The Potency Dilemma Part I
NATIONAL JOURNAL OF HOMOEOPATHY 1998 May / Jun VOL VII NO 3.
Dr Ajit Kulkarni

"Sometimes when I consider what tremendous consequences come from little things
.... I am tempted to think....
There are no little things."
.............Bruce Barton

Introduction:
Science demands an unfolding of the mystery that intrigues the inquisitive the research minded. This unfolding in the time space dimension, is an essential part of scientific development. Homoeopathy, is no exception.. Since its inception, several investigators have sponsored a variety of experiments and philosophical ideas & highlighted various facets of Homoeopathy. This Homoeopathic journey could well be described as "Spoof to splendour and sublimation".
Homoeopathic practice demands artistic prescribing backed by a logistic methodology. Since the problem of potency selection has remained a stumbling block in clinical practice, it is essential to see how art and science are blended in this intriguing aspect.
The present article focuses more on the potency selection than repetition schedule; as the latter more concerns 'movement' that occurs after the administration of a remedy.

Historical Background:
The literature on potency selection is full of contradiction; thus the resultant confusion.
The initial phase of Homoeopathic practice, showed the trend to use low potencies from decimal (3X) and centesimal scales [2 to 30C]. Hughes, Clarke, Boericke and others chiefly advocated the use of low potencies. The potency 200 came forcefully into operation with Nash, who found this to have more rapid action. Later, Kent introduced high potencies. Tyler, Borland and others experimented extensively with high potencies and frequent repetitions, esp. in acute prescribing. They made observations that low potencies, though cure without complications, allow the disease to take its own course i.e. the span of illness is not decreased. In contrast, high potencies administered repeatedly, allow cure without any sequelae and also shorten the span of illness. Dr Maganbhai Desai, Dr Sarabhai Kapadia et all, experimented with high potencies in acute and also in chronic cases.
But, interestingly, both low potency and high potency users have claimed equal success!

The State Of Flutter
Thus we have a panorama of utilization of potencies from low to high. This, instead of clarifying the potency problem, creates an embarrassment for a Homoeopathic physician. If Homoeopathy is a disciplined doctrine with a sound philosophical substratum, its clinical practice which chiefly concerns use of drugs on the basis of similia, must be characterized by certain rules. These rules should unfailingly guide a Homoeopathic physician, so that its operation at the bed side, on an individual instance, should have a scientific coherent base.
The rules of potency selection, however, are unknown to many Homoeopaths. Each one uses potency on the basis of his whims and limited experiences, which push aside the concept of individualization. Here, clarity at the level of rules and their application will immensely enrich his practice.

The Concept Of Minimum Dose
At the outset, let me reiterate that we are using potentized drugs and not the crude form. Therefore the whole perspective is different. We potentize so as to render the remedy simple enough to be drawn in by the vital force. Hahnemann progressively reduced the crude doses in order to moderate the patient's reaction & reduce the undesirable aggravation of symptoms. Progressive reduction of the material doses [to the extent of zero level] however, didn't reduce the unique medicinal action. 'The substance exerts its action irrespective of quantity' - is the inference one can draw from the doctrine of potentization. The qualitative part in terms of action, is retained and transmitted in stronger form in subsequent dilutions. This is truly an amazing phenomenon. - 'Qualification' of quantity in contrast to qualification of quality.

The potentization doctrine, which has opened up a new vista in the understanding of drug effects on an entirely different plane, makes one infer that: the quantity of substance necessary to effect any change in nature is the least [French Mathematician Mauperituiss's principle]. This least is minimum, infinitesimal - just enough to bring about a reaction in the vital force.

The concept of Minimum dose as propounded by Dr Hahnemann should be given utmost priority in potency selection. A Homoeopathic physician casts the drug force in the sick individual with the expectation that the vital force will rebound in favor of balancing the disturbed rhythm. The basic aim in giving the minimum dose; is to make the immune system mobilize its resources to annihilate the morbific influences that have disturbed the vital economy. Here one has to take into account the biphasic action of the drug, Primary and Secondary, and the field of operation of the law of similar. The concept of minimum dose will be understood if a Homoeopathic physician has adequately comprehended these issues.

When a drug is administered to the sick individual on the basis of the law of similars, it evokes a reaction from the vital force, which is trying its best to keep the state of Homeostasis. Thus, the already existing curative processes are intensified when the drug is administered on the basis of the law of similars. Through the production of an artificial disease having a similar pattern, the Homoeopathic remedy deals with the secondary curative reaction that steers the organism towards the goal of harmony. In short, the fact that Homoeopathic drugs act as assistants should be kept in mind when one is dealing with Homoeo potencies.

The minimum dose should not be confused with the infinitesimal dose. The concept of minimum dose could be applied to both crude and potentized. The infinitesimal is essentially an incalculably minute dose, whose value is arbitrarily close to zero when we are thinking from a material angle. But, therapeutically it has a vast potential.

Disease As An Adaptation
Disease essentially is an adaptive effort on the part of the organism through which it expresses itself. Disease as an adaptation makes one consider the disease, not as an enemy, but in terms of a vital reaction, a defense posture adopted by the system in favour of health. If a Homoeopath, like the Allopath, regards disease as an enemy, his thinking process will naturally be directed towards eliminating the disease by hook or crook, through haphazard and indiscriminate use of potencies. With the former attitude of adaptation, a Homoeopath will concentrate on whether the system is being properly assisted by the Homoeopathic remedies and on the way it is reacting. He will be more cautious disciplined and will welcome positive reaction. He will see that no harm is done to the system.

Individualization And Flexibility
Certain comments passed by our predecessors have become fixities in terms of danger signals. Nosodes should be given only as intercurrent, in high potencies and in an infrequent manner. Some deep acting constitutional drugs like Lyco, Phos, Sulph should not be repeated etc. Such taboos and injunctions from previous teachers need an unbiased thinking on the part of a Homoeo physician, understanding the need of the patient, individualization, doctrine of similia etc. Individualization, the dictum of Homoeopathy, means that what is applicable to one case may not be applicable to another case. Hence keeping rigid ideas about certain remedies and certain potencies should be avoided. I remember an old Homoeopath who uses Calc-carb only in 10M potency, as according to him no other potency of Calc-carb is helpful in practice. One Homoeopath uses drugs only above 1M potency, as according to him, Homoeopaths are failing in practice because of prescribing low potencies. We remember a case of pleural effusion in a boy, which baffled well-selected remedies like Bry, Kali-c, Rumex etc but finally responded to Tub 200 given repeatedly. This case taught us that nosodes have an acute dimension too.
Balancing the rules [theory] and their application [practice] is a difficult job. If experience is making us more rigid and affecting our sensitivity and sensibility we have to concentrate on the central tenet of Homoeopathic prescribing - individualization.

Categories Of Potency
I] All potencies from mother tincture to below 30 are termed as low potencies. This applies to decimal and centesimal scale of potencies. The equation of centesimal to decimal at 30C potency is 30C=60X, hence all decimal potencies below 60X should come under low potencies.
II] 30 to 200C i.e. centesimal potencies are termed as medium potencies.
III] 1000C and above are high potencies.
IV] 50 millisimal scale from 0/1 to 0/30 is regarded as highest potency.

Components Of Potency Selection
This issue of potency selection is not a simple one; it requires the consideration of various components that make up the totality. It is rather irrational to prescribe, without considering the totality as linked by several co-ordinates available in the system.
Favouritism is a No-No and comes when the totality is not comprehended. Science demands logical interpretation of the components and an accurate application of these components in clinical practice and not favouritism,.
What are the components to be taken into account while considering the problem of potency?:

1. Disease potential
2. Type of patient
3. Sensitivity
4. Susceptibility
5. Etiological factors: maintaining, precipitating and fundamental causes.
6. Miasmatic interpretation
7. Similarity- Degree and level
8. Suppression
9. The Nature of Sinew ?

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