Making a Medicinal Solution
In the 6th Organon Hahnemann mentions making an aqueous solution of the LM potency in 40, 30, 20, 15, or 8 tablespoons of water. The amount of solution most commonly used by Hahnemann was 7 to 8 tablespoons of water (around 31/2 to 4 oz. of fluid) including a sufficient amount of pure alcohol or brandy as a preservative. We have found it necessary to add 2 or more oz. of brandy to the solution if it is needed over a long period of time. For patients with more sensitive constitutions the medicinal action can be attenuated by increasing the amount of water in the medicinal solution. This is when the remedy solution may be made with 12, 15, 20, or more tablespoons of pure water depending on the sensitivity of the patient.
Persons who are hypersensitive respond better to a medicinal solution made with a larger quantity of water and the single dose or infrequent repetitions of the remedy. The homoeopathic pellets are viewed as quantum forces that can impregnate large amounts of water with their medicinal energy. With the medicinal solution we use the smallest amount of medicine possible, i.e. one poppy seed size pill. Once in a great while the homeopath may need two pills in a remedy solution to treat a patient with a hyposensitive constitution . The size of the dose is directly linked to the phenomena of the homoeopathic aggravation just as much as the potency. A fundamental reason for using the medicinal solution is to make it easier to adjust the dose of the remedy to fit the sensitivity of the constitution.
The second aspect of adjusting the dose is the number of succussions given to the remedy just prior to ingestion. The succussion of the aqueous alcoholic solution against a glass surface of a bottle produces large amounts of kinetic energy and frictional electricity. This raises the potency of the remedy solution in a manner that is impossible when using a dry dose. This dynamic alteration of the solution by succussions changes the remedy level so that the vital force is always offered something new. The power of the medicinal solution depends on three factors, the number of pills used, the amount of water in the solution, and the number of succussions given before ingestion. The number of succussions is directly linked to the dynamic effect of the remedy at the time of ingestion.
In aphorism 248 Hahnemann mentions 8, 10 or 12 as the number of succussion given to the solution prior to ingestion. We have found over the years that the succussions are one of the most dynamic aspects of the "new method". In hypersensitive cases the number of succussions should be lowered to 1, 2 or 3, if necessary. In the ultra hypersensitive constitutions we have used as little as 1 succussion at times. The average sensitivity utilizes anywhere between 4, 5, 6 and 7 succussions very well. Those constitutions that are somewhat hyposensitive may need as many as 8, 9, 10, 12 or more succussions to react well. We have found in cases where a remedy seems to no longer hold, that an increase of the number of succussions will start the case moving forward again. This aspect of adjusting the dose allows for the fine turning of the medicinal powers so that it is harmonious to a wide variety of constitutions and situations.
A Case History
An individual suffering from Myasthenia gravis consulted me after seeing the best allopathic specialists. This disease is characterized by muscular weakness which especially affects the ocular and bulbar muscles as well as other muscles. This person was manifesting the ocular symptoms of the disease quite strongly. He suffered with great ptosis (drooping of the eye lids) and paralysis of the muscles that move the eyes. There was also a certain amount of diplopia (double vision). This gentleman could not look upward and he had to lean his head back to be able to see straight ahead. His condition was getting worse, especially when he was under stress and strain.
After I took his symptoms I decided on Causticum as it appeared to resemble his case and it is keynoted for slow paralysis. As he seemed rather sensitive I began the case with a 6 oz. solution of the LM 0/1 potency and advised him to succuss the remedy 2 times before ingestion. From this bottle 1 teaspoon was then stirred into 6 oz. of water in a dilution glass. This first dose had an immediate effect that lasted for 4 days. During this period he could see very well and his eyelids no longer drooped. On the 5th day his symptoms began to relapse so he was advised to take the remedy every 4th day.
As the case progressed I tried to adjust the dose in an upward direction by increasing the number of succussions to 3 to see if the remedy would hold for a longer period of time. This caused him to see double for 24 hours and his eyes became puffy. After a few days the aggravation wore off and he improved for around 4 days before the remedy effect seemed to start wearing off. I returned to 2 succussions as 3 produced an aggravation without causing any increase in the length of the amelioration. Over time he has found that if he succussed the bottle too hard it makes his eyes a bit puffy for a day or two after he takes his dose. We also found through experimentation that 1 succussion did not produce much of an effect on his eyes. This individual's sensitivity is such that 1 succussion is too little, 2 succussions are just right, and 3 succussions are too much. This refined adjustment of the medicinal solution is necessary for his case to progress in a rapid and gentle fashion.
Over a period of time I have carefully raised the potency from LM 0/1 to LM 0/2 in such a manner that he has not been aggravated and has continued to improve. Such a gentle transition would be impossible with the dry dose of a centesimal potency raised from 30c to 200c or 1m. I hate to think of what a random number of pills of a high potency centesimal dropped under his tongue would do to him! This case of degenerative disease would be almost impossible to treat by the old 4th Organon 1829 method of Homoeopathy. Only the LM potency used in a medicinal solution is flexible enough to treat this individual. I have seen these things many times over the past decade. Those who think that it does not matter how you give your dose still have much to learn from Samuel Hahnemann.
Potencies and Repetition
LM potencies come in a graduated series from LM 0/1 to LM 0/30. This makes up 30 microtonal potency levels which allows for the fine tuning of the remedy. When using the LM remedies the case should be started from the "lowest degrees" of potency. Hahnemann’s Paris casebooks show that Hahnemann's opening potencies varied between LM 0/1 to LM 0/7 in most cases. The most common opening potencies are between LM 0/1 and LM 0/3. Most cases are started with LM 0/1 in a 4 to 6 oz. medicinal solution. Only under special conditions are cases started with LM 0/2 or LM 0/3, as these are progressively higher potencies. A constitution which is of normal sensitivity will always respond to the LM 0/1 potency if it is clearly indicated. LM potencies are given in a gradual serial progression from LM 0/1 to LM 0/2 to LM 0/3 to LM 0/4, etc.
Sometimes Hahnemann moved up and down the potency levels to try and find the most harmonic potency. After this he generally moved upward by 1 degree as the case progressed. There are no leaps between potencies like LM 0/1 to LM 0/16 to LM 0/30 in this system. The potency is raised for only two reasons: firstly, the bottle of the previous potency is completely consumed and there is a need to continue the remedy; Secondly, the client seems to relapse before the complete ingestion of the previous bottle, showing that they need a higher potency.
It is often said that the LM potency should be given daily in a mechanical fashion. This is a great mistake. In aphorism 246 Hahnemann says any "strikingly increasing progressive amelioration precludes any repetition of the remedy whatsoever [DL]." It is only in the more "slowly progressive improvements [DL]" that we need to repeat the remedy at suitable intervals to speed the cure. In the note to aphorism 246 Hahnemann says the LM remedies "may" be given daily "if necessary" not must be repeated daily in every case! In aphorism 248 Hahnemann says they may be given "daily or every other day" in long lasting diseases but the same if necessary applies. Do not misunderstand this point! When it is "not necessary" repeating LM remedies daily or every other day will either slow down the cure or cause unneeded aggravations.
The late, great, Dr. Hari Mohan Choudhury told me he made this mistake early in his career, but learned through experience, that the most important statement in the paragraphs dealing with repetition are the words "if necessary". If we do what is "not necessary" we slow down the cure, confuse the case, and overmedicate the patient. I also made this mistake in the early years of using LM potency as part of my personal lesson in "hubris". Always remember the four cardinal rules of Homeopathy: Similars cure similars, the single remedy, the minimal dose, and the potentized remedy. With these four golden rules in mind we cannot go far off the target of a rapid, gentle and permanent cure.
The Preparation of the Dose for LM Potencies
The size of the medicinal solution can be from 3 1/2 oz. to 20 oz. of water and alcohol solution depending on the sensitivity of the individual. The bottle which contains the medicinal solution is used by the patient to prepare their personal doses. The average size of the medicinal solution is between 4 oz. and 6 oz. of fluid. This solution consists of water mixed with 30% to 50% brandy, or a smaller amount of pure alcohol, as a preservative. The LM potency is always used in a medicinal solution with the addition of a dilution glass filled with 4 to 6 oz. of water. The medicinal solution bottle should be protected from sunlight, heat and strong odors.
The remedy is always succussed just prior to ingestion in order to slightly raise the potency. After the dosage glass has been used the remaining solution is thrown away and the glass and spoon are cleaned and placed in the sun. This two-fold process of succussing and diluting causes a considerable change in the dynamization of the remedy. As the succussing raises the potency, the dilution reduces the amount, thus allowing the remedy to work rapidly, gently and permanently.
The preparation of the medicinal solution may be summarized in four points.
1. Take 1 (very rarely 2) poppy seed size #10 pills of the desired potency (often starting at LM 0/1) and place it into a clean bottle. The average size of a medicinal solution is between 4 oz. and 6 oz. of fluid. Normally this watery solution includes at least 30 to 50% brandy, or a smaller amount of pure alcohol, as a preservative and stabilizer. I like to have at least 2 oz. of extra space in the bottle as an air gap so that there is room for succussions.
2. Succuss the bottle just prior to ingestion 1 to 12 times depending on the sensitivity of the patient. This slightly raises the potency and activates the remedy.
3. Take 1, or more rarely, 2 or 3 teaspoons of the medicinal solution and place it into 8 to 10 tablespoons of water in a dilution glass and stir it. Most cases are started with 1 teaspoon and the amount is increased only if necessary. In children the amount should be 1/2 teaspoon. Infants may only need 1/4 of a teaspoon.
4. Take 1, (or more rarely, 2 or 3) teaspoons from the dilution glass as a dose. Most cases are started with 1 teaspoon and the amount increased only if necessary. Children should be given 1/2 teaspoon. Infants should receive 1/4 or less of a teaspoon.
The dosage of the medicinal solution can be carefully adjusted to suit the sensitivity of the individual's constitution. This is why I have not given an exact size to the medicinal solution, nor the amount of the dose, and the number of succussions. The experience of the last decade has shown that the remedy bottle should be succussed between 1, 2, or 3 times for the hypersensitive types; 4, 5, 6, for the average sensitivity; and 8, 9, 10, or more, for the hyposensitive patients.
The average size of the dose is 1 teaspoon of the medicinal solution stirred into the water in the dosage glass. From this glass the patient takes 1, rarely 2 , teaspoons of the mixture. Sometimes it is necessary to slowly increase the number of teaspoons from the remedy bottle to get a favorable reaction. Those who are relatively more hyposensitive may need 2 or 3 teaspoons to get an adequate response.
Normally, I start with 1 teaspoon and only increase the amount when necessary. With the ultra hyper-sensitive patients one teaspoon from the first glass can be stirred into a second glass of water. From this second dilution glass one teaspoon is then given to the patient. This can be carried on through a series of several dilution glasses, if necessary. The patient then takes a teaspoon of solution from the last dilution glass as a dose. This has been used in the most sensitive types with great success.