Homoeopathic Posology
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Jan / Feb VOL III NO 1.
Dr S K Koppikar
'Bry / Apis / Dig / Ars-a / Bapt / Hyos / Stram / Mer-sol / Ars-a / Bar-c / Acon / Bry / Calc-c / Sul / Psor / Con / Ched / Bad / Psor / Orni / Carb-v / Myris / Calc-hyp / Ferr-phos / Calc-phos / Phos / Apis / Lyc / Ars / Lach
Next to selection of the right remedy, no problem so plagues the homoeopath as the selection of the right potency-its repetition and dose. Hahnemann and his immediate disciples started with low potencies, gradually going higher as they gained experience. The American Homoeopaths divided themselves sharply into low and high potency schools. Somehow the most accurate prescribers became enthusiastic supporters of high and the highest potencies.
I give below a few famous cases, where a definite reasoning led the doctor to the selection of the appropriate doses. The first case is from Hahnemann itself.
Case 1: Dr Hahnemann
A washerwoman, 40 yr, had been unable to earn her bread for 3 wks. She consulted me on September 1st, 1815.
- On any movement especially at every step, and worse on making a false step, she has a shock in the pit of the stomach that comes as she swerves every time from the left side.
- When she lies she feels quite well no pain anywhere, neither in the side nor pit of stomach.
- She cannot sleep after 3 am.
- She relishes her food, but when she has eaten a little she feels sick.
- The water collects in her mouth and runs out like water-brash.
- She has frequent empty eructations after every meal.
- Her temper is passionate, disposed to anger. When the pain is severe she is covered with perspiration.
Bryonia alone has among its chief alternating actions pain from movement, especially shooting pains, as also stitches beneath the sternum (in the pit of the stomach) on raising the arm, and on making a false step it causes shooting in the other parts.
"Now as this woman was very robust and the force of the disease must consequently have been very considerable to prevent her doing any work, on account of the pain and as her vital powers were not impaired, I gave her one of the strongest Homoeopathic doses, a full drop of the undiluted juice of Bryonia root to be taken immediately and bade her to come again in 48 hours".
She never returned as she was completely cured in one day and started working next day.
For contrast let us study another case, reported by Dr H N Guernsey the great professor of Materia Medica and father of "Keynotes".
Case 2: Dr H N Guernsey
I was called in consultation to see Miss M, who was thought to be near dying. I found the patient in great distress. Panting respiration, able to speak only in a whisper and each word uttered separately from the next by several respirations. She had informed me she could not long survive, as each breath seemed as if it would be her last one. She had no thirst, scanty urine, and had not slept for two days. Percussion over her chest gave a clear and healthy sound. Ausculation revealed permeability of the air through her lungs, but a very loud bronchial rale.
No other remedy has this combination of symptoms excepting Apis. My choice fell on the 40M potency, for the reason that she was too ill to bear a lower potency of a large dose of the material. Directions given to repeat Apis 40 M in water every hour till she seemed a little better, then to cease giving entirely till we saw her in the morning. After the third dose, she became quiet, fell asleep for two hours and remained quiet all night, sleeping at intervals till morning.
Contrary to instructions, the medicine was repeated every time she awoke, till 9 in the morning when she received the last dose remaining, soon after she became as bad as on the previous evening. We saw her at 10.30 am and found her about the same as on my first visit. Now what was to be done? The same remedy was still indicated, and it was very evident that she was overdosed, therefore Sac lac (blank powders) was given during the day and when we saw her at 6.30 pm she was again more comfortable. Next day still better and still Sac lac. The day after showed that on the whole she was improving and she made a perfect recovery without a further dose of medicine.
Let us examine two more contrasting cases, reported by Dr Stuart Close in his great book, "Genius of Homoeopathy"
Case 3: Dr Stuart Close
The first was a case of Valvular Heart disease of many years’s standing, which had reached the stage of fibrillation. In a previous crisis it had responded to potentised medicines. In this instance, however, potentised medicines selected with great care had no effect. An effort was made to arouse the dormant activity with the intercurrent remedies, also high potency, Laurocerascus, Carbo-vegetablis, Tuberculinum and Medorhinum given, as recommended by Homoeopathic authorities.
All efforts failed and the case rapidly progressed toward dissolution: Tachycardia, arrhythmia, oedema, ascites, hydrothorax, passive congestion of the brain and liver, delirium, suppression of urine and coma foretold the rapid approach of the end. For a period of over three weeks the symptoms had positively and unmistakably demanded Digitalis; but doses ranging from forty thousandth down to drop doses of the tincture produced no favourable change.
At this point, by advice of an eminent allopathic specialist who was called in at the request of the family, full doses of a special preparation of digitalis and salt-free liquid diet were given. Within thirty-six hours the patient was passing over one hundred ounces of urine. In twenty-four hours, brain, lungs and liver rapidly cleared up and the case, which had appeared absolutely hopeless, progressed steadily to a good recovery.
The action of the Digitalis was clearly curative. No pathogenic symptoms of any kind appeared, for the copious urine was distinctly a curative symptom. Only six doses of the drug were given, at intervals of twelve hours, and it was discontinued as soon as its full therapeutic action was established. One month later, it was necessary to repeat the medication in smaller doses a few times for a slight return of some of the symptoms due to over-exertion.
This patient was not cured in the sense that his structurally damaged heart valves were not restored, for that is an impossibility. But the action of the indicated drug was curative in nature, as far as it was possible to go, his life was saved and prolonged, and he was restored to a measure of comfort and usefulness when otherwise he would have died.
Digitalis in material doses was Homoeopathic to this condition, symptomatically and pathologically and no other drug could take its place at that stage of the disease. No other medicine of any kind was given.
In contrast to this case, and in further illustration of the necessity for being prepared to use the entire scale of potencies the following case from the practice of Dr Close is presented:
Case 4: Dr Stuart Close
A girl 8 yrs of age was in the late stages of incurable heart disease. She had been under allopathic treatment for over a year, steadily growing worse. When first seen by me, she was confined to a chair, unable to lie down or remain in bed. General oedema, ascites and hydrothorax existed. Urine was almost entirely suppressed, about four ounces in 24 hrs was being passed. Tachycardia and dyspnoea were most distressing and death seemed imminent. The history and anamnesis of her case, revealed unmistakable Calcarea symptoms. She was given a single dose of Calcarea-carb C M (Fincke). The reaction and response to the remedy was surprising. Within 48 hours, copious urine secreted. For several days she passed from one hundred and twenty to one hundred and fifty ounces per day. Dropsy rapidly disappeared and she was soon able to lie down and sleep comfortably. In about four weeks she was able to go out for a ride in a carriage, and not long after she was walking. She lived thirteen months in comparative comfort and happiness and then died quite suddenly of heart failure, after slight overexertion.
These two cases represent the extremes of therapeutic resources open to the homoeopathic practitioner."
So we see that for best results, we must use the full range of potencies from mother tincture to the highest ones. Most of us have one misconception, that for acute diseases we must use low potencies, reserving the high ones for chronic cases. We are afraid of high potencies. I have seen people swallow such drugs like Sulphas and Mycins without hesitation, but questioning our prescriptions of any potencies above 200. "Is it safe? Will there be serious aggravations? Can I take the dose and attend office? Do you want me to keep some antidote? And other such questions are freely asked. How shall we remove these doubts and fears?
The wonder is many of such ideas are mere hearsay. I have carefully gone through the writings of Hahnemann, Boenninghausen, Dunham, Wells, Hering, Lippe, Allen down to Roberts and other luminaries of the present time. They do not suggest low potencies for acute and high for chronic cases. They do not say that 200th is more dangerous than, say 6th. Most of these master prescribers used high and highest potencies in very acute and serious conditions.
When I was studying Homoeopathy with my uncle Dr D N Koppikar, I used to wonder why, in an ordinary case of (cholera-like) diarrhoea he would use Verat-alb in 30th, whereas a serious case, almost collapsing, he took out his high potency set and gave Verat-alb 1M, 10M and 50M potencies. He was right. Only these very high potencies were capable of saving those cases.
Dr Edmond Carlton, in his book "Homoeopathy in Medicine and Surgery" when dealing with Lachesis in Diphtheria says: "when these symptoms or most of them are present, Lachesis will yield wonderful results, as I have many times demonstrated. In critical cases, I review the eight pages of throat symptoms, which Hering devotes to this, his greatest single production, before prescribing. If any strength below the thirtieth centesimal potency is used in any such case, be ready to sign the death certificate. In fact I much prefer the two hundredth and higher".
Homoeopathy is essentially a practical science and as we always say "Proof of the pudding is in the eating". I shall give a few experiences of other Homoeopaths.
Let me give first the wonderful experience of late Dr B B Bharada of Bangalore.
Case 5: Dr B B Bharada
The case of intermittent fever, coming regularly daily at midday with restlessness, extreme thirst, and other typical symptoms of Arsenicum-alb. Dr Bharada gave Ars 30 six doses for two days expecting it would be cured by then. The fever continued to come, neither worse nor better. He gave 200th for two more days. No change. 1000th one dose was then given. The patient was a bit weaker, but absolutely no other change was seen. Then Dr Bharada remembered having read somewhere that in such cases the highest potencies should be used. So ultimately after waiting for three more days, he gave Ars-alb CM (100,000) one dose. The patient felt better at once and his fever etc. disappeared.
Case 6: Dr E B Nash
A case from his book "Testimony of the Clinic". The pains were intense, with burning; greatly aggravated from 1 to 3 am. The patient was prostrated and restless. The only relief was from the bags of dry hot salt continually applied along the nerve. Ars- alb was given in the 30th and 200th "To my surprise no good came out of it. The Sulphur was given in the possibility that Psora was complicating matters, but with no good results in the other remedies tried. It was in earlier part of my practice, so I had not gone above the 200th potency then. But I had a graft of Jenichen’s 8000th in the office so as nothing else did any good, I concluded to try it. It was given in solution with rapid and permanent relief. She was well in an incredibly short time and never had a return of the trouble".
Let us study few of the acute, serious cases treated by great physicians.
