedy it is unwise "to let
the patient have a second or third dose taken dry." The production of
these side-effects is the main reason why repeating remedies before
the relapse of symptoms is contraindicated in the Homoeopathy of the
4th Organon. The use of the medicinal solution overcomes this
problem because it can be adjusted with succussions so that the patient
never receives the exact same potency twice. Vide Concerning the
Technical Part of Homoeopathy.

"But in taking one and the same medicine repeatedly (which is

indispensable to secure the cure of a serious chronic disease) if the
dose in every case is varied and modified only a little in its degree of
dynamization, then the vital force of the patient will calmly, and as it
were willingly, receive the same medicine even at the briefest
intervals, very many times in succession with the best results, every
time increasing the well being of the patient. This slight change in the
degree of dynamization is even effected, if the bottle which contains
the solutions of one or more pellets is merely well shaken five or six
times."

The single unit dose is considered by many to be the only pure form of
Classical Homoeopathy as they are only familiar with the 4th Organon
"wait and watch" method. By 1833 the founder of Homoeopathy was
using the remedy solution in a split dose so he could repeat a
homoeopathic medicine whenever he felt it was necessary.
Homoeopathy as commonly practiced has not progressed past the
techniques Hahnemann introduced between 1828 and 1829 although
his more progressive techniques were published in the 5th Organon in
1833 and The Chronic Diseases in 1837.

The Use of the Medicinal Solution

Hahnemann often communicated his new techniques privately with

some of his most respected students before he made them public. One
year before the publication of the 1837 edition of The Chronic
Diseases, Hahnemann wrote a letter to Constantine Hering in which
he gave detailed instructions of the latest techniques relating to the
medicinal solutions. He gave the following advice to his life long
friend. This is recorded in Bradfords Life and Letters of Hahnemann,
page 367.

"I have made some improvements in the technicalities of our art,

which I will now first communicate to you.....Now, as my medicines
are very powerful, I seldom dissolve more than one globule in 7, 15,
20, 30, tablespoons of water [DL], and, because the patient has no
distilled water (which, besides, after a few days becomes spoilt and
ferments), I employ for this purpose spring or river water mixed with
1-15th or 1-20th part of spirits of wine or I put three or four small
pieces of hard wood charcoal into the solution. This mixture, (of
which the patient affected with a chronic malady takes a tablespoon
or 1, 2 or 3 teaspoons [DL] every day, or every other day, is to be
shaken in the bottle five or six times every dose taken, in order to
change the degree of dynamization each time. [DL]"

This is the first document we have that Hahnemann gives the full
details of the split dose and medicinal solution. Hahnemann suggested
that the medicinal solution be preserved with 1-15th or 1-20th parts of
spirits of wine. Where alcohol was unsuitable Hahnemann used three
of four small pieces of hard wood charcoal instead. He was witnessed
later in his career putting 1 teaspoon of alcohol into 4 oz. of water as a
preservative. We find that in environments that tend toward easy
spoilage, up to 1/3 of the solution must be preserved with brandy. In
Hahnemann's letter to Hering he mentions the proper amount of the
solution to be given to the patient varies from 1, 2 or 3 teaspoons,
depending on the sensitivity of the constitution, age, nature of the
disease, etc.

In the following year of 1837 Hahnemann released to the public the

conclusion of his experiments with the technical methods of giving the
homoeopathic dose. In this article he also gives the advice about the
repetition of the remedies in acute and chronic diseases. Vide
Concerning the Technical Part of Homoeopathy.

"Experience has shown me, as it has no doubt also shown to most of

my followers that it is most useful in diseases of any magnitude (not
excepting even the most acute, and still more so in the half-acute, in
the tedious and most tedious) to give to the patient the powerful
homoeopathic pellet or pellets only in solution, and this solution in
divided doses [DL]. In this way we give the medicine, dissolved in
seven to twenty tablespoons of water without any addition, in acute
and very acute diseases every hour or every half hour, a tablespoon at
a time, with weak persons or children, only a small part of a
tablespoon (one or two teaspoons or coffee spoonfuls) may be given
as a dose. In chronic diseases I have found it best to give a dose (e. g.,
a spoonful) of a solution of the suitable remedy at least every two
days, more usually every day."

Hahnemann had experimented with the use of the homoeopathic

remedies in water ever since the early provings of homoeopathic
remedies in 1813. He used the water dose as one of his techniques of
controlling the toxicity and power of the remedies during the provings.
The new split-dose is succussed just before each dose is ingested to
raise the potency in an upward direction. By replacing the single unit
dose with the new split-dose it became possible to use one pill several
times! This apparent contradiction is resolved by the fact that the
remedy solution is made with only one #10 pill that is dissolved into
several liquid portions that are used repeatedly.

For this reason Hahnemann called his new technique the "split-dose"
method instead of a "multi-dose" method as in this sense it is a still
only one dose (i.e., one pill). Hahnemann realized early on that too
many doses of the dry pills accumulated until they produced
troublesome aggravations. Even though the patient may be taking the
solution more times they are still receiving a smaller amount than they
would if they repeated a dry dose even once. This is a very subtle
aspect of the theory of the minimal dose that took Hahnemann many
years to fully understand.

Preparing and Administering the Medicinal Solution

The preparation of the remedy solution for the centesimal potencies

can be summarized in 7 easy steps.

1. Take a 6 to 8 oz. bottle and drop in one, rarely two, # 10 pills of the
chosen remedy. Hahnemann suggested that the size of the medicinal
solution could vary from 3.5 to 4 oz. (7 to 8 tablespoons) up to 20
ounces (4O tablespoons) of water mixed with brandy. I usually use
between 4 to 6 oz. of liquid in my medicinal solutions. I use slightly
larger bottles because this leaves enough space to produce good
succussions. When speaking of succussing to make potencies
Hahnemann suggested leaving up to 1/3 of the vial empty. The larger
medicinal solutions (8 oz., 12 oz., etc.) are only necessary when one is
treating a hypersensitive, as the larger amount of water makes the dose
act more gently.

2. Add enough water mixed with brandy to fill the bottle up to 2/3 to
3/4 full with liquid. A sufficient amount of brandy or pure alcohol, as
a preservative, should be included in the solution. If the solution is to
be used over a long period of time mix 30% to 50% brandy with the
water used in the solution. A lesser amount of ever-clear would do the
job.

3. The bottle is to be succussed just prior to ingestion in order to

activate the remedy and slightly raise the potency. The number of
succussions greatly affects the action of the remedy on the vital force.
For those who are hypersensitive 1, 2, or 3 succussions is usually
enough. Those of an average sensitivity more normally need 4, 5, 6 or
7 succussions. Those who have rather low sensitivity may need 8, 9,
10, 11, 12 or more succussions. It is best to start with a lower number
of succussions and increase the amount if and when necessary.
Succussions are one of the methods of adjusting the dose.

4. In this article Hahnemann suggests that 1, 2, or 3 teaspoons of the

medicinal solution should be given to the client depending on their
sensitivity. Children are given 1/2 teaspoon. Infants should receive 1/4
teaspoon or less depending on their age. Most adults do quite well
starting out with 1 teaspoon. The size of the dose can be gradually
increased if more reaction is needed. A constitution of a lower
sensitivity might need 2 or 3 teaspoons before they will react
sufficiently to the remedy. Hahnemann's Paris casebooks demonstrate
that the old master later preferred to use a medicinal solution and a
dilution glass to further attenuate his dose. 1, 2, or 3 teaspoons of the
medicinal solution are stirred into 4 oz. of water and 1, 2, or 3
teaspoons are given to the patient as a dose. Hahnemann gave his
centesimal potencies for the most part in the exact same manner as his
LM potencies. The dose can also be adjusted by the amount of the
remedy given.

5. The dose should be adjusted through a series of dilution glasses

when treating a hypersensitive, an elderly person, severe pathological
tissue changes, allergies or any dangerous condition. Succuss the
remedy bottle with a conservative number of succussions and take one
teaspoon and stir it into the first dilution glass. From this glass take a
teaspoon and stir it into a second dilution glass and from this a dose is
given to the client. An extreme hypersensitive may need the remedy
diluted through 2 or 3 such dilution glasses. In this case a teaspoon or
less is taken from the first glass and stirred into a second or third glass.
These individuals are normally almost impossible to treat with
Homoeopathy but adjusting the dose in this manner brings them great
relief.

6. Give the client one test dose and wait and watch for a reasonable
amount of time to see how the remedy reacts. This time period
depends somewhat on the timeline of the disease you intend to treat.
Acute and chronic diseases each have their own peculiar nature. If
there is a striking response and a dramatic improvement let the single
dose act without interference. If there is only a slow or moderate
improvement the dose may be repeated at proper intervals to speed the
cure.

7. If the remedy produces any aggravation it is best to wait and watch

for the expected amelioration. If the remedy is going to be given again
it must be adjusted in a downward direction. This means one could use
a lower potency, less succussions, a smaller dose, one or more dilution
 glasses, or give only one dose or repeat the remedy at longer intervals.
The homoeopath can use one or more of these techniques as needed.
These are examples of how to adjust the dose in a downward
direction.

Of course, all the normal precautions should be taken and the client
asked not to eat or drink 1/2 hour before and after taking the remedy.
These are the basic instructions on how to prepare and administer the
liquid dose. It may take some time to learn how to adjust the dose to
fit the sensitivity of the individual as well as to match the nature of the
disease to be treated. This comes with time and experience. Some may
ask why go through all the trouble to use the medicinal solutions? The
answer is quite simple. Do you want to treat the most chronically ill
and the most hypersensitive persons? Do you want to speed the time
of cure to 1/2, 1/4 or less the time it takes with the dry dose? Do you
want to use Hahnemann's most advanced methods and walk in his
footsteps? If you do, then a little more effort on your part is well worth
while.

How the Medicinal Solution Works

In order to understand how the medicinal solution works we must

understand the meaning of primary and secondary actions and how
homoeopathic remedies heal. Hahnemann discusses this subject in
aphorisms 63-69 of The Organon of Medicine. When an ill person takes
a remedy its medicinal energy makes a deep impression on the deranged
vital force which replaces the confused image of the natural disease. This
is called the primary action. During this phase the vital force passively
receives a delusive image of the disease magnified by the energy of the
homoeopathic remedy. After experiencing the primary action of the
remedy the vital force produces what Hahnemann called the secondary
curative action. It is the curative secondary reaction of the vital force that
removes the remedial disease from the constitution and replaces it with
the state of health. Using this explanation as a basis Hahnemann explains
how the medicinal solution works in the preface to the 4th edition of The
Chronic Diseases.

"But if we physicians are able to present and oppose to this instinctive

vital force its pathological enemy, as it were magnified through the
action of homoeopathic medicines (even if it should be enlarged every
time only by a little), if in this way the image of the morbific foe be
magnified to the apprehension of the vital force through homoeopathic
medicines which, in a delusive manner, simulate the original disease, we
gradually cause and compel this instinctive vital force to increase its
energies by degrees, and to increase them more and more, and at last to
such a degree that it becomes far more powerful than the original
disease."

By the end of the 1830s Hahnemann was using all the levels of potency
available from the lowest to the highest but only in medicinal solutions.
It is a known fact that he had both Jenichen's and Karsokoff's high
potencies. We have in our possession a copy of a letter written by
Madame. Hahnemann to an American doctor named Breyfogle in which
Melanie answers a question about what Hahnemann's views were on
potency and dosage in his later life. This is recorded in Haehls Samuel
Hahnemann, His Life and Works, Volume 1, on page 328.

"Your inquiry as to whether Hahnemann altered his views about

potencies in the last period of life and whether he made use of only high
potencies, I can answer in this way: Hahnemann used all the degrees of
dilutions, the lower as well as the higher according to the individual
case. I have seen him use the 3rd trituration but I have also seen him use
200th and even 1000, every time he thought it necessary."

That fact that Hahnemann used high potencies was confirmed in 1845 in
the Bulletin de la Societe Homoepathique de Paris by a Dr. Molin. Also
a Dr. Malan witnessed Hahnemann using the latest of Jenichen's ultra
high potencies effectively in Paris. This is recorded in Haehls Samuel
Hahnemann, His Life and Works on page 328.

"I frequently saw Hahnemann prescribe very high dilutions. One of the
most remarkable cures had been brought about by one single dose of a
very high potency: as far as I know this remedy came from Jenichen. I
have often heard him say that the 30c potency should by no means form
a fixed limit for medicinal dilutions."

It has been said by some modern homoeopaths that Hahnemann never

used potencies beyond the 30c. For this reason they opine that his case
management suggestion can be ignored when using higher potencies.
James Kent made a similar statement in his writings as he was not aware
of Hahnemann's use of high potencies and his advanced methods. Once
Hahnemann developed the medicinal solutions he found the freedom
necessary to experiment with the highest potencies available at the time.
The aqueous solution is a perfect medium for controlling the power of
the high potencies because the dose can be carefully adjusted to fit the
sensitivity of the individual.

The Two Types of Aggravation

Hahnemann taught that the phenomena associated with the

homoeopathic aggravation was caused by the remedy causing too strong
of a primary action (Organon, aphorism 161). This excessive primary
action suppresses the secondary response of the vital fore and displays
the medicinal symptoms of the remedy. The reasons for aggravations are
administering too high of a potency, giving too large of a dose, and
repeating the remedy too often. This is all too easy when a random
number of dry pills of high potency are dropped under the tongue, or
when there is the premature repetition of a dry remedy, especially of the
same, unadjusted potency.

If after a time the vital force is able to overcome this excessive primary
action of the remedy it will produce its own secondary response and
move the constitution toward cure. This is neither the most rapid nor
gentle way to heal a disease. If the dose is far too powerful for the state
of the constitution being treated, it may produce a long lasting medicinal
disease. To overcome these limitations Hahnemann developed the
methods of adjusting the dose of the medicinal solutions to fit the
sensitivity of the constitution. When there is an aggravation, lower the
potency, give the solution bottle less succussions, reduce the size of the
dose, and do not repeat the remedy unless it is needed to speed the cure.

Hahnemann points out in his writings that there are two types of
aggravation, the similar aggravation and the dissimilar aggravation. A
similar aggravation is an increase of the symptoms the individual is
experiencing or the appearance of old diseases. This is a sign of the
correct remedy but too strong of a dose. It is best to wait out this reaction
if it is not dangerous or extremely uncomfortable. If a second dose is
needed it will have to be adjusted in the downward direction. This means
less succussions, more water in the solution, the use of more dilution
glasses, a lower potency, a smaller amount such as 1/2 a teaspoon, etc.
These are all methods of adjusting the dose.

A dissimilar aggravation is the appearance of new symptoms which the

client has never experienced before or do not relate to the disease being
suffered. They are medicinal symptoms produced by the remedy that are
not homoeopathic to the condition of the individual who took the
remedy. This is a sign of the wrong remedy. Vide Organon, aphorism
249.

"Every medicine prescribed for a case of disease, which in the course of

its action, produces new and troublesome symptoms not appertaining
to the disease to be cured, is not capable of effecting a real
improvement and can not be considered as homoeopathically
selected [DL]; it must, therefore, if the aggravation be considerable, be
first partially neutralized as soon as possible by an antidote before giving
the next remedy chosen more accurately according to similarity of
action; or if the troublesome symptoms be not very violent, the next
remedy must be given immediately, in order to take the place of the
improperly selected one."

Let us look at the following examples to clarify the subject. If a person

has a painful lower back condition which is < resting and on first motion
and is > by continued motion while at the same time they are very
restless, chilly, weeps without knowing why, etc., we may give them
Rhus-t. If the lower back pain becomes a little more painful it is a similar
aggravation. This is a sign that the primary action of the remedy has
replaced the natural disease so we can expect the secondary reaction of
the vital force to remove the pain. This is a positive aggravation. If, on
the other hand, the individual develops headaches and stomach
discomfort, it is a dissimilar, negative aggravation. This is a sign of the
wrong remedy!

If the dissimilar symptoms are not excessive a new more proper remedy
should be chosen by the combination of the new medicinal symptoms
and the natural symptoms. This grand totality will correct the problem by
regularizing the vital force and move the case toward cure. If the
dissimilar aggravation is very strong, it should be antidoted immediately,
and a new remedy given as soon as possible. It is very important for a
homoeopath to understand the two types of aggravation.

Many homoeopaths think that all reactions are good reactions or that
they are a cleanse crisis. Unfortunately, this is not the case. A correct
simillimum, or an incorrect remedy, or a partial simillimum all elicit a
different reaction from the vital force. Only the Organon gives detailed
instructions on how to recognize these situations and make the necessary
adjustments in case management.

Following a Case

The administration of the first dose of a homoeopathic remedy is a test

dose. A single dose should be given and its reaction carefully studied.
Acute and chronic diseases have different natures. Acute diseases are
rapid in their onset, reach crisis quickly, and end with the return to health
or the demise of the individual. Chronic diseases are insidious in their
onset, slow in developing pathology, and fatal in the end. Depending on
the developmental timeline of the disease we must wait an appropriate
amount of time to see if the remedy is acting. In an acute injury or
emergency this could be only a few minutes, in an acute disease it could
be a few hours, and in a chronic disease a certain number of days. In
general when treating a chronic disease we must wait at least 4, 7, 14
days, or more, to see if the dose is acting.

As we have pointed out every striking reaction to the first dose of a

homoeopathic remedy precludes the repetition of the remedy until this
dramatic response slows down or there is a slight relapse of symptoms.
The number of days in which the dramatic effects last should be counted
and the remedy is repeated accordingly. If the dramatic effect lasts for 14
days, and then slows down, the remedy should be repeated every 12 or
13 days just before the relapse of symptoms.

If there is only a slow improvement the remedy may have to be repeated

at more rapid intervals to speed the cure. In slowly moving cases the
remedy may have to be repeated daily or every other day. If there is a
moderate reaction the remedy may have to be repeated every 3, 4 or 5
days. In cases that are progressing rather well the remedy may have to be
repeated only 1 time a week or so. Some individuals may only need the
remedy very occasionally whereas others will need it quite often.

Much of this depends on how high a potency level the case is begun with
and how dramatic its effects are on the vital force. In general, high
potencies such as 200c, 1m and 10m are suited to single doses and
infrequent repetitions. Lower potencies such as 6c, 12c, 24c, and 30c are
suitable for more frequent repetitions. Nevertheless, the response of the
constitution to the remedy is the most important indicator for how often
a remedy is repeated. The key to the split-dose method is to understand
the nature of the constitution, the nature of the remedy, and the nature of
the disease. If knowledge of these three factors is combined with the
methods of adjusting the dose one can safely repeat the remedy at
suitable intervals as long as the client is improving and no aggravations
appear. The idea is to find a rhythm of repeating the remedy that speeds
the cure, prevents relapses of symptoms, and produces no aggravations.

How to Complete a Cure

If you have been repeating the remedy for sometime, and the client is
improving, slow down the repetitions of the remedy accordingly. If all
the symptoms are gone, stop the remedy, and wait to see if there is any
relapse. If there is no relapse the client is healed! If there is a slight
relapse repeat the remedy at slower intervals until you feel it is time to
stop again. If this time there is no relapse of symptoms the case is cured.
As you repeat the remedy the client should be looking and feeling better.
If after such an improvement there is a slight similar aggravation it is a
sign that the patient may no longer need any treatment. When you stop
the remedy the symptoms should disappear in a few hours or days
depending on the situation.

After the removal of the symptoms the homoeopath waits to see if the
individual is completely cured. If there is a relapse of the symptoms after
a period of time continue giving the remedy but at slower and slower
intervals until it is no longer needed. When one uses the medicinal
solution correctly one should not see aggravations at any point in the
curative process. If one does, there are several ways to adjust the dose to
make the remedy more suitable for the sensitivity of the constitution.

Part 4: The LM Potency

The Discovery of a New Potency

Hahnemann was not completely satisfied with the medicinal solutions

of centesimal potencies, especially in weak sensitive constitutions
with chronic miasmic diseases. He found in certain cases that the
lower potencies were not able to stimulate a healing reaction, yet at
the same time, the higher potencies caused serious aggravations. He
wondered if it was possible to make homoeopathic remedies that acted
deeply, yet at the same time were gentler on the constitution. Even
though the medicinal solutions had greatly improved the centesimal
system he wondered how he could overcome aggravations in those
cases that were weak, over sensitive, and at the present time incurable.
Surely the answer to this question is not in raising the dynamizations
to even higher and higher ranges of potency.

By this time Jenichen's potencies where reaching levels of far beyond

1m, and in Hahnemann's experience, they were not suitable in weak
cases with advanced tissue pathology because of the serious life
threatening aggravations they could cause. Hahnemann's greatest
desire was to cure these degenerative chronic cases as they proved to
be the most resistant to his treatment. The only thing the old Master
could do was to begin a completely new series of homoeopathic
experiments even though he was in hi eighties!

At this time Hahnemann was assisted by a Reverend Everest, who was

in charge of making sugar globules for his remedies. He was a close
friend and confidante of Hahnemann's in his last experimental works.
On July 30, 1853 a letter was published in the Times that Rev. Everest
wrote to a Dr. Luthur in which he describes the experiments he
witnessed Hahnemann perform while he was improving the
homoeopathic system. We have included most of the letter as we think
it is enlightening as well as of great historical interest. This is recorded
in Bradfords Life and Letters of Hahnemann, page 473.

"Hahnemann endeavored to find means to administer remedies in such

a way that the least possible disturbances compatible with cure should
result. To this end he made a great variety of experiments. The first in
order was olfaction, and this he adopted in certain cases to the end of
his life, I am not aware that he altogether abandoned it.
But certain objections caused him to seek for some other means of
moderating medicinal action. His next experiment was to dissolve
three, two, or one globules in a glass of water, and then, carefully
stirring, to put a dessert or teaspoonful of this into another glass. He
still found, however, that is very delicate constitutions too excitement
was produce even thus, when the medicine was accurately chosen; for
if a medicine is not exactly harmonic to the case, its effects are, of
course, much less, inasmuch as in that case it acts on a part of the
organism not morbifically excited; and this remark will explain why
so many practitioners of modern or "improved Homoeopathy"
experience so few cases of aggravation, that is because they give
medicines at random, and so do not touch the disturbed nerves at all.

The attenuation was sometimes carried through two, three, four, five,
and six tumblers; but it was a very inconvenient proceeding, and it had
none of the simplicity which Nature's laws generally have. He tried, in
its order, the diminution of the number of shakes, but that seemed not
to give the accurate result that he wanted. He tried many plans and
made many experiments with one or two of which I am acquainted
and others I have forgotten, if ever I heard them. At last, however, and
the one that gave the most satisfactory results (I believe I may say that
he was perfectly satisfied with them) was the plan I now explain:

Starting from the first spirituous tincture of any medicine which I

believe was the third from the commencement (3c), and is, according
to the ordinary notation, written 1, instead of adding one drop of this
dynamization to one hundred drops of spirit of wine to make the next,
and so continuing the dynamization by drops he moistened a few
globules of a fixed normal size with it, and taking in the first
experiment, I believe, ten but in the latter and more satisfactory ones
only one globule of those so moistened he dissolved that in a minute
drop of water, and then added one hundred drops of spirit of wine.
Having shaken it (I forget how much) he moistened globules with this,
and having dried them, put them into a tube in his medicine chest, well
corked; these he labeled 0/1. The next dynamization was procured by
dissolving one globule of 0/1 in a small drop of water of water, and
adding one hundred drops of spirit of wine; with this he humected a
globule as before and called that dynamization 0/2...."

The LM Potency

After many trials and some tribulations, in the year 1840 Hahnemann
discovered the 1/50,000 dilution rate and created the new LM potency
system. Hahnemann began to do clinical experiments with raising the
dilution ratio of his dynamizations instead of raising the potency
because he felt that Homoeopathy had already developed the
 methodology of the centesimal potency as far as it was possible to go.
Of his new LM potency system Hahnemann wrote in the Organon

"this method of dynamization, I have found after many laborious

experiments and counter-experiment, to be the most powerful and at
the same time (the) mildest in action, as the material part of the
medicine is lessened with each dynamization 50,000 times and yet
incredibly increased in power."

The introduction of the new LM potency was Hahnemann's last great

gift to Homoeopathy and was the outcome of his 50 years of research.
With this higher dilution ratio Hahnemann found just what he was
searching for to break the impasse in treating the most chronically ill
of his patients. The 1/50,000 dilution ratio was to replace the 1/100
ratio as it was very powerful yet gentler than the higher potency
centesimals. At last he was satisfied that he had found "the most
perfect method" and had fulfilled the highest ideal of cure which is a
rapid, gentle and permanent restoration of the health.

As Reverend Everest said ,Hahnemann "was so entirely satisfied with

the gentle and kindly action of these preparations that they would, I
think, almost have superseded with him all other preparations."
Hahnemann called the new preparations medicamens au globule
(medicine of the globules, the one pill being noted by the 0) to
distinguish them from the centesimal potencies which were marked
with a small x, and were called medicamens a la goultte (medicines of
the drop).

The 6th Edition of the Organon

The 6th edition of Organon is the synthesis of Hahnemann's "new

methods" and his final discourse on the art and science of Homoeopathy.
In the 6th edition aphorism 246 integrates the ideas introduced in
aphorisms 245 and 246 of the 5th edition into one long paragraph. The
wording of this new aphorism is almost exactly the same as these two
paragraphs in the 5th edition. Vide the first section of paragraph 246 of
the 6th edition.

"Every perceptibly progressive and strikingly increasing amelioration

during treatment [DL] is a condition which, as long as it lasts,
completely precludes every repetition of the administration of any
medicine whatsoever [DL], because all the good the medicine taken
continues to effect is now hastening towards its completion."

The first part of this paragraph reflects aphorism 245 of the 5th edition.
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 possible rate. 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 can cause aggravations and relapse of the
symptoms or just slow down the cure. Single dose cures are more
common in acute diseases but there are also chronic patients that only
need a single dose or very 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. On 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.

An Example of a LM Single Dose Cure

While working in the hill district of Himachal Pradesh, inNorth India a

teenage girl was presented to me with the following symptoms: Her left
foot and lower leg had been terribly infected for at least a year and now
there was advanced blood poisoning and a danger of gangrene. She had
been given antibiotics several times but they did not help her.

Her foot and lower leg were very cold and there was numbness, tingling,
burning, itching, swelling and an angry red blister-like eruption. The
veins of her legs were swollen and icy cold and the condition was
aggravated in the cold weather or when the cold wind blew down out of
the mountains. These symptoms represented the location, sensations, and
modifications of the chief complaint.

I now began to probe for some concomitants to fill out the case. Most
people with such a serious complaint are very anxious or afraid yet she
bore her suffering bravely. I asked her how she did in school and she
mentioned to me that she had trouble reading because the letters seemed
to move or appear double. This would give her headaches and make it
hard to study. As her eye condition had nothing to do with her chief
complaint I looked up this concomitant in the repertory immediately.
Under Vision; moving; letters; I found Agar, am-c., con., Hyos., iod.,
merc., phys..

Then it struck me! Her leg looked and felt like it had been frozen. I
quickly looked up Fearlessness because she seemed so brave under the
condition she faced and found, Agar., bell., coca., OP., sil.. The coldness
of the limb, the numbness, tingling, the blistered eruptions are all found
in the materia medica under the remedy Agaricus. Agaricus LM 0/1 was
made in a 6 oz. remedy solution and the patient was given one teaspoon
as a dose and told to return the next day.

The next day the foot and leg looked much better! The swelling was
down and the girl seemed happy. I did not repeat the dose because this
response was "striking." I told her to come back in three days if the leg
continued to improve but immediately if there was any relapse. She
came back in three days and the leg was looking much better. The
blisters were healing, the red diminishing, and the blood poisoning was
reduced. I told her to come back in one week. After a week she returned
walking on her foot. It looked so much better it was amazing.

I told her to come back once a week unless there was a relapse of the
symptoms. The next week her foot was completely healed and warm. All
of this took place in just under three weeks. This is an example of a
single dose of an LM 0/1 causing a "striking rapid cure". A single dose
of LM 0/1 is not to be underestimated. One dose of a LM 0/1 has
removed severe attacks of asthma for 9 months before a relapse. A few
more doses and the case was cleared. We have seen this type of response
many times.

When using the LM potency it is always best to give a single dose and
ask the patient to come back in 3 to 7 days, or more, depending on the
nature of the disease. Cases of slowly developing chronic diseases may
take a little longer to clearly show the reaction to the first dose. If the
patient has a "striking" reaction to the remedy the repetition of the dose
is contraindicated. If the dramatic healing reaction slows down the time
has come to examine the case to see if it is time for the second dose. The
remedy should then be repeated to see how it acts the second time. One
may find that an infrequent repetition of the remedy is all that is
necessary.

If the reaction is not very dramatic then the remedy may be introduced at
intervals that correspond to the reaction of the constitution. The LM
potency should not be repeated mechanically as if they are a 6x remedy!
The LM system is far too deep acting for this kind of approach and
demands sensitivity and flexibility in the homoeopath's hands. The wait
and watch philosophy is still a very important part of Hahnemann's
advanced methods.

Speeding the Cure

Not all constitutions respond to a single dose as in the case I have given
above. It is more common in chronic disease to need to know how to
skillfully repeat a remedy in order to complete a cure. Hahnemann
reminds us that the single dose cure is much more common in acute or
recent cases than it is in chronic disorders and miasmic diseases. Vide
the second section of aphorism 246.

"This [the single dose cure] is not infrequently the case in acute diseases,
but in more chronic disease, on the other hand, a single dose of an
appropriately selected homoeopathic remedy will at times complete even
with slowly progressive improvement and give the help which a
remedy in such a case can accomplish naturally within 40, 50, 60,
100 day [DL]. 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 [DL], so that a much more rapid cure
might be obtained".

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 "progressive and strikingly increasing
amelioration during treatment". This is a strikingly progressive
increasing amelioration is a reaction that is enhanced day by day. Under
such conditions the repetition of the LM potency is normally precluded
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 uses the words "slowly progressive improvement". 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! It is only in these slow moving cases that aphorism
246 permits the repetition of the LM potency at suitable intervals to
speed the cure. If we want to speed the cure of these slow moving cases
to 1/2, 1/4 or less the time it takes with the old methods of the 4th
Organon one must use special techniques. What are they, Master
Hahnemann? The answer to this question is separated into four parts.
Vide the third section of aphorism 246.

1. "And this may be very happily effected, 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 [DL]."

The first condition for speeding the cure in slow moving cases is that the
remedy must be perfectly homoeopathic. If the consultant does not have
a clear picture of the remedy it is best to be conservative with the dose.
Repeating the wrong remedy can cause more harm than good. When
there is a marked, progressive amelioration of the 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
homoeopath 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 at all! 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.

2. "Secondly, if it is highly potentized, dissolved in water, and given in

a proper small dose that experience has taught as the most suitable.
[DL] "

The second condition for speeding the cure is the use of the medicinal
solution. Without the liquid dose none of the other advantages of the new
method are available. When using the dry pills the homoeopath should
follow the rules laid down in the 4th Organon. This simple change from
the static dry dose to the flexible liquid solution is the foundation of all
other breakthroughs. Hahnemanns Paris casebooks show that the
Founder used the medicinal solution with his centesimal potencies in
exactly the same manner as the LM potency in his last years. The
remedy solution is not only more flexible than the dry dose but also
much more powerful. Hahnemann also used olfaction of the medicinal
solutions as a delivery system. Vide aphorism 272.

"Such a globule, placed dry upon the tongue, is one of the smallest doses
for a moderate recent case of illness. Here but few nerves are touched by
the medicine. A similar globule, crushed with some sugar of milk and
dissolved in a good deal of water {refer to # 247} and stirred well
before every administration will produce a far more powerful
medicine for the use of several days [DL[. Every dose, no matter how
minute, touches, on the contrary, many nerves."

3. Hahnemann also suggested repeating the remedy:

"in definite intervals for the quickest accomplishment of the cure

[DL]"

The third aspect of speeding the cure is the repetition of the dose in
definite intervals of time. This is a new concept for those practitioners
who are not familiar with Hahnemann's most advanced teachings. The
intervals between these repetitions must be determined by the nature of
the reaction to the remedy, the sensitivity of the constitution, and the
nature of the disease. This allows the homoeopath to personalize the
remedy schedule in relationship to the time and progression of the
healing process.

4. The fourth condition for speeding the cure begins:

"with the precaution, that the degree of every dose deviate somewhat
from the preceding and following in order that the vital principle be
not aroused to untoward reactions and revolt as is always the case
with unmodified and especially rapidly repeated doses [DL]. "

This last aspect of the complete dose is the succussion of the remedy
solution just prior to the ingestion of the medicine. The succussion of the
remedy solution changes the potency of the dose so that the vital force
never receives the exact same dose twice in succession. This prevents the
relapse of symptoms that appears from the repetition of a dry dose before
the cessation of the action of the previous dose. These four points reflect
the improvements that had taken place in Homoeopathy during the
period between the years 1833 and 1843. These new methods can only
be applied by those homoeopaths that follow the explicit directions that
Hahnemann gave in the 5th and 6th editions.

If Necessary!

All of the statements about repeating the dose to speed the cure relate
specifically to those cases that demonstrate only a slow amelioration
that may take 50, 60 or 100 days to show any significant
improvement. These circumstances condition all the following
statements 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 repetitions then more rapid repetitions do not apply. There are
homoeopaths that mechanically administer the LM potency daily for
days, weeks and months on end with every patient. They have not yet
understood the fine print in the footnote to aphorism 246. Every case
must be individualized and the repetition adjusted accordingly. In this
footnote the Founder explains some of the changes he made in the 6th
Organon and when the daily dose is applicable.

"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 that 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 [DL] 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)."

In the footnote to aphorism 246 Hahnemann suggests that a well chosen

remedy (not a poorly chosen one) may be given daily if necessary in
slow improving cases. When repetition of the remedy is not necessary
the LM potency will cause strong aggravations, unproductive
accessory symptoms, and slow down the cure. Unneeded repetition
can make a patient more hypersensitive or make them non reactive due
to over exposure. Hahnemanns new posology method spans the single
unit dose in striking responses and the repetition of remedies at suitable
intervals to speed the cure in slower moving cases when necessary. In
this way, the 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 Boenninghausens Lesser Writings Croserio
said that Hahnemann would reduce the dose or stop the repetition of
his remedies as soon as he observed definite medicinal reactions. He
also noted that Hahnemann often gave a single dose of olfaction with
placebo and usually did not repeat the dose for at least one week. In my
review of the microfiches of Hahnemanns Paris casebooks I found that
in most cases the Founder often stopped his medicines, gave placebo,
and waited and watched for long periods. Hahnemann did not
mechanically gave the LM potency daily for weeks, months and
years on end! It was more common for him to use a series of doses
followed by, or interspersed with, series of placebos. In his later years he
sometimes gave a LM potency and placebo at the same time but he did
not note down the schedules. This means that some of the prescriptions
could be a single dose and others could be the interpolation of placebo
with the medicine at various intervals. Hahnemann only recommends the
daily dose when it was necessary.

Part 6: Preparing the Medicinal Solution

Making a Medicinal Solution

In the 6th Organon Hahnemann mentions making an aqueous

solution of the LM potency in 40, 30, 20, 15, or 8 tablespoons of
water. The amount of solution most commonly used by
Hahnemann was 7 to 8 tablespoons of water (around 31/2 to 4 oz.
of fluid) including a sufficient amount of pure alcohol or brandy as
a preservative. We have found it necessary to add 2 or more oz. of
brandy to the solution if it is needed over a long period of time.
For patients with more sensitive constitutions the medicinal action
can be attenuated by increasing the amount of water in the
medicinal solution. This is when the remedy solution may be made
with 12, 15, 20, or more tablespoons of pure water depending on
the sensitivity of the patient.

Persons who are hypersensitive respond better to a medicinal

solution made with a larger quantity of water and the single dose
or infrequent repetitions of the remedy. The homoeopathic pellets
are viewed as quantum forces that can impregnate large amounts
of water with their medicinal energy. With the medicinal solution
we use the smallest amount of medicine possible, i.e. one poppy
seed size pill. Once in a great while the homeopath may need two
pills in a remedy solution to treat a patient with a hyposensitive
constitution . The size of the dose is directly linked to the
phenomena of the homoeopathic aggravation just as much as the
potency. A fundamental reason for using the medicinal solution is
to make it easier to adjust the dose of the remedy to fit the
sensitivity of the constitution.

The second aspect of adjusting the dose is the number of

succussions given to the remedy just prior to ingestion. The
succussion of the aqueous alcoholic solution against a glass
surface of a bottle produces large amounts of kinetic energy and
frictional electricity. This raises the potency of the remedy
solution in a manner that is impossible when using a dry dose.
This dynamic alteration of the solution by succussions changes the
remedy level so that the vital force is always offered something
new. The power of the medicinal solution depends on three
factors, the number of pills used, the amount of water in the
solution, and the number of succussions given before ingestion.
The number of succussions is directly linked to the dynamic effect
of the remedy at the time of ingestion.

In aphorism 248 Hahnemann mentions 8, 10 or 12 as the number

of succussion given to the solution prior to ingestion. We have
found over the years that the succussions are one of the most
dynamic aspects of the "new method". In hypersensitive cases the
number of succussions should be lowered to 1, 2 or 3, if necessary.
In the ultra hypersensitive constitutions we have used as little as 1
succussion at times. The average sensitivity utilizes anywhere
between 4, 5, 6 and 7 succussions very well. Those constitutions
that are somewhat hyposensitive may need as many as 8, 9, 10, 12
or more succussions to react well. We have found in cases where a
remedy seems to no longer hold, that an increase of the number of
succussions will start the case moving forward again. This aspect
of adjusting the dose allows for the fine turning of the medicinal
powers so that it is harmonious to a wide variety of constitutions
and situations.

A Case History

An individual suffering from Myasthenia gravis consulted me after

seeing the best allopathic specialists. This disease is characterized
by muscular weakness which especially affects the ocular and
bulbar muscles as well as other muscles. This person was
manifesting the ocular symptoms of the disease quite strongly. He
suffered with great ptosis (drooping of the eye lids) and paralysis
of the muscles that move the eyes. There was also a certain
amount of diplopia (double vision). This gentleman could not look
upward and he had to lean his head back to be able to see straight
ahead. His condition was getting worse, especially when he was
under stress and strain.

After I took his symptoms I decided on Causticum as it appeared

to resemble his case and it is keynoted for slow paralysis. As he
seemed rather sensitive I began the case with a 6 oz. solution of
the LM 0/1 potency and advised him to succuss the remedy 2
times before ingestion. From this bottle 1 teaspoon was then
stirred into 6 oz. of water in a dilution glass. This first dose had an
immediate effect that lasted for 4 days. During this period he could
see very well and his eyelids no longer drooped. On the 5th day
his symptoms began to relapse so he was advised to take the
remedy every 4th day.

As the case progressed I tried to adjust the dose in an upward

direction by increasing the number of succussions to 3 to see if the
remedy would hold for a longer period of time. This caused him to
see double for 24 hours and his eyes became puffy. After a few
days the aggravation wore off and he improved for around 4 days
before the remedy effect seemed to start wearing off. I returned to
2 succussions as 3 produced an aggravation without causing any
increase in the length of the amelioration. Over time he has found
that if he succussed the bottle too hard it makes his eyes a bit puffy
for a day or two after he takes his dose. We also found through
experimentation that 1 succussion did not produce much of an
effect on his eyes. This individual's sensitivity is such that 1
succussion is too little, 2 succussions are just right, and 3
succussions are too much. This refined adjustment of the
medicinal solution is necessary for his case to progress in a rapid
and gentle fashion.

Over a period of time I have carefully raised the potency from LM

0/1 to LM 0/2 in such a manner that he has not been aggravated
and has continued to improve. Such a gentle transition would be
impossible with the dry dose of a centesimal potency raised from
30c to 200c or 1m. I hate to think of what a random number of
pills of a high potency centesimal dropped under his tongue would
do to him! This case of degenerative disease would be almost
impossible to treat by the old 4th Organon 1829 method of
Homoeopathy. Only the LM potency used in a medicinal solution
is flexible enough to treat this individual. I have seen these things
many times over the past decade. Those who think that it does not
matter how you give your dose still have much to learn from
Samuel Hahnemann.

Potencies and Repetition

LM potencies come in a graduated series from LM 0/1 to LM

0/30. This makes up 30 microtonal potency levels which allows
for the fine tuning of the remedy. When using the LM remedies
the case should be started from the "lowest degrees" of potency.
Hahnemanns Paris casebooks show that Hahnemann's opening
potencies varied between LM 0/1 to LM 0/7 in most cases. The
most common opening potencies are between LM 0/1 and LM 0/3.
Most cases are started with LM 0/1 in a 4 to 6 oz. medicinal
solution. Only under special conditions are cases started with LM
0/2 or LM 0/3, as these are progressively higher potencies. A
constitution which is of normal sensitivity will always respond to
the LM 0/1 potency if it is clearly indicated. LM potencies are
given in a gradual serial progression from LM 0/1 to LM 0/2 to
LM 0/3 to LM 0/4, etc.

Sometimes Hahnemann moved up and down the potency levels to

try and find the most harmonic potency. After this he generally
moved upward by 1 degree as the case progressed. There are no
leaps between potencies like LM 0/1 to LM 0/16 to LM 0/30 in
this system. The potency is raised for only two reasons: firstly, the
bottle of the previous potency is completely consumed and there is
a need to continue the remedy; Secondly, the client seems to
relapse before the complete ingestion of the previous bottle,
showing that they need a higher potency.

It is often said that the LM potency should be given daily in a

mechanical fashion. This is a great mistake. In aphorism 246
Hahnemann says any "strikingly increasing progressive
amelioration precludes any repetition of the remedy
whatsoever [DL]." It is only in the more "slowly progressive
improvements [DL]" that we need to repeat the remedy at
suitable intervals to speed the cure. In the note to aphorism 246
Hahnemann says the LM remedies "may" be given daily "if
necessary" not must be repeated daily in every case! In aphorism
248 Hahnemann says they may be given "daily or every other day"
in long lasting diseases but the same if necessary applies. Do not
misunderstand this point! When it is "not necessary" repeating LM
remedies daily or every other day will either slow down the cure
or cause unneeded aggravations.

The late, great, Dr. Hari Mohan Choudhury told me he made this
mistake early in his career, but learned through experience, that
the most important statement in the paragraphs dealing with
repetition are the words "if necessary". If we do what is "not
necessary" we slow down the cure, confuse the case, and
overmedicate the patient. I also made this mistake in the early
years of using LM potency as part of my personal lesson in
"hubris". Always remember the four cardinal rules of
Homeopathy: Similars cure similars, the single remedy, the
minimal dose, and the potentized remedy. With these four golden
rules in mind we cannot go far off the target of a rapid, gentle and
permanent cure.

The Preparation of the Dose for LM Potencies

The size of the medicinal solution can be from 3 1/2 oz. to 20 oz.
of water and alcohol solution depending on the sensitivity of the
individual. The bottle which contains the medicinal solution is
used by the patient to prepare their personal doses. The average
size of the medicinal solution is between 4 oz. and 6 oz. of fluid.
This solution consists of water mixed with 30% to 50% brandy, or
a smaller amount of pure alcohol, as a preservative. The LM
potency is always used in a medicinal solution with the addition of
a dilution glass filled with 4 to 6 oz. of water. The medicinal
solution bottle should be protected from sunlight, heat and strong
odors.

The remedy is always succussed just prior to ingestion in order to

slightly raise the potency. After the dosage glass has been used the
remaining solution is thrown away and the glass and spoon are
cleaned and placed in the sun. This two-fold process of succussing
and diluting causes a considerable change in the dynamization of
the remedy. As the succussing raises the potency, the dilution
reduces the amount, thus allowing the remedy to work rapidly,
gently and permanently.

The preparation of the medicinal solution may be summarized in

four points.

1. Take 1 (very rarely 2) poppy seed size #10 pills of the desired
potency (often starting at LM 0/1) and place it into a clean bottle.
The average size of a medicinal solution is between 4 oz. and 6 oz.
of fluid. Normally this watery solution includes at least 30 to 50%
brandy, or a smaller amount of pure alcohol, as a preservative and
stabilizer. I like to have at least 2 oz. of extra space in the bottle as
an air gap so that there is room for succussions.

2. Succuss the bottle just prior to ingestion 1 to 12 times

depending on the sensitivity of the patient. This slightly raises the
potency and activates the remedy.

3. Take 1, or more rarely, 2 or 3 teaspoons of the medicinal

solution and place it into 8 to 10 tablespoons of water in a dilution
glass and stir it. Most cases are started with 1 teaspoon and the
amount is increased only if necessary. In children the amount
should be 1/2 teaspoon. Infants may only need 1/4 of a teaspoon.

4. Take 1, (or more rarely, 2 or 3) teaspoons from the dilution

glass as a dose. Most cases are started with 1 teaspoon and the
amount increased only if necessary. Children should be given 1/2
teaspoon. Infants should receive 1/4 or less of a teaspoon.

The dosage of the medicinal solution can be carefully adjusted to

suit the sensitivity of the individual's constitution. This is why I
have not given an exact size to the medicinal solution, nor the
amount of the dose, and the number of succussions. The
experience of the last decade has shown that the remedy bottle
should be succussed between 1, 2, or 3 times for the
hypersensitive types; 4, 5, 6, for the average sensitivity; and 8, 9,
10, or more, for the hyposensitive patients.

The average size of the dose is 1 teaspoon of the medicinal

solution stirred into the water in the dosage glass. From this glass
the patient takes 1, rarely 2 , teaspoons of the mixture. Sometimes
it is necessary to slowly increase the number of teaspoons from the
remedy bottle to get a favorable reaction. Those who are relatively
more hyposensitive may need 2 or 3 teaspoons to get an adequate
response.

Normally, I start with 1 teaspoon and only increase the amount

when necessary. With the ultra hyper-sensitive patients one
teaspoon from the first glass can be stirred into a second glass of
water. From this second dilution glass one teaspoon is then given
to the patient. This can be carried on through a series of several
dilution glasses, if necessary. The patient then takes a teaspoon of
solution from the last dilution glass as a dose. This has been used
in the most sensitive types with great success.
Part 7: Administering the Dose
The Medicinal Solution and Olfaction

The key to the advanced methods of Homoeopathy is the use of the

medicinal solution. The remedy solution, however, has other
avenues of delivery than just the oral tract. This is more difficult by
the old method that exclusively uses dry pills as they are usually
placed in the mouth. At times alternative methods of applying the
dose may be more suitable or used in conjunction with the oral dose
to speed the cure. These methods may also be of use if the remedy
can not be given orally due to the nature of an injury or
unconsciousness on the part of the patient. Vide aphorism 284 of the
6th edition.

"Besides the tongue, mouth and stomach, which are most commonly
affected by the administration of medicine, the nose and respiratory
organs are receptive of the action of medicines in fluid form by
means of olfaction and inhalation through the mouth. But the whole
remaining skin of the body clothed with epidermis, is adapted to the
action of medicinal solutions, especially if the injunction is
connected with simultaneous internal administration".

The homoeopathic remedies can be given by a variety of methods.

The average median sensitivity does best on an oral dose of the
medicinal solution. Those who are somewhat hypersensitive may do
better on a dose given by olfaction. The preparation and
administration of the olfactory dose can be summarized in four
steps.

1. Take one #10 pill and place it into a one dram vial.

2. Drop one drop of water to melt the pill. Then fill the small vial
with alcohol leaving one third of the vial empty so that there is
sufficient air gap left for succussions.

3. The vial is to be succussed an average of 5, 6, 7 times. The

hypersensitive types may only need 1, 2, 3 or 4 succussions. Those
of a lower sensitivity may need up to 8, 10, or 12 succussion. The
remedy should be succussed just prior to the ingestion of the
remedy as with the medicinal solution.
4. The vial is then held under the nose and the vapors inhaled by the
patient. One dose is given to assess the sensitivity of the individual
and the remedy repeated, if and when necessary. In the Organon
Hahnemann says such a dose may be repeated every 1, 2, 3, 4, or
more days, as needed. In the Paris casebooks we find that
Hahnemann continued to use olfaction until his last days. Dr.
Croserio, a close colleague of Samuel, stated that Hahnemann often
gave an olfaction dose and waited one week. This is recorded in
Boenninghausens Lesser Writings. In the 5th edition Hahnemann
recommends not to give the olfactory remedy any more frequently
than one would give the dose by mouth.

A more complete explanation of administering olfaction can be

found in the note to aphorism 288 of the 5th Organon.

"The homoeopathic physician allows the patient to hold the open

mouth of the phial first in one nostril, and in the act of inspiration
draw the air out of it into himself and then, if it is wished to give a
stronger dose, smell in the same manner with the other nostril, more
or less strongly according to the strength it is intended the dose
should be..... Should both nostrils be stopped up by coryza or
polypus, the patient should inhale by the mouth, holding the orifice
of the phial between his lips. In little children it may be applied
close to their nostrils while they are asleep with the certainty of
producing an effect."

When using olfaction a sensitive may only need to use one nostril
and take just a tiny breath. If a stronger effect is needed a deeper
breath may be used. Those of a more moderate sensitivity may need
to breathe the dose in each nostril separately. There are some
individuals that are so hypersensitive they only need to put their
hand over the closed vial, or touch the top, and breathe in to open
their "aura" to the remedy. This is the subtlest form of "olfaction".
After this they may remove their hand from the remedy.

Hahnemann used olfaction almost exclusively for a period of time

but decided later that the oral medicinal solution was much more
appropriate as a median dose. He also mentions the application of
the medicinal solution directly on the healthy areas of the skin,
while at the same time, taking the oral solution to speed the cure of
a slow moving chronic disease. There is also a discussion of giving
the remedy to infants through the milk of the mother.

Assessing the First Dose

After administering the first dose the homoeopath should wait an

appropriate period to observe the action of the remedy. This time
period varies according to the nature of acute and chronic diseases.
Acute diseases are rapid in their onset and move rapidly toward
crisis. The period of waiting for the reaction to the dose may be a
matter of minutes to hours depending on the nature of the acute
illness. Any "striking" response precludes the repetition of the
remedy in any fashion as the vital force is moving rapidly toward
cure.

On the other hand, any slow progressive improvement is a sign that

the homoeopath may repeat the dose to speed the cure when
necessary. In a mild acute disease one dose a day is usually enough
to stimulate a rapid cure. In a more moderate case of acute illness
the dose may have to be repeated twice daily. In a more serious
acute illness the dose may have to be given as much as three or four
times daily until there is an improvement. Hahnemann reminds us
that in urgent cases the dose may have to be given every hour or
oftener. As soon as there is a clear improvement in an acute disease
the dose should be slowed down and gradually stopped as the state
of health returns.

The nature of chronic diseases is slow and insidious in their

development as they reach their crisis after a longer period of time.
For this reason the homoeopath should assess the dose over a period
of at least 3, 7, 11, or more, days depending on the nature of the
complaint and the sensitivity of the constitution. It is sometimes
necessary to wait for longer periods when treating hypersensitive
patients who have many alternations of their symptoms. Any
strikingly progressive amelioration is a sign that there is no reason
to give a second dose as the case is already moving rapidly toward a
cure.

If there is a relapse of the symptoms before the attainment of the

cure, the time has come to give a second dose. Many cases only
need a few infrequent doses to carry them through to completion. If
there is only a slowly progressive improvement on the single dose
the medicinal solution may be repeated at suitable intervals to speed
the cure. These intervals depend on the duration of the reaction of
the vital force to the remedy as there is no set fixed pattern that will
work for each and every individual.

After giving the first one or two doses the homoeopath should have
some idea of how long the reaction to the remedy continued. For
example, if the LM 0/1 potency produced a great improvement for
one week, and then the case relapses, the remedy may be repeated
around every 6 days in the beginning. If the reaction to the remedy
lasts for two weeks it may be repeated every 12 or 13 days to
maintain a continual improvement without relapse. When a remedy
shows very little response after 4, 7, 11, or more days, the remedy
should be repeated at conservative intervals until there is a response
and then assessed. Once there is a secondary reaction by the vital
force the remedy should be repeated at suitable intervals to maintain
that response. The repetition of the remedy may be needed every 2,
3, 4, or more days under these conditions.

It is only in the more hyposensitive patients that the LM potency

may be given every day or every other day for weeks on end. The
Paris casebooks show that Hahnemann liked to give a series of
doses followed by a series of placebos. There is not one case in the
Paris casebooks where the Founder gave the daily dose for weeks,
months and years on end. Hahnemann tended to give placebo
anytime there was a striking improvement as well as an aggravation
of symptoms. Sometimes he would give placebo when the symptom
picture was confused in order to let the symptoms settle before
proceeding. In some cases Hahnemann gave almost as much
placebo as medicine. As we said, Dr. Croserio's eyewitness account
of the Founder's practice states that Hahnemann would reduce the
dose or stop the medicine anytime there was significant medicinal
action. This is a point that is not well enough emphasized in the 6th
Organon.

A Change of the Symptoms

One of the most satisfying experiences for a homoeopath is when

one constitutional remedy given in a single dose cures a chronic
case. Unfortunately, this extraordinary response is a fairly rare
occurrence in the complex miasmic cases. More commonly we find
that a person moves slowly but surely towards cure under the
skillful repetition of the correct remedy. If the response to the first
dose is striking it is a sign that no repetition is needed. If the
response to the first dose is more moderate the remedy may be
repeated at suitable intervals.

If the patient relapses while on the LM 0/1 potency, the LM 0/2 is

given in a single dose, and its response is assessed. If the response is
dramatic the remedy is left to act without repetition. Where the
response is more moderate the remedy may then be repeated at
suitable intervals as needed. The LM remedies are used in a
gradually ascending fashion through the potencies LM 0/1, LM 0/2,
LM 0/3 and LM 0/4 up to LM 0/30 until the cure is completed.

This technique forms the middle path between the exclusive single
unit dose method and the mechanical repetition of remedies.
Normally, the repetitions of the remedy are slowed down as the
potency is increased so as not to provoke unwarranted aggravations.
Individuals who only need one remedy throughout the treatment of
a chronic disease possess relatively healthy constitutions. Chronic
patients with complex chronic diseases often present more of a
challenge. These individuals have several layers of disease that can
produce changes in the symptoms as the case proceeds toward cure.
What should we do when a patient has been improving but then
there is a change of symptoms? Lets see what Hahnemann say
about such a situation. Vide aphorism 248.

"For if this happens, if the balance of the disease appears in a

group of altered symptoms, one more homoeopathically related
medicine must be chosen in place of the last [DL] 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."

A perfect simillimum is a remedy that can be used over a longer

period of time in higher and higher potencies without changing the
symptoms. A partial simillimum is a remedy that only suits one
aspect of the case while producing new accessory symptoms in
other areas that change the natural symptoms. Partial simillimums
also seem to work at first but then are found to be less and less
effective as time passes. Completely new symptoms that do not
appertain to the disease under treatment are a sign that wrong
remedy has been given. I can always tell how well I understand a
chronic case by how many remedies I have given over a period of a
year or two. The fewer remedies I have had to use the better.
Frequent changes in symptoms calling for new medicines often
mean that the patient is receiving too many partial simillimum.

Anytime there is a change of the symptoms it is time to reassess the

nature of the case. Old symptoms coming to the surface is a sign
that the correct remedy is being used but one should be careful not
to overmedicate the patient. Too many doses at this time may force
an unneeded crisis. The surfacing of an old dissimilar layer can
produce a natural change in the symptom pattern that calls for a new
remedy. New symptoms have a number of different causes. Do the
new symptoms mean the patient has been given a partial simillimum
or the wrong remedy? Are they produced by a new cause affecting
the patient? Is the patient doing anything different that is affecting
their constitution? After a careful assessment of the cause of the
change in symptoms a new remedy may have to be selected. The
new remedy must be carefully chosen by the new characteristic
symptoms and a test dose given. The response to this test dose
should be carried out in the same manner as when giving the first
remedy.

Completing the Case

As a case progresses toward completion the repetition of the

medicinal solution should be slowed down to prevent any
unnecessary aggravation. As the cure begins to reach its final stages
there should be a great improvement in the general health of the
individual and all serious tissue pathology should be healed. If this
process is carried out perfectly the remedy may finally stop without
any aggravations or relapses. This is the most perfect cure; one
which is rapid, gentle and permanent. If the remedy is not slowed
down as we approach the completion of the case we will see the
homoeopathic aggravation at the end of the treatment. Vide
aphorism 248.

"On the other hand, should there appear during the repetition of the
well indicated homoeopathic remedy, towards the end of the
treatment of a chronic disease, the so-called {refer #161}
homoeopathic aggravation [DL] 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 for several
days in order to see if convalescence needs no further medicinal
aid [DL]. The apparent symptoms caused by the excess of the
homoeopathic medicine will soon disappear and leave undisturbed
health in its wake."

The aggravation at the end of treatment is a sign that the remedy

chosen is completing its action on the healthy constitution. At this
time the remedy needs to be stopped or repeated at longer intervals
if still needed. Hahnemann returns to the subject of completing a
case in aphorism 280. Vide Organon.

"The dose of the medicine that continues serviceable without

producing new troublesome symptoms is to be continued while
gradually ascending, so long as the patient with general
improvement begins to feel in a mild degree the return of one or
several old original complaints [DL]. This indicates an
approaching cure through a gradual ascending of the moderate
doses modified each time by succussion {refer #247}. It indicates
that the vital principle no longer needs to be affected by the
similar medicinal disease [DL] in order to lose the sensation of the
natural disease {refer #148}. It indicates that the life principle now
free from the natural disease begins to suffer only something of the
medicinal disease hitherto known as homoeopathic aggravation."

In order to test to see if the aggravation is a sign that no further

medicinal aid is needed, the remedy should be stopped. Leave the
patient without any medicine for eight, ten, or fifteen days so that
you can assess the nature of the new symptoms. If the complaints
are due to an excess of the remedy they will disappear in a few
hours to days. If there is no relapse of symptoms after the
dissipation of the aggravation the patient is truly well. If there is a
relapse of the symptoms during this waiting period the patient still
needs more of the same medicine but at slower intervals. This
remedy is continued until the time comes when it is necessary to
again test the patients state to see if the cure is complete.

If during the second test the patient has fully recovered there will be
no relapse after the medicine is stopped. Those of us who have
experience with LM potency have seen this process through to
completion many times. Our case histories confirm that there is no
need of aggravation at the beginning or end of treatment. We have
also observed at times the phenomena of the aggravation at the end
of treatment as a sign that the constitution needs no more medicine.
The general treatment plan is to always use the least number of
remedies, smallest amounts, and least number of doses possible.
New remedies are introduced only when there are definite changes
in the symptoms calling for their employment.

If at the end of treatment the homoeopath observes the so-called

homoeopathic aggravation then the time has come to stop the
remedy and watch for a relapse of symptoms. If there is a relapse
the remedies must be reintroduced in gradually ascending potencies.
If there is no relapse the condition is cured. This process clears the
constitution of both the acquired and inherited forms of disease and
leaves the vital force free to perform its primary duty of ruling the
state of health.

Much of what has been said about the LM potencies is true for the
centesimal potencies given in the medicinal solutions. The
methodology is the same for both if one is using Hahnemann's
advanced methods. I hope this series of 7 postings have cleared up
some of the confusion around the many different statements
attributed to Samuel Hahnemann. Once homoeopaths understand
the 7 levels of homoeopathic methodology that our founder
introduced many apparent contradictions will be transformed into a
 clear understanding of the evolution of Hahnemann's thought. Once
this is comprehended all the information found in the various
editions of the Organon and The Chronic Diseases can be put into
practical use in our lives.

Some may say that there is no need to study such "dusty old
fashioned books" as they are all outdated and we need to modernize
Homoeopathy. Who needs Hahnemann, Hering, Boenninghausen,
Kent, Lippe, Allen, etc., and their outdated 19th century baggage?
Such hubris knows no bounds! Our homoeopathic heritage is very
valuable as it is the sum total of our founder's efforts and the
experience of the 100's of men and women who followed him. This
information forms the fundamental basis of our science and art and
should not be underestimated by those who have never researched
it.

To "modernize" Homoeopathy by ignoring this legacy is like

throwing the baby out with the bath water. Such an endeavor is like
building the proverbial house on a base of sand. Sooner or later the
wind of clinical realities will blow and the rains of difficult cases
will fall and their house of conjecture will come crashing down. It is
much better to build a house upon the rock of the Organon so that
when hard times come there is a strong foundation. This foundation
is based upon the works of Samuel Hahnemann and the men and
women who have dedicated their entire livesto the enrichment of
Homoeopathy. No one is saying that we must stop growing with the
works of Samuel Hahnemann but we should certainly start there!

After all, Homoeopathy is De Medicina Futura.

Part 8: A Comparison of the Centesimal and LM Potency
Centesimal and LM Potencies

One of the first questions of those new to the LM potency is how do

the centesimal and LM potencies relate to each other in homoeopathic
posology? After more than 14 years of comparing their actions I have
come to the conclusion that there is no exact numerical equivalency.
Comparisons cannot be made by mathematically analyzing the amount
of the original substances present after dilution or by the numbers of
succussions cumulatively given. There is a definite qualitative
difference between the two potency systems as well as a quantitative
one. Their similarities and differences become more apparent on the
constitutions, sensitivities, and conditions for which they are most
suitable. It is by comparing the powers of the two potency systems on
similar constitutions, sensitivities, and diseases that we begin to build
a correlation of their complementary but opposite remedial powers.

John Morgan, a pharmacist/homoeopath working at Helios Pharmacy

Tunbrige Wells, England offers a comparison of the amount of
original substance between the C and LM potency. The LM 0/1 has
around the same amount of original material as a 6c. (5.5c); the LM
0/2 is equal to 8c; LM 0/3 is equal to 10.5c; and LM 0/4 is equal to
13c. It is at this point that the potencies pass beyond Avogadros
number . LM 0/30 has around the same amount of original material as
70c. Of course, these relationships are changed when 1 pill is dropped
into 4 oz. of water and then 1 teaspoon of the medicinal solution is
stirred into a dilution glass. Avogadros number is reached more
quickly when the entire process in taken into account.

Those of us who have used the LM potency have seen that the
remedies are much deeper acting than their centesimal counterparts in
relationship to the amount of original substance left. Boenninghausen
noted in his Lesser Writings that the 50 Millesimal remedies act as
deeply as the higher potency centesimals. This is because the 1/50,000
ratio with 100 succussion liberates a unique remedial potence that is
essentially different from the 1/100 ratio with 10 or more succussions.
The depth of penetration of the LM potency is more similar to the high
potency centesimals than the low potencies. This is why one must
learn how to use them correctly and know how to control their
remedial powers.

Constitution and Sensitivity

It is not possible to give a linear mathematical comparison of the

medicinal powers of the centesimal and LM potencies. They possess
remedial powers that are quite different and have proved to be
complementary opposites. I have obtained copies of the microfiches of
Hahnemann's Paris casebooks from the Robert Bosch Institute in
Stuttgart, Germany. During the years 1840 to 1843 Hahnemann
commonly used the 7 tablespoon medicinal solution for both the C and
LM potencies in his cases. He mostly used between 6c to 200c and a
full range of LM potencies on his patients. He seemed to use his
centesimals for the most acute diseases, crisis, or as acute intercurrents
during the disruptions of chronic treatment. Hahnemann used his LM
potencies mostly for chronic miasms, suppressions and degenerative
states. This pattern is followed throughout his casebooks until he left
for in his Heavenly Abode at 88 years old.

The pattern found in Hahnemann's cases led me to study the nature of

the centesimal potencies and LM potencies more closely. In the 5th
Organon Hahnemann states that the centesimal potencies are quick in
their onset and tend to aggravation in the beginning of chronic
treatment. In the 6th Organon Hahnemann states that the LM
potencies are gradual and tend to aggravate at the end of treatment. I
have witnessed this many times. This offers a clue to the differences
of the remedial powers of the centesimal and LM potencies. Acute
disease, crisis, and acute-like acerbations of chronic pathology all
have the same qualities of quick onset and rapid crisis much like the
aggravations of the centesimal potencies. The pattern of chronic
disease is slow and gradual and it reaches its crisis toward the latter
stages of development much like the aggravation of the LM potencies.
The pace, progression and termination of the remedial powers and the
acute and chronic states are similar. Is this the reason Hahnemann was
testing the centesimal remedies in acute disease, acute-like acerbations
of the chronic miasms or crisis? Did he use his LM potencies on the
miasmic and constitutional states because they are more similar to the
chronic disease process? Simillimum Simillimo!

In my 12 year trial in India I tested this hypothesis closely and found it

was relatively true but not an absolute fact. I did studies with LMs in
acute diseases and centesimals in chronic cases just to get a balanced
perspective. It is quite true that the higher potency centesimals can do
marvelous work in acute disorders and crisis. They also sometime
perform miracles in functional diseases of a chronic nature. The most
difficult area to use the high and highest potency centesimals is in
chronic diseases with miasms, suppressions, iatrogenic disease and
cases with serious organic pathology. In these situations it is very hard
to manage the case with high potency centesimals. Hahnemann knew
this from his experience of the 200c to 1M. That is why he began his
new experiments. He decided that raising the potency further was not
going to solve this problem. This is why he experimented with
increasing the dilution rate instead.

This is indeed an area where careful control of the LM potency can

perform wonderful cures and increase the quality of life and years of
the elderly and those severely damaged by pathology. Many of the
difficulties of the dry dose of the high potency centesimal in such
cases are completely overcome by the new methods. Some of the
quick acting qualities of the centesimal potencies are moderated by the
medicinal solution, and rendered more controllable, but their essential
nature remains. The centesimals have received an incredible number
of 1 to 100 dilutions and succussions forced into a small dilution ratio
compared to the LM potencies. This gives them their fiery nature and
quickly penetrating remedial qualities.

The LM potency depends on its high dilution ratio to produce its deep
acting remedial powers rather than the number of times diluted as in
the Cs. They are also not as immaterial of a dose as the high potency
centesimals. A 12c crosses Avogadros number while the LM 0/1, LM
0/2, and LM 0/3 still have material substance. This combination of the
qualities of the high dilution rate and serial potencies provides the best
qualities of a low and high potency. A 30c is much more immaterial
then the LM 0/1 but its remedial actions have much less medicinal
power. This is why the LM 0/1 acts more like a high potency yet it is
still less immaterial. The LM potency is the balance point between the
vital and the organic planes. This is why it is useful in advanced
chronic diseases and miasms.

After many years of observation I have come to the conclusion that the
centesimal potency suits some individuals while the LMs suit another.
Sometimes one can only tell by hind sight after testing both potency
systems on the same patient. Nevertheless, it does seem clear that the
C potency suits traumas, acute diseases, acute miasms, acute-like
acerbations of chronic diseases, chronic diseases that are still in a
functional rather than pathological state, and chronic diseases that start
with a serious crisis and rapidly progress toward pathology. The LM
potency seems to suit the long term affects of traumas, acute diseases
and acute miasms that have already produced organic pathology, crisis
that slowly develops, disease with well developed organic pathology,
and chronic diseases that develop insidiously over a period of years.
The fact that the C and LM potency are complementary opposites
greatly expands the therapeutic horizons of the homoeopathic
pharmacy. For this reason, it is our belief that homoeopaths should
take advantage of both potency systems.

The Sensitivity Scale

One area where the homoeopath can clearly compare the actions of the
centesimal and LM potencies is on individuals of similar
constitutional situations. Not all constitutions react in the same manner
to the same potency. Hahnemann adjusted the potency of his doses in
relationship to the constitutional susceptibilities of his patients. From
these observations he was able to observe a quantitative difference in
the sensitivity of a hyposensitive and a hypersensitive. Vide aphorism
281 of the Organon.

"If a cure is to follow, the first small doses must likewise be again
gradually raised higher, but less and more slowly in patients where
considerable irritability is evident than in those of less susceptibility,
where the advance to higher dosage may be more rapid. There are
patients whose impressionability compared to the unsusceptible
ones is like the ratio of 1000 to 1 [DL]."
The sensitivity scale of 1 to 1000 demonstrates the vast variations that
are found in the constitutions of individuals. A dose and potency
which would not affect a hyposensitive could cause a terrible
aggravation in a hypersensitive. The phenomenon of homoeopathic
aggravation is related to three factors, i.e., an excessively large dose,
too high of a potency and administration of a remedy when it is not
needed. The methods of adjusting the dose were developed to give the
homoeopath the ability to individualize the posology with the same
care as when personalizing the selection of the remedy by the
symptoms.

Judging Sensitivity

All individuals do not have the same sensitivity even if their vitality is
relatively equal. If we studied the constitution and temperament of the
individuals carefully we can observe certain signs and symptoms that
give indications as to their relative sensitivity.

1. The hyper-sensitive patient (700-1000). The major signs of

hypersensitivity include the following symptoms:

A. Highly nervous individuals, quick moving persons, rapid mood

swings and quick alternations of symptoms, active senses, quick,
strong reactions to environmental influences such as noise, lights,
crowds, etc., the need to eat a careful diet, multiple allergies or
chemical sensitivities, prone to side-effects from taking herbs and
vitamins, etc.. They often have trouble sleeping. These constitutions
are usually in a state of hyperfunction and hypertension and need to be
calmed down.

B. Sensitivity is often increased in those with advanced tissue

pathology, weakened vitality, oversensitive vital force, and a history
of prolonged drug use or drug reactions. Care must always be taken in
the elderly.

2. The hypo-sensitive patient (1-300). The major signs of hypo-

sensitivity include the following symptoms:

A. These constitutions manifest the opposite states of a hypersensitive.

Such person have slow movements, duller senses and intellect, the
ability to eat almost any foods, herbs, vitamins, etc., reduced reaction
to environmental stimuli (unmoved by noise, lights, smells, crowds,
etc..). They rarely have allergies. These constitutions are in a state of
hypofunction and need stimulation to get moving.

B. Sensitivity is sometime decreased in those who have taken too

many drugs, especially tranquilizers and sedatives. They often lack
energy and may be in a weakened condition and lack reactive
capabilities. If they have weak vitality the homoeopath should be
conservative with the dose and potency.

3. The moderately sensitive patient (400-700) represents your average

constitutional sensitivity. The major signs are as follows:

A. Those of average sensitivity usually have good vitality and are

moderate in their reactions to environmental stimuli. They are usually
able to eat a broad diet and can take vitamins, minerals and herbs in
reasonable doses. Few if any have allergies or chemical sensitivities.
Their organs and tissues are neither hyperactive nor hypoactive. They
demonstrate signs of moderation in all things. They are fairly stable
individuals who are not prone to rapid changes in symptoms.

Once the homoeopath becomes a good judge of the constitution they

can read the sensitivity to some degree. Of course, you never really
know for sure until you give the first dose! This is why it is always
best to give one test dose and assess the reaction of the vital force for a
reasonable time.

The Choice of Potency and Dose

When to Use Low Potencies

Lower potencies, larger amount of water and small doses should be

used in cases with *higher sensitivity* (700-1000), allergies, chemical
sensitivities, weakened vitality, and highly developed tissue
pathology. Care must be taken with elderly people and when the
organs of elimination are overloaded by toxins as there is usually
much hidden pathology. Low potencies can also be considered when
the symptoms are of a common nature, the illness on the physical
plane, and there are few characteristic signs.

1. With the *centesimal scale* the case should be started with 6c, 12c,
24c, or 30c depending on the individual. These cases do better on
medicinal solutions made with 1 pill in 6 to 8 oz of liquid. The first
test dose should be succussed only 1 to 3 times and the dose given in a
small amount. It is best to stir 1/2 to 1 teaspoon of the medicinal
solution into a dilution glass with 6 to 8 oz. of water. From this dosage
glass give the client 1/2 to 1 teaspoon of the remedy. To modify the
action of a remedy the homoeopath should use lower potencies,
smaller amounts of the remedy, just a few succussions and more water
as a buffering agent.
2. When using the LM potency in a true hypersensitive (700-1000) the
dose must be carefully adjusted to act in a gentle manner. The case
should be started with a 0/1 potency prepared in a medicinal solution
of 6, 8 to 12 oz. of water. The remedy bottle should be succussed only
1 to 3 times and 1/2 to 1 teaspoon should be stirred into 6 oz. of water.
From the dilution glass 1 teaspoon of medicinal solution should then
be stirred into a second dilution glass of 6 oz. of water.. From this
second dilution glass give the client a 1/2 or 1 teaspoon as a dose.
Hahnemann mentions using 2, 3, 4, 5, 6 serial dilution glasses in the
ultra hypersensitive. In this way we can treat over reactive individuals
who would normally be very difficult to cure with Homoeopathy.
Olfaction of the remedy is a good alternative to oral ingestion in
hypersensitive patients.

A. In order to use a LM 0/1 on the same type of person who requires a

lower potency like 30c the homoeopath must modify the dose
accordingly. The LM 0/1 is a much deeper acting potency than a 30c. I
have started many cases on 30c and moved them to LM 0/1 once they
gain strength and stability and appear to need a higher potency to
complete the case. If in doubt always choose the lowest potency and
work up as needed.

When to Use Higher Potencies

High potencies are suitable for those with lower sensitivity (1-300),
slow reacting nervous systems, clients who are non reactive to stimuli,
and have functional disorders rather than advanced pathology. They
are useful when the characteristic symptoms are mostly on the mental
plane and there is good vitality. Another criteria is that the remedy
picture is certain and there are clearly defined characteristics.

1. When using the centesimal scale one may begin these cases with
relatively higher potencies such as 1M or 10M. Ultra high potencies
(50M, CM, MM) are usually reserved for special circumstances or
following a case through to completion after the previous potencies
are no longer effective.

The solution should be made in an average of 3 1/2 to 4 oz. of water.

The remedy bottle should be succussed between 8 and 12 times. If you
using a very high potency it may be better to start with a lower
amount of succussions such as 3 to 5 in the beginning and work up if
needed. The client should be given 1 or increasing more teaspoons as
needed. The centesimals may be taken directly from the remedy bottle,
but in cases where there is concern about the possibility of
aggravations a dosage glass should be prepared and the remedy diluted
still further.

2. With the LM potencies the client may be started on LM 0/1, LM

0/2, and LM 0/3 depending on the variable factors of the case. Some
that are truly at the low end of the scale may need LM 0/4, LM 0/5
and LM 0/6 as an opening potency. These must be considered as ultra
high potencies. When using the LM 0/1 or LM 0/2 the remedy bottle
may be succussed between 8 and 12 times to raise the potency. If one
is beginning with LM 0/3, LM 0/4, LM 0/5, LM 0/6 it may be best to
start with fewer succussions and work up as needed. When using the
lower degrees of potency use more succussions, and when using the
higher degrees use less succussions. The amount taken from the
remedy bottle may be 1, or increasingly, 2 or 3 teaspoons of solution
stirred into 4 oz in a dilution glass. The client should take 1, or
increasingly, 2 or 3 teaspoons until a good reaction is attained. .

It is best to start with 1 or 2 teaspoons of the medicinal solution stirred

into a glass and then slowly increase the amount until you get the
reaction you want. The same is true with the amount of dosage out of
the dilution glass. We usually begin with 1 teaspoon and then increase
the amount to 2 or 3 until the proper reaction is elicited. With the
lower sensitivities the homoeopath uses relatively larger amounts,
higher potencies, larger numbers of succussions, and smaller amounts
of water.

When to Use Moderate Potencies

Moderate potencies suit patients with an average sensitivity (400-

700). These individuals demonstrate moderation in most areas. They
are neither too weak nor too sensitive, and have functional diseases or
the early stage of tissue pathology. They should have good vitality and
their organs of elimination function well. The remedy picture should
be relatively clear and the characteristics somewhat marked. Moderate
potencies work well on cases that affect the vital and mental level.

1. When using the centesimal potencies these cases may be opened

with 200c to 1M depending on the circumstances. The average
sensitive does best on a medicinal solution made in 4 to 6 oz which is
given 4 to 8 succussions. From the remedy bottle the client usually
begins with 1, or increasingly more, teaspoons until the healing
reaction is established.

A. The method is basically the same for the centesimal and LM

potencies although the dilution glass was not mentioned in the 1837
edition of The Chronic Diseases. Hahnemann was later witnessed
using a dilution glass with the centesimal potencies also. I use the
dilution glass in any case when I think it is better to be safe. This
moderates the action of the remedy.

2. When using the LM potencies in the average sensitivity we usually

begin the case with LM 0/1, LM 0/2 or more rarely LM 0/3 depending
on the circumstances.. The size of the solutions is usual 4 to 5 oz. and
the number of succussions used is 4 to 8. From the bottle 1 or 2
teaspoons are stirred into a dilution glass of 4 to 5 oz. from which the
client takes 1, or increasingly more teaspoons as a dose.

This gives us a basic idea of the relationship between the sensitivity

and constitutional states and the posology of the centesimal and LM
potencies. Such ideas help guide us in the choice of potency, dose and
repetition. One may find a mixture of signs in one individual as all the
factors included are relative in nature. Average out the related signs
and see where the predominance of factors point. One should always
err on the conservative side in the choice of the potency and dose
because it can always be increased if needed. Aggravations waste
time, slow down the cure, and are uncomfortable for the patient.

A Review of the LM and Centesimal Potencies

Hypersensitive patients (700-1000+)

Hypersensitivity is composed of over reactivity of the constitution,

idiosyncratic responses, the suppression of psora, suppression in
general, quickly developing organic pathology, diseases which up-
tune the vital force, and weakened vitality. The signs to look for
include rapid mood swings, hysterical states, nervous temperaments,
hyperactive senses, allergies, chemical and food sensitivities, quickly
changing pathological tissue changes, diseases in the later stages,
weakened vitality, and intolerance to changes in the environment,
weather and climates. Study the physical constitution to see if you see
diathetic signs of the chronic miasms or organic deformities.

Centesimals

Use 1 pill of the lower potencies like 6c, 12c, 24c, 30c in medicinal
solution.

LMs

Use 1 pill of LM 0/1 in medicinal solution.

Only use 1 pill in a larger medicinal solution. In sensitive patients one

can use from 5, 8, 10, 20, or more ounces of dilute to make the
medicinal solution. A larger amount of water helps moderate the
remedy right from the start. This medicinal solution should not be
succussed more then 1, 2, 3 times at the onset of treatment. Only 1/2
to 1 teaspoon should be taken and stirred into 4 oz to 6 oz of water in a
dilution glass. From this dilution glass only 1/2 to 1 teaspoon should
be used for the first dose. The number of succussion and the number
of teaspoons can be increased gradually if necessary to maintain a
curative response. When treating the true ultra-hypersensitive with the
LM 0/1 potency the dose must be moderated by diluting the remedy
through a series of dilution glasses. Hahnemann mentions up to 6
dilution glasses. The LM 0/1's medicinal powers are much more
developed than the 30 centesimal potency.

Moderate Sensitivity (400-700)

Constitutions of a moderate sensitivity (400-700) are the easiest to

treat. The moderate sensitivity is of balanced temperament, relatively
stable vitality, and their diseases are functional or at the beginning or
early development of pathology. These individuals are fairly tolerant
of different environments, foods and medicine.

Such constitutions can be started with the middle range potencies like
200c. In the LM system the 0/1, 0/2 or 0/3 are the normal opening
potencies. The succussions should start at a moderate number like 4, 5,
or 6. The average amount of the medicinal solution is 1 to 2 teaspoons
stirred in a dilution glass. From this glass the individual is given 1 or 2
teaspoons as a dose The dose can then be adjusted in the upward
direction by more succussions and amount if necessary. Please refer to
Hahnemann's Advanced Methods.

Hyposensitivity (1-300)

Constitutions low on the sensitivity scale (1-300). Hyposensitivity is

composed of inherited constitutional sluggishness, slow temperament,
low vitality reaction, venereal miasms, suppression, and diseases
which under-tune the vital force and produce slowly progressive
degenerative states. They are for the most part non reactive to
environmental stimuli or weather changes, etc. The signs of
hyposensitivity are flat mood, sluggish temperament, hypoactive states
and slow developing symptoms and insidious degenerative processes.
Investigate the physical constitution for the signs of the chronic
miasms or congenital deformities which stimulate low reactivity.
Normally, hyposensitive constitutions will have a history of lack of
reaction to natural treatments and homoeopathic remedies. They often
do not demonstrate the side-effects of allopathic medicines, and in
many cases, do not believe very much in healing.

The hyposensitive constitutions usually need fairly strong stimulation

to respond. They are suited to the higher potencies if there is not too
much organic pathology. In general, those with functional disorders
will tolerate remedies better than those with organic pathology. Many
of these cases can be started on the 200c and 1M potency centesimals.
Ultra high potencies like 10M, 50M, CM, and MM are normally
reserved for later if needed. One, or in the most hyposensitive, two
pills are used to make the medicinal solution. The upper range of the
LM potency is also indicated in many of these cases. The opening
potencies for true hyposensitives may be between LM 0/3, 0/4, 0/5,
and 0/6. It is better to start lower and work up than cause unneeded
aggravations.

The number of succussion should be at the higher end of the scale of 1

to 10. 7, 8, 9, 10, and increasing more, succussion may have to be
used. Succussion can really 'shake up' the vital force and get things
moving. Two or three teaspoons of the medicinal solutions should
then be stirred into the dilution glass and 1, 2, 3 or increasing more
teaspoons given as a dose until the desired response is attained. Many
of these individuals do very well on the 'split-dose' of the medicinal
solution or a series of dose. Refer to Hahnemann's Advanced Methods
for the details.

The Fine Tuning of the Medicinal Solutions

Now that we have discussed the basics of sensitivity and dose we need
to look at a few refinements and how to work up through the potency
levels. There are two ways to adjust the amount of the dose of the
aqueous solution. One way is to change the number of teaspoons of
the medicinal solution and the other is to change the the number of
teaspoons from the dosage glass. Increasing the number of teaspoons
(1, 2, 3) of the medicinal solution stirred into a dosage glass makes the
remedy act deeper progressively. At the same time, it dictates how fast
one moves through the potencies. If one uses 1 teaspoon of a 4oz MS
that makes 24 doses whereas if one uses 3 teaspoons from the
medicinal solution that makes 8 doses. After finishing the LM 0/1 the
standard practice is to move to LM 0/2 unless the case specifically
dictates otherwise.

When one uses a larger amount of the medicinal solution, it not only
increases the size of the dose, but also affects how fast one raises
potencies. Therefore, the amount and the arc of the potency is
increased at the same time. This means that in your lower average and
hyposensitive constitutions the progression through the potencies, LM
0/1, LM 0/2, LM 0/3, LM 0/4, etc, is much faster than the progression
a hypersensitive goes through. This is because a hypersensitive on the
smaller amount, and larger medicinal solution, may stay on LM 0/1
for a very long time with only the cumulative succussions slowly
raising the potency. The potency progression is almost self-regulating
in relationship to the sensitivity scale.

The second method is to increase the number of teaspoons from the

dilution glass. This is a more subtle increase of the amount and dose
which does not affect the progressive rate of consumption of the
medical solution or cause a more rapid ascent through the potencies.
This, however, can make a great difference in the reaction in some
sensitive patients. If you have a reaction but feel the need to increase
the dose, this is often the best way to start. I tend to first adjust the
action of a remedy up or down by increasing or decreasing the
succussions. If I am not satisfied with this, I will change the size of the
dose to larger or smaller amounts. First of all, I change the amount
from the dilution glass, and secondly, from the medicinal solution
itself. The same theorem is used with the centesimal potencies in
medicinal solution.

Succussions Versus the Amount

There are two major ways to adjust the medicinal solution. They are
increasing and decreasing the succussions and the size of the dose.
How are these two methods similar and how are they different? This
subtle question comes with experience in the method. These two
methods form a functional polarity of complementary opposites.
Succussions increase the potency causing the remedy to be more
active while diluting the remedy decreases the amount of the dose
moderating the effects of potency. In the best dose these twin factors
balance with each other. May I offer an analogy? When we increase
the succussions it seems to raise the frequency of the remedy to new
harmonics. When we increase the amount it seems to increase the
amplitude of the remedy. These have different effects on the vital
force. The succussions seem to 'shake things up' while the amount
seems to 'fill things out'. If I was going to use geometry as an analogy
I would say that the succussions have a vertical affect while the
amounts have a horizontal affect. The perfect balance of the two fills
the entire space. When I need more medicinal power to stir things up I
increase the succussions. When I wish to have more medicinal
qualities I increase the dose. This phenomenon can be witnessed but it
is hard to put into words.

Managing the Potency Factors

Normally, we work up through the potencies (LM 0/1, 0/2, 0/3, 0/4,
0/5 and 0/6, etc) as the solution is consumed. If one is not satisfied
with the progress of the case, or the effect seems to slow down, the
potency should be increased immediately. The same is true if a person
seems to relapse, i.e. the potency should be raised. This is another
reason you need to have LM 0/1, 0/2, 0/3, etc on hand. It is much the
same as with the centesimal potencies. For example, if a 12c
medicinal solution is not holding then the 30c might start the case
moving forward again. Of course, the higher the potency, the deeper
the effects, so more waiting and watching is in order with 200c, 1M,
10M, etc.. Nevertheless, with the medicinal solution in centesimal
potencies there is no need to wait if the client is only slowly
improving or wait for a complete relapse of the symptoms.

Once you have an LM 0/1 of a remedy it is fairly easy to make an LM

0/2, 0/3, 0/4, 0/5, 0/6 etc. This saves money but takes time and needs
the right pharmaceutical supplies (alcohol, distilled water, droppers,
and 1 dram vials). I have made many remedies in this fashion. One
must learn when one must raise the LM potencies while you follow
the case. As I said before most cases are started with LM 0/1, LM 0/2
and LM 0/3 but not all. This is like starting between 30 or 200 of the
centesimal remedies. The action may be even deeper although the
duration may not be as long in some cases. Starting an LM case with
LM 0/4, LM 0/5 and LM 0/6 is like 200c, 1M, and 10M but not
exactly the same. This is because the medicinal qualities of the LM are
quite different from the centesimals. The qualitative difference must
be learned through experience.

LM 0/1 has almost the same physical amount of the original substance
as a 6c but it certainly does not act like a low potency! LM 0/1 is
much deeper than a 30c and has the depth of a moderately high
potency (at least 200c or above but it's not really the same thing!). The
LM potency passes Avogadros number at around LM 0/4. This is
speaking of the base tincture, not the amounts when they are diluted in
the medicinal solution and the dilution glass. This causes the remedy
to pass Avogadros number more quickly. So in a sense you have a
remedy that is quite physical yet dynamic and has the best qualities of
both a high and low potency. It has great depth and yet it is repeatable
if and when necessary. The LM 0/1 is a much deeper acting remedy
than a 30c. It is best not to think of the LM potencies as low potency
remedies that can be repeated daily if you wish to avoid unnecessary
aggravations and utilize them in the proper manner.

Hahnemann's "new methods" are equally applicable to the centesimal

scale as the LM scale. The use of these complementary potency
systems greatly expands the therapeutic horizons of Classical
 Homoeopathy. We call on homoeopaths to make experiments and take
on trials with Hahnemann's definitive potency system. It will not be
easy for those who are only used to the posology methods of the 4th
Organon and the dry dose. Much new material must be digested and
trials carried out so that one gains experience. Those homoeopaths
who truly practice the methods of the 4th Organon are in a good
position to take on the advanced methods. This is because they have
mastered the wait and watch method and have real respect for the
medicinal powers of homoeopathic remedies. With this strong
foundation they have the background to truly practice the methods
Hahnemann introduced in his last 10 years (1833-1843). Many who
try to practice the LM potency without this background tend to
approach these dynamic remedies in a mechanistic fashion. They do
not have the experience in Homoeopathy to understand just what is
needed and what must be learned. Many students of Homoeopathy are
learning the correct way from the start which is indeed fortunate. As
more experience is gained in Hahnemann advanced methods more
qualified teachers will appear. Things are getting better.

I wish you all the best in your studies.

Similia Minimus

Sincerely, David Little

Part 1: The Origin of the Nosodes
Preface:

De Medicina Futura

"It is the duty of all of us to go farther in the theory and practice of

Homoeopathy than Hahnemann has done. We ought to seek the truth
which is before us and forsake the errors of the past."

Constantine Hering (1800-1880)

Hering and Nosodes

The advent of Hahnemann's theory of the miasms caused great interest in

the chronic diseases and their anti-miasmatic remedies. It was during this
period that the Hofrath introduced the methods of of acute and chronic
intercurrent remedies. During chronic treatment he interpolated acute
intercurrents when needed to remove a crisis and then he followed up
with complementary chronic treatment. Sometimes he would interpolate
a a dose of a chronic intercurrent during anti miasmic treatment. For
example, when Hahnemann was using Sulphur he would sometime
interpolate a dose of Hepar Sulph as an chronic intercurrent if the
Sulphur no longer seemed to hold as well. The chronic intercurrent
remedy is useful in the treatment of miasms, suppressions and obstacles
to the cure.

One of the direct consequences of the publication of The Chronic

Diseases (1828) was the development of the use of miasmic organisms
as potentized homoeopathic remedies for the treatment and prevention of
disease. It seems that shortly after Hahnemann published his chronic
disease theory, Hering performed the first proving of Psorinum on
himself. It was Hering's idea to use miasmic agents as potentized
remedies. The Greek word "Noso" is a prefix which is added to give the
idea of a disease indicating its morbid root. This term is also connected
with the Latin word "noxa", the root of the term noxious or damaged.
This implies the use of potentially dangerous noxious materials as a basis
for potentized remedies. That is why Hering called these remedies
"nosodes". As you can see by their very nature these remedies must be
used correctly.

Hering is responsible for greatly expanding the materia medica of

Homoeopathy and adding seven new categories of potentized remedies*.
At the same time, he was one of the true defenders of the four cardinal
rules of Homoeopathy, similars cure similars, the single remedy, the
minimal dose and the potentized remedy. Hering's seven uses of idem in
Homoeopathy includes:

1. The use of poisons taken from insects, snakes, and other venomous
creature (Animal poisons).

2. The use of remedies made from miasmas (Nosodes).

3. The introduction of potentized miasmas and morbid secretions taken

directly from the patient's body (Auto-nosodes).

4. .The use of homologous organs, tissue and secretions (Sarcodes).

5. The use of potentized miasmic products nosodes for the prevention of

infectious diseases (Nosode Homoeoprophylaxis)

6. The use of chemical and nutritional elements innate to the human

organism (Chemical and elemental relationships)

7. The use of potentized genus groups as curative and preventative

remedies for individuals, groups, and habitats. Hering suggests
potentized seed of weeds or dangerous plants to eradicate and destroy
those plants and potentized insects or animals to remove and prevent
infestations of dangerous species (Isodes).

*Lectures on the Theory & Practice of Homoeopathy, R.E. Dudgeon,

B.Jain Publishers (P) Ltd, Lecture VI, Isopathy, pages 141-175

Hering continued to experiment with nosodes of acute and chronic

miasms and invited others to conduct provings. He recommended the use
of potentized watery excrements of cholera, the black vomit of yellow
fever, the desquamated skin of malignant scarlet fever, to bind bags of
milk sugar in contact with skin of typhus patients, the use of leucorrheal
matter, etc. He introduced the use of psorine (Psorinum) gleet-matter
(Medorrhinum), pthisine (Tuberculinum) and syphiline (Syphilinum).
Many ancient isopathic remedies were introduced into the Homoeopathic
Materia Medica by dedicated homoeopaths of the 19th century.
Constantine Hering, W. Gross, Wilhelm Lux , Father Collet, Swan and
Burnett immediately come to mind.

Hering was the first to propose that the nosodes could be used for the
prevention of infectious diseases (homoeoprophylaxis). This research
was further confirmed by the work of Baron von Boenninghausen who
used Variolinum for the prevention of small pox. Hering also opined that
various disease vectors could be removed by the use of idem in potency.
He suggested that potentized weed seeds could be used for weed control
and that potentized insects could help remove infestations. At the same
time, he called on his colleagues to prove the nosodes of the chronic
miasms so that their therapeutic picture could be integrated into the
materia medica. Hering shared his information by letter with Hahnemann
and sent a sample of Psorinum which the Old Master proved on three
individuals. This research into the acute and chronic miasms, and their
nosodes, expanded slowly but surely under Hering's guidance.

Hahnemann's Views

Shortly after the publication of The Chronic Diseases, Hahnemann

reviewed the use of the miasms as homoeopathic remedies. He was
quick to point out that what Hering was suggesting was not the same old
isopathic method because the material used is potentized by the
homoeopathic technique and given in minimal dose. This changes an
ordinary isopathic substance into a homoeopathic remedy IF used
properly.

Vide aphorism 56 of the 4th Organon (1829).

"One could in reality admit a fourth manner of using medicine against

disease, i.e. to say the Isopathic method, to treat a disease by the same
miasm which has caused the disease. But supposing even that the thing
were possible, and it would certainly be a valuable discovery, as the
miasm is administered to the disease only after having modified it up to a
certain point by the preparation to which it is submitted, the cure will
take place in such a case only opposing the 'Simillimum simillimo'."

It is the transformation of the medicinal substances by potentization that

opens the Homoeopathic Materia Medica to the remedies used in the
ancient isopathic tradition. Dr. Swan, who proved Medorrhimun, was
once asked if it was legitimate to use nosodes against diseases when they
were not proven homoeopathically. His answer to this question was that
"since the symptoms of the infectious miasms have been observed in so
many individuals they represent a natural proving". The syndromes they
cause are similar to the conditions they remove even if the person does
not have the exact same disease. (What a rather interesting point!) In this
way a remedy like Morbillinum (measles nosode) has cured meningitis,
erthyematous lupus, conjunctivitis, and spontaneous abortion when
chosen by the characteristic signs and symptoms. All of these conditions
are similar to the complications caused by measles miasm in the
populace.

In the light of Hahnemann's logic the use of the miasmic material

without potentization was crude isopathy whereas their use in potencies
is within the realm of Homoeopathy. Vide The Chronic Diseases, the
chapter called "The Medicines".

"Thus potentized and modified also, the itch substance (psorin) when
taken is no more an idem (the same) with the crude original itch
substance, but only a simillimum (thing most similar). For between
IDEM and SIMILLIMUM there is no intermediate for any one that can
think; or in other words between idem and simile only simillimum can
be intermediate, Isopathic and aquale are equivocal expressions, which if
they should signify anything reliable can only signify simillimum
because they are not idem."

The major difference between isode and a homoeopathic nosode is that a

homoeopathic remedy is proven on the healthy so its symptom picture
and therapeutic range is greatly expanded. The idem prescription can
only be used for the same condition it causes or its prevention. Isopathy
without the principle of the potentized remedy is an extremely dangerous
method. Once an isopathic substance is dynamized it becomes a pure
homoeopathic potence. Therefore, it must be applied by the cardinal
principles of Homoeopathy if it is going to be used correctly.

Hering's Testimony

Hering wrote much on these subjects and we should research his original
works for a deeper understanding. He had complete faith in the
principles of Homoeopathy and wanted to apply them to new regions. Of
his tireless experiments Hering once said:

"It is the duty of all of us to go farther in the theory and practice of

Homoeopathy than Hahnemann has done. We ought to seek the truth
which is before us and forsake the errors of the past."

Hering gathered a tremendous amount of first hand experience in

proving nosodes and applying idem remedies to acute and chronic
diseases in the field. Hering introduced all these new remedies yet he
clearly pointed out their limitations when used by idem. All these
isopathic preparations cannot be regarded as absolute specifics, but only
as chronic intermediate remedies, which serve to stir up the diseases, and
render the reaction to the subsequently administered homoeopathic
remedy more permanent.

IN 1836 Hering stated that:

HE NEVER SUCCEEDED IN CURING BUT ONLY

AMELIORATING DISEASES WITH THEIR OWN MORBID
PRODUCTS

This was after 7 years of rigorous clinical trials. He gave a perfect

example of the proper use of idem in a case of suppressed syphilis which
would not respond to anti syphilitic remedies like Mercury so he used
Syphiline (his preparation of syphilinium) as an intercurrent. This
brought out the cutaneous eruption and chancre which was then perfectly
cured by Mercury followed by Lachesis. He had many similar cases.
Without constitutional treatment it is impossible to perform the perfect
cure.

THE TRUTH IS THAT POTENTIZED DISEASE SUBSTANCES ARE

ONLY TRULY CURATIVE WHEN THEY ARE *ADMINISTERED
BY THE TOTALITY OF THE CHARACTERISTIC SYMPTOMS*.
They then become the constitutional simillimum.

IF DISEASE PRODUCING PRODUCTS ARE ADMINISTERED

BY*IDEM* THEY ARE ONLY USEFUL AS *INTERCURRENT
REMEDIES* WHICH HELP TO REMOVE OBSTACLES TO CURE
AND MOVE THE CASE FORWARD. Their remedial actions must be
complemented by constitutional remedies if a complete cure is going to
take place. THIS IS THE PROPER USE OF IDEM REMEDIES
WITHIN COMPLETE CONSTITUTIONAL CASE MANAGEMENT.

These observations have been confirmed by generations of Classical

Homoeopaths. The pseudo homoeopaths remove the nosodes, allergens,
drugs and imponderabilia (magnet fields, electricity, etc.) from the
Homoeopathic Materia Medica and try to create their own healing
systems. These individuals often leave behind the maxim of the single
remedy and minimal dose and pay little attention to the individual
constitution and the symptoms. This leads one away from the permanent
cure because it looks outward at the medicinal substance rather than
inward at the individual constitution and the vital force.

Hahnemann's Concerns

From this time on Hahnemann became more cautious and conservative

in his comments on the use of idem in potency. In the 6th Organon (note
to aph. 56) he points out the isopathic work of Lux, and his close
associate Gross, but makes no mention of Hering. He reminds the reader
that once an idem is potentized it is a similar not identical remedy and
then speaks positively of the small pox inoculation with cow pox as an
example of prophylaxis by similar not same. Hahnemann supported
Jenner's small pox vaccinations because he felt they had reduced the
number of infections. It was Wolf, Hering and Boenninghausen who first
wrote about the negative affects of vaccinations. Hering and
Boenninghausen later used nosodes for the prevention of infectious
miasms. Hahnemann then goes on to say:

"But wanting to cure human disease (e.g. the itch diathesis or maladies
therefrom) with an identical human disease matter (e.g. with a psoricum
taken from the itch diathesis) is going too far. Nothing results from it but
calamity and aggravation of the disease."

Hahnemann was a Master Homoeopath who could not reduce the entire
case history to any one-sided aetiological symptom. Hering continued to
slowly expand his study of epidemiology, conduct provings and collect
clinical confirmations on the intercurrents and preventative remedies.
Nevertheless, Hering was always very clear about the limited yet
important role that potentized idem plays in homoeopathic methodology.

The half homoeopaths use intercurrent remedies (which cannot cure by

themselves in idem) in long mechanical schedules by allopathic concepts
of aetiology and antidotal medicine. This always runs the danger of
suppression, over medication and the disruption of the constitutional
picture. As Hering said, none of these isopathic remedies are curative in
themselves, and should only be used as intercurrents to remove obstacles
which block the complete action of the constitutional remedies! This is
the way to integrate the use of idem within the law of similars and
Classical Homoeopathy. This tradition is 160 years old!
Hahnemann taught that the totality of the symptoms includes all the data
related to the physical constitution, temperament, aetiology, miasms,
suppression, iatrogenesis and the signs (observations), befallments
(accidents, idiopathic conditions, coincidence) and symptoms as well as
the investigation of the obstacles to the cure. This complete case history
must be investigated in the order of its development (the timeline) so that
its fundamental causes and symptom layers are understood. Hahnemann
first recorded the phenomena associated with the reversal of symptoms
in 1828. Hering codified and expanded Hahnemann's observations and
Kent called them Hering's laws.

Obstructions to the Cure

Since the Old Master's time careful investigation of causation, the

reversal of symptoms and removal of obstructions to the cure has been a
center of classical case management. Sometimes constitutional treatment
needs to be complemented by the administration of an intercurrent
remedy to treat miasmic obstructions and suppressions so that blockages
to the cure are removed. When such knowledge is combined with
Hahnemann's advanced liquid delivery system and the methods of
adjusting the dose, aggravations can be kept at a minimum and the cure
rendered gentle, rapid and permanent.

The proper use of the idem intercurrent, IF AND WHEN NECESSARY,

is a method of traditional Homoeopathy when the maxim of the single
remedy and the minimal dose is respected. The use of a nosode, drug or
vaccine in potency is Homoeopathy when integrated into proper
constitutional case management. The same may be said of the use of
nosodes and homoeopathic remedies as prophylaxis for the prevention of
disease. All of this is an integral part of Classical Homoeopathy from its
earliest days. It is up to this generation of homoeopaths to bring it up to
date and put it into practice in the proper manner.

In review, what we have been discussing is part of Homoeopathy's

treasury of therapeutics when the cardinal principles are the guiding
light. If one separates the intercurrent remedies from traditional
Homoeopathy, and uses them only by idem, one cannot perform a
complete cure. If one overuses idem it will disrupt the natural symptom
pattern rendering the case more difficult to treat constitutionally.
Allopathic thinking combined with potentized remedies can only
produce a half homoeopathic-half allopathic system. If we want to
understand how to use nosodes correctly we must understand Hering's
complete strategy and posology methods and integrate them into
contemporary homoeopathic practice. This will be the subject of part
two.
Part 2: The Chronic Intercurrents
Hering and the Chronic Intercurrent Group

The following chapter brings up the subject of Hering's chronic

intercurrents and their role in constitutional treatment. An experienced
colleague on the Homeolist, the email group of the WWW.
Homoeopathic Webpage, inspired a discussion which elucidates the case
management strategies related to chronic intercurrent remedies.

Much of Hering's original contribution has been lost in the same way as
Father Hahnemann's. We only find references to his more exotic
experiments with nosodes, sarcodes, and isodes in our older works. For
example, Dudgeon gave his famous Lectures on Theory & Practice at the
Hahnemann Hospital, London, England between 1852-1853 only 10
years after Hahnemann left for his Heavenly Abode*. Hering was still
teaching and practicing in the USA until he passed away in 1880. The
more conservative Dudgeon's incredulous reactions to Hering's more
progressive experiments is one of the only remaining documents from
the time period. One of our mission goals is to find as much of Hering's
original material and make it available in the public domain. This will
help the worldwide homoeopathic community to begin research in many
of these little known areas of Homoeopathy.

*Lectures on the Theory and Practice of Homoeopathy, Dudgeon,

Lecture VI, Isopathy, page 141.

Questions:

Dear David,

Thank you for the very interesting post. It presented for me a new
viewpoint on the case management in classical Homoeopathy. At the
same time it created some additional questions.

You wrote:

The use of idem as an intercurrent, IF AND WHEN NECESSARY, is

one of the methods of Classical Homoeopathy if the maxim of the single
remedy and the minimal dose is respected. The use of a nosode, drug or
vaccine by idem is part of Homoeopathy when integrated into proper
constitutional case management.

My questions are:

1. Would you be able to explain more about indications for "the use of
idem as an intercurrent, IF AND WHEN NECESSARY"?
Answer:

First of all, we must deal with IF NECESSARY! A homoeopath studies

all the data related to the constitution, temperament, aetiology, miasms,
suppressions and their signs and symptoms in the chronological order of
development (aph 5.6.7.8). All the probable causes, befallments, miasms,
suppressions, drugs, immunizations, traumas and their symptoms are
reviewed in the order of their appearance. This information is needed to
study the phenomena associated with the laws of cure as expressed by
Hahnemann and Hering. If the totality of the characteristic symptoms
points clearly to a well proven remedy it is imperative to give the
simillimum at once.

The very fact that the vital force can express the disease state through
constitutional symptoms shows that no one aetiological layer demands
individual attention. To give a remedy that has an idem relationship with
any one supposed causation is counterproductive and potentially
disruptive to the natural symptom pattern. In such a condition an
intercurrent is NOT NECESSARY, and therefore, contraindicated. The
half homoeopaths often ignore this prime directive because they do not
understand the relationship between causation, constitution and
symptomatology.

Questions:

2. How would a homoeopath make a decision in case management to use

an intercurrent remedy? When would such usage would be
recommended to start?

Answer:

The subject of nosodes is quite misunderstood in modern Homoeopathy.

On the one hand, we have those who would only use a nosode as a fully
proven constitutional remedy, and on the other, we have those who give
them routinely by the name of a miasm without any symptomatology.
Surely there must be a middle ground between these two divergent
approaches? We know that in The Chronic Diseases Hahnemann
suggested the use of acute intercurrent remedies when constitutional
treatment was interrupted by an acute crisis.* Acute intercurrents are
chosen by the exciting cause and active symptoms of the acute crisis so
that they do not disrupt chronic treatment. Is there a relationship between
the usage of acute and chronic intercurrents for disruptions of the
curative process during constitutional treatment? What is the special role
of nosodes as chronic intercurrent remedies?
In 1833 Hering stated that:

"All these isopathic preparations can not be regarded as absolute

specifics, but only as chronic intermediate remedies, which serve to stir
up the diseases, and render the reaction to the subsequently administered
homoeopathic remedy more permanent."*

In 1836 Hering gave a perfect example of the proper use of idem in a

case of suppressed syphilis which would not respond to anti syphilitic
remedies like Mercury so he used Syphiline (his syphilinium) as an
intercurrent nosode.** This brought out the cutaneous eruption and
chancre which was then perfectly cured by Mercury followed by
Lachesis. Constantine Hering is the originator of the use of nosodes as
miasmic intercurrents.

*The Chronic Diseases (Theoretical Part), Hahnemann, B.Jain, page

224-230.

**Lectures on The Theory & Practice of Homoeopathy, Dudgeon, B.

Jain, page 146.

Characteristics of the Intercurrent Group

Hering noticed that certain characteristic symptoms are associated with

the indications of miasmic intercurrents. Just as the homoeopath who
works with families of remedies recognizes the nature of a plant group,
mineral group and animal group, Hering also recognized the
characteristic of the nosodes group picture. These characteristics
includes indications of the miasms concomitant to lack of vital reaction
to well chosen remedies, constant changing of symptoms, fragmented
pictures of constitutional remedies and one-sided miasmic signs with few
characteristic symptoms

Such individuals often have a sense of being tainted, guilty, dirty or feel
as if life is a burden, they never feel comfortable or satisfied in any
environment, they have discolored complexions and a look of suffering
in the face when relaxed, and they are prone to self destructive impulses,
cravings and habits. A differential analysis of the rest of the mental and
general symptoms will immediately uncover which chronic miasm and
therapeutic nosode is at the root of the picture.

Making a comparative study of the plant, mineral, animal and nosode

group symptoms is very helpful. The symptoms of the nosode group are
indications to study the case from the miasmic point of view. From a
study of the totality of the available symptoms one can uncover which
miasm is active or which nosode the vital force is calling to one's
attention. At such a time an intercurrent may be useful in removing
obstructions to the cure or bringing out a clearer picture. All miasmic
intercurrents should be complemented by constitutional remedies at the
appropriate time to complete the cure.

The following are some of the more characteristic rubrics associated

with the use of the nosode group as a chronic intercurrent remedy.

1. WHEN WELL CHOSEN REMEDIES DO NOT ACT, HOLD OR

JUST CHANGE THE SYMPTOMS. This is often caused by the
suppression of the chronic miasms, psora, sycosis, pseudo-psora, and
syphilis. This is one of the reasons it is important to know what miasms
are in the background of a constitutional syndrome. Otherwise the
prescriber may think they are choosing the wrong remedies and further
confuse the situation by picking more and more new ones. An example
of this usage of a nosode is Psorinum's keynote, Lack of reaction, when
well-chosen remedies fail to act, especially in those who are extremely
sensitive to cold, suffer from profuse sweating, filthy smell, dirty looking
skin, who tend to be very pessimistic about their recovery, etc..

Another example of this rubric is Tuberculinum's characteristic, when

symptoms are constantly changing and well-selected remedies do not
improve, especially in those who have light complexion, narrow chest,
lax fiber, low recuperative powers and constantly catch cold. There may
also be fear of cats, dogs, and animals in general, a desire to travel, and a
deep discontented state with a tendency to curse, swear, and a desire to
break things, etc.. All of the nosodes have these symptoms but each
characterizes it in their own way. This helps with the differential
analysis.

2. WHEN PROGRESS UNDER A CONSTITUTIONAL REMEDY

CEASES DUE TO A MIASMIC LAYER. This is a time when the use of
a miasmic intercurrent may be necessary. A client's symptoms point to
an inherited pseudo-psoric miasm and her symptoms fit Pulsatilla
perfectly. Pulsatilla is a strongly anti-tuberculin medicine as well as the
individual's constitutional remedy. After several months of solid
improvement the patient begins to relapse with the same symptoms, and
to one's great surprise, adjusting the dose of Pulsatilla no longer works.
Although there is no change of symptoms calling for a new remedy, the
previous remedy has become completely ineffective. If the
symptomatology shows an active tubercular miasm in the background
the homoeopath is led to the study of the tubercular nosode group.

The nosode may either move the case forward or set the stage for the
reintroduction of the Pulsatilla. If the case improves on the nosode the
remedy should not be changed. If the patient shows little change on the
nosode, one should retake the case, and if still indicated, give the
formerly used constitutional remedy. The nosodes are known for
resensitizing the vital force to a constitutional remedy making it act just
as dramatically as it did the first time it was given. This effect has been
witnessed by experienced homoeopaths over and over again. The
miasmic intercurrent may not radically improve the case other than to
make the former remedy act anew. There are times when this technique
is very useful.

3. "THE NEVER WELL SINCE SYNDROME" (NWS). Sometimes a

person never fully recovers from an acute or chronic miasmic episode.
The new miasmic layer changes their mentals and physical generals and
represses the innate constitutional picture. For example, one may use
Medorrhinum in a person who has a history of sycosis from which they
have never recovered. Once they may have been of sharp intellect, clear
memory, and of a calm nature, but all that has changed for the worse.
Now they have become very hurried as if time passes too slowly, they
can't follow the thread of a conversation because they are losing their
memory, and they've become fearful of the dark, superstitious, and suffer
from delusions that someone or something is always behind them. This
last symptom is very indicative of the paranoid suspicious state of
sycosis as it represents a subconscious delusion that something is going
on "behind their back" and is about to "get them". This can be an
indication that a miasmic intercurrent is needed.

The never well since syndrome (NWS) can also be applied to acute
miasms. There are times when a person has never fully recovered from
an acute illness and constitutional symptoms result. The affects of this
acute miasm remain in the vital force and form a layer of disruption
within the defense system. If this imbalance is strong it will become the
dominant layer and repress the weaker older symptoms. At other times,
the symptoms mimic the complications of the acute miasm in a subacute
or chronic-like form. Examples of potential causative agents are acute
miasms like influenza, diphtheria, measles, mononucleosis and
whooping cough from which the patient never really recovered. A study
of the potential disease states and complications combined the symptoms
collected from the individual can lead to the symptoms of Influenzinum,
Diphtherinum, Morbillinum, Pertussin, etc.

To never feel well since an acute episode can also be another indication
of the chronic nosode group as the true susceptibility lies in the
constitution. Knowledge of constitution, temperament, aetiology and the
signs and symptoms must be included in case taking. If the constitution
is healthy enough it will produce characteristic symptoms that will
dominate the vital force. This will lead to a constitutional remedy which
acts holographically and can affect any number of mixed susceptibilities
and complete the cure. A homoeopath does not give a nosode just
because a person has suffered from a miasms. The characteristics of the
miasms and the genus nosode remedies must be present.

4. THE LACK OF SYMPTOMS. There are times when there are very
few symptoms by which to prescribe. These are often one-sided cases
where a strong layer has repressed the ability of the constitution to show
symptoms. Other than the signs related to the pathology and the miasm
characteristics there is little on which to base a constitutional
prescription. This state may be caused by a combination of trauma,
miasms, suppression and drug side-effects. The underlying diathesis can
also be connected to inherited constitutional factors and miasms. The
miasmic nosode is sometimes used in one-sided cases with a limited
symptom picture (a prime characteristic symptom of the nosode group) if
there is a clear aetiological factor and nosode group characteristics.

Vide the discussion of the remedy, Tuberculinum, from Kent's Lectures,

"It seems from looking over the record of many cures that this remedy
has been given many times for just that state on a paucity of symptoms,
and if the records can be believed, it has many times balanced up to the
constitution in that anemic state, where the inheritance has been phthisis.
It is not the best indication for Tuberc., but where the symptoms agree in
addition to that inheritance, then you may have indication for the
remedy.".

There are two things that may happen after the ingestion of a nosode for
such conditions. Sometimes the symptoms improve, the vitality increases
and the constitution moves toward the state of health. At other times the
symptoms of the patient may become more plentiful as the suspended
layers within the constitution become active. This should then allow the
homoeopathic practitioner to prescribe a constitutional remedy based on
the newly arising syndrome and advance the case forward. The first new
characteristic symptom which arises is the key to the rubrics of the new
remedy.

5. WHEN PARTIAL PICTURES OF THE CONSTITUTIONAL

REMEDIES MANIFEST YET NO ONE REMEDY COMPLETELY
FITS THE CASE. Such cases seem to be fragmented and disorganized,
but in actuality, this pattern is characteristic of the miasms and nosode
group. An investigation of the miasms behind the fragmented picture
may reveal the symptoms of the nosode group. Differential analysis will
quickly show which nosode and miasm is involved. Such an intercurrent
often improves the state of health and regularizes the natural symptoms
pattern. After the nosode has done all it can do the symptoms will point
more clearly toward a constitutional remedy. In this way a nosode can
bring order out of chaos and clarity from confusion.

The nosode group characteristics are a signal to investigate the chronic

miasms and map their signs and symptoms as well as looking closely for
the symptoms of the major nosodes and anti miasmic remedies. There
are always objective signs and subjective symptoms which will
individualize the remedy if it is indicated. Over the years the use of
nosodes as intercurrents have proved useful assistants to constitutional
treatment if used correctly.

I would advise students of Homoeopathy to study constitutional

Homoeopathy deeply and integrate the use of intercurrent remedies
carefully into practice when needed to assist the cure. The isopathic
concept is so easy (use the same against the same) that many star-struck
beginners think they have found a short-cut way to do Homoeopathy.
They do not have enough experience in constitutional Homoeopathy to
understand those special moments when intercurrents are complementary
to constitutional treatment. Others are prone to falling into old allopathic
thinking combined with new age homoeopathic thinking. This leads to
the abuse of idem in potency and disruption of the natural symptom
pattern and constitutional state. In the name of treating layers, or
removing drugs and blockages, the half homoeopaths give more and
more remedies by idem and look less and less at the symptoms.

Posology Questions and Answers

Our homoeopathic colleagues asked two important questions:

1. "What would be posology recommendations for such intercurrent

remedy?"

David answered:

Questions of posology must always be individualized. There are no hard

and fast rules. Our strategy should be guided by the principles of the 4th,
5th and 6th Organon. If the nature of the situation and signs and
symptoms point to the use of an intercurrent remedy it should be given in
a single test dose. Remember, the idem remedy often stirs things up and
gets the symptoms moving so it is imperative to wait and watch. It is
quite foolish to rush into a series of doses at such a critical juncture in
the case. It is the role of the intercurrent to reorganize the symptom
pattern in such a manner that the signs and symptoms become clearer. If
the intercurrent starts a progressive improvement the single remedy
should be allowed to act alone. If there is slow progressive improvement
the intercurrent can be repeated at suitable intervals in the liquid split-
dose to speed the cure (5th and 6th Org). Only when the symptoms
change should the case be retaken and a complementary remedy given.

Do not repeat the nosodes without good reasons. By their very nature the
miasms and nosode group demands prudence and patience. Often an
chronic intercurrent brings out the symptom pattern so it is best to wait
until the symptoms have completely expressed themselves then retake
the case by the totality. The vital force will naturally show which
constitutional remedy it needs to complement the chronic intercurrent. In
this way miasms can be cured and obstructions to the action of remedies
can be removed.

2. What are the indications to stop using an intercurrent remedy?

As we have seen the symptoms of the nosode group appear when the
normal symptom pattern of the constitutional remedies is disturbed*.
There is usually lack of reaction, constant changes in the symptoms,
fragmented symptom pictures or one-side symptoms combined with the
signs of the classical miasms. What is normally considered a confusing
jumble of symptoms and pathology are actually characteristic rubrics of
the miasms and nosodes to one who understand the system. Thus
knowledge brings order out of chaos.

There are certain conditions which point to the conclusion of the

nosode's beneficial activity. If the first dose causes a striking
improvement wait until there are signs of relapse and begin to chart the
nature of the symptoms as they present themselves. If they are the
"same" symptoms continue to reintroduce the liquid dose. If a new
symptom pattern appears retake the case until you can find the
complementary constitutional remedy. It is important to wait and watch
the symptoms develop and be careful with the second prescription.

If the case progresses slowly but surely repeat the remedy at suitable
intervals (only in medicinal solutions of Centesimal and LM potencies)
as long as there is improvement and there are no new symptoms or
aggravation of old befallments. The "wait and watch philosophy" must
be the guide when the chronic intercurrent is being carefully repeated. If
old diseases appear from the past then suspend the dose and wait and see
how the symptom pattern develops. If they pass off without difficulty
continue repeating the well adjusted dose at longer and longer intervals.
Perhaps the nosode intercurrent was really the true simillimum and will
lead to a complete cure.

If there is a change of symptoms under the influence of the remedy it is

best to stop and see how the new symptom pattern develops. Wait and
see what the vital force is trying to show the homoeopath. Remember,
you are directly working with the chronic miasms when you use a
miasmic intercurrent so caution is advised. Keep retaking the case until
the new picture points clearly to the next remedy. A study of the new
symptoms will often lead clearly to a simillimum and the case will move
toward cure. This has been an area of research in Homoeopathy for 160
years.

The use of potentized drugs by idem (isodes) is much more

experimental in nature. They are useful as intercurrent remedies to
remove iatrogenic and toxic obstructions. The routine use of such
unproven drugs is normally unnecessary because constitutional treatment
often removes such toxins in the course of constitutional treatment.
There may be cases, however, where the use of isodes may be of benefit
as an intercurrent remedy. If we are to use the most offending drugs in
such method a deep study of the side-effects and overdose symptoms
should be collected. On top of this information provings of the most
common drugs should be untaken. This will complete their therapeutic
image.

One can see that to make a long list of drugs, suppressions,

immunizations, miasms and traumas along the timeline, and try to treat
them one by one by idem and specifics, is a counterproductive approach.
On the one side, we have the "classical purists" who ignore Hahnemann's
miasmic doctrine and Hering's intercurrents, and on the other, the
isopaths who give everything by a one-sided concept of aetiology. Some
claim they are practicing "Homoeopathy renewed' but in reality it is
allopathicoid thinking combined with hubris. We few Hahnemannians
are right in the middle working to reconstruct the original research of the
great masters and integrate it into contemporary practice.

Hering's contribution to the Homoeopathic Materia Medica is mythic in

its proportions. We must collect all his original material on these arcane
subjects and learn the signs and symptoms associated with the nosode
group and miasms. Those most qualified to do this research are
experienced traditional homoeopaths who have a deep understanding of
the totality of the symptoms and the nature of disease signs. It is time to
put our full classical legacy through a complete review and bring those
techniques which are useful up to date. It is for the homoeopathic
community to do the hard work like the Founders did in their time.

Ars Longa-Vita Brevis

The Second Prescription
James Tyler Kent
paper read before the International Hahnemannian Association
at Niagara Falls, 1888

What is more beautiful to look upon than the bud during its hourly changes to the rose in its
bloom. This evolution has so often come to my mind when patiently awaiting the return of
symptoms after the first prescription has exhausted its curative power. The return symptom-
image unfolds the knowledge by which we know whether the first prescription was the specific
or the palliative, i.e., we may know whether the remedy was deep enough to cure all the
deranged vital wrong or simply a superficially acting remedy, capable of only a temporary effect.
The many things learned by the action of the first remedy determine the kind of demand made
upon the physician for the second prescription.

Many problems come up to be solved that must be solved, or failure may follow.

How long shall I watch and wait? Is a question frequently asked but seldom answered.

Is the remedy still acting? Is the vital reaction still affected by the impulse of the remedy?

If the symptoms are returning, how long shall they be watched before it is necessary to act or
give medicine?

Is the disease acute or chronic?

Why is the second prescription so much more difficult than the first?

Why is it that so many patients are benefited when first going to the physician and thereafter
derive no benefit?

I presume that most good prescribers will say: "We have often acted too soon, but never waited
too long." Many physicians fail because of not waiting, and yet the waiting must be governed by
knowledge. Knowledge must be had, but where can it be obtained? To know that this waiting is
right is quite different from waiting without a fixed purpose. This knowledge cannot be found
where its existence is denied; it is not found with unbelievers and agnostics.

When the first prescription has been made and the remedy has been similar enough to change the
existing image, we have but to wait for results. The manner of change taking place in the totality
of symptoms signifies everything, yet the manner of the return of the image, provided it has
disappeared, signifies more.

First. If aggravation of symptoms follow;

Second. If amelioration of symptoms follow;
1. Aggravation of exiting symptoms may come on with general improvement of the patient,
which means well; but --

If aggravation of the symptoms is attended with decline of the patient the cure is doubtful, and
the case must be handled with extreme care, as it is seldom that such patients recover perfectly.

2. If amelioration follow the prescription, to what does the amelioration apply?

It may apply to the general state or but to the few symptoms. If the patient does not feel the
elasticity of life returning, the improved symptoms are the facts upon which to doubt recovery.

The knowledge that the disease is incurable often is obtained only in this way. In such cases
every remedy may palliate his sufferings, but cure does not come. The symptoms that are the
expressions of the debility are there, and hence the totality of the symptoms is not removed.

After the curative impulse has entirely subsided, the symptoms will appear one by one, falling
into place to arrange an image of the disease before the intelligent physician for the purpose of
cure.

If the first prescription has been continuously given, there has been but little if any chance of a
pure returning image of the disease, therefore this image must be very unreliable.

When the remedy has been fully exhausted, then, and only then, can we trust the symptoms
constituting the picture.

If the first prescription was the similimum, the symptoms will return - and when they return -
asking for the same remedy.

Too often the remedy has been only similar enough to the superficial symptoms to change the
totality and the image comes back altered, therefore resembling another remedy, which must
always be regarded as a misfortune, by which the case is sometimes spoiled, and the hand of the
master may fail to correct the wrong done.

Whenever the symptoms return the same image, calling for the same remedy, then it is that we
have demonstrated, that - for a time, if the disease be chronic - we can but recommend the range
of dynamics to cure this case. This rule is almost free from exceptions if the remedy is an
antipsoric.

What must the physician do who has not the knowledge of dynamic medicines? He must
sometimes see sick images come back without change of symptoms, though I believe it is
seldom.

The symptoms may call for Phosphorus as strongly as when he began, and Phosphorus 6x has
served and no longer cures. What can he do but change his remedy?
Can it be possible that man can be so ignorant of how to cure as to give a drug that is not
indicated because the one that is indicated does not cure?

These ignorant mortals condemn the system of Homoeopathy and feel that they have performed
their duty to the sick, forgetting that ignorance was the culprit.

I have observed in cases where a low potency had been administered in frequently repeated
doses, that some time must elapse before a perfect action will follow the higher potency; but
where the dose had not been repeated after its action was first observed, the new and higher
potency will act promptly.

When the symptoms come back - after prudent waiting - unchanged, the selection was correct,
and if the same potency fail to act a higher one will generally do so quite promptly, as did the
lower one first. When the picture comes back unaltered except by the absence of some one or
more symptoms, the remedy should never be changed until a still higher potency has been fully
tested, as no harm can come to the case from giving a single dose of a medicine that has
exhausted its curative powers. It is even negligence not to do such a thing.

Proper Time to Change

When the demonstration is clear that the present remedy has done all it is capable of doing - and
this demonstration can not be made until much higher potencies than usually made have been
tried - then the time is present for the next prescription.

To change to the next remedy becomes a ponderous problem, and what shall it be?

The last appearing symptom shall be the guide to the next remedy. This is so whenever the image
has been permitted to settle by watching and waiting for the shaping of the returning symptom-
picture. Long have I waited after exhausting the power of a remedy, while observing a few of the
old symptoms returning; finally a new symptom appears. This latest symptom will appear in the
anamnesis as best related to some medicine having it as a characteristic which most likely have
all the rest of the symptoms.

It is not supposed that this later appearing symptom is an old symptom on its way to final
departure, for so long as old symptoms re-appear and disappear it is granted that no medicine is
to be thought of.

It is an error to think of a medicine when a symptom-image is changing. The physician must wait
for permanency or firmness in the relations of the image before making a prescription.

Some say, "I must give the patient medicine or he will go and see someone else." I have only to
say that it were better had all sick folks gone somewhere else, for these doctors seldom cure but
often complicate the sickness.
The acute expressions of a chronic disease have a different management from the acute disease,
e.g., a child suffers from bronchitis in every change of weather. It may grow worse if treated
with the remedy for the acute symptoms.

The miasm that predisposes the child to recurrent attacks must be considered.

One recently under my care had received Antimonium tart., Calcarea, Sulphur, Lycopodium,
etc., in such indiscriminate confusion that the child was not cured. The waiting on Sac.-lac.
through several attacks permitted the drug-effects to pass off, and the true image of the sickness
was permitted to express itself through several of the exacerbations taken as a whole.

When western ague is complicated with a miasm, a single paroxysm does not fully express the
totality, but several must be grouped and the true image will be discovered. If the acute disease
be complicated with a miasm the indicated remedy will wipe it out "cito, tuto et jucunde."

Avoid Haste

All things oppose haste in prescribing. In very grave diseases haste is a common error, more
frequently with the second prescription than the first. Many doctors suppose that a diphtheria
demands a medicine immediately because "something must be done." This is an error; many a
life has been saved by waiting and waiting.

For example:

A little girl was suffering from a severe attack of diphtheria and the mother had treated it four
days with Mercurius 3x, and Kali bich. 3x, in alternation. She was poor, and therefore I did not
refuse to take the case which was then in a very bad state: nose, mouth and larynx full of
exudate.

After a long study the child received Lycopodium cm., one dose, dry, which cleared out the
exudate from nose and fauces, but did not touch the larynx.

I dare not tell you how long I watched that child before I saw an indication for the second
remedy which it would have needed had the Lycopodium been given when the child first took
sick. I waited until the poor child was threatening dissolution when I saw a little tough yellow
mucus in the mouth. Kali bich., cm., one dose, cleared the larynx in one day and there was no
further medication necessary.

The first prescription is made with the entire image of the sickness formed. (People usually send
for the doctor after there can be no doubt of the sickness to be treated.)

The doctor watches the improvement of the patient and the corresponding disappearance of the
symptoms under the first prescription, and when the case comes to a standstill he is uneasy, and
with increasing fidgetiness he awaits the coming indication for the next dose of medicine.
The fidgetiness which comes from a lack of knowledge unfits the physician as an observer and
judge of symptoms; hence we see the doctor usually failing to cure his own children. He cannot
wait and reason clearly over the returning symptoms.

While watching the prescriptions of beginners, I have observed very often the proper results of
the first prescription. The patient has improved for a time, the ceased to respond to any remedy.

Close investigation generally reveals that this patient improved after the first dose of medicine,
that the symptoms changed slightly without new symptoms, and the new "photo" seemed to call
for some other remedy, when, of course, the remedy was changed and trouble began. Constant
changing of remedies followed until all the antipsorics in the Chronic Diseases had been given
on flitting symptom-images, and the patient is yet sick. This is the common experience of young
Hahnemannians trying to find the right way. Some of experience make lesser blunders and some
make few, but how many have made none? All of these blunders I have made, as I had no
teacher, until I blundered upon the works of the great Master.

Wait and Observe

The first prescription may not have been well chosen medicine, and then it becomes necessary to
make a second effort.

As time brings about the re-examination of the patient, new facts are brought out in relation to
the image of the sickness, indicating that the first medicine had not been suitable; perhaps several
weeks have passed and the re-examination finds no change in the symptoms.

Shall I compare all the facts in the case to reassure myself of the correctness of the first
prescription, or shall I wait longer?

Yes, to the former, of course, and if the remedy is still the most similar to all the symptoms, wait,
and watch, and study the patient for a new light on his feelings to which he has become so
accustomed he has not observed.

Commonly the new study of the case will reveal the reason why the first prescription has not
cured: it was not appropriate.

If it still appears to be the most similar remedy the question arises: "How long shall I wait?"

At this point it should be duly appreciated that the length of time is not so important as being on
the safe side, and "wait" is the only safe thing to do. It may have been many days, but that
matters not, wait longer.

The finest curative action I ever observed was begun sixty days after the administration of a
single dose.
The curative action may begin as late as a long-acting drug can produce symptoms on a healthy
body. This guide has never been thought of by our writers, but it is well to be considered. Why
not?

It is the practice for some to go lower if a high potency has failed.

This method has but few recorded successes but should not be ignored.

The question next to be considered is the giving of a dose of medicine in water and divided
doses. This has at times seemed to have favor over the single dry dose. This is open for
discussion, requiring the testimony of the many, not of few, to give weight. The best reports are
made from both methods, and both are in harmony with correct practice.

Improper Action

The next important step to be considered is when the first prescription has acted improperly, or
without curative results. Then it becomes necessary to consider a second prescription. The first
prescription sometimes changes the symptoms that are harmless and painless into symptoms that
are dangerous and painful.

If a rheumatism of the knee goes to the heart under a remedy prescribed for the one symptom,
the remedy has done harm. It is an unfortunate prescription and must be antidoted. In incurable
diseases when a remedy has set up destructive symptoms, an antidote must be considered.

If the remedy changes the general symptom-image, and the general state of the patient is growing
worse, the question then comes up, was the prescription only similar to a part of the image, or is
the disease incurable? Knowledge of disease may settle this question. If the disease is incurable,
the action of the remedy was not expected to do more than to change the sufferings into peaceful
symptoms, and the second prescription is to be considered only when new sufferings demand a
remedy.

But suppose such a change of suffering comes after the first prescription and the disease is
undoubtedly curable, then the conclusion must be that the first prescription was not the true
specific, and that the true image has not been seen.

Wait until the old image has fully returned is all there is to do.

It is hazardous practice to follow up rapidly all the changing symptoms in any sickness, with
remedies that simply for the moment seem similar to the symptoms present. The observing
physician will know by the symptoms and their directions, whether the patient is growing better
or worse, even though he appear to the contrary to himself and his friends.

The complaints of patient or friends constitute no ground for a second prescription.

The greatest sufferings may intervene in the change of symptoms during progress of permanent
recovery, and if such symptoms are disturbed by a new prescription or palliated by inappropriate
medicine, the patient may never be cured.

The object of the first prescription is to arrange the vital current or motion in a direction
favorable to equilibrium, and when this is attained it must not be disturbed by a new interference.
Ignorance in this sphere has cost millions of lives.

When will the medical world be willing to learn these principles so well that they can cure
speedily, gently and permanently?

There can be no fixed time for making the second prescription; it may be many months.

The second prescription must be one that has a friendly relation to the last one or the preceding.
No intelligent prescription can be made without knowing the last remedy. Concordances in
Boenninghausen must not be ignored. The new remedy should sustain a complementary to the
former.

Remedies Suitable to Follow

In managing a chronic sickness the remedy that conforms to an acute experience of the illness is
worth knowing, as very often its chronic may be just the one that conforms to its symptoms.

Calcarea is the natural chronic of Belladonna and Rhus;

Natrum mur. sustains the same relation to Apis and Ignatia;

Silicea to Pulsatilla;

Sulphur to Aconite;

When Pulsatilla has been of great service in a given case and finally cures no more, while the
symptoms now point to Silicea, the latter will be given with confidence as its complementary
relation has long been established.

On the other hand Causticum and Phosphorus do not like to work after each other, nor will Apis
do well after Rhus.

How physicians can make the second prescription without regard to the experience of nearly a
century, is more than man can know.

These things are not written to instruct men of experience in the right way, but for the young
men who have asked so often for the above notes of our present practice.

I am told almost daily that this kind of practice is splitting hairs, but I am convinced of the
necessity of obeying every injunction.
 Careful Records

You should have no confidence in the experience of men who do not write out faithfully all the
symptoms of the patient treated, and note carefully the remedy, and how given. Especially is this
necessary in patients likely to need a second prescription.

The physician who has in his case-book the notes of every illness of his patients has wonderful
hold of any community. He has the old symptoms and the remedies noted that cured, and he can
make indirect inquiry after all the old symptoms long ago removed.

The pleasure is not small found in consulting such a case-book.

Experience soon leads the close prescriber to note all the peculiar symptoms and to omit the
nondescript wanderings indulged in by sick people; however, it is important to be correct in
judgment.

Many physicians make a correct first prescription and the patient does well and cheers up for a
while, but finally the test is made for the second and then all is lost. Homoeopathy is nothing if
not true and, if true, the greatest accuracy of detail and method should be followed. It is fortunate
that the physicians who repeat while the remedy is acting are such poor prescribers or their
death-list would be enormous.

Golden advice from "Kent".

Dr. Sayeed Ahmad D. I. Hom. (London)

* Experienced homopathic observers know very well that the burning, stinging, enlarged glands,
infiltration, hardness of the part, weakness, loss of flesh in a scirrhus of a mamma will not lead to a
remedy that will act curatively, also that dema of extremities, weakness, albumen in urine and heart
symptoms, dyspna and anxiety furnish no basis for a remedy for the patient. All know that
remedies given on such symptoms are only expected to comfort, and will not restrain the progress
of disease nor very much prolong life.

* The case is incurable until the case can be taken in a manner to Present what is true of the patient.

* It has often occurred that a remedy has made brilliant cures when it suited the patient, even
though it was not known to possess a strong likeness of the disease ; but let the likeness be first to
the patient and last to the disease. The patient is first and the disease is last.

* Study the patient and everything of the patient.

* The hip-joint patient has pain in the knee, perhaps some trouble in the uterus, or headache which
is said to be due to constipation.

To what is the constipation due ? Perhaps they had not thought of that.

* The center of man is his LOVES. When the loves go wrong he is sick in his will, the very center.
This we find in dealing with those who threaten to destroy their own life or the life of another.

EXAMPLE :

A faithful, noble wife has no fault to find with her husband in her natural life, but finds herself with
an aversion to him, does not want him to touch her. This is a symptom of the innermost of man, it
is not on a par with the skin and the toe-nails.

* The second point of consideration in the study of the patient is the intellectual functions, the
reasoning faculties.

* Memory disturbances come next in order in the mind but in study are less important.

* Next to the mental symptoms in importance are the PHYSICAL GENERALS. The physical
generals cannot be cured with Remedies that do not have the mental conditions.

* First of these to be considered is the patient's relation to heat and cold. He may be very warm,
desiring cool things, cool air, cool applications, cool food and light clothing ; or he may want heat,
cannot be too warm. He may be so cold that there is lack of vital heat.

* His desire for MOTION or REST is the next important physical general. Perhaps he cannot keep
quiet, never comfortable unless he is walking. At the same time his shoulder may be more painful on
motion of that part ; working the arm from the shoulder, and all that relates to that part, may be
worse from motion.

* The patient is first before his parts. Again you may have the patient himself worse from motions,
and all his aches and pains worse from motion. How he is affected by the air is another physical
general. He may be better or worse in the open air. If the patient is a woman, her menstruation must
be considered.

Menstruation is a function of the body, and she will say that she is worse or better during
menstruation, or worse just before or just after menstruation. The patient as a unit may be worse or
better after eating ; himself all over may be better or worse after the rectal evacuation, better after
stool ; these are important generals of the body.
* As the blood is, so is the love. The colour of the discharge expresses the condition of the blood
when there is a deterioration which renders them greenish. The greenish colour to discharge from
the vagina, as in cancer, represents the condition of the blood.

* When a symptom is common to all or to many remedies it is not important. Hahnemann's

emphasis is upon the symptoms strange, rare, and peculiar. These are most important.

* We go first to the generals and then to the particulars, proceeding from center to circumference.

* Then we come to the particulars, the thing for which the patient comes to be treated. Most cases
of hip-joint disorder cured by me in the past twenty-five years were cured by remedies not in the
hip-joint list. By beginning the investigation in relation to the patient, you may find none of the
particulars in the remedy selected, but the remedy cures the patient, and the particulars disappear.

EXAMPLE : DRY HACKING COUGH the patient was steadily emaciating.

Dr. Kent looked at the young man and noticed he had no overcoat on though it was very cold
weather. Asking him why he wore no overcoat, Dr. Kent found that he was never chilly, but wanted
the cold air, felt better in the open air, wanted to walk and work rapidly. LYCOPODIUM stopped
his cough and he increased in weight and was cured.

* You can give different remedies in succession without holding to any one, and after years, the
patient is no better, they are not curing the patient.

* Very sensitive patients should not be given too high a potency. For oversensitives it is best to
begin not higher than 1M. This can be repeated two, or sometimes three times, and then a higher
potency used. Each potency can be used two or three times with benefit.

* Remedies will seldom be found in the lists of all the particulars ; you must omit some, but be
certain to omit the particulars and not the generals.

* Start with the most important, proceed to the less and less important, on to the least important.

* You must get at the thing that is at the bottom.

* The man himself is prior to his organs, more interior than his organs. The condition of the organs
is the result of disorder more interiorly.

* You become expert in the use of the repertory, increasing from year to year, as long as you live. It
is a life work, a beautiful work, worth living to perform.

* In the woman the menstrual symptoms, of all particulars, are nearest to the generals ; they are
close to the life of the woman.
* Sexual symptoms, especially desires and aversions, are analogus to loves and aversions.

* The condition of the blood is analogus to the loves. Few remedies have recorded the condition of
the blood, that it will not coagulate, but it is a high grade symptom. It is common for blood to clot,
and rare for it not to clot.

* The study of man as to his nature, as to his life, as to his affections, underlies the true study of
homopathics.

* The more interior first, the mind, the exterior last, the physical or bodily symptoms.

* The doctor who violates the law also violates his conscience, and his death is worse than the death
of the patient.

* Removing symptoms may not restore health to the patient. Curing the patient will remove the
symptoms and restore his health (Organon No. 8).

* We must be guided by the symptoms that are strange, rare, and peculiar.

* However, some of the common symptoms may become peculiar where their circumstances are
peculiar -- i. e. --- Trembling before a storm, or during stool, or before menses, or during urination,
is rare and strange.

--- Weakness is also common if constant, but it comes only before menses, or before stool, or
during a storm, it is at once quite uncommon, and changes the view of the case.

--- Chilliness, if constant, is common to many people, but if comes only before or during menses,
before or during stool, or while urinating, or only when in bed in the night, or only while eating -
then it is strange and peculiar, or uncommon.

* The mental symptoms, composed of his reasoning powers, loves and hates, and memory. And
then his general bodily symptoms and their circumstances, such as worse from cold, from warmth of
every kind, from weather, wet and dry, from motion or rest, time of day, etc. These are of highest
importance when they apply to the whole body.

--- The pain in the shoulder was worse before a storm.

DULCAMARA cured at once.

--- Cold air may aggravate the patient but ameliorate the headache.

--- The patient is often better by motion, but his parts, if inflamed, are worse from motion.

--- Parts are better by heat when the patient is better from cold, and vice versa. The headache is
better from cold, and the body is better by heat.

If we do not consider these circumstances, we do injustice to the Patient and his parts.
* Common symptoms alone will lead to failure of the prescription.

We might as well attempt to prescribe for nervous dyspepsia, gastritis, jaundice, gallstone colic,
enteritis, constipation, or a bilious temperament. The beginner often fails because he has secured
only the common symptoms.

* Many cases coming for advice express the particulars, and fail to give the symptoms that
characterise the patient. This must be one of the most frequent causes of failure with the young
physician.

EXAMPLE :

With menses too late or suppressed or scanty, the patient weeping, with aversion to fats, nausea,
vomiting, weight after eating, the young man will say PULSATILLA at once ; but wait a moment.

The patient is very chilly, likes the house, never needs the open window, is worse from motion,
wants to keep very quiet ; now you change your mind and give her CYCLAMEN. Or, if she is
better in motion and in open air, and craves it, and is too warm, then PULSATILLA. The physician
cannot be careless, and cure as Hahnemann did.

* I (Kent) seldom administer medicine until the paroxysm has been completed. When the first dose
is followed by a perceptible aggravation, a second dose should never be administered until the
amelioration, which follows the aggravation, has ceased.

* An amelioration that begins forthwith also demands that all medicine be stopped, but such
amelioration is seldom so striking as when the amelioration has been preceded by a slight
aggravation. Immediate amelioration often indicates the absence of deep-seated disease.

* The law seems to fail where the selection has been perfect, and the potency suitable by meddling
with the action of the remedy. This fault is a common one and depends upon ignorance of the
philosophy of Homopathy.

* A deep seated trouble changing under the action of a remedy, coming to the surface, though the
suffering be increased ten fold the remedy must not be disturbed or the cure may never be realised.
Though the patient say "I am so much worse, just see how I suffer", he must have sac lac.

* The ulcer may close and a diarrha appear as intractable as the ulcer. This shows that the proper
disease has no tendency to recover.

* Nature operates under fixed principles. Now it must be known first of all that diseases recover
from above downward from within out and in the reverse order of their coming. When the
phenomena of disease do not follow this circumscribed limit of directions the disease is growing
worse or at least progressing.
* It is so common for a patient to return after a correct prescription saying, "I am much worse
today". The physician must now look into the case. If the new symptoms are such as were noticed in
the early progress of the disease the cure is certain if properly conducted.

* If the new manifestation is felt on deep organs that have not heretofore been touched or given rise
to symptoms, the disease may be known to be deep seated and most likely incurable.

* Sharp aggravations after a prescription the direction being from within out is a sign of speedy
recovery.

* Following a prescription for chronic rheumatism, if heart symptoms intervene the patient never
will recover.

* If the acute symptoms following a careful prescription are prolonged, the recovery will be slow.

* The law will fail to be of service to him who knows not how to apply it.

* When you do not know what to do, why do you do anything ?

The great mistake rests in the ambition to do something. No man should consent to do a wrong as a
substitute for an unknown right way. Be sure that you are right, then go ahead.

* When we have to do with an art whose end is the saving of human life, any neglect to make
ourselves thoroughly masters of it, becomes a crime. (Hahnemann).

* There are physicians who call themselves homopaths, but are so only in name, as they do not
follow the methods worked out by Hahnemann.

* The name of the disease does not reveal the symptoms in any case of sickness ; the symptoms are
the sole basis of the prescription.

* The intelligent physician does what law and principles demand and nothing more ; but the
ignorant one knows no law and serves only his wavering experience, and appears to be doing so
much for the patient, in spite of which the patient dies.

* You cannot depend on lucky shots and guess work, every thing depends on long study of each
individual case.

* Science ceases to be scientific when disorderly application of law is made.

* The physician spoils his case when he prescribes for the local symptoms and neglects the patient.

* It is better to do nothing at all than to do something useless ; it is better to watch and wait than to
do wrong.

* Large doses really aggravate the disease, high potencies aggravate the symptoms of the disease.
* A man who cannot believe in GOD cannot become a Homopath.

* Repeated doses may suppress the symptoms but will not cure ; you are getting only the primary
action, the curative action is not at work.

* It is worse than useless to give a second dose until the effects of the first dose have ceased.

* Pathology has no place in an effort to select a medicine for the sick.

* When a remedy has benefited a patient satisfactorily, never on your life, change your remedy, but
repeat that remedy so long as you can benefit the patient. Do not regard the symptoms that have
come up.

* Never prescribe for a chronic case when you are in a hurry ; take time. Never give a dose of
medicine until you have duly considered the whole case.

* A keynote prescriber is but a memory prescriber ; he has memorised only and has not made it a
part of his understanding.

Such prescribers are almost useless and it is among them that we find "falling from grace".

* If a cure is made in the course of two or three years it is indeed a speedy cure. It takes from two to
five years to cure chronic diseases.

* In advance phthisis with pathological symptoms, if you prescribe for the old symptoms which
should have prescribed for some years before, you kill your patient.

* A sycotic is never cured unless a discharge is brought back.

* Treat the cause and not the effects of disease.

* The mind symptoms, if you can know them, are the most important. If the pathological symptoms
seem to contra-indicate a remedy, and the mental symptoms to indicate it, these are to be taken.

* In cases without symptoms, the patient must be kept on sac lac until you can discern some general,
such as aggravation of symptoms in the morning, or at midnight. If the patient is only "tired",
without guiding symptoms, you may know that it is liable to terminate in some grave disorder.
Consumption, Bright's Disease, Cancer, or the like.

* The healthier the patient becomes the more likelihood there is for an eruption upon the skin.

* Never leave a remedy until you have tested it in a higher potency if it has benefited the patient.

Reference :
"New Remedies Clinical Cases Lesser Writings Aphorisms and Precepts" of J. T. Kent.

Can Homoeopathy be Dangerous?

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David Little 1996-2007, all rights reserved.

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Healer Do No Harm!

The question has been asked "Can Homoeopathy be dangerous?". Homoeopathy is an extremely
safe healing art when the practitioners is well trained in this healing art. Homoeopathy is only
dangerous when the cardinal principles which Samuel Hahnemann integrated into Homoeopathy
are ignored. The cardinal principles are similars cure similars, the single remedy, the minimal
dose, and the potentized remedy. These four principles form the checks and balances which
make Homoeopathy a safe and effective healing art. When the cardinal principles and
methodology of The Organon of the Healing Arts are carefully learned they provide the
foundation of a safe, rapid and gentle cure.

On this solid basis a homoeopathician learns how to avoid and manage the potential side-effects
encounter ed during the process of healing. For this reason it is important to learn proper case
management procedures. One of the most important areas of study is the nature of various
remedy reactions and their causes. If this basic material is understood Homoeopathy is extremely
safe when compared with other systems. If, however, homoeopathic remedies are used without
an understanding of the basic principles and methodology of Homoeopathy they have the
potential to be dangerous. Homoeopathy provides its own safety net which can not be found in
other systems which use homoeopathic potencies in unhomoeopathic ways.

It is most important point is to understand homoeopathic posology and methodology very well.
This avoids most of the potential trouble and offers effective counter measures for those negative
situations which may arise. In order to offer some light on this subject we offer the following
material for study which reviews the safety factors integrated into Homoeopathy by Samuel
Hahnemann.

1. Appendix 1a., The 4 Cardinal Principles of Homoeopathy.

2. Appendix 1b. A Concise Review of Remedy Reactions.

3. Appendix 1c. Questions and Answers.

The Four Cardinal Principles of Homoeopathy

Homoeopathy is based on four cardinal principles: likes cure likes, the single remedy, the
minimal dose and the potentized remedy. These are the checks and balances which make
Homoeopathy a safe and effective system. Thus Homoeopathy has a safety net integrated into
the use of similars. The following article is a post from my archive that deals with this subject.
This sets the foundation of homoeopathic philosophy.

1. The First Principle of Homoeopathy is Similars cure Similars.

Homoeopathy uses the similar remedy to cure similar diseases. All homoeopathic remedies are
tested on healthy volunteers so that the symptoms they produce demonstrate the nature of the
illnesses they will cure. After careful provings they are tested in clinical trials on those who are
ill with similar disorders. After a detailed assessment of their potential causative rubrics and
symptomatology these similar remedies are entered into the homoeopathic repertory and materia
medica. Thus the homoeopathic reference works are a careful balance of provings and clinical
confirmations. Homoeopathic remedies are chosen by similar constitutional factors, aetiology
and the totality of the signs and symptoms. A remedy chosen in this way is called the
"simillimum".

All diseases have an effect on the entire human organism which manifests as signs and
symptoms on the mental and physical levels. The instinctive vital force attempts to externalize
constitutional disharmony in the form of local affections and one sided complaints in the more
external parts. This movement outward acts as a pressure valve which seeks to protect the inner
most sensitive organs of the mind, nervous system, lungs, heart, liver, kidneys, etc. Therefore,
the constitutional vital force may set up a local discharge, a regional affection or a persistent one-
sided complaint to palliate an internal disorder. This phenomena has been observed since the
time of Hippocrates (c. 450 B.C.), the father of the constitutional philosophy.

If a local manifestation of this constitutional derangement is treated one-sidedly by a single

symptom or a common disease name it may suppress this palliatory expression of the vital force
causing the disease to metastasize to the interior regions producing a more complex pathological
state. This is a primary aspect of the suppression syndrome as recorded in the Introduction of The
Organon of the Healing Arts (page 32 & 33) and The Chronic Diseases. Such phenomena can be
caused by homoeopathic, naturopathic and allopathic remedies when used improperly. For
example, I once gave a remedy which cleared up a digestive problem and rapidly caused
maddening headaches and a crisis of the inner ear. One would have to be in tremendous denial
not to admit such a mistake. Fortunately, those trained in the complete homoeopathic system
have been taught to watch for such negative signs and know how to apply the appropriate
counter measures.

For these reasons traditional homoeopaths collect all the data related to the spirit and mind,
domestic and social relationships, the physical constitution, aetiology, miasms, iatrogenesis,
suppressions and the signs and symptoms (Org. 5, 6, 7, etc.). In this way a homoeopath avoids
treating any one single symptom and the use of nosological disease names as a basis for a
prescription. A homoeopath uses the symptoms of the complete mind-body complex as the basis
for the administration of a homoeopathic potency. In this way the suppressive potential of
homoeopathic remedies is neutralized.

Many eclectics mix several healing methods in such a manner that can only be called unique.
Some are using potentized remedies in combinations under the illusion that they practice a new
improved form of Homoeopathy or naturopathy. Others give new-age health products which
have vitamins, minerals, herbs and homoeopathic remedies. These remedies are not administered
by the law of similars and can truly be called unhomoeopathic. The combination remedies of old
times were low potencies given by simple indications. Today's new age combinations have high
potencies or all potencies mixed together. These individuals are under the illusion that
homoeopathic remedies are completely safe no matter how one uses them. Nothing could be
further from the truth.

Some individuals use potentized remedies in a questionable manner because they remove the
safety features Hahnemann integrated to lower the chance of side-effects. One such system is the
Sequential Therapy (ST) of Elgimer which uses combinations of high potency remedies chosen
by causations, disease names, and isopathy. Some of his students claim that Hahnemann had two
methods of giving remedies, the homogenic and homoeopathic. These so- called "homogenic
remedies' are prescribed by disease names without any recourse to the signs and symptoms of
the patient. Such methods increase the chance of suppression, prolonged aggravations and
remedy produced diseases.

2. The Second Principle of Homoeopathy is the Single Remedy.

Homoeopaths do not look at each individual disease name or symptom in isolation. They look at
the entire constitutional expression of the individual through the totality of the symptoms. As
each individual represents a single mind/body organism any mistunement of the unitary vital
force produces a syndrome of signs and symptoms. This singular constitutional state is most
similar to the single remedy that is the simillimum of the entire derangement. The singularity of
the similar remedy reflects the integrated nature of the defensive powers as well as the unitary
nature of the vital force. The single remedy allows the vital force to concentrate its maximum
healing power on the essential picture of the illness rather than dispersing vital energy in reaction
to several medicinal influences simultaneously.

The reason homoeopaths do not use combination remedies is that it makes case management of
complex problems almost impossible. Combination remedies often have remedial qualities
which are contradictory in nature. The practitioner has no idea what the combined action of
several remedies and potencies may have on the individual. There is no way to manage a case
because you can not tell what may be causing aggravations, new symptoms or amelioration.
Combinations have no provings which test their actions on the healthy so their indications in
disease are completely unknown. Hahnemann also experimented with dual remedies in 1832 but
found them ineffective and their actions difficult to assess. For these reasons he left them
completely behind. These are a few of the reasons homoeopaths do not use combination
remedies. They are inherently allopathic in nature.

A homoeopathic remedy works by being similar to the disease state but slightly stronger due to
potentization. The primary action of the homoeopathic remedy is opposed by the secondary
healing action of the vital force which leads to the cure. If a constitution is too warm a similar
warm remedy in potency will stimulate the opposite reaction of coolness from the instinctive
vital force bringing the individual toward a balanced state of health. This is Hahnemann's model
of how homoeopathic remedies work (Organon, 63, 64, 65, 66). Sensitive constitutions make
the best provers (remedy testers) of homoeopathic remedies because they will react to almost any
remedy. This has been demonstrated many times. The homoeopathic materia medica is based on
provings on the healthy as well as clinical confirmations on the ill. In this way homoeopaths
know the remedial actions of their potentized remedies.

It is those with sensitive constitutions, hidden pathology, and weakened vitality who are prone to
be hypersensitive to homoeopathic remedies. They make up a significant percentage of our
contemporary cases. If such a constitution is too warm, and they are given a cold remedial
potency, the vital force will oppose this primary coolness by producing more secondary heat
making the disease worse not better. Such phenomena have been documented. If we give a
combination of remedies including a shy remedy, an aggressive remedy, a cold remedy, a hot
remedy, a dry remedy and a moist remedy, the secondary action of the vital force may become
fragmented running the danger of confusing secondary reactions, coincidental suppression and
disruption of the natural symptom pattern. Such reactions are often mistaken for deeper
layers, cleansing crises or new diseases by those who have not mastered the fundamentals of
homoeopathic methodology. Such difficulties can be avoided by a proper education in
homoeopathic philosophy.

3. The Third Principle of Homoeopathy is the Minimum Dose.

Hahnemann learned early in his career that medical practice was dangerous. The side-effects he
experienced with orthodox medicine upset him so much he stopped using allopathic drugs and
treatments. After this bitter experience he decided to practice the natural healing arts in the
tradition of Hippocrates, the father of western medicine. The ancient Greeks were very careful
with the use of medicines. They relied on diet, lifestyle, exercise and philosophy for cure as well
as materia medica. Hahnemann's use of the Hippocratic methods was so successful that the first
"Hahnemannian Treatment" was pure Greek naturopathy. As the young doctor applied his 'new'
treatments he began a search for the proper ways to use remedial agents. This was the beginning
of Homoeopathy.

Hahnemann was very careful with his doses of homoeopathic remedies. Many homoeopaths
misunderstand the nature of the minimal dose. Most modern homoeopaths believe that there is
no difference in the action of one homoeopathic pill and one thousand pills ad infinitum. They
confuse the small amount of original substance in a high potency with the maxim of the minimal
dose. In truth they are two different synergistic principles. The concept that the dose does not
matter can be traced to James Kent and can be found in his classic Lectures on Homoeopathic
Philosophy in the chapter called On Simple Substance. In this work Kent explains the
Swedenborgian theory that energy is based on a fourth state of matter called the "simple
substance". Hahnemann noticed right from the very start that a homoeopath must be very careful
with both the potency and size of the dose. He found that the size of the dose was as important as
the potency factor in the producing the phenomena of aggravation. For this reason the amount of
the dose is as carefully regulated as the level of the potency in Hahnemannian Homoeopathy.
Vide aphorism 275.

"The suitableness of a medicine for any given case of disease does not depend on its accurate
homoeopathic selection alone, but likewise on the proper size, or rather smallness, of the dose. If
we give too strong a dose of a medicine which may have been even quite homoeopathically
chosen for the morbid state before us, it must, notwithstanding the inherent beneficial character
of its nature, prove injurious by its mere magnitude, and by the unnecessary, too strong
impression which, by virtue of its homoeopathic similarity of action, it makes upon the vital
force which it attacks and, through the vital force, upon those parts of the organism which are the
most sensitive, and are already most affected by the natural disease."

Modern physics states that all forms of energy are contained in small energy packets called
quantums. The amplitude of a force is increased when the number of quantums of energy present
are expanded at any given wave length. In the same way, Hahnemann taught that each pill of a
homoeopathic remedy possessed a certain amount or "quantum" of medicinal energy. In a sense
the potency of a remedy represents the wave form or frequency of the energy and the number of
pills represents the amplitude or power of the signal. This is why the power of a homoeopathic
dose increases each time the practitioner uses more pills when preparing the remedy for
ingestion. Hahnemann gave a direct warning about the abuse of the small number #10 pills. Vide
The Chronic Diseases.

"The physician can, indeed, make no worse mistake than first, to consider as too small the doses
which I (forced by experience) have reduced after manifold trials and which are indicated with
every anti psoric remedy...."

As the potencies of homoeopathic remedies became higher Hahnemann progressively reduced

the size of the dose. This is why he stopped using drop doses of the alcohol base potencies and
began using the small pills we are all so familiar with. Even here he found that the number of
pills still needed to be strictly controlled. In the note to this page Hahnemann speaks of the
mistakes he made in his earlier experiments when he used too many pills in his homoeopathic
practice.

"I have myself experienced this accident, which is very obstructive to cure and cannot be
avoided too carefully. Still ignorant of the strength of its medicinal power, I gave Sepia in
too large a dose. This trouble was still more manifest when I gave Lycopdium and Silicea,
potentized to the one-billionth degree, giving four to six pellets, though only as large as
poppy seeds. Discite moniti!"

Most modern homoeopaths interpret the size of the dose as being synonymous with the level of
the potency. They mistakenly believe that using the smallest dose relates to the tiny amount of
the original substance present in a high potency remedy. This is not the full story as Hahnemann
speaks of the difference between the size or amount of a dose and the potency factor in his
writings. Hahnemann taught that the phenomenon of the aggravation was not only linked to the
potency, but also to the number of pills used when giving the dose. The unwarranted use of a
random number of pills of a high potency remedy is the exact opposite of what Hahnemann
taught as the minimal dose.

The minimal dose means that the homoeopath should use the least amount of medicinal
stimulation necessary to bring about a healing reaction. This is why the maxim of the minimum
dose includes three variable factors, i. e. the size of the dose, the level of the potency, and the
number of times the remedy is used. Hahnemann recommends that a homoeopathic remedy be
given in a dose as "sufficiently minute i.e. as small as possible". This is because even the correct
homoeopathic remedy given in proper potency but in an unnecessarily large amount will
aggravate the case and delay the cure. In patients with severe pathological tissue changes,
hypersensitivity, or suffering from lack of vitality, large doses may be dangerous.

4. The Fourth Principle of Homoeopathy is the Potentized Remedy.

Some remedy combinations are low potencies, some are high potencies, some are mixtures of
both. Some have several potencies of several remedies. None of the potencies in such
combinations can be individualized to the disease state nor symptoms. There is absolutely no
standard of manufacture nor uniform code of administration. Potentized remedies are extremely
powerful and should not be treated like some new age holistic "good for everyone" health
product. Most combination practitioners do not understand the homoeopathic posology system
nor how to apply it to an individual state of disease. This is because they do not understand the
science and philosophy of Homoeopathy. *This increases the risk of side-effects.

* In this document I have exclusively used the words like "potential to, may cause and runs the
danger of, etc.." This is because such negative phenomena depend on variable causes and
circumstances and are not absolute in nature. Nevertheless, the percentage of cases in which they
do occur should be of concern to healers in all fields.

Discite Moniti! (Heed this warning!)

"Discite Moniti!" cried Hahnemann in The Chronic Diseases (page 206) after he misused his
new anti-psoric remedies in ignorance of their potential powers. Homoeopaths have always tried
to learn from their mistakes and prevent others from repeating them. It is the principles of
individualization, likes cure likes, the single remedy, the minimal dose and the potentized
remedy which makes Homoeopathy a safe and effective system. Without these cardinal
principles the use of similars is potentially dangerous. These are the checks and balances that
Hahnemann integrated into his system as he perfected the method. It is these principles which
provide the path to a gentle, rapid and permanent cure.

Why do classical homoeopaths respect these principles so much??? Because over the years in our
ignorance we have given the wrong remedies and caused negative affects, suppressed symptoms
with partial simillimums, given the wrong potency, used too large a dose, disrupted the vital
force with untimely repetition, and aggravated cases to the point of danger on occasions. Such
difficult moments are great teachers. They cause one to go back to basics and see where one has
gone wrong. Our cautions are not given lightly nor with lack of personal experience. We have
also witnessed suppressions, over medication, and symptom disruptions coming from other
healing disciplines. Remember the first Hippocratic maxim is "Healer ,do no harm!"

The night can be long and sleepless for a homoeopath with a conscience. Hahnemann learned by
trial and error and so must we. That is the lonely path a healer must tread. No one has a perfect
track record. Homoeopaths have always been very honest about this. As one's remedies become
more accurate, and one's cases more serious, the potential for difficulties only deepens. Some say
they have never seen any problems, suppressions, aggravations nor side-actions caused by
homoeopathic remedies. For them such a thing is impossible, and therefore, it does not exist at
all. Do they mean that all those homoeopaths who have witnessed such things over the last 200
years must be crazy? Such is the state of their denial.

To those of us who have caused problems in our own cases, as well as discussed them in the
cases of our honest colleagues, such absolute claims sound very, very hollow. We have case
histories which demonstrate the negative affects of giving an incorrect homoeopathic remedy and
the wrong potency and dosage. We have accepted our mistakes and try to learn from them as all
responsible healers must do. If one carefully follows the cardinal principles of Homoeopathy
such difficulties can be reduced to a minimum and mistakes easily rectified. Without the
homoeopathic principles the power of potentized remedies is very difficult to control.

This wisdom is born of two centuries of clinical experience and is not religious dogma,
fundamentalism nor prideful fanaticism. Many do not understand the chain of human experience
behind these cardinal principles and cautions. Even to become a homoeopath takes 5 years of
training to learn the basics and another 5 years of clinical experience to master those
fundamentals. For the next 10 years one must keep studying case histories and materia medica
daily. Then one finally is an experienced homoeopathician. There is no other way. Of course,
many are looking for a short cut because they lack the dedication it takes to be a real
homoeopathician. I have watched such healers over the last 25 years and their knowledge of
Homoeopathy never grows. They do the same things today as they did all those years ago. If one
takes a "short cut" in the beginning one's knowledge is "cut short" in the end. You get out exactly
what you put in!

A Concise Review of Remedy Reactions

The Organon of the Healing Art is the text on which Homoeopathy is based. It teaches
homoeopathic methodology and case management in a grand fashion. One of the subjects is a
detailed study of the positive and negative signs which may be elicited by homoeopathic
remedies. Much of the material on remedy reactions seems very complex, but when it is broken
down into its basic components, it becomes easier to understand.

The first dose of a homoeopathic remedy is a test dose. No one can judge the constitutional
sensitivity of each individual perfectly. For this reason the safest thing to do is give one single
test dose and carefully watch for signs of action of the remedy. There are always three questions
to consider right at the start of any treatment i.e., is the remedy the true simillimum, is it a wrong
remedy, or is it a partial simillimum? Of course, the best sign is a striking improvement in all the
symptoms and the state of vitality. What does it mean when there is an increase of the symptoms
present or the production of new ones? What does the return of old symptoms mean? The
answers to these questions revolve around the following four queries

1. What is similar aggravation?

A similar aggravation is an increase of the symptoms the individual already suffers. For example,
a remedy is given for a chronic backache and the pains become worse after the dose. This is
caused by too large a dose (too many pills or teaspoons), too high a potency (C or LM), or the
repetition of the remedy when not needed. No further doses are needed as the primary action of
the remedy is too strong for the vital force to begin its secondary reaction. If the aggravation is
not severe it is best to wait and watch the symptoms closely as there soon will be a healing
secondary action which will not only bring relief but start the road toward a greater state of
health. If the aggravation is causing great pain and distress the remedy may have to be canceled.

2. What is a dis-similar aggravation?

A dis-similar aggravation is when a remedy produces "new and troublesome symptoms" not
appertaining to the disease being treated. For example, one is treating the chronic backache and
the person gets a stomach ache after taking the remedy and feels bad all over. If the headache is
no better and these new symptoms persist it is a sign of the wrong remedy. The key here is "the
new and troublesome" aspect. A new case should be built around the combination of the natural
and new remedial symptoms and a corrective remedy given. If a dis-similar aggravation is severe
it should be antidoted.

3. What are accessory symptoms?

Sometimes a remedy will bring out side-actions which are called accessory symptoms. These
are symptoms of the remedy that are unhomoeopathic to the person who is taking the remedy. If
they are mild and transient they will not interfere with the cure. If they increase it is a sign that
the remedy is only a partial simillimum and has done all the work it can do. The case should be
retaken.

This often leads to the question; what is the difference between accessory symptoms and the
symptoms of a dis-similar aggravation? Both involve an increase of new signs rather than an
increase of the symptoms present or the appearance of old ones from the past. The differential
analysis used to assess these two states are as follows.

A. A dis-similar aggravation produces "new and troublesome symptoms" not directly related to
the case while the mental state, general vitality and health of the person seems to be getting
worse. The person's chief complaints are not improving while new symptoms of a troubling
nature increase. It is time to retake the case and find an alternative that suits the situation.

B. Accessory symptoms are seen when the person is improving in health and vitality but new
symptoms begin to appear. These symptoms are side-actions of the chosen remedy that are
unhomoeopathic to the individual's complaint. When these symptoms are trifling and pass off
rapidly they will not interfere with the cure. If the symptoms increase or become persistent this
means the remedy is a partial simillimum that is beginning to obstruct the cure. This is a sign it is
time to retake the case and give a more perfect remedy. It is only when such symptoms become
severe that an antidote is needed.

Thus in a dis-similar aggravation new symptoms increase and the vitality is lowered. A partial
simillimum produces new symptoms while the person's health is improving and vitality
increasing. If the partial simillimum is close enough to the center of the derangement it will
move the constitution closer to a greater state of health. If the partial simillimum is too distant
from the central core of the vital disruption it will continue to produce its own signs until they
dominate the symptomatology. Such a situation can be aborted if the homoeopath readily
understands the nature of the presenting signs and acts accordingly. All of these essential aspects
of case management are carefully explained in the aphorisms of The Organon.

4. What is a natural healing crisis?

Lastly, the homoeopath must know the difference between the 3 types of homoeopathic reactions
and a natural healing crisis.

A. A homoeopathic aggravation is controlled by the primary action of a homoeopathic remedy

while a natural healing crisis is controlled by the secondary action of the vital force. Therefore,
natural healing cycles are under the curative power of the vital principle within the constitution.
Such a natural crisis is not overly prolonged nor dangerous to the health of the individual.

B. A homoeopathic aggravation is the increase of those things present (similar aggravation) or

the production of unrelated new symptoms (dis-similar aggravation). A true natural healing crisis
produces the return of old symptoms and suppressed disease signs as well as surrogate
eliminations. A natural healing crisis is always quickly followed by a greater sense of health and
an increase in vitality. This is the basis of Hering's Laws. If the return of old symptoms is
prolonged, or more painful than the original complaint, it is a sign of a similar homoeopathic
aggravation. In this situation the primary action of the similar remedy forces a severe crisis as the
old symptoms return. This is a sign that the size of the dose is too large, the potency too high, or
the remedy was repeated when it was not needed.

Similibus Curentur

Sincerely, David Little

Questions and Answers

"Hi David,

I do so love the way you tease out a complex question into component parts. This is an area that
can trip us all up! Can I ask some daft questions as I'm very fascinated by all of this?" You
wrote: A similar aggravation indicates the right remedy in the wrong dose. I assume you mean a
worsening of the symptom picture?"

Answer:

Yes! For example, if we had a Rhus-t. client who has a backache, and the backache becomes
intensified, this is a similar aggravation. A similar aggravation is caused by the primary action of
a homoeopathic remedy as it replaces the natural disease with its remedial action. If the size of
the dose, the level of the potency, or the number of repetitions are excessive, the symptoms of
the remedy which are truly homoeopathic to the individual will be heightened for a longer or
shorter period of time. Normally, it is only a matter of time before the remedial effect lessens and
the secondary counteraction of the vital force moves the constitution toward the state of health. If
the remedy preparation was exceptionally excessive for the sensitivity of the individual, the
primary action may dominate for long time periods, thus weakening the vitality of the organism,
and lessening the curative secondary effects. If the primary action is so excessive it is dangerous
the remedy must be canceled by a dynamic antidote.

Question:

"What do you do with cases that have a hair trigger eg: thuja 6c one dose leading to status
asthmaticus and 8 weeks in hospital? (this was her first ever homoeopathic remedy and a very
close match). I don't know if you caught the trauma debate in the autumn, but this issue came up
a lot with cases that through trauma were tightened up real tight and tended to explode on contact
- no matter what technique or potency was attempted. This was always worse when you got a
simillimum as it tended to remove defensive structures/symptoms, thus releasing the state - often
memory of the trauma or flash backs would come up."

Answer:

Her sensitivity must have been 1000 +++ on Hahnemann's sensitivity scale. If the dose is
carefully adjusted in a medicinal solution, and given in small doses, most of these side-effects
can be overcome. In such cases it is wise to prepare the remedy in a medicinal solution with the
addition of a dilution glass. In the extremely sensitive patients a second, third, or more dilution
glasses can be used. Even if it is a 6c, the dose should be prepared in the same way as an LM
potency. Hahnemann was witnessed administering his centesimal potencies in this fashion. In the
last two recorded cases he prepared the centesimals and the LMs in exactly the same fashion. If
one gets strong reactions such as in the above case, it is best to antidote the remedy as fast as
possible with a dynamic antidote. The same remedy can be reintroduced, if thought to still be
indicated, at a later time in a much more refined dose.

Question:

"Could you clarify your following statement?"

"A dis-similar aggravation indicates the wrong remedy".

Answer:

A dis-similar aggravation occurs when the remedy produces new and troublesome symptoms not
appertaining to the disease at hand. To use our same example of the Rhus-t and the backache:
after administering the remedy the backache is no better and the person develops headaches and
chill which they have never experienced before. This is a sign of a wrong remedy. If the
disruption is not severe the case should be retaken and a more perfect simillimum given as soon
as possible. The will regularize the vital force and move the case forward. If the reaction is
severe, the remedy should be canceled by a dynamic antidote.

Question:

"David wrote: accessory symptoms means a partial simillimum. So a partial simillimum can
produce accessory (proving symptoms) of that partial simillimum?"

Answer:

Hahnemann states in The Organon that is very difficult to get a remedy which fits the disease
exactly like two triangles of the exact same size one over the other. There are always a few edges
or corners that will stick out. These edges represent areas where the remedy is not perfectly
homoeopathic to the case at hand. When a remedy is a partial simillimum it has the potential to
bring out "side-effect" symptoms of the remedy which are unhomoeopathic to the individual.
This is somewhat common, but when the remedy is close enough, the remedial symptoms are so
slight and trifling they pass off easily without much bother. The farther away from the central
disturbance the remedy is, the more potential there is for the production of strong accessory
symptoms. A partial simillimum moves the case forward, but at the same time, it produces new
symptoms which may mix with the natural symptoms impeding the cure. When this is the
situation, the case must be retaken, and a new more perfect remedy given. This new remedy
should regularize the vital force, remove the remedial symptoms, and ameliorate the natural
symptoms.

Question?

"If it was the wrong remedy and not a close simillimum would it do anything at all? This may be
true with acutes, but I tend to think that a reasonably carefully chosen remedy (even if it is
wrong) will affect the case on some level."

Answer:

That depends on the individual. Some sensitive individuals will act like "provers" and produce
many symptoms from any remedy they take. When the dose is given in a proper small amount in
a conservative potency a wrong remedy often has no effect on the vital force. Since the remedy
does not suit the susceptibility within the constitution, there is no specific hypersensitivity to the
remedial potence. Of course, during the process of rejection there may be a slight shift in the
vital force but it should not disrupt the constitutional reserves of vitality.
Question:

"About the reversal of symptoms. A suppression is a reversal of the Law of Cure. This is the
easiest to see. Presumably antidote (restoring the original picture) comes in here?"

Answer:

Yes, Hahnemann's direction of cure, or as it is more commonly known, Hering's laws, make this
quite clear. If a suppression produces an acute crisis the medicinal and natural symptoms are
combined in a grand totality and the most similar remedies given. The long term effects of
suppression often require constitutional treatment and intercurrent remedies. This will restore the
original symptom pattern and then remove the disease from the organism.

Question:

"A healing crisis can show new symptoms - my father developed a leg ulcer with treatment, but
this soon became a discharging vent which has been producing pus for months now, leading to
amelioration on all levels. The vent is now showing signs of healing up!"

Answer:

Yes, a surrogate elimination can be set up by the vital force to drain morbid energy from the
more important vital organs. One might suspect a active chronic miasm behind this phenomena.
There is a chance that this ulcer was experienced sometime back in the family tree in one of your
ancestors. I do not have the details of the case so I cannot comment further. One can tell which
miasm is behind the ulcer by the nature of its discharge, the sensation associated with it, its
visual appearance, and other concomitant symptoms. A hopeful prognosis can be attained when
the central disturbance is healing while the one sided local complaint has developed.
Nevertheless, it is important not to over medicate the individual as it can aggravate the local
lesion if one is not careful. At the same time, Hahnemann also mentions increasing the amounts
of medicinal solution when a local lesion lags too far behind the healing process of the general
constitution. Very careful adjustments of the medicinal solution can make a big difference in
such situations. This a part of the "finer arts" which Hahnemann taught to his colleagues in Paris.

All of this information can be found in The Organon and Hahnemann's Lesser Writings. Much of
this information points in the opposite direction to the theory that the remedy effect disappears as
soon as the remedy is ingested. The primary action of a remedy acts for a longer or shorter time
depending on the nature of the dose and the internal state of the individual under treatment.
There is a transition period where there is an interchange between the primary action of the
remedial potency and the secondary action of the vital force. It is the interchange between the
remedial powers and the life force that produces the signs of similar and dis-similar aggravations
as well as accessory symptoms. When the size of the dose, the potency, and number of
administrations, are in perfect harmony, the secondary action of the vital force removes the
remedial affects in an appropriate period of time. This is not always all at once nor immediate. It
may happen in stages as the healing process reverses the time-line of the disease toward a new
state of health.

I hope I haven't raised more question than I have answered. Maybe I have. After all, the question
is sometimes more important than the answer.

Similia Minimus
Dose and Potency According to The Organon
You are: / Home / Education / Little Library /
David Little 1996-2007, all rights reserved.
Tools: Printable Version
This article was presented in The American Homoeopath, the Journal of the North
American Society of Homoeopaths, 1998, page 128.

Classical Homoeopathy

Homoeopathy as commonly practiced was first established by Samuel Hahnemann in the

late 1820s. These were watershed years for our healing art as they represent the beginning
of the most productive years of Hahnemann's career. The year 1828 brought the
publication the 1st edition of The Chronic Diseases, their Peculiar Nature and their
Homoeopathic Cure. This masterpiece was quickly followed by the publication of the 4th
Organon (1829) which further elucidated homoeopathic philosophy, case taking and
methodology.

In the 1st Chronic Diseases, and its companion volume, the 4th Organon Hahnemann
taught the administration of a single unit dose of one or two poppy seed size pellets placed
dry on the tongue. The single dose was then followed by a period of observation of the
client to assess the remedy's action. Vide aphorism 242 of the 4th Organon.

The Single Unit Dose

"As long, therefore, as the progressive improvement continues from the medicine
administered, so long we can take for granted that the duration of the action of the helpful
medicine, in this case at least, continues, and hence all repetition of any dose of medicine is
forbidden."

The same point is also stressed in Aphorism 245.

"Even one dose of the same medicine which has up to now proved beneficial, if repeated
before the improvement has begun to stand still in every direction, will, like an untimely
interference, only aggravate the state....."

The Wait and Watch Method

These aphorisms introduced the "wait and watch philosophy" which is a manifestation of
the principles of minimal intervention and the minimal dose. If the client is improving after
the administration of the first dose of a remedy all repetitions of the dose are completely
counter indicated. It is only when there is a clear relapse of the symptoms that a second
dose of a remedy may be contemplated. This injunction was introduced to prevent
disruption of the natural healing process by the premature repetition of the homoeopathic
remedy.

Hahnemann observed that premature repetition of the homoeopathic pellets often caused a
relapse of the disorder as well as accessory symptoms of the remedy. This mixture of
natural and remedial symptoms confuses the picture and slows down the curative process.
This is why classical homoeopaths are very conservative about the repetition of the remedy
before there is a definite relapse of the symptoms. This demands great patience as even
during slow progressive improvement the client must experience a relapse of symptoms
before a remedy can be repeated.

New Experiments

Over the following fifteen years Homoeopathy went through a dramatic transformation as
Hahnemann sought to improve his new system. The Master Homoeopath introduced
several innovations which brought Homoeopathy closer to perfection. The 5th Organon
was published by Samuel Hahnemann in 1833. This was followed by the publication of the
3rd, 4th and 5th editions of The Chronic Diseases in years 1835, 1837 and 1839
respectively. In these twin manuscripts he shares the outcome of his new experiments. The
6th and final edition of the Organon was finished in 1843 but was not published until 1920.

Hahnemann was not completely satisfied with the posology and case management
procedures he published in the 4th Organon, especially in complex diseases and chronic
miasms. The old master felt there must be a more flexible delivery system for
homoeopathic dynamizations. In aphorisms 285, 286, 287 and 288 of the 5th edition he
introduces the method of using a freshly succussed aqueous solution in teaspoon doses. He
gives one of the principal reasons for this in aphorism 286.

For the same reason the effect of a homoeopathic dose of medicine increases the greater the
quantity of fluid in which it is dissolved when administered to the patient although the
actual amount of medicine it contains remains the same. For in this case, when the
medicine is taken, it comes in contact with a much larger surface of sensitive nerves
responsive to the medicinal action. Although theorists may imagine there should be a
weakening of the action of the dose of medicine by its dilution with a large quantity of
liquid, experience asserts exactly the opposite, at all events when the medicines are
employed homoeopathically."

At the same time, Hahnemann elucidated one more critical aspect of the new posology in
the note to aphorism 287. This is the importance of succussing the remedy solution
immediately before administration in the same manner as one succusses the homoeopathic
dynamizations when preparing the stock potencies. In the note to this aphorism
Hahnemann points out that anywhere from 1, 2, 3, to 10 or more succussions are used to
progressively increase the potency of the aqueous remedy solution. For this purpose the
homoeopath uses a 4 to 8 oz bottle filled with a solution made from 1 globule of the
homoeopathic dynamization.

From this remedy bottle Hahnemann was witnessed stirring 1, or increasing more,
teaspoons of the solution into a 4oz. of water in a glass. From this glass he would then give
1, 2, or 3 teaspoons of the aqueous solution as a dose. In Hahnemann's new posology the
potency, size of the dose, number of succussions given to the remedy bottle, and the number
of teaspoons administered are all adjusted to suit the constitutional sensitivity of the client.
The renewed posology system offers more power and more flexibility than the static dry
pellets. These methods of adjusting the dose are one of the greatest gifts of the 5th Organon
and the 1837 edition of The Chronic Diseases.

The Middle Path

Another important aspect of the 5th Organon is Hahnemann's review of dose and
repetition. In the 4th edition he outlined the single unit dose and the philosophy of the
"wait and watch" method. In the aphorisms 245, 246 and 247 of the 5th Organon
Hahnemann introduces what he calls the middle path concerning the methods of
administrating homoeopathic remedies. He begins his discourse on posology by clarifying
the proper view of the single unit dose and when it is appropriate in treatment. He begins
his new review in aphorism 245.

Every perceptibly progressive and strikingly increasing amelioration in a transient (acute)

or persistent (chronic) disease, 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 toward its completion. Every new dose
of any medicine whatsoever, even of the one last administered, that has hitherto shown
itself to be salutary, would in this case disturb the work of amelioration."

Anytime there is a "strikingly increasing amelioration" on a dose of a homoeopathic

remedy there is no need for the repetition of the remedy. If the remedy is repeated when it
is not needed it will only slow the cure or disrupt the case. Unfortunately, many chronic
patients only slowly improve over a period of weeks to months on a single dose of the
appropriate remedy and potency. What can we do to speed the cure? Hahnemann sheds
light on this subject in aphorism 246. Vide Organon.

One the other hand, the slowly progressive amelioration consequent on a very minute dose,
whose selection has been accurately homoeopathic, when it meets with no hindrance to the
duration of its action, sometimes accomplishes all the good the remedy in question is
capable of performing by its nature in a given case, in a period of forty, fifty or a hundred
days.

This is however, rarely the case, and besides, it must be a matter of great importance to the
physician as well as the patient that were it possible, this period be diminished to one-half,
one quarter, and even still less, which many often repeated observations have shown under
three conditions.

Firstly, the correct homoeopathic remedy must be chosen by the totality of the symptoms.
Secondly, the remedy is to be given in the minimal dose so as not to overexcite the vital
force [refer aphorisms on the medicinal solutions]. Thirdly, the remedy may be repeated at
suitable intervals to speed the cure, if necessary, without producing aggravations."

The new posology maxim states that anytime the first dose produces a striking
amelioration no more medicine is needed for the time being. If, one the other hand, the first
dose only produces a slow amelioration the remedy may be repeated at suitable intervals to
speed the cure.

This new methodology can only be carried out if the remedy is prepared in a medicinal
solution and given in a "split-dose". If the homoeopath is still using the dry pellet dose then
they must follow the rules as given in the 4th Organon. This means the homoeopath can
only repeat a remedy when there is a definite relapses of the symptoms even if the person is
only slowly improving.

With the medicinal solution, however, the remedy may be repeated at suitable intervals as
long as the patient is improving without any aggravations. This is how the cure can be
reduced to 1/2, 1/4 or less the time it takes with the ordinary dry dose method. These are
some of the directions contained in the 5th Organon on the advanced methods of using the
centesimal potencies.

It is often said that Hahnemann's introduction of the medicinal solution was only for the
LM potencies and that he used his centesimal potencies dry. This is not the case. For a least
during the last years of his life Hahnemann used both his centesimal and LM potencies
exclusively in the medicinal solution with the addition of a dilution glass. In 1843, just prior
to the Master's death, Hahnemann sent Boenninghausen two cases in which he used the C
and LM potencies in exactly the same fashion. This proves two important points; first that
the new methods of using the aqueous solutions is for all homoeopathic remedies. The
second point is that Hahnemann considered the two potency systems to be complementary
and used them both to increase the range of the homoeopathic pharmacy. Now he had 6c to
1M centesimal and 0/1 to 0/30 LM potencies at his disposal.

The Limitations of the Dry Dose

Hahnemann suggested that each edition of The Organon and The Chronic Diseases should
be studied together as companion volumes. In the 1837 commentary of The Chronic
Diseases Hahnemann begins by assessing his experience of the dosing procedures that he
used during the late 1820's and shares the outcome of his latest research in homoeopathy.

"Since I last addressed the public concerning our healing art I have had among other
things also the opportunity to gain experience as to the best possible mode of administering
the dose of the medicines to the patients, and I herewith communicate what I have found
best in this respect. A small pellet of one of the highest dynamizations of a medicine laid
dry upon the tongue, or the moderate smelling of an open vial where one or more such
pellets are contained proves itself the smallest and weakest dose with the shortest period of
duration in its effects."

Due to the great diversity of constitutions and sensitivity, a homoeopath needs a flexible
delivery system which allows for the adjustment of the remedy in each individual case. This
is something that the medicinal solution supplies. Vide The Chronic Diseases.

"Nevertheless the incredible variety among patients as to their sensitivity, their age, their
spiritual and bodily development, their vital powers, and especially in the nature of their
disease necessitates a great variety in their treatment, and also in the administration to
them of the doses of medicine."

Also of great importance is the following revelation which explains why the untimely
repetition of an unmodified dose causes complications and explains the reason
homoeopaths disagree so much about the repetition of doses.

"Before proceeding, it is important to observe, that our vital principle cannot bear well
that the same unchanged dose of medicine be given even twice in succession, much less
more frequently to a patient. For by this the good effect of the former dose of medicine is
either neutralized in part, or new symptoms proper to the medicine, symptoms which have
never before been present in the disease appear, impeding the cure. Thus even a well
selected homoeopathic medicine produces ill effects and attains its purpose imperfectly or
not at all. Thence come the many contradictions of homoeopathic physicians with respect to
the repetition of doses."

The observation that the vital force is disturbed by the repetition of an unadjusted dose is
the conclusion of around 35 years of experimentation and should not be taken lightly. In
the 6th Organon Hahnemann adds that even with the perfect remedy it is unwise "to let the
patient have a second or third dose taken dry.". The production of these complications is
the main reason why repeating remedies before the relapse of symptoms is counter
indicated in the classical Homoeopathy of the 4th Organon. The use of the medicinal
solution however, overcomes this problem because it can be adjusted with succussions so
that the patient never receives the exact same potency twice. Vide The Chronic Diseases.

"But in taking one and the same medicine repeatedly (which is indispensable to secure the
cure of a serious chronic disease) if the dose is in every case is varied and modified only a
little in its degree of dynamization, then the vital force of the patient will calmly, and as it
were willingly, receive the same medicine even at the briefest intervals, very many times in
succession with the best results, every time increasing the well being of the patient. This
slight change in the degree of dynamization is even effected, if the bottle which contains the
solutions of one or more pellets is merely well shaken five or six times."

The Discovery of a New Potency System

Hahnemann was not completely satisfied with the medicinal solutions of centesimal
potencies. especially in complex disorders and chronic miasms. He found in those with
hypersensitivity, low vitality, complex chronic miasms and organic pathology that the high
potencies produced unproductive aggravations while the lower potencies could not cure.
How could he make a potency which could fill this lacuna in homoeopathic treatment?
Surely the answer to the question did not lie in raising the centesimal potency to still higher
levels so he decided to increase the dilution rate instead.

After many experiments Hahnemann settled on the 1/50,000 dilution ratio called the LM
potency. His new potencies use a serial dilution system which begins with the LM 0/1
potency and progresses through 0/2, 0/3, 0/4, 0/5, 0/6, onward to 0/30. This gradually
increasing scale of 30 potencies is the perfect balance to the rapidly ascending centesimal
scale. Now the new posology included the adjustments of medicinal solutions of two
complementary yet opposite potency systems. This expanded the range of homoeopathic
treatment.

Modern Times

Human beings have always been subject to the stresses of birth, life and death. Such
conditions are universal in their proportions. Nevertheless, our modern times present the
homoeopath with tremendous challenges. We live in a world of environmental degradation
and endangered species, nuclear radiation, chemical and toxic waste, universal
immunization and drug use, rapid urbanization, psychological complexities and spiritual
crisis. This is accompanied by the rapid mutation of acute and chronic miasms into new
drug resistant strains and the appearance of new miasmic diseases that lead to auto
immune diseases and immuno-deficiency disorders.

Today's homoeopath sees mixtures of inherited predispositions, inherited and acquired

miasms, multiple immunizations (iatrogenic miasms), along with chemical exposures, drug
suppression and psychological and physical traumas. This makes it all that much more
important that the entire legacy of Samuel Hahnemann is put into practice in the field.
Many cases that were incurable with the method of the 4th Organon were cured by the
methods of the 5th and 6th Organon. Hahnemann's claim that the new posology could
speed the cure to 1/2 or 1/4 the time of the method of the 4th Organon must be put to the
test by experienced classical homoeopaths.

Much of this new material has been misrepresented because it has been misunderstood.
The posology methods of the 5th and 6th Organon are placed on top of the strong
foundation of the 4th Organon. The "wait and watch method" is the basis on which the
careful repetition of remedies to speed the cure is placed. Many people think that the LM
potencies can be given in some mechanical manner daily or every other day as if they are
some low potency. This is a great mistake as the repetition of the LM potency when it is not
needed will either slow down the cure or cause aggravations. LM potencies will aggravate
cases the same as the centesimals if they are given when they are not needed to speed the
cure.
The first dose of any homoeopathic remedy should be a single unit test dose (C or LM)
which is left to act for a reasonable period of time. When there is a striking response to the
first dose there is nothing else to do for the moment. If there is only a slight or slow
improvement the remedy may be repeated to speed the cure if the four cardinal rules are
followed. These are that the remedy is perfectly homoeopathic, that the remedy is given in
medicinal solution, that this solution is succussed before each dose to change the potency
slightly and that the remedy is repeated at suitable intervals to speed the cure without
causing aggravations.

The Size of the Dose

There is a commonly held belief in modern homoeopathy that the size of the dose makes no
difference in the action of a homoeopathic remedy. Therefore, it follows that the
administration of 1 or 1000 drops, globules or teaspoons are all "the same". Some of these
ideas originate with James Kent in his Lectures on Homoeopathic Philosophy where he
combines the Swedenborgian view of energy as a simple substance with the homoeopathic
potency. As the simple substance represents the fourth state of matter it could have
qualities but no quantity. Therefore the size of dose makes no difference. This is one area
where our two great teachers disagree.

Hahnemann taught that potentization releases dynamic forces similar to electromagnetism

which carry the inner medicinal energies of a substance. He discovered that each pellet
contained a certain "quantum" of pure remedial energy at specific potency levels. As both
the amplitude and frequency affect the wave form of a signal, the size of the dose,and the
potency affects the remedial powers. The Old Doctor's views of energy dynamics are more
similar to modern physics than the Swedenborgian paradigm. He taught that the more
perfect the simillimum, and the higher the potency, the more the size of the dose dose must
be controlled. Vide aphorism 275.

"For this reason, a medicine, even though it may be homoeopathically suited to the case of
disease, does harm in every dose that is too large, and in strong doses it does more harm the
greater its homoeopathicity and the higher the potency selected, and it does much more
injury than any equally large dose of a medicine that is unhomoeopathic and in no respect
adapted to the morbid state (allopathic)".

The Founder taught that the phenomenon of the aggravation was related to the size of the
dose as well as the the potency. These two factors become far more critical in individuals
with sensitive constitutions, weakened vitality, chronic miasms and organic pathology.
Hahnemann wrote of his own experience in relationship to the size of the dose in The
Chronic Diseases.

"I have myself experienced this accident, which is very obstructive to cure and cannot be
avoided too carefully. Still ignorant of the strength of its medicinal power, I gave Sepia in
too large a dose. This trouble was still more manifest when I gave Lycopodium and Silica
potentized to the one-billionth degree, giving four to six pellets, though only as large as
poppy seeds. Discite moniti!"

Hahnemannian posology is based on the size of the dose, the potency factor and the nature
of the delivery system. All of the breakthroughs of the 5th and 6th Organon are founded on
the medicinal solution, olfaction, and the methods of adjusting the dose. In my own 12
years study I have put Hahnemann's theory to the test in the field and found his postulate
to be true. Kent faithfully applied the methodology of the 4th Organon and never put the
posology of the 5th Organon into practice. He did not see the 6th edition nor know about
the LM potency. It seems he was not privy to Hahnemann's final insights in homoeopathic
methodology. Even our grand teacher of Constitutional Homoeopathy still had something
to learn from The Elder Homoeopath.

Case Histories

The following examples demonstrate the Hahnemannian methods of posology and highlight
the methods of adjusting the dose.

1. A very hypersensitive lady who was taking one 6c pill dry was experiencing strong
aggravations every time she took the dose after which she would improve a little and then
relapse. She thought she was too sensitive for Homoeopathy and may have given up. On
making a medicinal solution, and taking one teaspoon, the remedy no longer aggravated,
and she was able to repeat the remedy at suitable intervals until she was cured. This is an
example of how changing from the dry dose to the liquid dose, and succussing before each
teaspoon dose transmuted an aggravation and made the remedy repeatable in a sensitive
who had trouble taking even one dose dry. This is an example of changing from a dry dose
to a liquid dose which shows there is a difference in the way you give the dose and its
amount.

2. A homoeopath who took Carbo Veg. 200c in a dry dose did not react. The remedy
seemed to fit her case. She then was told to try it again but in a medicinal solution. The
dose was one teaspoon. A few doses of the 200c succussed 5 times before each dose to
slightly change the potency cure rapidly. This is another example of a solution curing
where a dry dose failed. If dosage makes no difference wet or dry as Kent said why did this
work?

3. A woman who took one dose of Cimicifuga LM 0/1 in a 4oz. solution for migraine
headaches experienced a similar aggravation. After increasing the amount of water in the
solution by making an 8oz solution there was no aggravation and she was able to repeat the
remedy every three days for a month and her migraines never came back. She never
experienced aggravation again. This is an example of adjusting the dose by using more
water in the original solution. This made the remedy act more gently on her constitution
and made it repeatable without aggravation.

4. A person suffering from sleep apnea was given Arsenicum Album LM 0/1 in a 6oz
solution, succussed 3 times before ingestion, 1 teaspoon was taken and stirred into 6oz of
water, 1 teaspoon was given as a dose. After taking the remedy there was an aggravation of
some of the concomitant symptoms for three days, then a slight improvement for a short
while, and a relapse. The remedy was given again, but 1 teaspoon was taken out of the first
dilution glass, and placed in a second glass from which the client was given 1 teaspoon. The
succussions were the same. This caused a radical improvement and removed the sleep
apnea. There was no aggravation on the dose made in this manner. This is an example of
diluting the remedy through two glasses of water and getting a striking response when the
remedy out of the first glass caused an aggravation and then only a made a small
improvement. Doesn't this show a difference in the size of the dose? According to modern
Homoeopathy this would not make any change in the effect of the remedy.

5. A patient was given a remedy in a medicinal solution which was succussed 5 times before
ingestion. He responded well to the first dose, but when he was told to take a second dose,
he forgot to succuss the bottle and the remedy did not act. After the situation was discussed
he was reminded to succuss the remedy before taking it again and it worked just as well as
the first time. This is an example of taking the same unsuccussed, unmodified remedy twice
in succession and having no affect at all. When the remedy was "potentized anew" as
Hahnemann suggested in paragraph 248 it acted very deeply. This demonstrates the
important of succussion and changing the potency of each dose. This is a related subject
but does not really deal with changing the amount of the dose.

Hahnemann mentioned in Organon that there are special conditions when the size of a dose
must be increased to overcome a disease. The first example he gives is when there are the
primary eruptions of the chronic miasms are on the skin. Here are some example of this
method.

6. In a case of scabies (one of psora's primary eruptions) the normal one teaspoon dose did
not act deep enough to remove the mites. In aphorism 248 Hahnemann mentions giving
"one or increasing more teaspoons" of the remedy when needed. By gradually increasing
the amount of the dose from 1 teaspoon to 2 then 3 teaspoons the parasites were quickly
removed. (I have done similar cases to this many times.)

7. A case of ringworm (a primary eruption on the skin related to the TB miasm) was only
responding slowly to repeated doses of Bacillinum LM1 given in teaspoon doses. The
succussions were raised but it did not help. The dose was repeated more often but there
was no change. The size of the dose was increased to 3 teaspoons and the ringworm
immediately responded and began to disappear. This larger dose acted where a smaller
dose did not. The succussions were kept the same.

Another example Hahnemann gave of cases that often need an increase of the size of the
dose is when the general health of a person has improved but a stubborn local complaint
remains. I have often seen cases where there is a general improvement but a lesional or
pathological complaint lingers on. In cases like this it is best to start with the smallest
possible doses to get a reaction and slowly augment them until there is an effect on the local
complaint.

8. I gave Calcarea Carb LM1 to a gentleman who had an incredible number of symptoms
including impotency which brought him great despair. He responded mentally and vitally
to the first doses but the local complaint lingered until the size of the dose was gradually
augmented over a period of time by increasing the number of teaspoons taken as a dose.
The impotency vanished and he has remained cured to this very day.

Another reason for increasing the size of the dose is when a case no longer seems to be
moving forward.

9. A person was suffering from a swollen prostate with concomitant melancholia and
impotence, and obstruction of the flow of urine, a pressure-like sensation in the perineum.
He was first given 1 teaspoon of Conium which caused a fair response. He increased the 1
teaspoon to 2 on his own and got an similar aggravation (too large of a dose). He was
advised to stop the dose for a few days and to start again with 1 teaspoon. This worked very
well as LM1 and LM2 were used and the worst symptoms disappeared. Then it seemed as
if the movement of the remedy forward had reached a plateau so the size of the dose was
slowly increased from 1 teaspoon to 2 then to 3, and the case once again started moving
rapidly forward and is much, much better. If the size of the dose makes no difference, how
did this all happen?

These are examples of cases where the methods of adjusting the dose made a difference
between success and failure. If I did not adjust the size of the dose in these cases the correct
remedy might have been called into question. These methods are all connected to the
innovations that Samuel Hahnemann introduced in the 5th (1833) and 6th Organon
(finished 1842) and the 1837 edition of the Chronic Diseases. This methods demand more
artistry on the part of the homoeopath but with more knowledge comes more
responsibility.

How to Make a Medicinal Solution

The preparation of the remedy solution for the centesimal and LM potencies can be
summarized in 3 easy steps.

1. Take an 8 oz bottle and drop in one, rarely two, # 10 pills of the chosen remedy. The
minimal amount of water mentioned by Hahnemann is 7 tablespoons which is 3 1/2 oz. I
usually use 4 to 6 oz solutions. That leaves at least 2 oz. as a small air gap which makes for
good succussions. The larger bottles (6 oz., 12 oz. etc.) are only necessary when one is
treating a hypersensitive as the larger amount of water makes the dose act more gently.
Add a sufficient amount of brandy or pure alcohol for a preservative. Up to 1/4 or 1/3 of
the solution should be brandy to assure lack of spoilage.

2. The bottle is to be succussed just prior to ingestion in order to activate the remedy and
slightly raise the potency. The number of succussions greatly affects the action of the
remedy on the vital force. For those who are hypersensitive 1, 2 or 3 succussions is usually
enough. Those of an average sensitivity more normally use 4, 5, 6 or 7 succussions. Those
who have rather low sensitivity will need 8, 9 or 10 succussions. It is best to start with a
lower number of succussions and increase the amount if and when necessary. This is one of
the primary methods of adjusting the dose.

3. From this bottle 1, 2, or 3 teaspoons (depending on sensitivity) are stirred into a 4oz glass
of water. From this dilution glass 1, 2 or 3 teaspoons are giving to the adults. Infants are
given 1/4 teaspoon or less depending on age and the average child 1/2 teaspoon, The size of
the dose can be gradually increased if more reaction is needed. A constitution of a lower
sensitivity might need 2 or 3 teaspoons before they will react sufficiently to the remedy.
This is another way to adjust the dose. An extreme hypersensitive may need the remedy
diluted through 1, 2, or 3 such dilution glasses. In this case a teaspoon or less is taken from
the first glass and stirred into a second or third glass.

Give the client one test dose and wait and watch for a reasonable amount of time to see how
they react to the remedy. This time period depends on the nature of the disease you intend
to treat. Acute and chronic disease each have their own peculiar cycles. If there is a striking
response and a dramatic improvement let the single dose act without interference. If there
is only a slow or moderate improvement the dose may be repeated at proper intervals to
speed the cure. Slow down the repetition of the remedies as the client improves. If the
remedy produces any aggravation it is best to wait and watch for the expected
amelioration. This is the middle path. Why not put Hahnemann's postulates to the test for
yourself! The study of the 5th and 6th Organon will make this all possible.

Homoeopathic Doctrine
Theoretical and Practical Condensed Pure Homoeopathy

(A synopsis of Homoeopathic philosophy)

By Dr. Robert GIBSON MILLER, of Glasgow

French translation of Dr. Robert SROR

This is a classic of the homeopathic doctrine, coming from a direct

English student of Kent, and corrected by Kent. This translation has been
reviewed and improved. Dr. RS 30/10/98.

Introduction by Dr. Robert SROR

In his posthumous works, Kent writes that very often, many confreres
know how to find the simillimum, but then they no longer know how to use
it.

This is true today, where many homoeopaths are unaware of the Laws and
Universal Principles of Homoeopathy.
 These rules are found to be scattered within the fundamental works of
HAHNEMANN, BOENINGHAUSEN, HERING, KENT, to mention only
the principal ones. They had to be united and condensed. This was done
before 1900 by Dr. Robert GIBSON MILLER, in a luminous form, after
having benefited from the teaching of KENT. The latter corrected the text
of his pupil, completed it, annotated it, and had it published in his Revue,
so that everyone could benefit from it.

By this gesture Kent conferred great value on his pupil's article , both in
the present and in the future of Homoeopathy.

That is to say the importance of the pages that follow.

You will find the KENT annotations in the text when a sentence is
followed by (KENT).

All the practical as well as theoretical rules appear there in a concentrated,

but sure form, but full of creative potentialities for the reader, and then
reflects.

At the moment when pure Homoeopathy is of increasing interest to

confreres, seduced by its simplicity and its astonishing efficacy, I thought
that the French translation of the main text of Dr. Robert GIBSON
MILLER would allow those whose " Organon "of HANNEMANN, as
well as the KENT Philosophy Conferences, are the basic works, to sit
down and better understand their daily practice.

Homoeopathic Doctrine
Theoretical and Practical Condensed Pure Homoeopathy

I felt the deep need to condense in a few pages the Laws and Rules, which
govern Homoeopathy. The lines that follow were originally written for my
personal use. Dr. Kent agreed to review my manuscript and complete it.
He also informed me of the interest which our confreres would find there,
if these pages were published in the Journal of Homoeopathics; that's
done.

I. Classification of diseases.

Any non-surgical disease necessarily belongs to one of the following

groups: acute illness, chronic illness, disease by abuse of remedies or
unhealthy living conditions.

A. Acute illness:
1) The existence of an acute illness is limited without therapeutics, it
ceases by healing or death. However, an acute illness may leave behind no
sequelae. Often, what is called sequelae is really only a manifestation of a
chronic miasma; The activity of this miasma having been revived during
the acute illness.

2) In all its evolutionary stages, the acute disease can be treated

successfully, by the same remedy.

3) In the course of an infectious disease, infection ceases as soon as the

simillimum is administered.

4) During an epidemic, the best prophylactic is the remedy indicated for

the symptoms of this epidemic.

5) If during the treatment of a chronic disease appears a common acute

affection, prescribe the remedy indicated, in low dynamization, so as not
to interfere the action of our remedy of bottom. As soon as the acute
episode is cured, you will see your remedy continue its action. (J.-T.
KENT: This is only valid for acute cases without seriousness, but in a
serious acute case, this is not correct, and it is necessary to prescribe the
indicated remedy in high dynamization .)

6) After curing an acute intercurrent illness, and before repeating the

chronic remedy, make sure that your chronic patient's symptomatic chart
has not been altered by the acute episode or by the remedy prescribed
during that period , For if it were so, perhaps an indication of another
remedy would appear.

7) When the symptoms of an acute illness have been altered by an

allopathic, or inappropriate homoeopathic, prescribe on the present
symptoms, not on the original symptoms.

(8) Exacerbations of a chronic active disease should not be treated as

acute intermittent illnesses, provided that no long-term remedy has been
prescribed for chronic miasma. Very frequently, the remedy of this
exacerbation is the acute complement of the remedy of profound action
which the chronic disease would have required, but this is true only for
antipsorics; The best thing is to prescribe nothing.

9) In the presence of a partially active chronic disease, which means that

your patient is apparently in good health, except for a few small acute
manifestations, well, in this particular case, knowledge of the remedy that
cuts these small manifestations Acute can lead us to its complementary
chronic and thus allow the cure of the underlying chronic disease.
B. Chronic Disease :

1) Is characterized by its progression from the outside to the inside, and

from bottom to top; Moreover, although its symptoms may vary, they
never disappear in the inverse order of their appearance, except under the
action of the same remedy.

1. In the present state of our knowledge, there are only three chronic miasms,
which are: Psora, Syphilis and Sycosis . These miasms can be active or latent.
They can be met in three different ways:

a. A unique miasma;
b. Two or three coexistent miasmas;
c. Two or three miasms can unite and form a complex; The latter may be further
aggravated by the addition of a therapeutic disease.

If two or more miasms form a complex, the indicated remedy will cause it
to burst; It would be advisable at this moment to attack the miasma whose
activity is most manifest, but prudence, for the slightest technical fault
would favor the inter-miasmatic combination, and nothing could
subsequently dissociate this recasting from the complex .

3) For a long time, these three chronic miasms are latent. Grief, an acute
illness, an unhealthy life, etc., can trigger their activity again. As long as
these miasms are in the latent state, the patient only objects with ordinary
symptoms and little marked, he accuses an indefinable sensation of
discomfort. For this purpose, nosodes are used, which promote the
emergence of clear and characteristic symptoms, from which we are able
to discover the curative remedy.

4) The transmission of the miasma is always at the stage in which it is

found in the affected person. Thus, if a husband is in the secondary stage
of his syphilis, he will contaminate his wife by passing the secondary
stage of the disease, not the chancre. (Kent, Journal of Homoeopathics,
March 1899.)

(5) A man affected with Sycosis or Syphilis will not be able to

contaminate his wife if she has another, dissimilar chronic disease which
protects her (tuberculosis, for example); In fact, dissimilar diseases repel
each other.

II. - All symptoms.

It is necessary to make clear what it is, for our only guide in the choice of
the curative remedy is the totality of the symptoms.
During an acute illness, each symptom of the patient (felt by himself or
noted by his entourage) must be included in the totality of the symptoms;
As well as any etiological symptoms: fear, moisture, etc., without omitting
the modalities of aggravation and improvement.

An acute illness never forms a complex with a chronic disease. In acute

intercurrent episode, the chronic disease ceases to manifest, but be careful
not to confuse the reappearance of old symptoms of chronic miasma with
acute intercurrent symptoms.

However, it should be noted that in some acute cases, chronic symptoms

remain active; They are singular symptoms since they have not
disappeared. They are used as guide symptoms to find the cure for the
acute case. As well as these chronic symptoms have allowed you to find
an acute condition remedy, you must know that this acute remedy will
have absolutely no action on your chronic case. Such symptoms are
peculiar to the patient. (KENT, Medical Advance, January 1890.)

In a chronic disease, all symptoms include all the symptoms experienced

since the birth of the patient, excluding from this table the acute
symptoms.

Although theoretically all symptoms since birth are valid, practically great
caution is required because: 1) it is quite possible that during your life
your patient has been affected by another chronic miasma or: 2) The
symptoms have been disguised by unexpected and inappropriate treatment
and therefore you are not confronted with the true face of the disease.
(Kent, Journal of Homoeopathics, July 1899.)

In the latter case, we may sometimes have a certain basis of prescription,

by retaining the symptoms preceding the unexpected prescription, of
which we have already spoken.

The search for the old symptoms of the patient proves to be of great
practical utility when the symptoms present do not enable us to clearly
isolate the remedy.

Let us take an example. Here is a patient who presents with neuralgia but
whose present symptoms are vague and do not lead to any prescription;
We then interrogate our patient on his personal antecedents, and learn that,
as a child, he had a "crust of milk", type Mezereum; eh Well, you will be
surprised to find in your patient of the neuralgic symptoms type Mezereum
; This remedy will cure your patient by making the crust of milk of his
childhood reappear.
It often happens that in trying to collect all the symptoms, we realized that
they do not represent the actual picture of the internal disease, these
symptoms having been suppressed or modified by inappropriate therapy.
Thus, let us take a case of gonorrhea suppressed by nitrate of silver (
Argentum nitricum ); Well, on examination, we shall give a complete
picture of Medorrhinum , plus some symptoms of Argentum nitricum and
Natrum muriaticum (in such cases we should prescribe, if possible,
symptoms, Is obtained, and that the "suppressive" remedy is known, it is
better to select the antidote for the "suppressive" remedy (KENT).

In the search for all symptoms, especially with regard to the symptoms
preceding the chronic disease, it is necessary to know whether we are in
the presence of one or more miasma, for it is evident that only one
Remedy can not cover the symptoms caused by several miasmas.

In such cases, it is necessary to take as a rule the following: a single

miasma is active at once, and the therapy must be centered solely on this
active miasma. When two or more miasmas form a complex, we must
endeavor to make it burst, in order to free the miasmas which compose it.

(Only symptoms should guide us to separate the miasma from the

complex.) The path of death is not simple, and any remedy that improves
the patient will make this path less complicated by separating miasma -
KENT.

III - Selection of the remedy.

After collecting all the symptoms, we must find the similar remedy.

Theoretically, this remedy must correspond exactly to the patient's

symptoms, both in valorization and in characteristics, but this is rarely
practically achievable.

HAHNEMANN advises us, during our research, to be particularly

attentive, for singular, extraordinary and particular symptoms (
characteristic symptoms ).

It is above all the symptoms peculiar to the patient, and not those of the
disease, which ought to guide us in the search for the specific remedy. For
example, symptoms of dysentery consist of bloody stools, pain and
tenesmus; But if a lipothymia accompanies each saddle, we have here a
symptom peculiar to the patient, and not to the disease; It is this symptom
that will serve as our guide. In establishing the characteristic symptoms of
the patient, we must not forget the following rules and precautions:
1. The characteristic symptoms must also be marked in the patient and in the
pathogenesis of the remedy.

In other words, regardless of the singularity of the symptom, both in the

patient and in the remedy, the important thing is that it is striking and
distinctive in the opposite case, pay little attention to it.

2. No symptom, however singular, can be our true guide in the search for the
specific remedy, for unless there is a general correspondence between the
symptoms of the patient and those of the remedy, you are going to fail.

However, these isolated, singular symptoms have a certain value, pointing

out to our attention special remedies, for a more thorough study.

3. The general symptoms, or those which relate to the whole body, are of much
greater value than the particular local symptoms; Therefore, regardless of the
number of particular symptoms that exist, only one general symptom, well
marked, is superior in the hierarchy of symptoms.

When the patient speaks to the first person of the singular, it is generally a
general symptom; Thus, for example: I am thirsty, that means that it
concerns its whole body, and not of any particular organ. However, it must
be known that within the general symptoms there is a hierarchy that must
be respected.

Mental symptoms, if they are well marked, occupy the first place.

Among these symptoms, the most important are those which manifest the
will and the affectivity of the patient, including desires, aversions,
irritability and sadness.

On a somewhat lower plane, we find the troubles of the intelligence;

Finally, at the last level, we find the troubles of the memory.

Within the general symptoms, one should include: sleep and dreams,
menstrual symptoms and menstruation, climatic effects and sensitivity of
the subject to warmth and cold.

The five senses are an integral part of the human being as a unit;
Therefore, they may be classified as general symptoms. For example,
when a patient tells you that the smell of food makes him nauseous, it is a
general symptom; On the other hand an unpleasant odor in the nose should
be considered as a particular symptom. Frequently, by examining the
organs one by one, you will find a symptom or a modality common to
them; You will then have a general symptom composed of several
particular symptoms.
4) Be careful not to confuse modalities and symptoms; However, if you
have modalities that relate to many symptoms, they become marked
features and, as a result, are important.

5) The skin being the most external part of the body, the skin symptoms
will have less importance and value.

(6) In an organic disease, as well as in many affections of the female

reproductive system, the local symptoms are only of minor importance.

7) A tumor or other pathological condition should not be used as a guide

for the search for the indicated remedy. Why ? Because, first of all, we are
not in the presence of the disease itself, but of its effects; Then, because
the provings were not pursued long enough to produce similar disease
states.

IV. - Pathology.

We must ignore the anatomo-pathological changes when we seek the

indicated remedy; Yet an exact knowledge of the pathology is absolutely
necessary.

1) Because we can follow and understand the evolution of the disease.

2) We can also recognize the symptoms that are common to a particular

disease and those that are unique to the patient.

(3) In the same way, it will be possible for us to know, in this or that
disease, or at one of its stages, the little action which a cure of superficial
action, even indicated by the symptoms, would have. For example, in the
exudative stage of pneumonia, even if the symptoms evoke Aconite , we
know that this remedy can not produce such a state; So we take up our
observation in a more attentive manner, and we perceive that the patient
needs a deeper remedy of action, such as Sulfur or Lycopodium .

(4) When new symptoms appear, it is the pathology which enables us to

discern whether they are due to the natural course of the disease or to the
action of the prescribed remedy.

5) We must clearly conceive that what is curable is not the disease, but the
patient; And, without a real knowledge of the pathology, we are led to
confound the symptoms of the patient and those of the disease; As a result,
we make mistakes.

Take for example a case of arthritis, which results in ankylosis. The

remedy indicated will cure the inflammation, but will have no effect on
the ankylosis; It will be necessary to consider the help of the surgeon. The
tumor is the same, as the patient is cured, the tumor growth ceases, and
perhaps disappears, but very often it persists and, again, the surgeon will
have to be called in.

6) Pathology warns us of the danger of curing certain diseases, such as

end-stage tuberculosis, or certain foreign bodies, encysted near vital
organs. In such cases, nature can only cure by provoking a local
suppuration, which will expel the foreign bodies; The exhaustion caused
by another mode of cure is often fatal for the patient.

V. CONCLUSIVE SYMPTOMS.

It is a fault to think that a cure can cure groups of symptoms, only in the
order of their appearance during the proving.

Often a remedy cures a group, whose symptomatic components were

observed in different provers, and often in a different order from that in
which they were experienced. Despite this, experience teaches us that
certain groups of symptoms tend to appear at the same time and together;
When this is so, these groups are the most characteristic of the remedy.
HERING writes that the comparative value of the concomitant symptoms
can be determined as follows: if they are really concomitant, one is really
the cause of the other (thus lacrimation due to a general catarrhal
condition), and , This striking feature of observation must be retained; But,
on the other hand, we must ignore it and reject it, if we do not deny any
relation of cause and effect.

VI. Effects produced by the remedy.

The remedy once administered, will alter your case in one of the following
ways

1) No change; Either the remedy or the dynamization are not the right
ones.

2) Regular and rapid improvement without any aggravation

A) the remedy and the dynamization are correct. They are exactly similar
to the dynamic degree of the disease;

B) it may also mean that the disease was not deeply rooted.

NB - There may be an almost complete disappearance of the symptoms,

and yet your patient does not feel the general and euphoric well-being of
health; It means that your therapy has not been curative, but only
palliative.

3) Acute and short worsening, followed by rapid improvement; In this

case, the improvement must last for a long time.

4) Long aggravation followed by slow improvement. Weak, almost

insignificant: this no longer appears in patients with low vitality; Your
patient is in great danger if you repeat your remedy too soon.

5) Long aggravation, followed by the decline in "gentle slope", of your

patient. These cases are incurable. And you must employ only small
remedies of short duration of action.

6) Significant worsening, followed by an improvement that "does not

hold" especially when a deep acting remedy has been administered. Such
cases are usually incurable.

7) Rapid improvement followed quickly enough by an aggravation. If you

have prescribed the simillimum, your case is incurable, but if your remedy
covers only superficially the case, it has only had a palliative action.

8) The improvement lasts a normal time, but a new symptomatic grouping

appears, which leads to the prescription of another indicated remedy; This
group disappears for some time, then you notice the appearance of a new
symptomatic grouping; Despite the successive disappearance of these
groupings of symptoms, under the effect of your therapy, you notice the
general and progressive weakening of your patient. These cases are
incurable. You will observe them among the old and the people whose
vitality is diminished.

9) New symptoms appear (not to be confused with the return of old

symptoms that the patient presented long before the administration of the
remedy indicated ):

A) if the new symptoms are pathogenic symptoms of the remedy

administered, the remedy is the right one, it must be allowed to act without
intervening. If the new symptoms do not belong to the pathogenesis of the
remedy administered but your patient is getting better and better, it is
likely that later provings will show that such symptoms actually belong to
the remedy administered ;

B) if the new symptoms are part of the course of the disease, it means that
you have chosen your remedy incorrectly, and that it has not produced any
effect. These new symptoms may also be due to a natural effect of the
disease, such as typhus epistaxis. In this case, do not interfere;
C) if the new symptoms, although numerous and violent, do not belong to
the normal course of the disease (and your patient does not improve), this
means that the cure is not the right one.

10) Aggravation, followed by the return of old symptoms. This is the best
case. Do not act, not interfere, because it is a reaction, and no homeopathic
cure for a reaction. When these old symptoms persist, it is necessary to
prescribe again, these old symptoms occupying the first place in the choice
of the following remedy.

11) Improvement, but in a wrong direction. For example, a leg ulcer heals
under the action of the remedy, but hemoptysis appears. This shows that
your case is only partly covered by the remedy, and that depending on the
closure of the ulcer it is harmful.

12) In some patients, you will find that they are making a "proving" with
any cure administered. They are hypersensitive, and therefore extremely
difficult to treat.

VII - Homoeopathic aggravation.

In acute illness, homoeopathic aggravation is not mandatory unless the

disease is severe and dangerous.

In chronic diseases, without tissue modification, the aggravation is usually

not too severe, but when there are tissue changes, you will invariably have
a marked worsening, with elimination through a natural orifice of the
body.

In the first case, the aggravation is due to the medicinal disease, while in
the second case, the aggravation is due to a natural effort to put everything
in order, a kind of great cleaning of the house.

When the prescribed remedy is not the simillimum, one should not expect
an aggravation (except in hypersensitive, but it is a medicated aggravation,
not a curative one).

This is particularly the case in weak patients with deficient vitality, whose
organism is incapable of objectifying any characteristic symptom which
might serve as a guide in the search for the remedy. (KENT, Journal of
Homoeopathics, May 1900.)

VIII. - The repetition of the remedy.

You must not repeat your remedy until the action of the preceding remedy
is completely exhausted.
In other words, the time of therapeutic repetition can not be fixed in
advance, each case to be examined separately.

In acute cases it is easy to realize the exhaustion of the action of the

remedy by observing the general state and the psyche of the patient; And
also, to a lesser extent, by examination of the pulse and temperature.

During a typhoid in a robust patient, KENT gives his remedy every two or
three hours, in water, and for several days, because it is a continuous
fever, but at the slightest sign of reaction, It interrupts the administration
of the remedy.

On the other hand, in a weak patient. Who presents a continuous fever, he

refrains from repeating the remedy.

In a relapsing fever, the reaction will occur within a few hours, and a
single dose is sufficient. On the other hand, in chronic diseases, it is not as
easy as this, for it is normal and not exceptional to have improvement
interrupted by acute and short exacerbations.

Therefore, when we are faced with such an exacerbation, must we be

certain that it is permanent, and not transient, as is the rule.

In chronic cases, as long as the old symptoms reappear, it means that the
remedy continues to act.

The same signification, if the symptoms continue to disappear in the

reverse order of their initial appearance, or if they evolve, from internal
organs to superficial ones, or if they go from top to bottom.

Many cases are blurred by too frequent therapeutic repetition, and much
more than by any other cause; Do not forget that in an acute illness the
improvement may be delayed for three days, and in some chronic cases,
sixty days.

When the patient's vitality is weak, as in collapse, for example, it is

dangerous to repeat the remedy. But when there is no answer to the
remedy, after allopathic drugs, this lack of response being due to the
softness, the laziness of the organism, and not to a lack of vitality, it is
necessary to repeat more often (Kent).

Incurable cases require a more frequent repetition of shallow action

remedies, in order to obtain palliative action; It is not recommended to
exceed 200 'dynamization. (Kent, Journal of Homoeopathics, Nov. 1897 ).
Some antipsorics also have acute action, and when indicated in some acute
cases, they behave exactly like short-acting remedies.

When the remedy tightly covers the case, after a while, the symptoms on
which you have prescribed reappear, with sometimes one or two fewer
symptoms.

In such cases, all you have to do is to repeat the same remedy, to the same
dynamization, until it ceases to be active; It is necessary to use another
dynamization.

Unfortunately, in chronic diseases it is rarely possible to find a remedy

which covers the disease exactly, and as a result the symptoms return, they
are somewhat modified; Moreover, frequent therapeutic repetitions blur
your case, as many people are unaware of the possibility of suppressing
symptoms, by the frequent and repeated prescription of high revitalized
remedies.

IX. - The second remedy.

When you have obtained the therapeutic maximum of the first

prescription, you should select a second remedy.

Let the symptoms a, b, c, d, e ; After a dose of an anti-psoric, we find a

great improvement for six to eight weeks, as well as the disappearance of
the symptoms e, d, c , whilst a and h increase, at the same time as e
reappears; On the other hand, d and c have definitely disappeared; Finally,
a new symptom appears, so that the symptomatic picture is a, b, e, f; F, the
symptom appeared the last, must be the guide symptom.

We must find a remedy that possesses this characteristic symptom.

HERING thinks that it is part of the symptoms of the first remedy, but that
it occupies a low, little marked plane.

It is because of the appearance of f and the disappearance of d and c that

the original remedy is now contraindicated.

The second remedy must be complementary to the First, this is the reason
why this last remedy, whether homoeopathic or allopathic, and which has
been active, forms one of the surest guides in the choice of the second
remedy.

If the patient has been hyper-drugged, we are often obliged to antidot with
Nux.
However, prescribing Nux can in no way restrict our future choice to the
eight or ten supplements of Nux , for Nux having a certain action after its
administration, the case will become clearer; You will be able to prescribe
the remedy of your choice, except Zincum , which is incompatible with
Nux .

X. Dynamization.

The minimum dose is as essential in Homoeopathy as the Law of the like

itself.

The best results are obtained when the dynamic force of the disease and
that of the remedy are on the same plane. This may explain why, in some
cases, a low dynamic brings healing, whereas a high potency failed.

When a remedy needs to be repeated, it should be administered in the

same dynamic as long as it is. If the remedy indicated during an acute
episode is the same as that shown later in chronic disease, it will vary the
stimulation.

The very high potencies should never be used in incurable diseases. In

some hypersensitive patients, very high potencies, rather than cure, cause
of "provings"; such patients are doing better with 200th or M. When your
patient has been accustomed for a long time at low potencies, you will not
get good results at the beginning, using the high potencies.

Conversely, the frequent use of high potencies appears to increase

susceptibility and such "provers" symptoms get much more nuanced than
those who only experience the low potencies.

In all diseases, periodic exacerbations, such as pain. convulsions, or

leakage, it is recommended not to administer the cure during an
exacerbation, but immediately after (KENT, Journal of Homoeopathics,
September 1897).

XI. - Directorate for symptoms during the healing process.

1) From the inside outwards.

2) Usually from top to bottom.

3) In reverse order of their appearance.

The process continues until the appearance of the primary cause of the
disease or canker syphilis, gonorrhea sycosis, or the outbreak of Psora.
The initial flow may not be reappear in the original location, but from
another mucosa. We must also remember that the miasma can be taken at
all stages: for example, if a woman takes her husband syphilis from the
pharyngeal stage, the disease will come back to this starting point. but not
to canker.

XII. - Incompatible Remedies.

The remedies, the action is very similar, if antidotent or are incompatible.

This rule only applies if the first administered remedy has had some
influence on you.

By cons, if the first remedy has brought no effect, his inconsistent can be
administered safely.

Some remedies are inconsistent only in acute, while others are only in the
column. (KENT, Medical Advance, January 9, 1895.)

XIII. - Driving forward regarding abnormal desires.

During an acute illness, it is recommended to assign the marked desires of

the patient, by cons in a chronic disease, we must not give in to their
whims.

It should be noted that when a patient uses long toxic such as morphine,
tobacco, etc ... homoeopathic remedy sometimes act, even if the patient
continues to intoxicate; but obviously the action of the remedy will be
short and imperfect.

XIV. - Precautions for the use of certain remedies.

Some remedies like Sulfur, Silica, Phosphorus, Sulfuricum ac, are very
dangerous in certain diseases.

In fact, these remedies have the ability to act by expelling foreign bodies;
gold, they can not be disposed of, by a suppurative process.

In cavitary tuberculosis, or in cases where the healing process resulted in

the formation of calcareous concretions, or in the case of foreign bodies,
such as: a ball near a vital organ, this danger is extremely real and
permanent, if it is prescribed Sulfur, Silica , Phosphorus or Sulfuricum
acidum.

There are two kinds of symptoms in all suppurative pneumonia or

tuberculosis, with advanced what are the symptoms toxemic and
constitutional symptoms, chest pain, hectic fever, mental symptoms and
dreams of being toxemic symptoms.

If one of these four remedies, say Silica, only corresponds to toxemic

symptoms and not with constitutional symptoms, it will act as a palliative,
mitigating toxemic symptoms, and without causing damage.

But if in a period before the formation of the tuber, the patient suffered
from migraines weekly localized in the occipital region and extending
forward, with very fragrant plantar sweating, cold sensitivity, etc ... and
that all these symptoms have disappeared before the onset of consumption,
Silica become an extremely dangerous cure for your sick about that
Arsenicum , unnecessary stress on his schedule and agitation, anxiety
accompanying access.

It remains to establish relations Nat sulfuricum on the digestive plan. It is

still the disruption of water metabolism that is causing intestinal disorders:
flatulence, diarrhea, and indirectly of liver failure. It's not that the liver is
so touched, the reticuloendothelial tissue.

The usual complementary Nat sulfuricum is then china , which acts in

conjunction with it such as preventive of hypercholesterolemia and of the
lithiasis, organic suckers which can be then necessary being, as
appropriate, carduus , chelidonium or taraxacum .

Finally, Nat sulfuricum perhaps a background cure some chronic malaria

cases. It is then complemented by china with its well-typed access by
Arsenic , which is indicated by incomplete or prolonged access, or in case
of failure of quinine, and again, by Aranea diadema , often suitable for
malaria, returning to France, which are ill-defined access, especially in
cold and humid weather. The spleen is drained by coenothus or Helianthus
. (Kent journal of homoeopathics, November 1899 ).

Sometimes, and for the same reason, these remedies can cause some
damage after a brain hemorrhage is bleeding other vital organs. Ferrum
and Aceticum ac , are dangerous in many cases of advanced tuberculosis,
because of the power they possess to cause bleeding.

Ferrum is able to turn into an ulcer phadgnique ulcer in old syphilitic.

The antipsoric can cause major damage during an active syphilis, as it is

the dominant miasma; but this rule does not apply if the antipsoric is also
an anti syphilitic. It is not recommended to remove diarrhea of advanced
tuberculosis, even by the same remedy.
Kali c, is a very dangerous remedy in patients with gout for long, but Kali-
iod , is often very effective (KENT).

Ars, is a very dangerous remedy in heart, especially if it is organic disease,

as it can trigger a parenchymatous nephritis (KENT). Ars, is a dangerous
remedy in dysentery, if not the exact simillimum because it can "confuse"
your whole case. (KENT, Medical Advance, November 1899.)

XV. - Idiosyncrasie.

Each of us has an idiosyncrasy is a susceptibility

specific to certain influences.

This is why only a few people are affected by evil when they are in the
presence of the infinitesimal cause that triggers the disease.

The sensitivity of a sick man simillimum homoeopathic is beautiful, while

a cure is not homoeopathic to this state can be administered in massive
doses, without the slightest effect.

Nobody can be sickened in a sustainable manner by a cure for which he

has no susceptibility.

This may serve as an explanation to show how sometimes a high potency

of the drug may prove curative for poisoning the same drug.

In other words, in such a case, the patient was poisoned because he was
sick or likely, and he needed that remedy, but the drug is not on the same
plane as its susceptibility, the poison instead of healing it.

Kent also believes that too frequent repetition of a non-boosted drug

awareness to this drug and after a while, the slightest inhalation of this
drug is active ( Hom . Phys., September 1889)

XVI - "Proving" (Experiments).

it is recommended when making a "proving" to start with a single dose,

but in most cases, this approach will be ineffective.

If the single dose fails, try creating a susceptibility repeating the dose until
he can save some effect; but dosing should stop at the onset of symptoms
and not be repeated until the complete disappearance of all symptoms.

Many "provings", especially those of Thuja, are almost worthless because

the drugs was repeated after the first symptoms.
The symptoms are more subtle, according to the rule, which develop later,
months after the drug administration ceased.

We should pay no attention in "proving" the so-called primary or

secondary symptoms, because as long as the drug causes symptoms, it can
heal.

In some "provers" symptoms that are considered secondary appear during

the primary phase of drug action.

In a "proving" if symptoms that the experimenter felt there very long,

reappear, this means that, under its own constitution, the "prover" has a
special tendency to manifest (Organon, 138).

XVII. - The psora.

In the treatment of non-venereal chronic diseases, Hahnemann discovered

that the same remedy was as effective as in acute diseases, by eliminating
existing symptoms.

But he also noticed that after a period of considerable better. the same
symptoms returned, without any apparent cause; the similar remedy made
them disappear again, but in a less than perfect at the first prescription.

This phenomenon occurred several times until the remedy ceased to be

beneficial. Being convinced of the universality of the law of homoeopathic
curability, he concluded that the apparent illness was only a part of
something deeper, because otherwise the cure should be permanent.

He began the careful study of the history and evolution of a significant

number of chronic diseases comments in order to discover all the signs
and symptoms from this deep disease, primitive and unknown.

He discovered that most of these patients had scabies or quelqu'autres skin

diseases such as eczema, herpes, ringworm, etc ..., and the symptoms of
chronic disease manifested after the disappearance of cutaneous
manifestations disappearance either spontaneous or "suppressed" by an
external processing; he discovered that most of the disease tended
constantly to progress from the outside to the inside of the less vital to the
most important organs.

He knew then that he had found the common origin of all chronic diseases,
apparently so different.

He dnomma: Psora.
Moreover, he chose of all the remedies experienced, who had produced
symptoms similar to those of Psora and decided to use them to heal.

Hahnemann believed that Psora was always the result of direct infection
and as was probably the case at the origin; but currently, and according
KENT, all mankind is more or less itch. and acute manifestation is only
the sign of a new aggravation of the miasma.

Many would have refuted the theory of psora, but practical experience
shows us that we must prescribe most often true antipsoric, for healing.

This preference is not theoretical, but is constantly subject to the general

principles of homeopathy.

Dr. Rueter has issued a publication in which he describes the order in

which the different organs are affected by] a Psora, when unchecked, but
Kent has not confirmed.

KENT observed that many diseases appear to be on the same plane, a

family member with epilepsy, while others present madness, cancer,
tuberculosis, etc ....; the organs being affected following the circumstances
in which the patient is not following a specific order.

XVIII. - Syphilis.

The natural evolution of this disease will be studied little, according to

data from the allopathic school, because the habitual use of massive doses
of remedies prevents the disease to follow its natural course.

The first event is the canker, which usually appear a fortnight after casting.
This canker, under the influence of a correct homoeopathic treatment,
tends to spread, and the suppurating bubo frequently; while under
allopathic treatment, bubon persists in the form of a hard mass which
rarely suppurating.

Under homoeopathic treatment, if the chancre disappears bubon presents

profuse and profuse discharge.

Hahnemann taught that it was possible to prevent the occurrence of

secondary symptoms, but this is a mistake, because these symptoms
always appear sooner or later.

At the time of Hahnemann, we did not distinguish canker chancroid, and

undoubtedly there was the cause of the Master error. The chancre is
followed by eruptions, which require the prescription of a different
remedy. More canker cure will simillimum and less important will be the
eruption.

Under homoeopathic treatment, the rash is usually very abundant, but

never pustular; it is followed by ulceration of the throat. The first ulcer
will be the last to disappear under the influence of, homoeopathic
treatment. The next event is hair loss (Kent). The tertiary stage, should he
appear under homoeopathic treatment would be very light, almost
imperceptible (KENT).

The above applies only when treatment was homoeopathic from start to
finish, but when we come to treat a patient who received allopathic
treatment to the tertiary stage, it should proceed in a very different way.

In such a case, and ad hoc sub-therapeutic. all the symptoms already

experienced by the patient reappear, but in reverse order of their
appearance, that is to say hair loss and sore throat, rashes, and finally
canker. Of course, at each stage, it will be necessary to prescribe the
indicated remedy. (Never stop prescribing Mercurius, as the patient is
benefiting. - KENT)

Syphilis, like sycosis, are made at this stage of evolution; therefore,

therapeutic under homoeopathic, symptoms return in the reverse order of
their appearance, but does not move beyond contagion.

In syphilitic old, whose body is worn out, without any symptoms guide, it
is good to prescribe few doses of Syphilinum to restore the vital reaction
and show the symptoms.

After that, the indication of antipsoric appears because when syphilis was
so far away, it is always mixed with Psora (KENT).

If psora or sycosis are active when the patient contracted syphilis, it

removes the other miasma, and after being treated with anti-syphilitic
remedies, the disease becomes latent and psoric symptoms reappear or
sycosiques; they must be treated in turn by the corresponding remedies
until the disappearance of symptoms.

Syphilis can then become active again, and this alternation of miasmatic
events may persist until complete recovery of the patient. This alternation
of miasmatic events is very important, because such antipsoric Sulph.,
Calc. and Phosp . can do more harm than good if one prescribes when
syphilis is active (KENT).
When syphilis is accompanied by sclerosis gummy formations perianal,
intra-periosteal and intracerebral, Sulfur, if required, triggers a suppurative
process that worsen your illness.

So after prescribed Sulph ., In a syphilitic patient, but I never knew the

disease, I have seen indicate significant suppuration of the palace. You
may then have to prescribe immediately Merc. or Merc. horn. to stop the
action of Sulph . (Kent).

XIX. - The sycosis.

There are two kinds of gonorrhea, acute and chronic. There is also a
catarrhal form itch or urethritis. The acute form is by far the most common
and its removal does not appear to constitutional symptoms (KENT,
Journal of Homoeopathics April 1899).

The chronic form begins in exactly the same manner as the acute form
and, apparently, the flow is the same (KENT).

As long as we let "flow" freely, no constitutional symptoms appear; as you

saw, it was not the same in syphilis (KENT, Medical Advance, November
1888).

The second manifestation sycosis is the wart, usually soft, sensitive, easily
bleeding, red, emitting a sweet, strong smell; sometimes the wart is flat,
smooth, red, brilliant.

As long as we let alone those warts, no constitutional symptoms appear. It

is important not to forget that the flow and the warts can be removed by
the continual use of inappropriate homeopathic remedies.

The first symptom of constitutional Sycosis is rheumatism, which may not

appear until months after the disappearance of the original event. This
arthritis is very similar to that of Rhus., But this remedy acts only as a
palliative, since it is not an anti-sycotic.

The order of the other events is known in May, but among the main, it is
worth mentioning: orchitis, pulmonary tuberculosis with hemoptysis, and
many diseases of the genitals of the woman.

Severe asthma in hot and humid weather, and spring, is one of the
manifestations of sycosis.

According KENT, spasmodic asthma is almost invariably a sycotic

asthma, especially if it is hereditary; also remedies such as Spong., ipec.,
Carbo v., Bry . and Ars, do not they act only as palliatives.
One of the last and most significant manifestations of Sycosis is a singular
anemia, characterized by a waxy appearance, shiny, greenish gray of the
face, with sunken cheeks and hollow voice.

Sycosis as Syphilis can be caught only once, according to Kent, who

considers this law:

During repeated gonorrhea, one is real, that is to say sycotic.

Exceptionally, a man lying in the last period of his constitutional sycotic
state, can catch gonorrhea in the first stage and browse the whole
evolution; in addition, if a woman is at the stage of the said anemic
Sycosis is contaminated, it is possible that the present gonorrheal flow
characteristic (KENT).

Sycosis, like syphilis, is always taken to the stage where it is in the person
who sends it, and therefore, many women who do catch him at the stage
anemic. When you have, you must choose to treat a case of constitutional
sycosis, your remedy according to symptoms present, and rationally latter
remedy will be found to be an anti-sycotic.

Sometimes you have to draw out of the list of known anti-Sycotic because
now this list is far from complete. In these cases constitutional sycosis,
when the indicated remedy will remove symptomatic group, you will see
emerge another, which will require a new remedy, and so on, step by step:
the patient will return any earlier symptomatic groups lived, but in reverse
order of their appearance.

In advanced cases, two or three years will be needed before you can bring
back the original event, either gonorrhea, rheumatism, or a catarrh. If at
the time of the reappearance of the original gonorrhea, it is ephemeral, it
means that there is a lack of vital reaction, and we must consider healing
as doubtful.

Mercurius and Sulfur can only be harmful in advanced sycosis, although

they are often given at the stage of flow.

It is rarely possible to medically healing the old strictures Sycotic, this is

possible only when the remedy cures acute urethritis, with the return of the
original gonorrhea. While recovering from an acute illness is disrupted, we
must not invariably turn to the Psora, but seek and find the miasma and
administer the indicated remedy, antipsoric, syphilis or antisycotique.

A marked resemblance between the symptoms of sycosis and those

generated by vaccination, led BOENINGHAUSEN and others, to identify
one another, but KENT does not consider this hypothesis to be correct.
 A "drop" commonplace during for months, is not always an indication of
sycosis, but often the Psora, and, therefore, has the same meaning as a
mucous catarrh of another region ( KENT).

There are many remedies that have a curative action on gonorrheal

discharge, but that never healed warts or brings back a deleted flow.

These are only gonorrhea remedies, they can heal the flow, but not
sycosis.

Any urethral inflammation can occur testicular inflammation, not

necessarily sycotic; thereby, the remedies that suppress flow are not
necessarily anti-Sycotic (KENT).

Copyright 1998 Robert Sror

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