The 6th Edition of the Organon

The 6th edition of Organon is the synthesis of Hahnemann's "new methods" and his final discourse on the art and science of Homoeopathy. In the 6th edition aphorism 246 integrates the ideas introduced in aphorisms 245 and 246 of the 5th edition into one long paragraph. The wording of this new aphorism is almost exactly the same as these two paragraphs in the 5th edition. Vide the first section of paragraph 246 of the 6th edition.

"Every perceptibly progressive and strikingly increasing amelioration during treatment [DL] is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever [DL], because all the good the medicine taken continues to effect is now hastening towards its completion."

The first part of this paragraph reflects aphorism 245 of the 5th edition. When a single dose of the LM potency produces an obvious progressively increasing amelioration the remedy should not be repeated. This is because the simillimum is already hastening toward cure at the fastest possible rate. A strikingly increasing amelioration is one in which the patient feels better day by day as the symptoms are rapidly reduced and the vitality increases The repetition of the LM potency under this condition can cause aggravations and relapse of the symptoms or just slow down the cure. Single dose cures are more common in acute diseases but there are also chronic patients that only need a single dose or very infrequent repetitions. For the above reasons, I usually give my patients a single test dose of the chosen remedy at the start of the treatment. On rare occasions, I may give a patient a series of three test doses with the instructions to stop the remedy immediately if there is any aggravation or striking amelioration. I only use this triple-split dose on those patients that appear hyposensitive when they cannot return for a quick follow up assessment.

An Example of a LM Single Dose Cure

While working in the hill district of Himachal Pradesh, inNorth India a teenage girl was presented to me with the following symptoms: Her left foot and lower leg had been terribly infected for at least a year and now there was advanced blood poisoning and a danger of gangrene. She had been given antibiotics several times but they did not help her.

Her foot and lower leg were very cold and there was numbness, tingling, burning, itching, swelling and an angry red blister-like eruption. The veins of her legs were swollen and icy cold and the condition was aggravated in the cold weather or when the cold wind blew down out of the mountains. These symptoms represented the location, sensations, and modifications of the chief complaint.

I now began to probe for some concomitants to fill out the case. Most people with such a serious complaint are very anxious or afraid yet she bore her suffering bravely. I asked her how she did in school and she mentioned to me that she had trouble reading because the letters seemed to move or appear double. This would give her headaches and make it hard to study. As her eye condition had nothing to do with her chief complaint I looked up this concomitant in the repertory immediately. Under Vision; moving; letters; I found Agar, am-c., con., Hyos., iod., merc., phys..

Then it struck me! Her leg looked and felt like it had been frozen. I quickly looked up Fearlessness because she seemed so brave under the condition she faced and found, Agar., bell., coca., OP., sil.. The coldness of the limb, the numbness, tingling, the blistered eruptions are all found in the materia medica under the remedy Agaricus. Agaricus LM 0/1 was made in a 6 oz. remedy solution and the patient was given one teaspoon as a dose and told to return the next day.

The next day the foot and leg looked much better! The swelling was down and the girl seemed happy. I did not repeat the dose because this response was "striking." I told her to come back in three days if the leg continued to improve but immediately if there was any relapse. She came back in three days and the leg was looking much better. The blisters were healing, the red diminishing, and the blood poisoning was reduced. I told her to come back in one week. After a week she returned walking on her foot. It looked so much better it was amazing.

I told her to come back once a week unless there was a relapse of the symptoms. The next week her foot was completely healed and warm. All of this took place in just under three weeks. This is an example of a single dose of an LM 0/1 causing a "striking rapid cure". A single dose of LM 0/1 is not to be underestimated. One dose of a LM 0/1 has removed severe attacks of asthma for 9 months before a relapse. A few more doses and the case was cleared. We have seen this type of response many times.

When using the LM potency it is always best to give a single dose and ask the patient to come back in 3 to 7 days, or more, depending on the nature of the disease. Cases of slowly developing chronic diseases may take a little longer to clearly show the reaction to the first dose. If the patient has a "striking" reaction to the remedy the repetition of the dose is contraindicated. If the dramatic healing reaction slows down the time has come to examine the case to see if it is time for the second dose. The remedy should then be repeated to see how it acts the second time. One may find that an infrequent repetition of the remedy is all that is necessary.

If the reaction is not very dramatic then the remedy may be introduced at intervals that correspond to the reaction of the constitution. The LM potency should not be repeated mechanically as if they are a 6x remedy! The LM system is far too deep acting for this kind of approach and demands sensitivity and flexibility in the homoeopath's hands. The wait and watch philosophy is still a very important part of Hahnemann's advanced methods.

Speeding the Cure

Not all constitutions respond to a single dose as in the case I have given above. It is more common in chronic disease to need to know how to skillfully repeat a remedy in order to complete a cure. Hahnemann reminds us that the single dose cure is much more common in acute or recent cases than it is in chronic disorders and miasmic diseases. Vide the second section of aphorism 246.

"This [the single dose cure] is not infrequently the case in acute diseases, but in more chronic disease, on the other hand, a single dose of an appropriately selected homoeopathic remedy will at times complete even with slowly progressive improvement and give the help which a remedy in such a case can accomplish naturally within 40, 50, 60, 100 day [DL]. This is, however, but rarely the case; and besides, it must be a matter of great importance to the physician as well as to the patient that were it possible, this period should be diminished to one-half, one-quarter, and even still less [DL], so that a much more rapid cure might be obtained".

Many individuals read the above paragraph but fail to note that Hahnemann makes a grand differentiation between two fundamental types of remedy reactions. In the first part of aphorism 246 the Founder describes the reaction as a "progressive and strikingly increasing amelioration during treatment". This is a strikingly progressive increasing amelioration is a reaction that is enhanced day by day. Under such conditions the repetition of the LM potency is normally precluded because the first single dose is already moving the patient toward cure at the fastest possible rate. In the second section of aphorism 246 the Founder uses the words "slowly progressive improvement". There is a vast difference between a rapid improvement where the patient feels much better every day and a slow improvement where the patient barely notices any changes! It is only in these slow moving cases that aphorism 246 permits the repetition of the LM potency at suitable intervals to speed the cure. If we want to speed the cure of these slow moving cases to 1/2, 1/4 or less the time it takes with the old methods of the 4th Organon one must use special techniques. What are they, Master Hahnemann? The answer to this question is separated into four parts. Vide the third section of aphorism 246.

1. "And this may be very happily effected, as recent and oft-repeated observations have taught me under the following conditions: Firstly, if the medicine selected with the utmost care was perfectly homoeopathic [DL]."

The first condition for speeding the cure in slow moving cases is that the remedy must be perfectly homoeopathic. If the consultant does not have a clear picture of the remedy it is best to be conservative with the dose. Repeating the wrong remedy can cause more harm than good. When there is a marked, progressive amelioration of the symptoms on the single test dose, I do not repeat the remedy. I very carefully observe the number of days that this increasing amelioration lasts. This offers the homoeopath insights into the duration of the remedy and reveals what a suitable interval might be for the patient. If the striking response lasts forever one does not need to repeat the remedy at all! If the markedly progressive improvement lasts for 1, 2, 3, 4, 5, or 6 days, the remedy is only given every 1, 2, 3, 4, 5, or 6 days respectively. If the increasing amelioration lasts 1, 2, or 3 weeks, the remedy may be repeated every 1, 2, or 3 weeks. If the increasing amelioration lasts 1, 2, or 3 months, the remedy may be repeated every 1, 2, or 3 months. If it lasts 1, 2, or 3 years, give the remedy every 1, 2, or 3 years, etc.

2. "Secondly, if it is highly potentized, dissolved in water, and given in a proper small dose that experience has taught as the most suitable. [DL] "

The second condition for speeding the cure is the use of the medicinal solution. Without the liquid dose none of the other advantages of the new method are available. When using the dry pills the homoeopath should follow the rules laid down in the 4th Organon. This simple change from the static dry dose to the flexible liquid solution is the foundation of all other breakthroughs. Hahnemann’s Paris casebooks show that the Founder used the medicinal solution with his centesimal potencies in exactly the same manner as the LM potency in his last years. The remedy solution is not only more flexible than the dry dose but also much more powerful. Hahnemann also used olfaction of the medicinal solutions as a delivery system. Vide aphorism 272.

"Such a globule, placed dry upon the tongue, is one of the smallest doses for a moderate recent case of illness. Here but few nerves are touched by the medicine. A similar globule, crushed with some sugar of milk and dissolved in a good deal of water {refer to # 247} and stirred well before every administration will produce a far more powerful medicine for the use of several days [DL[. Every dose, no matter how minute, touches, on the contrary, many nerves."

3. Hahnemann also suggested repeating the remedy:

"in definite intervals for the quickest accomplishment of the cure [DL]"

The third aspect of speeding the cure is the repetition of the dose in definite intervals of time. This is a new concept for those practitioners who are not familiar with Hahnemann's most advanced teachings. The intervals between these repetitions must be determined by the nature of the reaction to the remedy, the sensitivity of the constitution, and the nature of the disease. This allows the homoeopath to personalize the remedy schedule in relationship to the time and progression of the healing process.

4. The fourth condition for speeding the cure begins:

"…with the precaution, that the degree of every dose deviate somewhat from the preceding and following in order that the vital principle be not aroused to untoward reactions and revolt as is always the case with unmodified and especially rapidly repeated doses [DL]. "

This last aspect of the complete dose is the succussion of the remedy solution just prior to the ingestion of the medicine. The succussion of the remedy solution changes the potency of the dose so that the vital force never receives the exact same dose twice in succession. This prevents the relapse of symptoms that appears from the repetition of a dry dose before the cessation of the action of the previous dose. These four points reflect the improvements that had taken place in Homoeopathy during the period between the years 1833 and 1843. These new methods can only be applied by those homoeopaths that follow the explicit directions that Hahnemann gave in the 5th and 6th editions.

If Necessary!

All of the statements about repeating the dose to speed the cure relate specifically to those cases that demonstrate only a slow amelioration that may take 50, 60 or 100 days to show any significant improvement. These circumstances condition all the following statements made about the use of daily and alternate day doses in aphorism 248. If the patient is doing very well on a single dose or infrequent repetitions then more rapid repetitions do not apply. There are homoeopaths that mechanically administer the LM potency daily for days, weeks and months on end with every patient. They have not yet understood the fine print in the footnote to aphorism 246. Every case must be individualized and the repetition adjusted accordingly. In this footnote the Founder explains some of the changes he made in the 6th Organon and when the daily dose is applicable.

"What I said in the fifth edition of the Organon, in a long note to this paragraph in order to prevent these undesirable reactions of the vital energy, was all that the experience I then had justified. But during the last four or five years, however, all these difficulties are wholly solved by my new altered but perfected method. The same carefully selected medicine may now be given daily and for months, if necessary [DL] in this way, namely, after the lower degree of potency has been used for one or two weeks in the treatment of chronic disease, advance is made in the same way to higher degrees, (beginning according to the new dynamization method, taught herewith with the use of the lowest degrees)."

In the footnote to aphorism 246 Hahnemann suggests that a well chosen remedy (not a poorly chosen one) may be given daily if necessary in slow improving cases. When repetition of the remedy is not necessary the LM potency will cause strong aggravations, unproductive accessory symptoms, and slow down the cure. Unneeded repetition can make a patient more hypersensitive or make them non reactive due to over exposure. Hahnemann’s new posology method spans the single unit dose in striking responses and the repetition of remedies at suitable intervals to speed the cure in slower moving cases when necessary. In this way, the posology strategy can be tailored to a great variety of patients and conditions.

Boenninghausen sought detailed information about how Hahnemann administered his medicines in his last years from Dr. Croserio, a close colleague of the Founder. In Boenninghausen’s Lesser Writings Croserio said that Hahnemann would reduce the dose or stop the repetition of his remedies as soon as he observed definite medicinal reactions. He also noted that Hahnemann often gave a single dose of olfaction with placebo and usually did not repeat the dose for at least one week. In my review of the microfiches of Hahnemann’s Paris casebooks I found that in most cases the Founder often stopped his medicines, gave placebo, and waited and watched for long periods. Hahnemann did not mechanically gave the LM potency daily for weeks, months and years on end! It was more common for him to use a series of doses followed by, or interspersed with, series of placebos. In his later years he sometimes gave a LM potency and placebo at the same time but he did not note down the schedules. This means that some of the prescriptions could be a single dose and others could be the interpolation of placebo with the medicine at various intervals. Hahnemann only recommends the daily dose when it was necessary.