The Medicine of the Future
The time period around the publication of the 5th Organon (1833) was one of radical change and experimentation for Samuel Hahnemann. He was not completely satisfied with the single dry dose of 30c, and the wait and watch philosophy he taught in the1st edition of the Chronic Diseases (1828) and the 4th Organon (1829). Now that the Founder was concentrating on chronic degenerative diseases, he wondered how he could treat the miasms with a limited materia medica of around 100 remedies in potencies no higher then 30c? The areas where he searched for answers were in proving more remedies, raising the potencies, and changing the delivery system from the dry dose to the medicinal solution. This was complemented by his new middle path philosophy about repetition and the introduction of the split-dose, if necessary.
In aphorisms 245 and 246 of the 5th edition the Founder taught that any "striking response" to a single dose precludes the repetition of the remedy in any manner. On the other hand, in those cases only noted by a "slow progressive improvement", the remedy may be repeated at "suitable intervals to speed the cure''. In this way, he claimed, it is possible to speed the time of treatment to "one half, one fourth, or even less" then with the single dry dose. Hahnemann's revised philosophy includes both the single unit dose and the repetition of the remedy when necessary. The key to the new posology method is the medicinal solution as well as the methods of adjusting the dose. With the new aqueous solutions and olfaction the Founder began a radical set of clinical trials that included double remedies, alternations, intercurrents, and a series of remedies. The most controversial of these early experiments were the double remedy trials of 1833.
The Double Remedy Experiments of 1833
The method of combining two homoeopathic remedies in mixture originated with Dr. Aegidi, who forwarded Hahnemann 233 cases of his method. Aegidi found a confidant in Baron von Boenninghausen who used his influence with the Founder to support the new method. The Hofrath was so impressed by the enthusiasm of his disciples that he promised to refer to the double remedies in the 5th Organon even before trying them!
Coethen, June 15th, 1833
"Do not think that I am capable of rejecting any good thing from mere prejudice, or because it might cause alterations in my doctrine. I only desire the truth, as I believe you do too. Hence I am delighted that such a happy idea has occurred to you, and that you have kept it within necessary limits; "that two medicinal substances (in smallest doses or by olfaction) should be given together only in a case where both seem homoeopathically suitable to the case, but each from a different side." Under such circumstances the procedure is so constant with the requirement of our art that nothing can be urged against it; on the contrary, homeopathy must be congratulated on your discovery."
Hahnemann had not yet tried Aegidi's method but he was very hopeful that it would prove a benefit to his new healing art. For this reason he promised to take up testing the hypothesis in the clinic as soon as possible.
"I myself will take the first opportunity of putting it into practice, and I have no doubt concerning the good results. I think too, that both remedies should be given together; just as we take Sulphur and Calcarea together when we cause our patients to take or smell Hepar sulph, or Sulphur and Mercury when they take or smell Cinnabar. I am glad that von Boenninghausen is entirely of our opinion and acts accordingly. Permit me then, to give your discovery to the world in the fifth edition of the 'Organon', which will soon be published."
Some of Hahnemann's critics claim the Founder was close-minded, dogmatic, and against all innovations in his new medical system. The above letter puts such myths to rest. He was so optimistic that he offered to refer to Aedigi's method in the 5th Organon before he tried it in the clinic. He began his first experiments with the olfaction of a double remedy on February 17th, 1833. What was the outcome of the Founders 5 months of clinical trials?
Hahnemann to Boenninghausen
Cothen, October 16, 1833
"Easily your eloquence would have defeated me, if I were in the same case as you, that is, if I had already been as convinced by several and by so many experiences of the utility, even preference/superiority of the giving of a double remedy as you supposedly had been. BUT FROM SEVERAL TRIALS IN THIS MANNER ONLY ONE OR TWO TURNED OUT WELL, which isn't sufficient for the apodictic [irrefutable] proposing of a new theorem."
*Capitals by DL.
Hahnemann's experiments with the double remedies proved a failure because they did not work as well as the single remedy. He was critical of the double remedies because he could see their limitations. The second half of the letter offers more clues to his feelings
"I was therefore in this practice still too far behind to proceed with full conviction. Therefore it required only a slight moment to induce me to a change of these passages in the new Organon, which results in this, that I concede the possibility that two well-selected, different remedies can be given simultaneously [together] with advantage in some cases, but that this seemed to be a difficult and critical [/serious/delicate] procedure."
Translation from German by Gaby Rottler, copyright 1999.
In the beginning, Hahnemann hoped to have "some good results' with the double remedies. He wrote of this in his letter of June, 1833 to Boenninghausen before he tried the method. In the letter dated September 17 he told Boenninghausen that the double remedies are "never, as we know absolutely necessary". On October 17th offered the Baron his final analysis that "only one or two" of his experiments "turned out well". It was the Hahnemann's opinion that one single remedy alone, or in alternation at different times, and a series of remedies was superior to combinations.
The Hofrath listened pensively to his disciples Aegidi and Boenninghausen with increasing reservation. He was now caught between his own inner convictions and the enthusiasm of his two younger students for a simple but less effective method. The meeting of the Central Society on August 10th, 1833 offered the Founder a perfect way out of his difficult position. Hahnemann decided to bring the subject of the double remedies to the floor of the meeting for a discussion of all their ramifications. Vide Bradford's Life and Letters of Hahnemann, page 488.
"Dr. Aedigi proposed to Hahnemann to administer a mixture of two highly potentized remedies each corresponding to different parts of the disease. In the potentized state the medicines thus mixed would be incapable of chemical reactions, but would each act separately in its own spheres. Dr. Boenninghausen approved of the idea and Hahnemann was induced to present the matter to the meeting of the Central Society in 1833. Hahnemann was persuaded that this would probably lead to the polypharmacy of the old school, and he decided to exclude this doctrine from the new edition of the 'Organon'."
Although Bradford highlighted the political aspects, Hahnemann's letter to the Baron in October confirms that the failure of his double remedy trial was a major factor in the withdrawal of his support at the meeting. Every commentary notes that Hahnemann was not very enthusiastic about the double remedies although at first he hoped they might have some use. All present at the meeting unanimously agreed that the passage in the 5th Organon would be removed allowing the Founder to dismiss the subject. The failed double remedy experiments became a political liability to young homoeopathy.
One month later, Hufeland was given a copy of the passage on the double remedies from the printer calling for quick action by the homoeopaths. The passage on the limited role of the double remedies was replaced with a strong caution in which the Founder called the trials a 'hazardous experiment'. Was this because Hahnemann noticed side effects after 5 months of clinical observation? Vide aphorism 272 of the 5th Organon.
"In no case is it requisite to administer more than ONE SIMPLE medicinal substance at one time. 2 (a)
2 (a) Some homoepathists have made the experiment, in cases where they deemed one remedy homoeopathically suitable for one portion of the symptoms of a case of disease, and a second for another portion, of administering both remedies at the same time; but I earnestly deprecate such a hazardous experiment, which can never be necessary, though it sometimes may be of use."
This footnote expresses the same thoughts Hahnemann wrote in his letter to the Baron in October 1833. He did not wish to say that Aegidi and Boenninghausen never got "any results" but the experiments convinced him that the single remedy was superior. He also realized that there were inherent hazards in a double remedy so he advised against the method. There was also the concerned that those who used the double remedies would never learn how to use a single remedy correctly. It would become a self-defeating process in homoeopathic education. For these reasons all reference to the double remedies were removed and the aphorisms on the single remedy was strengthened further in aphorism 273 of the 6th Organon.
"In no case of cure is it necessary to employ more than a SINGLE SIMPLE medicinal substance at one time with a patient. FOR THIS REASON ALONE, it is INADMISSIBLE TO DO SO. It is inconceivable that there could be the slightest doubt about whether it is more in accordance with nature and more reasonable to prescribe only a SINGLE SIMPLE, well know medicinal substance at one time in a disease or a mixture of several different ones. In homoeopathy-the only true and simple, the only natural medical art-it is absolutely prohibited to administer to the patient, AT ONE TIME, two different medicinal substances."
Hahnemann further points out in aphorism 274 that there are two major reasons why the single remedy is far superior to polypharmacy. The first is that even with proven single remedies it is impossible to "predicted HOW two or more medicinal substances might hinder or alter each other actions on the human body". The second point is that a single proven remedy offers therapeutic knowledge through cured cases as well as knowledge of the accessory symptoms brought out by improper use. Provings, clinical confirmations, and knowledge of side actions are three essential aspects of materia medica. What Hahnemann learned from his failed double remedy trial in 1833 is that the mixing of homoeopathic remedies makes it is impossible to predict, analyze, or understand their actions in human beings.
The information found in the materia medica under the single proving of a remedy is not valid when the medicines are combined. How can one predict the actions of two or more medicines at the same time in differing individuals and conditions? How can one tell which one is producing side-actions and accessory symptoms from one that is producing a similar aggravation? How do you know which of these medicines might be truly useful and which one might be causing difficulties? This is exactly why the maxim of the single remedy is so essential for knowledge of remedial powers and proper case management procedures. There is no scientific way to predict or regulate the remedial powers of potentized polypharmacy because it is the same old allopathy in new age bottles.
Many have pointed to the radical nature of the Paris epoch but the most controversial experiment took place before the publishing of the 5th Organon while Hahnemann was living as a widower in Coethen. In 1837 he mostly used the 30c but by 1843 he administered the 50c, 100c, 150c, and 200c and tested the 1M. He also utilized a full range of the complementary LM remedies in potencies from 0/1 to 0/30. This new dual high potency pharmacy had an immediate effect on Hahnemann's case management strategies. As the Paris casebooks reach their conclusion the Founder again becomes more conservative as he found a more perfect method. The records of this last period correspond very well to the eyewitness account of faithful Doctor Croserio, who practiced with Melanie after Samuel's death. The 6th Organon is the Founder's last testament and a guidebook to the medicine of the future.
A New Beginning
After the death of his first wife, Samuel continued his practice of medicine at Coethen where he wrote the 5th edition of the Organon. Although he was still in good health, he decided that he was going to retire from his active practice and remove himself from day to day involvement with homeopathy. In the year 1835 a French woman named Mademoiselle Melanie D' Hervilly, who was destined to become his second wife, closest confidante, and apprentice, visited the Founder. She was well known among Parisians as a philanthropist, poetess, artist, and feminist, and she had been interested in the healing arts since her youth. She called on the doctor for the treatment of an ailment, and even though she was half his age, they instantly found themselves falling in love.
The marriage of Melanie and Samuel took place quietly on January 18th, 1835. It was a great surprise to most of his close friends, as they were not informed of the wedding, and the couple soon left for Paris. He wrote Hering that his new wife made him feel like a "younger man again", and that he had taken up a new life. Melanie learned the healing arts at his side and became the first in a long line of female homeopathic doctors. So instead of the old doctor retiring, they built a very large practice in Paris. It wasn't long before Samuel began a new series of experiments in posology and pharmacy. We are grateful to Melanie for opening a new chapter of the old Master's life and inspiring him to reach new heights.
Hahnemann was not completely satisfied with the medicinal solutions of 30c potencies, especially in the treatment of the chronic miasms and complex degenerative diseases. He had given his blessings to the high potency movement in the 5th edition, but he was raising his own potencies very slowly. It was in 1839 that he began to routinely administer the 200c in the clinic. In certain cases he found that the lower potencies were too weak, yet at the same time, the higher potencies caused strong aggravations. He wondered if it was possible to make a remedy that acted deeply but was gentler on the constitution. Even though the medicinal solutions had greatly improved the centesimal potency system, he still wondered how he could overcome aggravations in those cases that were weak, over sensitive, and at present incurable.
The Founder would ponder these problems, as he was not yet satisfied with his methodology. If a low potency is too weak to act, and a high potency only aggravates, what are we supposed to do? How can we acquire the advantages of both a low and high potency in one remedy? Surely, the answer to this question did not lay in raising the centesimals to ever higher and higher degrees. He had tested Jenichen's high potencies but they were not suitable in chronic pathology in those with weakened vitality. It was his greatest desire to cure these complex diseases in those with an injured vital force. The only thing the old master could do was to begin a new series of experiments even though he was in his eighties!
An 1837 Case from Hahnemann's Paris Journals
Most of the symptoms of the Paris casebooks are recorded in Melanie's handwriting although Samuel wrote the prescriptions and repertory insertions. The following case is from the same year that he introduced the split-dose of the medicinal solution in the Paris edition of the Chronic Diseases. His client was *Duke Valmy, who was unmarried, and was 35 years old. Valmy's case history is suggestive of venereal miasms, suppression, and Mercury poisoning. He visited the good doctor complaining of throat pain, loose teeth, bleeding, pus of the gums, ulcers, and apthae.
These symptoms began after taking a sea journey at the age of 25. His throat pains were treated with bleeding by leeches. Fourteen days before his visit he suffered a relapse of the pain but it passed off naturally. He was constipated and needed to take enemas of water to pass stool. For three years he suffered arthritic pains and edema of the left knee that was < worse when fatigued by walking. He was also treated with Mercury for blood of the urethra although the date is not given. Complex diseases involving miasms, suppression, and drug poisoning are the most difficult to cure.
*Samuel Hahnemann, Krankenjournal, DF-5, 1837-1842, Karl F. Haug Verlag, Heidelberg, Germany, lower page number, 521. Research on the French documents by David and Jill Little and Gamberra who also compared it with the German translation.
In the 1st edition of The Chronic Diseases (1828) the Founder wrote that the treatment of the venereal miasms by allopathic Mercury often causes a flare-up of latent Psora producing an obstructive layer. For this reason he used Sulphur, and other anti psoric remedies in many of his suppressed VD cases. By removing the Psora, and the suppression, the VD would then surface unmasked. The Paris casebooks are full of patients with infectious Itch miasm, sycosis, syphilis, and tuberculosis mistreated by the crudest allopathy imaginable. Gay Pari was reeling under the influence of many acute and chronic miasms as well as faulty medical practice. The following is Hahnemann's July 26th prescription.
Sulphur, 1 pill, 30c, in 500 drops of mixture.
1 drop in 6 tablespoons of water
Take one tablespoon every morning.
This is an example of a miniature solution made with 1 pill in 500 drops of 50% brandy and water. After succussing this bottle he placed 1 drop of solution into 6 tablespoons of water in a glass. The water in the glass was then stirred and 1 tablespoon was given to the client as a dose. This technique is called a split dose instead of a multiple dose because it only uses 1 pill to make an aqueous solution that is then 'split' over several days, weeks, or months. In this way, it is possible to take "1 pill many times". This keeps the amount of the dose very small allowing for the repetition of the remedy to speed the cure if and when necessary. He referred to this method in the Paris 1837 edition of The Chronic Diseases.
In the year 1837 Hahnemann was still facing several limitations in his therapeutic system, especially in cases like Duke de Valmy. At this time the Founder was working with around 100 remedies in 30c. Although he spoke of potencies above 30c in the 5th Organon, in 1837 he mostly used 60c, 30c, 24c, 18c, 12c, and 6c. It is only in 1839 that his journals show him regularly administering the 198c, 199c, or 200c. By 1840 we find him using a full range of C potencies [6c-200c] side by side with his new LM potencies 1/0 to 0/30. The increased remedial powers of the high potency C and LM potency were critical to the development of the complete homoeopathic paradigm.
On September 12th, Valmy was aggravated Sulphur 24c in 15 tablespoons of water and given placebo, but he misunderstood the instructions, and continued to take the remedy also. When returning on September 20, Hahnemann gave him Sulphur in alternation with a placebo by the symptoms, and on October 23 he gave a series of placebos without Sulphur. Valmey's second prescription was given after three months of interspersing placebos with Sulphur in various combinations. In this case the good doctor used both the small dropper bottle dose and the larger tablespoon solution.
The Second Prescription
On October 28th, 1837 the case journals noted that Valmy has apthae inside the lip again, bleeding gums, but no pain in the knee, shoulder, or chest muscles. The spots itching on the chest had changed to white discolorations and there were no rushes of blood to the head when getting up. Valmy's case demonstrates chronic miasms, suppression, and Mercury poisoning. At this time, Hahnemann makes his second prescription, and changes his remedy to Cinnabaris, the red sulfate of Mercury, a well known anti syphilitic remedy.
RX Cinnabaris, 30c 1 pill in 15 tablespoons with 1 spirit,
1 tablespoon in a glass of water to take 1, 2, 3 increasing small spoons.
In this prescription Hahnemann uses a standard sized medicinal solution that is made in 7 to 15 tablespoons of water [3 1/2 to 7 ounces] with spirits as a preservative. After succussing the remedy bottle, 1 tablespoon was stirred into a glass of water, and 1, 2, 3, or increasingly more teaspoons were given until reaction was attained. This method of using a dilution glass was first published in the 6th edition of the Organon, which introduced the LM potency. This case shows that he administered his C potencies exactly like his LM potencies for his last 5 years.
The Founder used the 30c, 24c, 18c, and 6c in their descending order through out his entire career. It is only in the 1840's that we find him raising the potency from 198c to 199c to 200c and using the LM 0/1, 0/2, 0/3 in the ascending order. Nevertheless, he still seemed to favor progressively lowering the degree of his lower potencies 30c to 6c. This opens the C potency scale to an upward or downward movement depending on whether one is using the high or low potencies. The Cinnabaris prescription began a series of remedies that started on October 28, 1837 and continued to March 27, 1838. In the last entry Valmy was much better then when he came.
In the 1839-1840 Paris case journals we find the appearance of new notations for potencies that are little understood to this day. After the publication of the 1837 edition of the Chronic Diseases, Samuel began a series of pharmacy experiments in which he was searching for a new potency system to complement the centesimals. Reverend Everest, who was a close confidante of his last experimental works, witnessed many of these trials. On July 30, 1853 a letter was published in the Times that Reverend Everest's wrote to Dr. Luthur in which he describes these experiments in detail. We have included most of the letter as we think it is enlightening as well as of great historical significance.
"Hahnemann endeavored to find means to administer remedies in such a way that the least possible disturbances compatible with cure should result. To this end he made a great variety of experiments. The first in order was olfaction, and this he adopted in certain cases to the end of his life, I am not aware that he altogether abandoned it. But certain objections caused him to seek for some other means of moderating medicinal action. His next experiment was to dissolve three. two, or one globule in a glass of water, and then, after carefully stirring, to put a dessert or teaspoonful of this into another glass."
First the Founder tested olfaction of the remedy rather then the dry dose, and then he began to makes medicinal solutions in a glass with 1, 2, or 3, pills, and then stirring tablespoons in another dilution glass. These methods date from the early 1830's.
"He still found, however, that in very delicate constitutions too much excitement was produced even thus, when the medicine was accurately chosen; for if a medicine is not exactly harmonic to the case, its effects are, of course, much less, inasmuch as in that case it acts on a part of the organism not morbifically excited; and this remark will explain why so many practicers of modern or "improve Homeopathy" experience so few cases of aggravation, that is because they give medicines at random, and so do not touch the disturbed nerves at all. The attenuation was sometimes carried through two, three, four, five, and six tumblers; but it was a very inconvenient proceeding, and it had none of the simplicity, which Nature's laws generally have. He tried, in its order, the diminution of the number of shakes, but that seemed not to give the accurate result that he wanted."
Here we can see that Hahnemann is trying to find a method to overcome the aggravations caused by his high potencies through diluting the remedy in two or more glasses by stirring. In the extremely sensitive he would gently stir the remedy through a series of glasses. This method is included in the 6th edition of the Organon for adjusting the dose for hypersensitive constitutions.
The Reverend continues:
"He tried many plans and made many experiments with one or two of which I am acquainted and others I have forgotten, if ever I heard them. At last, however, and the one that gave the most satisfactory results (I believe I may say that he was perfectly satisfied with them) was the plan I now explain.
Starting from the first spirituous tincture of any medicine which I believe was the third from the commencement (3c), and is, according to the ordinary notation, written I, instead of adding one drop of this dymanization to one hundred drops of spirit of wine to make the next, and so continuing the dynamization by drops he moistened a few globules of a fixed normal size with it, and taking in the first experiment, I believe, ten but in the latter and more satisfactory ones only one globule of those so moistened he dissolved that in a minute drop of water, and then added one hundred drops of spirit of wine, Having shaken it (I forget how much) he moistened globules with this, and having dried them. put them into a tube in his medicine chest, well corked; these he labeled 0/1. The next dynamization was procured by dissolving one globule of 0/1 in a small drop of water, and adding one hundred drops of spirit of wine; with this he humected globules as before and called that dynamization 0/2."
This quote offers many clues to the transition potencies witnessed between 1839 and 1840. Hahnemann had two favorite new potencies, one of which was marked 0/1, and the other is marked 00/1. The 00/1 potency may have been made with 2 pellets at every degree instead of the 1 pellet as in the LM potency. Our eyewitness has forgotten one stage of the LM potency process, i.e. the 3c is mixed with 500 drops of dilute. Then one drop is mixed with 100 drops to make LM 0/1. Please refer to the 6th Organon for the complete details.
After many trials and tribulations Hahnemann discovered the 1/50.000 dilution rate in 1840, and created the new LM pharmacy. He had decided that raising the dilution ratio to the LM scale increased the therapeutic range of homoeopathy more then just continuing to raise the potencies of the centesimals. The Hofrath wrote:
"This method of dynamization, I have found after many laborious experiments and counter-experiment, to be the most powerful and at the same time (the) mildest in action, as the material part of the medicine is lessened with each dynamization 50,000 times and yet incredibly increased in power."
The introduction of the LM potency was Hahnemann's last great gift to homeopathy and was the fruit of his 50 years of research. With this higher dilution ratio he found the means to break the impasse in treating many of his incurable patients. The 1/50,000 dilution ratio was to complement the 1/100 ratio, as they both possess their own unique remedial qualities. At last, the old doctor was satisfied that he had found his "most perfected method' and had come closer to his goal of a rapid, gentle and permanent cure.
Reverend Everest said that Hahnemann "was so entirely satisfied with the gentle and kindly action of these preparations that they would, I think, almost have superseded with him all other preparations". He called the new preparations medicamens au globule (medicine of the globules, the one pill being noted by the 0) to distinguish them from the centesimal potencies which were marked with a small x, which were called medicamens a la goultte (medicines of the drop)".
The Centesimal potencies are usually applied by Kent's theory of harmonics in which the potency is raised from lower to the higher in 7 radical jumps. For example, if one begins a case at 30c, and then observes a relapse, one would give the 200c. If the patient relapses again one gives the 1M, followed by the 10M, 50M, CM, and MM, if necessary. In the LM system, the homeopath uses a series of gradually ascending potencies that starts at the LM1, and continues gradually upward though LM 0/2, LM0/3, LM0/44, LM0/5, LM0/6 up to LM 0/30 in a gently ascending arc. The difference in their dilution rates and potency scales makes their remedial actions complementary opposites.
The C and LM potencies are used exclusively in the medicinal solution in Hahnemann's final Gestalt. The average medicinal solution is made in a minimum of 7 tablespoons of water [3-1/2 oz]. This aqueous solution is then succussed 1 to 12 times just prior to the administration of the dose. After this 1, 2, 3, or increasingly more teaspoons are stirred into a dilution glass of water. From this glass 1, 2, or 3 teaspoons is the average adult dose. This dose may be tuned by adjusting the number of succussions and the amount of the solution to the individual's constitutional sensitivity. This transforms the static dry dose into a dynamic solution of which the patient never receives the same dose or potency twice. This remedy can be given as a single or split-dose depending on the circumstances. This work is the Founder's last great gift to suffering humanity and became the foundation for the 6th Organon of the Healing Art.
The Homoeopathy of the 1840s
The sixth edition of the Organon was completed in 1842 when Hahnemann was 87 years old and is the fruit of his life long experiments. On February 20th, 1842 he wrote a letter to Baron von Boenninghausen to announce the completion of his new work.
"I have now, after 18 months of work finished the sixth edition of my Organon, the most nearly perfect of all."
Hahnemann planned for the printing of this final work, but unfortunately, problems arose with his publishers. For this reason, the 6th edition was not published before he died on July 2nd, 1843. It would take more than 80 years before his masterpiece was rescued from obscurity and presented to the homoeopathic community. It is recorded on page 74 of Boenninghausen's Lesser Writings that Hahnemann had shared the new LM potency with the Baron.
"In the new edition of the Organon, improved and completed by Hahnemann himself, a new simplified procedure for the potentizing of medicine will be taught, which has considerable advantages over the former and yields a preparation as to the efficiency of which I can, from my own experience, give full praise."
Boenninghausen's contribution to homeopathy is vast as he gave us the first complete homeopathic repertories and the relationship of remedies. That the Baron's stated that he was speaking from his "own experience" shows that he had tested the LM remedies. He considered them to have a medicinal power similar to the higher potency Cs rather then a low potency. Hahnemann's low potencies were 30c, 24c, 18c, 12c, 6c and 3c. His high potency range ran from 50c to 200c [tested 1M] and LM 0/1-0/30. He often alternated a placebo with his remedies at various intervals, or followed a series of doses with placebos. The idea that he used the daily dose for weeks, months, or years in Paris is a complete myth.
The 10 years between the writing of the 5th and 6th Organon were the most productive of Samuel Hahnemann's long career. The homeopathy of the 1840's is based on the use of the C and LM remedies in medicinal solution and the repetition of the split dose, when necessary. One of his first LM cases was started in 1840 with Sulphur 0/10 causing a strong aggravation that was treated with placebos for some time. In the beginning, he tried to move downward from 0/10, 0/9, 0/8 as he had done with his lower potency Cs. He soon found that the new LM remedies were high potencies and then changed to starting in the lowest degrees like 0/1, 0/2, 0/3, and then moving upward through the scale. By the year 1843 he began most of his LM cases between 0/1 and 0/3, although occasionally he would start at 0/4, 0/5, 0/6, etc., depending on the circumstances.
The following is a redaction of a Paris case dated January 14th, 1843, just six months before Hahnemann left for his Heavenly Abode. On this client he used the C and LM potencies in medicinal solution at different times in the case. This example was sent by letter to Boenninghausen and is recorded on page 192 of the Baron's Lesser Writings.
"O-t, an actor, 33 years old, married. 14 January, 1843. For several years he had been frequently subject to sore throats as also now for a month past. The previous sore throat had lasted six weeks. On swallowing his saliva, a pricking sensation, feeling of contraction and excoriation. When he does not have the sore throat he suffers from a pressure in the anus, with violent excoriated pains, the anus is then inflamed swollen and constricted; it is only with great effort that he can pass his stool, then the swollen hemorrhoidal vessels protrude."
On January 15th Hahnemann gave 1 pill of Belladonna 30c in a 7-tablespoon medicinal solution that was succussed just prior to administration. One tablespoon was then taken and stirred in a glass of water. The exact number of succussions and the dosage given to the patient is not noted. By the next day, the sore throat was gone, but the old rectal affection had resurfaced as an anal fissure. Under questioning the actor confessed that he had contracted syphilis eight years earlier that was treated with caustics. This confirmed that the doctor was treating a case of active secondary syphilis. He then administered Belladonna's anti syphilitic complement Merc. Viv. LM0/1.
"Merc. Viv. one globule of the lowest new dynamization. (which contains a vastly smaller amount of matter than the usual kind), prepared in the same manner, and to be taken in the same as the Belladonna (the bottle being shaken each time), one spoonful in a tumblerful of water well stirred."
The Founder then repeated the dose of Merc LM0/1 and LM0/2 until January 30th when the throat became inflamed again. He then used a placebo for seven days until February 7th. By then the anus was better but the sore throat was still lingering. He then realized that Psora was interfering with his anti-syphilitic remedy as he warned about such things in the Chronic Diseases. Hahnemann then used his cardinal anti psoric remedy, Sulphur in LM0/2 as a chronic intercurrent, and repeated the dose until February 13th.
During this period the client developed clear Mercury symptoms like ulcerative pains in the throat and profuse saliva, so on Feburary 13th he was again given Merc. Viv., LM 0/2. The Sulphur had removed the obstructive layer of Psora and suppression allowing the syphilitic symptoms to surface. By the 20th the sore throat was completely gone and the anus once again became inflamed and hemorrhoidal. The Founder now used placebo for 13 days! Hahnemann favored the alternate day over the daily dose and often interpolated placebos with his remedies. His case journals put an end to the myth that he used the daily dose for weeks, months and years on end.
On the 3rd of March the sore throat was gone, but the patient experienced blind piles that protruded at stool, but the pains were much better. Hahnemann then prescribed Nitric Acid by olfaction [potency unknown]. The patient was given milk sugar in medicinal solution as a placebo to keep him under control. According to the Founder 's notes, " He remained perfectly cured". After first giving Belladonna 30c as an acute remedy, Hahnemann used 3 anti-miasmatic remedies in 3 months, Merc viv., Sulphur, and Nitric Acid.
A letter of Dr. Croserio's, Hahnemann's close colleague in his 3 last years, states that he never saw Hahnemann alternate remedies. If one investigates the Paris case journals very closely an occasional alternation is noted under special circumstances. In the LM period [1840-1843] such prescriptions are indeed so rare that Croserio did no even noticed them in his visits. One interesting example of alternation is the case of *Madam Gardy, 44 years old, who was seen on April 18, 1842.
Madam Gardy suffered from womb problems since a childbirth 19 years prior that was treated with a variety of suppressive treatments. This complex chronic state was then complicated by a crisis caused by cerebral fevers. Hahnemann began this case with an alternation of Aconite 30c and Sulphur LM 0/5 in medicinal solution. The case improved radically and the crisis was overcome. We note these unusual cases in which he used alternations, or an intercurrent remedy to complement his constitutional treatment. This is an alternation of two remedies as well as the C and LM potency systems. In this way, any promising techniques may be tested in clinical trials and updated if found effective.
*A case from the author's collection of microfiches obtained from the Robert Bosch Institute, Germany.
The higher and highest potencies (200c, 1M, 10M, and above) must be used with great caution in cases where there are special sensitivities or too much tissue pathology. Therefore, in many serious diseases there is very little leeway in the choice of potency. Sometimes the lower C potencies are not deep enough to cure while the higher C potencies only produce unproductive aggravations. This is one of the times the LM potency may be a lifesaver. When the C potencies are used in the split-dose of the medicinal solutions they act more like the LM potencies yet each pharmaceutical method retains its individual character.
It may be noted in the Paris casebooks that Hahnemann used his Cs in crisis and acute conditions, and his LMs for chronic degenerative disorders and chronic miasms. This tendency, however, was neither absolute nor exclusive as he sometimes used the Cs in chronic cases, and the LM in acutes. The C and LM potencies in medicinal solution greatly expanded the therapeutic horizons of classical homoeopathy when compared with the 4th Organon techniques and the dry dose.
Samuel Hahnemann worked for 50 years to perfect his new healing art. The final definitive years were 1840 to 1843, the epoch around the creation of the 6th Organon. Unfortunately, the Paris period is being misrepresented by a number of so-called reformers of our healing art. They speak as if the Paris casebooks contain some new revelation that sweeps away the cardinal principles of homoeopathy. They use polypharmacy terms like "dual remedies" and "combinations" to describe the Founder's use of alternation and a series of remedies. "Hahnemann, Hahnemann, Hahnemann" they cry while in truth they use too many remedies or mixtures chosen by so-called causations or disease names. This has confused new students as well as old practitioners that are only familiar with the methods of the 4th Organon. Their hubris knows no bounds.
The 1840-1843 Paris casebooks, and the 6th edition of the Organon of the Healing Art, contain the seeds of the best of contemporary homoeopathy, and much more. Those trained in the 4th Organon and the wait and watch method are the best prepared to test the hypothesis of the Paris methods in the clinic. Without this solid foundation in homoeopathy it is almost impossible to understand the sophisticated posology techniques, and case management procedures of the 1840's. Why allow our heritage to be misrepresented and abused by the pretenders? Hahnemann's advanced methods require more knowledge of classical methods not less. Homoeopaths, Dare to know!