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H.O.E Poll
What homoeopathic potencies do you use?
C (Centesimal) 41.6%
C and LM 19.7%
X, C and LM 18.0%
LM (50 Millesimal) 11.1%
X (Decimal) 9.6%

Total votes: 8703


 
 
Version 2.04
Adjusting the Size of the Dose
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© David Little 1996-2007, all rights reserved.
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It is truly wonderful to see the depth of the discussion of The Organon. As I do not read German nor French (I'm still struggling with Hindi), it is a great benefit to read the posts of Chris, Michel, Alain, Peter and others. The are several places in Hahnemann's writings which refer to the gradual increase of the size of the dose by increasing the number of teaspoon of the solution.to be administered  The size of the dose is one major aspect of adjusting the dose. Those who still think that it makes no difference whether one gives 1 or 1000 pills may find some of this information new. I would request that experienced homoeopaths test Hahnemann's assertions about the dose by putting this new posology method through trias in the field. Students should be taught correctly right from the start under the guidance of one experienced in these methods.

The Size of the Dose

In Hahnemann's advanced methods the administration of the dose (Grm. Gabe) includes a number of synergistic factors. In order to get the complete picture we need to study The Organon, The Chronic Diseases, eyewitness accounts, testimonies and letters as well as Hahnemann's casebooks. If we put all this information together we get a good idea of what Hahnemann's experiments entailed. It is important to point out that Hahnemann used his centesimal and LM potencies in exactly the same manner. It is wrong to think that these methods only apply to the LM potency. Both the 5th and 6th Organon focus around the same new posology. This is not the "LM method", but rather, the "Hahnemannian Method". It is equally applicable to the Centesimal as well as LM potencies.

It is no surprise that Chris Kulz, PH.D., translates §280  as follows:

"Die Gabe der anhaltend dienlichen, keine neuen, beschwerlichen Symptome

Translation: the dose of the continued serviceable, not new, troublesome Symptoms

erzeugenden Arznei wird, allmählich erhöhet so lange fortgesetzt, bis der

Translation: produce medicine arise, gradually raise/increase as long as continue, as far as the

Kranke, bei allgemeinerm Beserbefinden, anfängt, eine oder mehre seiner

Translation: patient, with generally ? improvement? , begins, one or more former

alten, ursprünglichen Beschwerden aufs Neue in mäßigem Grade zu spüren.

Translation: old, original complaints on? New in moderate stages to perceive or trace.

Dieß deutet bei einer so allmäligen Erhöhung der, jedesmal durch Schütteln

Translation:These indicate with one so gradual? increase the, eachtime through succussed

modificirten (para 247), sehr gemäßigten Gaben auf nahe Heilung, nämlich

Translation: modification very moderate dose on near healing, namely

darauf, daß nun das Lebens-Princip fast nicht mehr nöthig habe, durch die that,

Translation: that now the life principle almost not more need have, through the

ähnliche Arznei-Krankheit afficiert zu werden [snip]."

Translation: similar medicinal disease affected to become.

Hahnemann's use of the word "Gabe" clearly means that the amount of total medicine administered is to be gradually increased, as the reading of the following passages indicate. This means a larger amount of the medicine and does not speak of the potentization at all. It could mean more of a higher or more of a lower potency. Only in the second sentence, does he speak of potency, where he says (my translation, which is closer to the original yet less readable):

"...With such a gradual increase of the very moderate dose, which is each time modified by succussion, this renewal of old ailments indicates that cure is near..." (Here I have translated "Gabe" with "dose". This is supported many times throughout the Organon.)

Finis

Thanks Chris!

I am not a translator so I cannot comment on the text directly. I must refer to the expertise of others. I can only share my last 12 years of experiments with the methods suggested by Hahnemann in his last 14 years. Knowledge of this method did not come automatically. I have made several fundamental mistakes over the years, but by constant application of the principles, I slowly gained personal insights into the new method. Through trial and error in the field I have tried to reconstruct the methods of the 5th and 6th Organon and bring them up to date. I hope that my experience can make these methods more accessible to other homoeopaths who have the spirit of investigation and patience to put them into practice.

Adjustments of the Medicinal Solution

The adjustment of the size of the dose as well as the number of succussions is reflected in aphorisms 248, 282 and others. Vide aph. 248, part 1.

"Before each administration of the medicinal solution, potentize the medicinal solution anew with about eight, ten or twelve succussions of the bottle. Then give the person one or, ascendingly, several teaspoons."

If one takes Chris's translation of §280 and O'Reilly's translation of §248 one can see they both reflect the two major aspects of adjusting the dose, i.e. individualization of the amount as well as succussions. All of this is central to the art of adjusting the dose. Let us look at some of the factors of Hahnemann's new posology. There are five factors related to the preparation of the dose (Gabe), i.e. the preparation of the dynamization to be administered.

1. The delivery system, the medicinal solution. The vehicle makes all of the other adjustments possible.

2. The number of pills used when making the solution.

3. The size of the medicinal solution.

4. The amounts of the medicinal solution used.

5. The potency factor and the number of succussions given just prior to ingestion of the remedy.

All of these factors directly affect the remedial powers of the homoeopathic dynamization. The primary factors in adjusting the dose are dilution ratios and succussions. These aspects both affect the medicinal solution by altering the remedial powers.

Now let us look closely at the adjustment of the amounts of the remedy related to the size of the dose. This also has five areas of application.

1. The number of pills used in the solution bottle.

I, or more rarely, 2 pills are commonly used to make a medicinal solution. This is a powerful increase of the energy of the dose because each pill represents an increase in the "quantum" of remedial power. Only the most insensitive constitutions need 2, or increasingly more, pills in the medicinal solution. Hahnemann spoke of a ratio of constitutional sensitivity of 1000 to 1 in aph. 281. I call this the sensitivity scale (1 to 1000). Understanding this is a key to the art of adjusting the dose. Individuals who need an increase of the number of pills are on the lowest end of the sensitivity scale (1-250). I have not used more then 2 pills yet but it could happen any day. This is the first adjustment of the size of the dose.

2. The size of the medicinal solution.

The size of the solution can vary from 4 to 20 or more, ounces of solution. This also directly affects the size of the dose right from the foundation of the solution. I often use 4oz, 6oz, or 8oz solutions depending on the sensitivity. The more hypersensitive individuals (750-1000+) require more water in their medicinal solution. More water makes the remedy act more gently. This is another aspect of the reduction of the dose. This is the second adjustment of the size of the dose.

3. The number of teaspoons taken from the freshly succussed medicinal solution and stirred into the dilution glass.

Normally, we begin with 1, 2 or more rarely, 3 teaspoons. This amount can also be gradually increased until the required reaction is attained. This is the third adjustment of the size of the dose. This is a relatively large intensification in the remedial energy as the increase comes directly from the medicinal solution. This is the third method of adjusting the size of the dose.

4. The number of teaspoons which is taken from the dilution glass and given to the client.

Normally, we begin with 1, 2 or more rarely, 3 teaspoons and increase this amount only when necessary to get the required reaction. Once a reaction is attained the dose is held at this level, and increased again, only if there is a need for more remedial action. The is a gentle increase in the remedial power. This is the fourth adjustment of the dose.

5. The use of a series of dilution glass for the most hypersensitive (900-1000+++).

  One coffeespoon or teaspoon is taken from the first dilution glass and stirred into a 2nd, 3rd, 4th, or more glasses, depending on the sensitivity factor.

The Methods of Adjusting the Dose

I have used every one of these adjustments many times over the last 12 years. There is no doubt the all these factors affect the dose in slightly differing ways. I have even observed a difference in the activity of increasing the size of the dose versus increasing the number of succussions. Both of these strengthen medicinal powers but in different ways. This is very hard for me to verbalize but I am observing the phenomena. If I was to use a radio wave analogy I would say that the succussions increase the frequency of energy while the amount increase the amplitude of the remedial signal. Graphically, I might say more succussions increase the vertical plane while larger amounts increase the horizon plane of the remedial powers. The succussions seem to activate, stimulate and heighten the remedial energy while an increase in amount seems to strengthen, stabilize and ground remedial energy. I am searching for words and images to express what is only a glimpse into another level of understanding the art of adjusting the dose. Perhaps someday this will all become clear.

The perfect combination of these factors seems to produce the most stable and energetic primary action and elicit the most beneficial secondary reaction from the vital force. The increase of the number of teaspoons and the number of succussions, makes the remedy progressively much more active. *I would advise those new to the method not to get the idea that one should give long routine schedules with corresponding increases of the size of the dose and succussions. * This will lead to over medication, accessory symptoms and aggravations as the remedial powers accumulate in the vital force. This will only slow down the cure, cause unneeded sufferings, and confuse the case management. One still needs the patience and prudence so well expressed in the 4th Organon combined with the revolutionary methods of the 5th and 6th editions.

The Single Unit Test Dose

In this artistic method the preparation of the solution, the amounts used, the number of succussions, and the repetitions must be individualized to the nature of the disease state and the constitutional sensitivity of the person. Start with a smaller amount and do not overdo the succussions in the beginning. Do not succuss the remedy bottle overly hard because it forces too much concussive energy into the solution. Normally, we give a test dose of the chosen potency (C or LM) and observe its effects for a relatively longer or shorter period depending on the nature of the disease state. If the reaction of the vital force is *striking and progressive*, leave the single dose to act alone. Watch the healing cycle and follow the individual toward cure. I have seen a single dose of an LM act for months and remove several layers with their complex aetiologies. In some case I have never had to repeat the remedy. Some think this is only possible of the high potency centesimals but it is not the truth.

Don't underestimate LM potencies. Don't underestimate the C potency either! The striking single dose cure is a wonder to perceive. Nevertheless, this wonderful accomplishment is not an overly common occurrence as a slow or moderate response is more normal. Many cases will need the repetition of the remedy at suitable intervals to speed the cure. Therefore, three vital factors must be regulated, the size of the dose, the number of succussions, and the intervals between repetitions. Don't get the idea that LMs can be repeated mechanically everyday for months (an modern myth that Ms Handley's "Later Hahnemann" perpetuates). This is a gigantic mistake. LM 0/1 acts much more deeply than a 30c so do not get the idea LMs are some type of low potency remedy to be repeated mechanically for long periods of time. Whenever Hahnemann gave a series of doses he followed it with an equally long period of placebos. This is obvious in his Paris casebooks. When he received a strong remedial action he would wait and watch!

Start with a prudent potency, small dose, average medicinal solution and a moderate amount of succussions. If the remedial action does not seem to have stimulate the hoped for response, gradually increase the amount and succussions until the required action has been elicited. Then keep the size of the dose and the number of succussions the same so as not to aggravate the individual. If the case again slows, increase the succussions and amounts gradually until the desired reaction is seen again. As the client improves, slow down the medicine to avoid aggravations. This leads to a rapid, gentle permanent cure with no aggravations and no relapse of symptoms.

Succussions

in the 6th edition of Organon Hahnemann suggested giving  8, 10, or 12 succussions to the medicinal solution. In the 5th edition he spoke of using 1 to 10 to activate the solution just prior to ingestion. In aphorism 281 of the 6th Organon ( Boericke's edition) Hahnemann notes that there is a great difference in the levels of sensitivity of various individuals.

"If a cure is to follow, the first small doses must likewise be again gradually raised, but less and more slowly in patients where considerable irritability is evident than in those of less susceptibility, where the advance to higher dosage may be more rapid. There are patients whose impressionability compared to that of the unsusceptible ones is like a ratio of 1000 to 1."

This rather profound statement holds many keys to the selection of the potency and dose. I call this the *sensitivity scale* because it give us an idea of the vast differences in the susceptibility of individuals to the action of the remedies. What a #1 sensitivity would not even feel will cause a dangerous aggravation in a #1000 sensitivity. Through years of experiments I have found that those of a hypersensitive nature and physical constitution (700 -1000+) do better on less succussions (1-4). Those of average sensitivity (300 to 700) do well on a moderate number of succussions (4, 5, 6, 7). Those who are hyposensitive (1 to 300) may need a higher number from the start (6 ,9, 10, 11, 12).

Those with very sensitive nervous systems often do not need the stimulation that a large number of succussions produce. In such cases a small increase in the amount is a better option than increasing the number of succussions. This increases the "amplitude" of the remedial powers but does not over stimulate the potency factor. I start the sensitive, nervous and changeable temperaments with a smaller number of succussions than those of average sensitivity. They do better on less teaspoonfuls (a coffee spoon), fewer succussions (1 to 3), and more water in their solutions (6, 8 or more oz). The ultra hypersensitive should be given the dose diluted in several dilution glasses (2 to 6, etc.). In this way the liquid dose becomes tremendously flexible in a way that the old pellet dose cannot be. This is what allows for the speeding of the cure to 1/2, 1/4 or less the time of the static dry dose which is prone to accumulate in the vital force and produce aggravations.

It is best to start with a conservative dose until one is sure of the true homoeopathicity of the chosen remedy. Only increase the amounts and succussions when necessary. Over medication always produces aggravations which slow down the cure, and runs the risk of producing accessory symptoms which disrupt the case. If the accessory symptoms become strong they will cancel the homoeopathicity of the simillimum changing the symptom pattern and disrupting the case. Sometimes, the routinist homoeopath is caught in the vicious cycle of treating the symptoms they are producing without knowing it. They think they are treating new layers, removing the causes, or stimulating a healing crisis, when in fact, they are like a dog chasing its own tail. They are going around in circles. Be gentle with the vital force.

Discite Moniti! (Don't Do This!)

As homoeopaths grow old and gray they become more conservative. Why is this? It is because we have made many mistakes and wish others not to repeat them. Hahnemann also warned us but we were too young in our years to really understand him. I have seen both the healing and disruptive power of high potency centesimal and LMs and have great respect for our remedies. No homoeopathic remedy can be given mechanically or in a routine manner. The careful patience and prudence of the 4th Organon forms the foundation of the 5th and 6th editions. The 5th and 6th edition did not replace the 4th Organon, but rather, brought it to completion. Without understanding the fundamentals of Hahnemannian Homoeopathy one is prone to bring allopathic conditioning to the new methods. These new methods demand more, not less, individualization and more knowledge of remedial actions. This is because with more knowledge comes more responsibility and with more responsibility comes more wisdom.

I hope this clarifies some of the salient features of Hahnemann's posology methods. There is much misunderstanding in the general homoeopathic community about these methods but a new day is dawning. All good things take time to cultivate. I will do my best to help. I wish you all the best in your studies and experiments!

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