Introduction
Dear Colleagues,
A homoeopath should have a deep knowledge of the models of the 4th and 5th Organon to understand the Homoeopathy of the 1840s, which is found in the 6th edition. Homoeopathy as commonly practiced today is based on the single dry dose wait and watch method of the 1st Chronic Diseases (1828) and the 4th Organon (1829). In this method a single pellet dose of the centesimal potency is used as long as the patient is improving even in the slightest manner. Many of the great 19th century homoeopaths like James Kent were masters of this method. The dry dose may only be repeated when there is a definite relapse of the old symptoms calling for repetition. Hahnemann was not completely comfortable with this method in cases that only slowly improved over a longer period of time.
For this reason, in the 5th Organon (1833) Hahnemann introduced olfaction and the oral medicinal solution as a new delivery system for homoeopathic remedies. The change from a dry static pellet dose to a dynamic medicinal solution succussed prior to administration had an immediate impact on his posology and case management strategies. In the 5th Organon he suggested any "striking progressive improvement" precludes the repetition of the remedy because the cure is already taking place at the fastest possible rate.
At the same time, he taught that the single dose was not sufficient for those cases that slowly improve over a period of weeks to months. For these cases the Founder recommends administering the remedy in medicinal solution or olfaction at "suitable intervals to speed the cure". Hahnemann called this his new "middle path" as it stands between the single dose wait and watch and the mechanical repetition of remedies. This is a truly artistic method that demands individualization of the case management procedure.
Over the next 10 years Hahnemann worked exclusively with the medicinal solution for oral administration and olfaction. Around the year 1840 the Founder began to introduce his new LM potency into clinical practice to complement his C potencies. The discovery of the new 1/50, 000 dilution ratio introduced a new potency system with unique medicinal qualities. From the year 1840 to 1843 the Great Experimenter used both the C and LM potencies side by side in medicinal solution. This new double pharmacy greatly expands the therapeutic horizons of Homoeopathy.
The Paris Casebooks
I wish to review the posology systems of the 5th and 6th Organon in relationship to the centesimals and LM potencies. It is very important to study the remedial powers of Hahnemann's twin potency systems and recognize their similarities and differences. The most important aspect of the revised methods of the 1840's is the medicinal solution and the methods of adjusting the dose. Many people think that Hahnemann used the dry dose for his centesimal potencies and the medicinal solution exclusively for the LM potency. This is incorrect. The Founder used the C and LM potency side by side in the clinic in medicinal solution from 1840-1843.
An investigation of Hahnemann's cases from 1840-1843 shows that he used a remedy bottle with the addition of a dilution glass for all his homoeopathic remedies (C and LM). In his last 10 years he refined the Homoeopathy of the 4th Organon (1829) and expanded his posology and case management strategies. So the first point is that Hahnemann introduced his revised liquid method for the centesimals in 1833 and the LM potency in 1843.
The Mother of All Potencies
The 3c is the mother of all homoeopathic potencies. When Hahnemann first proved Arsenicum in 3c he wrote an article in 1806 titled "What are medicines and What are Poisons?". The 3rd Centesimal was the first true homoeopathic dynamization and the root of the centesimal scale. At the 1 to 1,000,000 ratio 3c marks the level that homoeopathic remedies become non-toxic. For 34 more years he would run trials with raising the potency of the centesimal scale until he had experimented with the 3c to the 1M.
After years of experiments he settled on the 6c, 12c, 24c, 30c as the most suitable lower potencies. With his low potencies Hahnemann started with the 30c potency and then used the 24c., 18c., etc., in their descending order. He continued to lower the degree of his low potencies 30c - 6c in his last years 1840-1843. At the same time, the Paris casebooks record him raising his high potency C's through potencies like 197c, 198c, 199c, 200c. Melanie Hahnemann wrote a letter that stated that Hahnemann used a 1M potency on occasions during his experiments. It seems he kept his high potencies separately from his low potencies, in small tubes with poppy seed size pellets. The Founder always gave his high potency Cs in medicinal solution just like the LM potency.
At 85 years old the Founder came to another turning point in his long career. With his young wife Melanie at this side, Samuel Hahnemann began to ponder his legacy. Homoeopathy had come a long way since its birth in late 1700's, but the old homoeopath was not satisfied with his system. The medicinal solution had greatly improved the treatment of the virulent acute, and degenerative chronic diseases, but the weak, the elderly, and those suffering from the chronic diseases and miasms still presented a particular dilemma.
When Hahnemann used his low potencies (6c, 12c, 24c, 30c) they would not cure but if he used the high potencies (200c-1M) they produced unproductive aggravations. What could he do with this unfortunately large percentage of cases that still resisted homoeopathic treatment? This was a lacuna in his therapeutic system that he wished to fill before he died.
The Development of the LM Potency
After 36 years of raising the potency of the centesimal remedies, Hahnemann decided to raise the ratio of dilution instead. Leaving the 1/100 dilution ratio of the centesimals behind, Hahnemann started searching for a potency that would fill this hole in homoeopathic therapeutics. After countless experiments the Founder settled on the 1/50,000 dilution ratio associated with the 50 Millesimal potency. I have reviewed 100s of Hahnemann's cases from the LM period (1840-1843) over the last 2 years. One of the first things one notices is that Hahnemann used both he centesimal and LM potency in medicinal solution with the addition of a dilution glass during these 3 years.
The LM potency is first made from the 3c trituration (1:100x100x100). Next 1 grain of this trituration is placed into 500 drops to make the LM/0 solution (1 to 501 ratio). Then 1 drop is taken from the LM/0 solution and added to 100 drops of dilute and succussed 100 times. This makes the LM 0/1 potency, the first degree of the LM pharmacy (100x100x100x500x100x500 = LM 0/1). The C's of the 5th Organon (1833) were made with 10 succussions by hand although many modern potencies are made with 10 to 40 or more succussions by machine.
When speaking of the amount of original medicinal substances in the LM 0/1 it is similar to the amount found in the 6c potency although its remedial powers are greatly expanded due to the larger dilution medium. A mere comparison of the amount of original substances found in the C and LM potency does not show the differences in their inner medicinal qualities. The LM pharmaceutical solution is then used to moisten 500 tiny poppy seed size pellets.
One pellet of the LM 0/1 is further diluted in a minimum of 3 & 1/2 oz to make the medicinal solution. After succussions 1, 2 or 3 teaspoons are taken from the medicinal solution and further diluted in a dilution glass of water. From this dilution glass 1, 2, 3 teaspoons are given to the patient as a dose. The final liquid dose has been diluted through two more stages than the dry dose. The final amount of original substance given to the patient is more diluted than the dry pill since it has been dissolved in the medicinal solution and stirred into a dilution glass. This final amount of original substance in the teaspoon of solution given to the patient has yet to be calculated in the equation.
The Differences between the C and LM Potencies
The high potency Cs are diluted more times then the LM potency although they receive less succussions at each dilution level of potency. The higher potency Cs like 200c and 1M have a smaller amount of substance, and more commutative numbers of succussions and dilutions than the LM potency. For this reason, some persons think the LMs are low potency remedies. The LM potency, however, has a much larger dilution ratio that greatly transforms the medicinal qualities of the LM remedies. In footnote f to aphorism 270 of the 6th Organon (O'Reilly edition) Hahnemann suggests the following:
"In earlier instructions, I specified that a whole drop of a liquid in a given potency be added to 100 drops of wine spirit for higher potentization. But meticulous experiments have convinced me that this proportion of the dilution medium to the medicine being dynamized (100:1) is much too narrowly limited to develop the powers of the medicinal substance properly and to a high degree, by means of a large number of succussions, unless one uses great force."
The Founder realized that continuing to increase the number of dilutions and succussions of the centesimal potency did not fill the desired therapeutic lacuna in his new healing art. He came to see that the 1 to 100 dilution ratio is limited by its smaller dilution factor so he began to experiment with new larger dilution ratios rather than raising the C potency to higher and higher degrees. He also noticed that when strong succussions were used in such a small dilution medium as the centesimal 1 to 100 ratio it makes aggressive medicines prone to quick aggravation and unproductive secondary curative effects in the long run.
"With a ratio of the dilution medium to the medicine as low as 100:1, very many impacts by means of a powerful machine, as it were, are forced in. As a result, medicines arise that, especially in the higher degree of dynamization, almost instantaneously but with stormy - indeed dangerous - intensity, impinge on patients (especially the delicate ones) without bringing about an enduring, gentle counter-action of the life-principle."
Once again we see the importance of the balance of the primary action of the remedy and curative response of the vital force. When too many dilutions and strong succussions have been forced into the higher centesimal potencies it makes medicines that are prone to aggressive primary actions and strong aggravations that do not produce an "enduring gentle counter action of the life principle". Such furious or prolonged aggravations are to be avoided at all cost as they disrupt the natural symptom pattern, waste vitality, and complicate the cure. The LM potency, on the other hand, is given in the smallest liquid dose so it produces a mild primary effect and a long enduring gentle counter action of the vital principle.
During the period of the 5th Organon (1833) Hahnemann used the unmodified liquid dose made up each time from 1 or 2 poppy seed size pellets. In aphorism 29 of the 5th Organon Hahnemann described how the centesimal method works. He wrote that the similar homoeopathic remedy "pushed into the place of the weaker natural disease" against which the instinctive vital force was "compelled to direct an increased amount of energy". The idea of pushing into place and compelling the vital force to increase its energy against the remedy is based on the phenomena of the homoeopathic aggravation. The methods of the 4th and 5th Organon are based on a crisis-like aggravation in contrast to the gentle medicinal solution and the non-invasive LM method.
Aggravation in the 5th edition (1833)
The centesimal model of cure still involves the idea of crisis where aggravation of symptoms compels the vital force to increase energy in order to remove the remedy disease and begin convalescence. The idea of crisis as an integral part of the cure is very ancient. This is before Hahnemann discovered the non-invasive method of the LM potency, the medicinal solution, and the split-dose. Vide aphorism 279 of the 5th edition (1833).
“The pure experience shows UNIVERSALLY….
A DOSE OF THE HOMOEOPATHIC SELECTED REMEDY CAN NEVER BE PREPARED SO SMALL THAT IT SHALL NOT BE STRONGER THAN THE NATURAL DISEASE, AND SHALL NOT BE ABLE TO OVERPOWER, EXTINGUISH, AND CURE IT, AT LEAST IN PART, AS LONG AS IT IS CAPABLE OF CAUSING SOME, THOUGH BUT A LIGHT PREPONDERANCE OF ITS OWN SYMPTOMS, OVER THOSE OF THE DISEASE RESEMBLING IT (slight homoeopathic aggravation, aph. 157-160) IMMEDIATELY AFTER ITS INGESTION.” [Capitals by DL.]
The need for aggravation was also stressed as an integral part of cure in aphorism 282.
"The smallest possible dose of homoeopathic medicine capable of producing only the very slightest homoeopathic aggravation, will because it has the power of exciting symptoms bearing the greatest possible resemblance to the original disease (but yet stronger even in the minute dose), attack principally and almost solely the parts in the organism that are already affected, highly irritated and rendered excessively susceptible to such a similar stimulus".
Hahnemann goes on to say that this medicinal disease alters the vital force that rules the susceptible parts to a state of very similar artificial disease "so that the living organism now suffers from the artificial medicinal disease alone, which, from its nature and owing to the minuteness of dose, will soon be extinguished by the vital force that is striving to return to the normal state". The idea of a crisis-like aggravation compelling the vital force to increase its energy was part of the old dry dose and unadjusted liquid dose method of the 1830s.
In the 6th Organon Hahnemann replaces the model that includes the necessity of a aggravation-like crisis with the idea that the dose can never be made so small that it cannot overcome the disease without aggravation. In the LM model aggravation at the start of treatment is a sign of too large a dose or too high a potency and unnecessary repetition of the remedy. Vide aphorism 279 of the 6th Organon (1842).
"This pure experience now shows UNIVERSALLY that:
1. if considerable corruption of an important [vital organ] organ does not obviously lie at the base of the disease (even if the disease is chronic and complicated) and
2. if during treatment, all other foreign medicinal impingements on the patent have been withheld, then THE DOSE OF A HOMOEOPATHICALLY CHOSEN , HIGHLY POTENTIZED REMEDY FOR THE BEGINNING OF TREATMENT OF AN IMPORTANT (ESPECIALLY CHRONIC) DISEASE, AS A RULE CAN NEVER BE PREPARED SO SMALL THAT IT WOULD NOT:
1. BE STILL STRONGER THAN THE NATURAL DISEASE,
2. BE ABLE, AT LEAST IN PART, TO OVER-TUNE THE NATURAL DISEASE,
3. EVEN BE ABLE TO EXTINGUISH A PART OF THE NATURAL DISEASE IN THE FEELING OF THE LIFE PRINCIPLE, THUS PRODUCING A BEGINNING OF THE CURE." [Capitals by DL.]
All of the references to the need for crisis-like aggravation to push the remedy in place of the natural disease and compel an increase of energy of the vital force are removed from the 6th Organon. There is no need to force, push, compel, or aggravate in the non-invasive LM method of the 1840s. This represents a shift in the homoeopathic paradigm from compelling through aggravation to a completely non-invasive method of posology. In Hahnemann’s advanced methods there is no need of aggravations, crises, over medication, antidotes, long periods of waiting, or any excess counter reactions. All these side effects have been removed from the homoeopathic system of the 1840s.
The old dry dose method is like a roller coaster ride as first comes the homoeopathic remedy, then comes waiting out the crisis-like aggravation, then comes waiting out any improvement, and then comes waiting for the relapse. Then the dry dose is given again and the whole "up and down start and stop process” begins all over again. The idea that aggravation is necessary is common among 4th and 5th Organon homoeopaths, especially those who use too many dry pills as a dose. This is because too many pills of the high potency centesimals can cause aggravations that can run for days, weeks, and months. Hahnemann noted clearly that too large a dose (too many pills) will cause an aggravation even if the potency is correct. Many consider aggravations necessary because the idea of the need for aggravation is over stressed in the Homoeopathy of the 1820’s and 1830s.
To overcome these side-effects Hahnemann used the medicinal solution of the LM potency made from 1 poppy seed size pill in a minimum of 7 tablespoons. From this solution 1, 2, or 3 teaspoons was stirred into a glass with 8 to 10 tablespoons of water and 1, 2, or 3 teaspoons was given to the patient. In this method the size of the dose is greatly reduced as the potency is gradually increased so that the vital force never receives the same exact dose twice in succession. In this way, the vital force can receive the single dose or a series of doses in medicinal solution without the aggravations witnessed in the dry or unmodified liquid dose. In this way, we can speed the cure to one half, one fourth, or less than the time of the old method.
Primary and Secondary Effects
There are many powers in nature but the potentized remedy is a unique creation of the intellect of Samuel Hahnemann. In aphorism 64 of the 6th Organon the Founder recorded that there were two types of secondary actions. The first is the opposing counter action where the organism automatically presents an opposite state proportionate to its energy. The second is the curative counter action to a homoeopathic remedy where the vital force directs its whole energy to remove the mistuning from without while reestablishing homeostasis. Vide part two of aphorism 64 of the 6th Organon.
"If there is no state in nature exactly opposite to the initial action, THE LIFE FORCE APPEARS TO STRIVE TO ASSERT ITS SUPERIORITY by extinguishing the alteration produced in itself from without (by the medicine), in place of which it reinstates its norm (after-action, curative-action)." [Capitals by DL.]
This action by the life force to assert its superiority is the power of the curative secondary action. To accomplish this goal the vital force heals the pathology in stages from within to without in response to the remedy as seeks control over homeostasis thus completely removing the dynamic mistuning. This establishes another aspect of Hahnemann's Direction of Cure as compiled in Hering's Laws.
If the balance between the primary action and the secondary action is maintained there will be no aggravations or excessive counter actions during the process of cure. The instinctive vital force does not react in an opposing manner to a potentized remedy, but rather, seeks to manifest its superior vitality over the remedial disease from without while reestablishing homeostatic balance within.
The life force may produce opposing reaction against the wrong remedy and too large a dose. If the remedy has been given in the medicinal solution in a proper small amount the vital force will have little problem removing the remedial influence and no antidotes will be needed. If the dose is too large or in too high a potency it may mistune the vital force with a long term medicinal disease (aphorism 276). For this reason, the dose, potency and repetition must be carefully controlled.
Opposing Secondary Actions
In aphorism 65 Hahnemann gives several examples of the primary and opposing secondary actions that take place under the influence of various medicinal powers (counter-action - after action, aph. 64, point 1).
"Where there is such a one, the life force brings forth the exact opposite condition-state (counter-action, after-action) to the impinging action (initial action) that has been absorbed into itself. The counter-action is produced in as great a degree as was the impinging action (initial action) of the artificial morbific or medicinal potence on it, proportionate to the life force’s own energy.”
Here the vital force is compelled to produce an antagonistic secondary action in which it presents the opposite state in proportionate energy. The following 3 examples represent the principles very well. Vide Organon aphorism 65:
“A hand bathed in hot water is at first much warmer than the other unbathed hand (initial action), but once it is removed and thoroughly dried, it becomes cold after some time, and then much colder than the other hand (after-action).”
“An arm immersed in the coldest water for a long time is at first far paler and colder than the other one (initial action), but once it is removed from the cold water and dried off it becomes not only warmer than the other but hot, red and inflamed (after- action of the life force). “
“The heavy, stuporous sleep caused by opium (initial action) is followed the next night by greater insomnia (counter action)."
“And thus, after each initial action of a potence that in large dosage strongly modifies the condition of the healthy body, our life force always and everywhere brings to pass, in the after action, the exact opposite state (when, as stated, there really is such).”
Strong medicines in large doses tend to cause opposing counter actions from the life force. Sooner or later the vital force will oppose any medicine in a large dose (including homoeopathic) with antagonistic counter actions. In Homoeopathy the vital force is exposed to a very small dose of a highly potentized substance that elicits a pure curative effects from the Lebenskraft without any over reactions.
Curative Action
Homoeopathic cures take place because of the unusually small dose of a high potency of a similar remedy (aph. 68 with reference to 64, point 2). To this subtle medicinal disease the life force needs to use no more secondary effect than necessary to remove the new similar artificial disease and return the organism to complete recovery. There is no state in nature that is exactly the opposite of a simillimum in the correct potency and a minimum dose.
Due to the extraordinary high potency and small amount of the remedy the primary action gently overtunes the natural disease without any aggravation (primary action- 63). After this the life principle seeks to assert its superiority by removing the remedy mistuning from without by returning to full health and vitality within (counter action - curative action - 64B).
“If there is no state in nature exactly opposite to the initial action, the life force appears to strive to assert its superiority by extinguishing the alteration produced in itself from without (by the medicine), in place of which it reinstates its norm (after-action, curative-action).”
This healing process ideally takes place with no aggravations, no crisis, and no overly noticeable reactions other than the rapid restoration of health and vitality (148). That is the goal of the Similia Minimus of the 6th Organon.
High potency centesimals made on machines with many dilutions with strong succussions produce aggravations at the start of treatment that limit the curative secondary effect of the vital force. In the LM method the gentle primary effect of the remedy replaces the natural disease without aggravation at the start of treatment and produces a long enduring gentle curative effect in the life force that removes the remedy disease from without and returns to full and health vitality within. With the LM potency there is no need for a crisis-like aggravation to cure natural diseases. The proper LM simillimum in the minimal dose produces rapid transformations to the state of health and the restoration of vitality without any noticeable excessive reactions.
The 6th Organon demonstrate the foolishness of those who say the vital force removes no mistuning and plays no active role in healing. Like the mechanists of the old school they think of cure only in terms of a medicinal power rather then a combination of the remedy action and the curative effect of the Lebenskraft, the Vigor Vita. Hahnemann spoke of the essential role of life force, in the Preface to the Introduction of the 6th Organon in 1842. .
"Homoeopathy is aware that a cure can only succeed through the COUNTER-ACTION OF THE LIFE FORCE AGAINST THE CORRECTLY CHOSEN MEDICINE. The stronger the life force that still prevails in the patient, the more certain and faster the cure that takes place".
Samuel Hahnemann, confirmed Paris, 184-." [capitals DL]
The correct dose of the LM potency in medicinal solution produces a non-aggressive primary action, no aggravations, and a long enduring gentle curative effect by the life principle. Even during the curative response the remedy may still be repeated at suitable intervals when it is necessary to speed the cure. The curative reaction of the vital force is not disrupted by the repetition of the minimal size dose of the medicinal solution of the remedy as is witnessed by the repetition of the dry dose.
The cycle of healing with the LM remedy is - small liquid dose - no aggravation - enduring gentle secondary effect - removal of the remedial disease - cessation of remedy duration - the complete return of health and full vitality. This demonstrates the important role that Hahnemann gave to the Lebenskraft in the 6th Organon. The goal of the LM strategy is a smooth, continuous, graduated ascent to health and vitality through 30 microtonal potencies without aggravations.
The Actions of the Centesimal Remedies
Hahnemann wrote in the 5th Organon (1833) that the C potency tends to produces aggravations within one to two weeks after the administration of a C potency in chronic diseases. In 1833 the Founder still thought that he had to compel the vital force to increase its energy through crisis-like aggravation to produce a enduring curative effect over time. This phenomenon is so common with the dry C pellets that many homoeopaths still think they must aggravate to compel the vital force to cure. Hahnemann changed his opinion about the need for aggravation when he discovered the LM potency and the split-dose of the medicinal solution in the 1840s.
The remedial powers of the centesimal scale reaches its peak very quickly, promotes crisis, and then brings on a longer duration of secondary action. The Kentian high potency system has become the modern potency standard with great jumps of potency levels between 30c - 200c - 1M - 10M - 50M - CM, etc. This trend was established by Hahnemann as he quite commonly used the 30c, 200c and experimented with the 1M. These large jumps in potency cause a quick vertical arc of the potency scale in the upward direction. Even in medicinal solution the 200c and 1M tend to aggravate toward the beginning of the treatment rather than the end. This is due to the 100 to 1 dilution ratio and strong succussions.
The nature of the centesimal potencies is quick in their onset as they reach aggravation at the beginning of the treatment when the pathology is at its maximum and the vitality the weakest. This tendency is still witnessed (although in a modified form) in the Cs in medicinal solutions. The power of the C potency is most similar to rapid onset, quick crisis, and the aggressive power of the Cs is similar to accidents, trauma, crisis, strong acute diseases, virulent acute miasms, crisis or acerbations of the chronic states and miasms, the functional states of the chronic diseases, and chronic states that start with strong crisis and then progress over a longer duration.
The large increases in potency degrees of the centesimal potencies enhance the aggressive nature of the 1/100 dilution ratio and the centesimal potency system. The medicinal solution moderates the aggressive tendencies of the Cs but they still tend to aggravate more quickly, more forcefully, and for longer duration than the correctly given LM potencies.
The Actions of the LM Potencies
Chronic diseases often have an insidious onset, slowly increasing pathology, and reach crisis after a longer period of years. The LM potency is subtle in its onset, uses a series of slowly increasing potencies, and they reach aggravation at the end of the treatment. The LM potency scale is homoeopathic to many chronic diseases and miasms. In the 6th Organon (1843) Hahnemann wrote that the LM scale produces aggravations at the end of the treatment when the patient is completely well if the dose is controlled.
By the publication of the 6th Organon Hahnemann no longer believed it was necessary to compel the vital force to cure through aggravations. There are no aggravations with the LM potency if the remedy is slowed down as the patient improves and stopped at the correct time. This effect is enhanced with the C's in medicinal solution but their nature still tends toward a quicker aggravation due to their 1 to 100 dilution ratio.
Partial simillimums tend to change the natural symptom patterns too quickly calling for a new more perfect remedy. For this reason, the first prescription is a very important moment in every case. If the remedy is a true simillimum the patient can be exposed to longer series of LM potencies 0/1, 0/2, 0/3 to 0/30 until cure is completed over a longer period of time. The LM potencies are a gradually increasing microtonal scale of 30 potency degrees that are very similar to the slowly increasing symptoms of degenerative disease and miasms. This is why they are so well suited to chronic degenerative diseases and miasms.
The LMs tend to aggravate at the end of treatment when the pathology is healed and vitality restored. This is a sign that the remedy is no longer needed. If the remedy is slowed down as the patient improves, there will be no aggravation at the end of treatment. The C potencies have a rapid onset and reach aggravation at the beginning of treatment when the patient is the most ill and the weakest. This is not the best situation. This is another reason why the LMs are suitable for many inherited and acquired chronic diseases and miasms. The properly adjusted LM also works well on serious trauma, virulent acute disorders, and crisis. Here the higher opening potencies (0/3-0/6) are sometimes of use although most cases resolve on LM 0/1 -3.
We have discussed some of the difference between the remedial powers of the C and LM potency that makes them complementary opposites. Once the homoeopaths understand the inner nature of the Cs and LMs they will understand how to use them at the correct times. The Paris casebooks show that Hahnemann often used his centesimal potencies for crisis and acute diseases and switched to the LM potencies for constitutional treatment and miasms. This is not an absolute rule but a tendency one sees throughout the cases of his last three years (1840-1843).
Administering the LM Potencies
The 3c is called the mother of all potencies because it is the root of the centesimal scale and LM potency scale. The LM base potency is made from the 3c potency. Hahnemann's low potencies were the 6c, 12, 24, 30, and his high potencies reached 50c to 200c and the LM 0/1 to 0/30. In some ways, the LM potencies possess many of the positive qualities of both low and high potencies in balance.
The lower degrees of the LM potency are deeper acting then the 6c to 30c but they are also more gentle than 200c or 1M on the constitution. They reach a depth of cure without producing the overly strong primary actions and rapid aggravations like the high Cs. They have the stability and consistency of the low potency C's but the power to cure deep chronic diseases and miasms like the high potencies.
One can tell from Hahnemann's Paris journals that the Founder considered the LM 0/1 a higher potency than 30c as he sometimes started people with a 30c for the acute and then switched to the LM potency for the chronic conditions. Also if the lower potencies up to 30c were insufficient, he would then switch to the LM scale and work upward. In some cases, he began with an anti-psoric in 30c and then moved over to the LMs. He also stated in the Organon that the 50,000 to 1 dilution ratio is more powerful than the 100/1 ratio even at the lowest degrees. One reason is that many succussions can be used without “forcing” any excess energy into the pharmaceutical solution.
The LMs are not a "low potency" remedy that can be given daily or every other day for weeks in some mechanical fashion. They aggravate just like all other homoeopathic remedy if misused. I know this personally because I aggravated a number of cases in the beginning of my LM career. I quickly found out that the LM 0/1 would aggravate certain sensitive patients and those with organic pathology. In general, aggravations caused by LMs are of a shorter duration than the high centesimal potencies. This is another reason they are safer then the ultra high potency centesimals in many conditions. The LM potency has the best qualities of the high and low potency without the aggressive primary actions of the Cs.
If the patient will over react to the action of potencies higher then 30c it is best to use the lower potency Cs like 6c, 12c, 24c, 30c. I tend to use the lower centesimal potencies in medicinal solution and the split-dose where I fear aggravations, pathology, and crisis. Then I work my way up to the 30c and change to the LM 0/1 and go through the LM scale. These people do not do very well on 200c, 1M, etc. In fact, many of them are incurable by the centesimal potency system alone. Hahnemann used this method also, although I did not confirm this fact until I studied his casebooks many years later.
It is a false claim to say that the LMs cannot aggravate so they can be given daily or every other day for weeks, months and years. Some suggest giving potencies like LM 0/6, LM18, or some other odd potency daily rather than using the complete graduated potency scale 0/1 to 0/30 in an artistic manner. The Paris casebooks show that Hahnemann never gave his remedies in such a mechanistic manner! The healing artist takes into account the constitutional sensitivity or the nature of the disease so they individualize their dose and potency properly. Mechanical methods are prone to over medication. Some use the LM potency but they do not understand how to apply the appropriate case management strategies contained in the 6th Organon and Paris casebooks in the clinic.
Only When Necessary
In the footnote to aphorism 247 Hahnemann discusses what he said in the 5th Organon updated with the new LM posology methods of the 6th edition. When he introduces the concept of the daily dose he says that the LM potency may be taken daily "when necessary". He also suggested starting the case with the "lowest degrees", which his Paris casebooks show to be 0/1 to 0/3, and more rarely, 0/4, 0/5, 0/6, 0/7. This is the first octave of LM potencies with the LM 0/8 starting the next range.
When the daily dose is "not necessary" it will rapidly produce an over medicated state in which there will be aggravations or accessory symptoms that change the natural symptom pattern. Hahnemann rarely used the daily dose for very long and always interspersed his doses with a period of placebo and a period of waiting and watching. The idea that Hahnemann gave the daily dose of the LMs for months or years is a complete myth as proven by his writings and Paris case journals.
The LM potency will cause aggravations and accessory symptoms just like every other homoeopathic remedy. The Paris casebooks show that Hahnemann constantly alternated placebos with the remedy to control the power of the LM remedies. In his journals he never gave the alternate day dose for very long without a period of giving placebos and waiting and watching. The 6th Organon offers a guidebook on how to use the LM potency scale safely and effectively through opening in the lowest degrees (0/1., 0/2., 0/3, etc.) and then ascending through the potency range (0/30).
Hahnemann's opening potencies were 0/1 to 0/7. In most cases he started with LM 0/1., 0/2., 0/3 in his last years. LMs must be treated with the same respect as all high potencies like 60c, 90c, 100c and 200c. The mechanical repetition of the LM potency will lead to over medication just like any other homoeopathic medicine. There is quite a bit of misunderstanding on this point. Over medication always causes side effects, changes the natural symptom pattern, and slows down the cure.
There are many times when a low potency like 30c can only palliate yet the 200c causes unproductive aggravations that weaken the vitality. This is because the pathology is too deep for the low potency (6c-30c), and the high potencies (200c-1M) only cause aggravations without amelioration and loss of vitality . In such cases, the LM potency will cure when the centesimal potency will only palliate or cause harm. This is an area where the LMs act more gently and safely than high potency Cs if carefully adjusted. The LM potency is also useful in the elderly where the high potency C's may be counter productive but cure is still possible.
Confessions of an Aspiring Homoeopath
I studied in the school of "hard knocks" but I have tried to learn by my mistakes. I started as a 4th Organon Kentian homoeopath and I still study Kent as he is one of my favorite teachers. It took me ten years before I seriously tested Hahnemann's Similia Minimus found in the Organon. The first time I read the Organon I began to doubt the Kentian teachings that the "size of the dose has no effect on remedial actions". For this reason, I stopped giving a random number of pills under the illusion that the size of the dose makes no differences. Now I was using only a few carefully chosen little pills as a dose. To my surprise I did see less aggravations, especially when using high potencies like the 200c, 1M and 10M.
At this time, many homoeopaths were just throwing a random number of pills in the mouth of the patient as a dose. Then the pharmacies started to make "single dose packs" which contain a large number of pills. When I read how small Hahnemann's doses were in the 5th Organon I thought that the dose must be "too small". One pill looks so small in that great big bottle so I used more. The true power of the Minimus had not yet dawned in my mind because I was still trying to give the largest dose instead of the minimal.
At last, I decided to test the methods of the 5th edition (1833), the 1837 Paris edition of the Chronic Diseases, and the 6th edition (1842) in that order in a long clinical trial in India. Yes, I finally tried 1 tiny little poppy seed size pill to make a 7 tablespoon medicinal solution. Then I thought, "If I am not going to give a single dose and wait and watch for a relapse, then what am I going to do?". It is a very common fault to read the 6th Organon without paying much attention to the fine print in the footnotes.
In the main text Hahnemann says the LMs can be given daily or on alternate days but the fine print in the footnotes says "when necessary." So first I gave the daily and alternate day dose when it was "not necessary" in a mechanical fashion causing unneeded aggravations in a certain percentage of cases. I could tell in the first months that the LM potency was a very deep acting potency which possesses a unique quality when given in its proper small dose. I also knew it was easy to over medicate the patient if the LMs are given in a mechanical fashion every day or every other day. Then I read the first sentence of aphorism 246 of the 6th Organon more closely.
“During treatment, every noticeably progressing and conspicuously increasing improvement is a state which, as long as it persists, generally excludes any repetition of the medicine being used because all the good being produced by the medicine is still hastening towards completion.”
This aphorism is very similar to aphorism 245 of the 5th Organon (1833) Dudgeon edition.
“Every perceptibly progressive and striking 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 completion”
Aphorism 246 of the 6th Organon
Aphorism 245 and 246 of the 5th edition are combined and rewritten in the final 6th edition making one very long paragraph. Hahnemann first says that any noticeably progressing and strikingly increasing improvement during treatment excludes the repetition of the remedy because the cure is already hastening to take place. This means that any time a single dose, or a series of doses, causes a strikingly progressive improvement any repetition is counter indicated for the time being. This is because the vital force is moving toward the cure at a maximum rate and any more doses will only slow down the cure.
Then the Founder takes up the subject when a single dose only causes a “slow, continuous improvement” that may take over 50, 60, or 100 days to complete the cure. In these cases the split-dose of the medicinal solution may speed the cure to 1/2,1/4, or less the time it takes the single static dry dose. This goal may be accomplished under five conditions.
1. The remedy must be a true homoeopathic simillimum.
2. The remedy should be administered in medicinal solution.
3. It must be administered in the smallest of doses.
4. The medicinal solution should be repeated at suitable intervals.
5. Each dose should be succussed prior to administering the dose.
This is the basis of Hahnemann’s advanced posology that teaches the practitioner when to wait and watch as well as when to act according to circumstances. This is what Hahnemann called the middle path approach to posology. Homoeopathy is a system of flexible response in which the methods of adjusting the dose are central to case management. In the 1840s Hahnemann administered 30c to 6c in their descending order starting from the 30th as he suggested in the Chronic Diseases (1828). At the same time, he was raising his high potency centesimals like the 198c, 199c and 200c and the LM potencies (0/1- 0/30) starting at the lowest degrees (0/1-0/7).
Hahnemann wrote that the ratio of individual sensitivity varies on a scale of 1 to 1000 (aph. 281). Doses that will not affect a number 1 sensitivity will cause prolonged aggravations in the number 1000 sensitivity. For this reason, the Founder used the medicinal solution and the methods of adjusting the potency and size of the dose. I quickly found that the LM 0/1 was actually too high a potency for oversensitive patients even if diluted in 2 or 3 dilution glasses. Such remedies could not be repeated in many sensitive constitutions. In some cases I switched to the 6c -30c range and the patients did much better. When I worked them up to the 30c, I would then switch them to LM 0/1 rather than give them a 200c. I learned that such constitutions do not tolerate the large jump in potency offered by 30c, 200c,.1M, 10M, 50M, etc..
In those cases that were too sensitive to tolerate the LM 0/1, I began with low potency C's and then worked them up to the 30c and finally the LM 0/1. This works well with heavy organic pathology, hypersensitivity, allergies, old chronic diseases, one-sided states, and weakened vitality. I have done this in many cases and it works very well. When I began to study the microfiches of the Paris casebooks I noticed immediately that Hahnemann used his lower potencies (30c-6c) on certain case. He did not give everyone high potency Cs and LMs. I also noticed that he lowered the potency scale from 30c to 24c, etc., in the 1840s just like he did in 1828. At the same time, he raised his high potency Cs (198c, 199c, 200c) and LM potencies (0/1-0/30).
The LMs act smoothly for their remedial powers considering their high potency actions. For this reason, the LMs are far more suitable than the 200c and 1M for a good number of patients. The large gaps between the 30c, 200c, 1M and 10M Centesimal are too large for many constitutions and chronic conditions. This Kentian system only offers 7 potencies while there are 30 different micro tonal LM potencies. These individuals usually do very well on the LMs when they are given properly. If they take 200c or 1M (esp. the dry dose) it causes unproductive aggravations and accessory symptoms.
These are some of the differences. The LMs are safe and effective when the potency, succussions, and dose are individualized and the patient is not over medicated. This microtonal series of 30 graduated LM potencies is much more similar to the development of degenerative chronic diseases and miasms then the radical jumps of the centesimals. For this reason it is naturally suited to slow developing, long lasting chronic diseases and miasms.
It has only been in the last few years that I have the advantage of reading the microfiches of Hahnemann's Paris Casebooks. This allowed me to personally review the records of his cases from the LM period (1840-1843). By carefully reading the 6th Organon and the Paris casebooks much more information has come to light. I only wish I had access to all this lost information when I was young.
This situation is finally starting to change as homoeopaths experienced in the 4th Organon method take up experiments with the revisions introduced in 5th (1833) and 6th editions (1842). Today's students are better educated and have more literature then we did back in 1970. Those who are well trained in the classical methods of the 4th Organon and the single dose wait and watch method are in a good position to test the Paris methods of the 1840s. Why?
The method of the Organon is an artistic method that must be individualized to the patient. There are no preconceived schedules that can guide one. The daily dose or alternate day dose may be correct for one person while one dose a week, month or year is sufficient in another. Any time one gives too many doses one sees the side-effects of over medication. What a homoeopath learns is when to wait and watch as well as when to act to speed the cure. Much of modern posology is still 167 years behind the times but "the times they are a changing".
Review of the C and LM Pharmacy
The following is a review of the C and LM pharmacy by potency actions rather then comparison of the amount of original substance left in the dilution.
1. The Low Potencies 30c, 24c, 18c., 12c, 6c., 3c. The 30c is the median potency between the low and high potency systems and has some of the qualities of both.
2. The High Potencies.
A. The high potency Centesimals 200c and 1M (opening potencies), and the higher centesimal potencies 10M, 50M, CM, etc. (rarely used for opening a case).
B. The 50 Millesimals, the opening potencies, LM 0/1, 0/2, 0/3, 0/4,0/5, 0/6, 0/7. The middle range (rarely used for opening a case) LM 0/8, 0/9, 0/10 and the higher LM potencies, 0/11 to 0/30.
One of the first times Hahnemann tested the LM potency in 1840 he gave the 0/10! This caused a strong aggravation in the gentleman. He then gave the patient a placebo and waited and watched. After the aggravation had subsided, the Founder lowered the potency degree to avoid further aggravations. In his last years Hahnemann tended to begin cases with LM 0/1, 0/2, 0/3 but occasionally opened a case with 0/4., 0/5., 0/6, 0/7. The medicinal solution is suitable for both the split-dose, and when needed, the split-dose given at suitable intervals to speed the cure.
I hope this material is useful to the homoeopathic community.
Similia Minimus
Sincerely, David |
