How To Prepare The Dose

Posology and case management is both an art and science. It must be remembered that finding a good remedy only overcomes half the problem. The other half of the challenge is how to prepare and administer the remedy properly. This includes selecting a potency system (C or LM) and degree of potency, preparing the dose and repeating the remedy if and when needed. There are two major ways of giving homoeopathic remedies i.e. the dry dose and the water dose.

Covid-19 is a virulent acute miasma that is prone to relapse and sequels. For this reason, one should be aware of the progression of the symptoms as presented in A Homoeopathic Approach to Covid-19 and the symptoms and therapeutic hints offered in Comparative Homoeopathic Materia Medica of Covid-19. If the dry dose is being used it is best to use 1, rarely 2, pills. If the remedy is to be repeated often it is better to follow the dry dose with a medicinal solution.

Starting the case with a remedy solution offers several advantages. First of all, the liquid dose comes in direct contact with more inner surfaces than the dry dose. Secondly, the remedy solution bottle can be succussed prior to each administration to slightly raise the potency so that the vital force never receives the exact same potency twice in succession. This makes the remedy act more gently and deeply than repeating the dry dose.

Another factor is that hyposensitive persons become used to receiving the same dry dose and potency several times in a row and become unresponsive. This may cause the practitioner to leave the correct remedy in a fruitless search to find another remedy. When hypersensitive individuals receive a series of dry doses of the same dose and potency they tend to aggravate easily and become progressively more over-reactive and idiosyncratic. In this situation a perfectly good remedy is no longer useable unless corrective measures are employed. These posology factors become even more important the closer the remedy is to a simillimum.

There are 3 major methods of administering the water dose. This a short review of the methods. For a more extensive study of posology and case management please refer to Hahnemann's Advanced Methods.

1. The water glass method. 1, rarely 2 small pellets are dissolved in a glass with 4 oz (125 ml.) to 8 oz. (250 ml.) of water. The glass is stirred vigorously and the dose is a given in a spoonful or a portion of a spoonful dose. This method is useful when no bottles are available. Large glasses and portions of a spoonful are used in those more sensitive, and a smaller glass and spoonful doses are used in those of moderate to low sensitivity. This was Hahnemann's first extensively tested water dose.
2. The large remedy solution bottle method. 1, rarely 2 small pellets are dissolved in an 8 oz (250 ml.) to 16 oz (500 ml.) bottle of pure water. The remedy bottle is succussed 1-12 times and a spoonful is given directly from the bottle. Larger remedy solution bottles require 2 to 4 tablespoon of alcohol (brandy) as preservative. The prototype of remedy solution bottle method was introduced in the Paris edition of The Chronic Diseases and larger bottles are mentioned in aphorism 248 of the 6th Organon.
3. The small bottle and dilution glass method. 1, rarely 2 small pellets are dissolved in a 4 oz (125 ml) bottle. The bottle is succussed between 1-12 times and 1, or increasingly more, spoonfuls are stirred into a dilution glass with 4 oz. (125ml.) water and 1, or increasingly more, spoonfuls are given from the glass. The smaller remedy solution bottles require 1 tablespoon of alcohol (brandy) as preservative. This method was introduced in aphorism 248 of the 6th Organon.

Potency, Dose And Repetition

Hahnemann wrote that the sensitivity of patients varies on a scale of 1 to 1000. A number 1 individual is very hyposensitive, a 500 has moderate sensitivity, and a 1000 is extremely hypersensitive. A dose that a hyposensitive would not even feel will cause strong aggravations in a hypersensitive. Hyposensitive persons require higher opening potencies (200c-1m-LM1-3), less water (4 oz.-125 ml), maximum succussions (8-12), more teaspoons (2-3 or more), and shorter waiting periods. Moderate sensitivity requires moderate opening potencies (30c-200c-LM1-2) moderate numbers of succussions (5-8), teaspoon doses (1-2), and moderate periods of waiting. Hypersensitive patient require lower opening potencies (6c-30c-LM1), larger amounts of water, less succussions (1-3), and small portions of a teaspoon (1 or 2 drops or 1/4, 1/2). In the ultra hypersensitive and idiosyncratic patients; several dilution glasses (2-6) and drop doses are best. They also require fewer doses and longer periods of waiting. These are the basic guidelines.

In each and every case it is best to begin with a single test dose followed by an appropriate time of waiting and watching. In cases where there is a perceptibly progressive and strikingly increasing amelioration it is best to wait and watch without repetition as long as this extraordinary state lasts. The dose is repeated only on the early signs of relapse. Single dose cures in moderately ill patients have occurred even with the 30c potency. In severe cases the waiting period may be a matter of 5, 15, 30, 60 minutes to 2 hours depending on the intensity of the symptoms. The interval between these rapid repetitions should be slowed as the patient improves.

In more moderate cases the intervals between doses could be every 3, 6, 9 or 12 hours. In milder cases the intervals between doses could be every 6, 12, or 24 to 48 hours. In light cases the remedy could be needed every 3, 4, 5 days, etc. As Covid-19 is subject to relapses the remedy should be slowed down to longer intervals rather than the dose stopped immediately. This comes with the caveat that any time during treatment there is a striking amelioration where the patient seems almost well; the repetition should be stopped as long as this extraordinary state lasts. There is no one protocol that suits all individuals under every circumstance. Just as the remedies must be individualized, the same individualization is required in posology and case management.

If the opening potency is working well there is no need to make changes. If, however, the opening potency works well for some time, but then the symptoms start to relapse, increase the number of succussions of the bottle and/or the size of the water dose. If this is not sufficient raise the potency to the next degree and give a new test dose. Then repeat the remedy at suitable intervals to speed the cure if necessary. It is not uncommon to need to raise the potency after 7 or so doses.

How Homoeopathic Remedies Work

It is important to understand how homoeopathic remedies work. The primary action of the similar remedy overpowers the sensation of the disease in the life force and brings a clear image of the mistunement to the perception of the natural healing powers.

This stimulates the vital force to produce a secondary healing reaction which removes the disease state in stages. This brings about a rapid restoration of the state of health with increased vitality and sense of well being. This is called the action-reaction model of healing.

In some cases of acute and chronic disease, especially in those that involve hypersensitivity, suppression by drugs, unresolved emotional trauma and compromised organs of elimination, the primary action of the remedy may cause what is called a similar aggravation. This is an intensification of the presiding symptoms. This takes place as the homoeopathic remedy seeks to overpower the disease state.

This aggravation may take place when the potency is too high, the remedy bottle receives too many succussions, the size of the dose was too large, or the remedy was repeated before it was truly necessary. The next time the remedy is given these factors must be adjusted so that the remedy acts deeply yet more gently on the vital force. Finding the perfect balance between the primary and secondary actions are an art as well as science.

During the process of healing the secondary action of the vital force may produce a healing crisis. During this process there may be a return of old symptoms with heightened emotional states, detoxification, externalizations and eliminations. This process follows the natural direction of cure in which healing takes place from within to without, from above to below, from the more important systems to the less important, and in the reverse order of the developmental timeline of the disease layers.

As the curative secondary action of the vital force gains supremacy it intensifies the amount of vitality in degrees until it is much more powerful than the original disease state. During this process there is a clear amelioration in which the vital force removes the symptoms layer by layer until complete health is restored.

Remedy Reactions

There are 4 major remedy reactions that must be understood to administer the dose in a safe and effective manner.

1. A rapid restoration of the state of health with increased vitality and greater sense of well-being. This is a sign that the remedy is a simillimum and the potency, dose and the single dose or repetition of the remedy is harmonic.
2. A similar aggravation. This is the increase in the intensity of the presiding symptoms. As was stated earlier, this is a sign that the potency may be too high, the remedy bottle succussed too many times, the size of the dose was too large, or the remedy was repeated before it was truly necessary.

   If the aggravation is mild it will pass off quickly and be followed by amelioration. If the aggravation is moderate it usually resolves in reasonable period of time followed by amelioration. These are times when waiting and watching is important. At times like this Hahnemann sometimes used placebos. The next time the remedy is given it should be toned-down by adjusting the dose as recommended earlier. A strong aggravation that persists may be toned-down by giving a corrective dose of a much lower potency diluted in a large amount of water and given in drop doses. If this is not sufficient the remedy should be antidoted.

3. Accessory symptoms. In this case, some of the symptoms ameliorate while new symptoms of the remedy appear. This is a sign of a partial simillimum. If the remedy is close enough the accessory symptoms will be mild and disappear as the healing secondary action increases and ameliorates the symptoms.

   If the remedy is too far away from the essential disturbance, the accessory symptoms strengthen and the amelioration weakens. This is a sign of too distant a partial simillimum and a new more correct remedy must be found.

Another sign of a partial simillimum is some of the symptoms ameliorate and others show no real healing after a reasonable time of observation. This is also a sign to retake the case by the remaining symptoms and find a more suitable remedy. Too many partial simillimums lead to "zig-zag prescribing" where the cure is not a straightforward affair.

4. A dissimilar aggravation. This is the appearance of new and troublesome symptoms not appertaining to the disease state. This happens when a remedy is incorrect and the individual has reacted negatively to the remedy. If the dissimilar aggravation is weak the vital force will clear the symptom quickly. If the dissimilar aggravation is moderate, the natural symptoms and the medicinal symptoms may be combined and a corrective remedy administered. If the dissimilar aggravation is strong and persistent the remedy should be antidoted and the case retaken at the appropriate time.

There are cases where the patient is hovering between life and death. Such a situation may call for the end of life remedies. These remedies reduce the pain and mental suffering an individual may experience while dying. In some instances they extend life when the person was already near death. Some with sufficient vitality may even enter convalescence and fully recover. This was witnessed in a case of hydrocephalus where a baby was sent home from the hospital to die. The child was given Arsenicum album to relieve the mental anguish of dying and they fully recovered! In another case the doctors informed the family of the patient's imminent death due to kidney failure but Carbo vegetabilis extended their life and they were able to go home. This remedy has certainly earned its reputation as the "corpse reviver". From birth to death Homoeopathy is always there.

Samuel Hahnemann introduced a system of checks and balances that make Homoeopathy a safe and effective system. That is why it is important to understand how to use Hahnemann's advanced methods as they represent insights the Founder gained during his 40 years of experience. One should know how homoeopathic remedies work and the various remedy reactions they may produce. This offers deeper understanding of the suitability of remedy, potency, dose and repetition and offers insights into the various aspects of case management. For a deeper study of these subjects please refer to The Homoeopathic Compendium, Volumes 1-6.

The Road Ahead

This is a very difficult time for everyone everywhere. The fear and uncertainty is palpable worldwide. Orthodox medicine has limited viral medicines and no vaccine. Up to 80% of those being placed on ventilators do not survive. At such a time Homoeopathy may play an important role as it has over two centuries of experience in the prevention and treatment of epidemic diseases. The Indian government has set the standard by using Homoeopathy as a front-line medicine in both the prevention and treatment of Covid-19. 100,000's if not 1,000,000 doses of homoeopathic remedies have been distributed throughout the country.

Central Counsel of Research in Homoeopathy is collecting data on the Covid-19 pandemic as it has in other epidemics like dengue fever, Japanese encephalitis, cholera, chikungunya, influenza, gastroenteritis, hepatitis, malaria, measles, meningitis, plague, typhoid, etc. They are documenting the Covid-19 pandemic and collecting data on the use of homoeopathic remedies for the prevention and treatment of Covid-19. Those interested in the work being undertaken by CCRH should visit their Home page, Face Book and Twitter account.

The management of epidemic disorders involves serious public health concerns. This includes hygienic measures, testing, notification, contact tracing, isolation and quarantine and the management of serious cases in hospital ICU wards. Homoeopaths should act in accordance with the laws and directives of their prospective governments. This material is offered for educational purposes only and in accordance within the traditional homeopathic paradigm. If anyone is suffering from the symptoms of Covid-19 they should see a doctor, and if serious, call emergency services immediately.

Resources

For information on Homeoprophylaxis please refer to Prevention and Treatment of Epidemic Diseases by Homoeopathy. This article contains a review of the history of preventative remedies and the experience of great homoeopaths.

For a detailed study of the history and preparation of the water dose and case management read Hahnemann's Advanced Methods:

For an in depth study of the complete practice of Homoeopathy, refer to The Homoeopathic Compendium, Volumes 1 to 6, by David Little.

Disclaimer: This information is supplied for educational purposes only. It is not for the treatment of any individual person or disease condition. If there is a possibility that you have acquired a Covid-19 infections call your doctor or emergency services for immediate help.