Problem Of Potency- Principles And Practice
NATIONAL JOURNAL OF HOMOEOPATHY 2000 Nov / Dec VOL II NO 6.
Compiled by
T K Kasiviswanathan
'Calc-c
Editor: This is a very comprehensive article on the subject where the author has searched much literature and quoted extensively form various sources to bring to us a very interesting and highly readable account. So though long, we thought it worthwhile to include it in this issue, than what other authors contributing to this issue have written on the subject. We have removed portions of repetition from the other articles each article, so that all the three articles can be read as one comprehensive article on the subject.
Hahnemann said, "The reasonable physician will choose only the most suitable dose of the indicated remedy so that hardly a sign of aggravation of the disease will be aroused. The counterforce chosen as exactly as possible for the removal of a natural disease force should be so calculated that it will only just attain its object and will do the body no harm in any way through unnecessary strength."
This has been the guiding factor for his potentisation of remedies and further research to make the dose so minimal to achieve the objective; and it culminated in his evolving the 50 ML potencies, which he expounded in his 6th Edition of Organon. Unfortunately all the stalwarts of Homoeopathy were not aware of the latest potencies and experimented only the centesimal potencies and left behind their experiences in this regard.
- It was Boenninghausen, who had kept a record of his cures with 200th potency of various Homoeopathic drugs and has written various articles on its efficacy and these are available in his Lesser Writings. "When I first began 20 years ago my experiments with 200 potency I limited these experiments exclusively to animals, but by the most surprising successes I soon gained the courage to transfer them also to men. The successes were of such a kind that I at this day never descend as low as the 30th potency, while I only rise to Jenichen's highest potencies when compelled by necessity." He has cited several cases of trauma, typhoid and animal diseases cured with 200 potencies.
- "The physician who knows how to use various potencies has ten times the advantage of the one that always uses one potency no matter what the potency is. After thirty years of careful observation and comparison with the use of various potencies it is possible to lay down the following rules. ( Kent)
In persons suffering from chronic sickness and not so sensitive, the10M may be first used and continued without change so long as the improvement lasts; then the 50M will act precisely in the same manner and should be used so long as the patient makes progress towards health; then the CM may be used in the like manner, also the DM and MM. By this use of the series of potencies in a given case the patient can be held under the influence of the similimum of a given remedy until cured."
"Whenever the similimum is found, the remedy will act curatively in a series of potencies. If the remedy is only partially similar it will act only in one or two potencies and the symptoms will change and a new remedy will be called for. The patient can feel the medicine when it is acting properly; each time the patient will say that the new potency acted like the first one received. (Dr Kent- Successful Prescribing- Lesser Writings)
"After 30 years of active practice as a Homoeopath, I find that I require all deep-acting remedies in the 30th, 200th, 1000th, 10M, 50M and CM and often need DM and MM
I am able to see the vast difference in the action of these various potencies. I once used potencies that ranged nearer to each other, but repeatedly found that the degrees must be far enough apart to represent an octave or failure followed. I observed that after the good action of 200th, after waiting until it was no longer active, although I gave 300 or 500 or 800, the 1M acted much more strongly. Frequently I gave the 45M (Fincke) with excellent results; but after it had done all it would, I would give an 80M,or a 73M or a 60M with failure but always the CM will work as the 45M had done.
Many times I used to give first a CM, but found that when going lower the action was seldom so strong as when climbing upward. Of late years, I always begin lower and gradually go higher and thereby avoid shocking even the very sensitive women and children. An extremely sensitive woman will receive for her chronic condition the 30th or 200th then followed by higher potencies while those not so sensitive receive the 10M to begin with and then the higher as the case progressed to recovery. (Dr Kent- Series in Degrees- Lesser Writings)
Second Prescription:
" I have observed in cases where a low potency has been administered in frequently repeated doses, that some time must elapse before a perfect action will follow a 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 fails to act, a higher potency will generally do so quite promptly as did the lower one at first. When the picture comes back changed only by the absence of some one or more symptoms and no new symptoms, the remedy should never be changed until a higher potency has been fully tested." (Dr Kent- The Second prescription-Lesser Writings)
Dr Stuart Close states in his book " The Genius of Homoeopathy" that five considerations influence the choice of the dose ie its potency:
- The susceptibility of the patient
- The seat of the disease
- The nature and intensity of the disease
- The stage and duration of the disease
- The previous treatment of the disease
"The more similar the remedy, the more clearly and positively the symptoms of the patient take on the peculiar and characteristic form of the remedy, the greater the susceptibility to the remedy and higher the potency required."
He quotes Dr Jahr that the essential difference between the action of the low and high potencies consists not in their strength or weakness but in the development of the peculiarities of the remedy, as we rise in the scale of potencies. He says that in a given case, where the symptoms are not clearly developed and there is an absence or scarcity of characteristic features or where two or three remedies seem about equally indicated, susceptibility and reaction may be regarded as low- we give low (3rd to 12th) potency. When the symptoms of a case whose characteristic symptoms correspond to characteristic symptoms of one remedy we give higher potencies depending on the confidence of the prescriber. In other words, " the finer, more peculiar and more characteristic symptoms of the remedy appear in a given case, the higher the degree of the susceptibility and higher the potency." (Dr Close)
The Susceptibility Is Modified By Age:
Generally the susceptibility is greatest in children and young, vigorous persons and it decreases with age. In children developing organs are very sensitive and hence those drugs, with a peculiar affinity to those organs should be given in medium or high potencies.
Dr Close: higher potencies best adapted to sensitive persons of the nervous, sanguine or choleric temperament; to intelligent, intellectual persons who are quick to act and react and also to zealous and impulsive persons. Those in sedentary occupations. Contrary to expectations, those who have taken many crude drugs from allopathy often require high potencies. Here, their susceptibility to crude drugs and low potencies has been exhausted and even massive doses seem to have no effect, and will often respond at once to high potencies.
Lower Potencies And Frequent Doses:in torpid and phlegmatic constitutions, dull of comprehension and slow to act; to coarse fibred, sluggish individuals or those with great muscular power but who require a greater stimulus to excite them- require low potencies or even material doses. Persons exposed to the continual influence of drugs such as tobacco workers and dealers, distillers and brewers, perfumers etc have little susceptibility and require low potencies.
Susceptibility is also modified by pathological conditions. In certain conditions the power of the organism to react even to the indicated remedy may become so low that only material doses can raise it. Dr Close cites the example of terminal cases of valvular heart diseases, where Digitali, the indicated remedy, produced no effect by any potency; but responded to tangible doses of pure tincture " It is solely a question of approximating the quality and quantity of the dose to the grade or plane of the disease." " In terminal conditions, therefore, when the patient does not react to well selected remedies, nor to inter-current reaction remedies, given in potentised form and small doses, resort to the crude drug and increase the dose to the point of reaction."
Case 1
Dr Close cites a case in support: A case of valvular heart disease of many years' standing which had reached the stage of fibrillation. In previous crisis it had responded to potentised medicines; but now they did not elicit any response. Tachycardia, arrhythmia , oedema and passive congestion of brain and liver, delirium and suppression of urine and coma foretold the rapid approach of the end. Though Digitalis was clearly indicated, no potency including mother tincture produced any change. At this point, with the assistance of an eminent allopathic physician, full doses of special preparation of Digitalis and a salt-free diet were given; within next 36 hours the patient was passing copious urine thus clearing lungs, brain and liver and eventually the patient recovered; only 6 doses were given at intervals of 12 hours and stopped when therapeutic reaction established.
Case 2: girl with an incurable heart disease with dropsy, ascites and hydrothorax- prescribed a single dose of Calc-carb CM and within 48 hours she had copious urine which continued for several days. Dropsy rapidly disappeared and she recovered well enough to live comfortably for 13 months. These cases, states Dr Close, represent the extremes of therapeutic resources available to the Homoeopath.
Dr Close states that the seat, character and intensity of the disease have some bearing upon the question of the dose. Certain malignant conditions and rapidly fatal diseases, like cholera, may require material doses or low potencies because of the low vitality and deficient reaction. Later higher potencies may be needed once the reaction arises. The question is entirely one of susceptibility: higher the susceptibility, the higher potency.
"Generally speaking, diseases characterized by diminished vital action require lower potencies; while diseases characterized by increased vital action respond to high potencies." (Dr Close)
Occasionally a case will be met which is not at all susceptible to the indicated remedy. In such cases the temporary insensibility to the medicine may be traced to the previous abuse of the medicine or to an existing regimen. If time and exigencies permit it is sometimes best to cease all medication for a few days and carefully regulate the diet and regimen. Then the medication may be resumed in low or medium potency based on temperament and constitution. Hahnemann has recommended in such cases the administration of Opium, in one of the lowest potencies, every 8 to 12 hours until some reaction. By this the susceptibility is increased and new symptoms of the disease are brought in light. (Dr Close)
