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This open e-mail by David Little on Minutus group very nicely stresses the importance of taking LM potencies in a right way and avoid overdoing it by unnecessary and often harmful repitition of the remedy.

Date: Mon, 17 May 2004 15:56:15 +0530

From: David Little <little@simillimum.com>

Subject: The LM Potency 1

Dear Colleagues,

There are many who say that Hahnemann gave his patients the LM potency daily. There are even pharmacies that are suggesting that the LM potency should be given daily in there informations packages. Too many persons are telling their patients to take the LM potency daily for 1 month before returning for a follow up. Is this the way Hahnemann prescribed the LM potency? I have personally studied 100s of Hahnemann's cases in the microfiches of the Paris casebooks and this is NOT the way the Founder practiced! The idea that Hahnemann gave the LM potency daily for weeks, months and years on end is a complete myth.

Hahnemann begins his discourse on using the LM potency in aphorism 246 and aphorism 248 of the 6th Organon. Aphorism 246 of the 6th edition is based on a synthesis of the ideas introduced in aphorisms 245 and 246 of the 5th edition with the addition of five conditions for speeding the cure. The first topic taken up is when a single dose of the LM potency produces a strikingly progressive and increasing improvement in the patient’s symptoms.  "During treatment, every noticeably progressing and conspicuously increasing improvement is a state which, as long as it persists, generally excludes any repetition of the medicine being used because all the good being produced by the medicine is still hastening towards completion. This is not seldom the case in acute diseases."

Organon of the Medical Art; S. Hahnemann (O’Reilly 6th Edition), Aphorism 246.

In first half of aphorism 246 Hahnemann speaks of a *noticeably progressive and conspicuously increasing improvement".Does he say to repeat the dose daily or on alternate days under these conditions? NO, he does not! He says that such a state, as long as it exists, excludes any repetition of the medicine. When a single dose, or a short series of doses, causes a strikingly progress increasing improvement the remedy should NOT be repeated. I have personally seen several single dose LM cures in acute and chronic diseases. I have also seen many cases where the patient only needed infrequent doses like every week, every fortnight, every month, or even longer to progress rapidly to cure. Those who give the LM daily will never see these fantastic cures because these are the very cases that are easy spoiled by rapid repetitions. Instead of a miracle cure these are often the cases that become extremely complex and confused by overmedication.

After speaking of strikingly increasing ameliorations in the first part of aphorism 246 Hahnemann goes on to speak about those protracted cases that do not improve on a single dose.

"On the other hand, with somewhat chronic diseases, there are, to be sure, *some cases that have slow, continuous improvement based on one dose of an aptly selected homeopathic medicine (taking 40, 50, 60, 100 days to complete the cure depending on the nature of the medicine) * but this is very seldom the case. Also, it must be a matter of great importance, to the physician as well as to the patient, to foreshorten this period, if possible, by half, three-quarters, indeed even more, in order that a far more rapid cure might be attained. The most recent and frequently repeated experiences have taught me that such rapid cures can be favorably carried out under the following conditions:

1.     Select with all circumspection, the aptly homeopathic medicine.

2.     Use a highly potentized [fifty-millesimal] dose, dissolved in water.

3.     Administer a properly small dose of this to the patient.

4.     Give a dose of the solution at intervals that experience has shown to be the most distinctly appropriate for the            best possible acceleration of the treatment.

5.    Prior to each administration of a dose of the solution, alter the degree of potency of the dose. It is very important      that the degree of potency of each dose deviate somewhat from the previous and subsequent ones. This is so that the life principle, whose tunement is to be altered to that of the similar medicinal disease, may never feel itself agitated to adverse counter-actions and enraged, as happens when repeated, unmodified doses are given, especially when such doses are rapidly repeated one after another.

Organon: of the Medical Art; S. Hahnemann (O’Reilly 6th Edition), Aphorism 246.

*Many individuals read the above paragraph but fail to note that Hahnemann makes a grand differentiation between two fundamentally different remedy reactions*. In the first part of aphorism 246 the Founder describes the remedy reaction as a “NOTICEABLY PROGRESSIVE AND CONSPICUOUSLY INCREASING IMPROVEMENT"  In the second section of aphorism 246 the Founder speaks of cases where the single dose only causes a  SLOW, CONTINUOUS IMPROVEMENT that may take 50, 60, or 100 days to show any significant amelioration. There is a vast difference between a rapid improvement where the patient feels better and better every day and a slow improvement where the patient barely notices any changes! It is ONLY for these slower moving cases that aphorism 246 suggests repeating the remedy suitable intervals speed the cure. This paragraph say say nothing about repeating the remedy daily and ask homeopaths to use there "experience" to choose the proper remedy schedule.

Hahnemann's statements about SLOW IMPROVEMENTS condition all the following remarks he made about using daily and alternate day doses in "protracted diseases" aphorism 248. If the patient is quickly getting better on a single dose, or infrequent repetition, suggestions about rapid repetitions do not apply. There are homœopaths who try to mechanically administer the LM potency daily for days, weeks and months on end to every patient. They have not yet understood the true essence of aphorism 246 nor its footnote. Hahnemann is suggesting the individualization of the treatment according to the time and circumstances.

In the footnote to aphorism 246 Hahnemann says that a well chosen remedy (not a poorly chosen one) may be given daily WHEN NECESSARY. When repetition of the remedy is not necessary the LM potency will cause strong aggravations, accessory symptoms, relapses and only slow down the cure. Over medication can make a patient overly hypersensitive to remedies or make their vital force non reactive due to over exposure. The same principles apply when using the C potency in a medicinal solution. From 1838 to 1843 Hahnemann gave his C and LM potency in medicinal solutions in the same manner.

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 when necessary in slow moving cases. The homoeopath does not need to speed the cure when it is already taking place in a rapid manner. Here one only needs to wait and watch the cure unfold. Hahnemann stated that when all five conditions are met the time of cure of *slowly improving cases* can be reduced to 1/2, 1/3 or less the time it takes with the single dry dose.  To do this the homeopath must met the following five conditions.

1. The first condition for repeating the dose to speed the cure is the selection of a good simillimum! How can one know if they have the correct remedy if one doesn't test it with a single dose or short series of test doses first? If we don't test the dose first how to we know if there will be a strikingly increasing response to the single dose or short test series? I normally give a single dose first and then wait and watch to see what happens. If there is a strikingly increasing amelioration I do not repeat the dose as longs as this rapid improvement lasts. If there is no change or only slow improvement on a single dose I use my experience to individualize a test series of doses at intervals that seem suitable for the patient and their condition. Then I act accordingly.
2. Use a properly potentized remedy. Ms. O' Reilly has written the [fifty-millesimal] in brackets but it is not in the German text. Hahnemann used the exact same method with the C and LM potency from 1838 to 1843.
3. Administer the proper small sized dose. Here he means the amount of the remedy, i.e. 1 or 2 small poppy seed size pills in a minimum of a 7 tablespoon medicinal solution with the addition of the dilution glass of 8 to 10 tablespoons. When the dose is too large it is very difficult to repeat the dose without producing aggravations, accessory symptoms and antagonistic secondary reactions of the vital force. When Hahnemann is speaking of the proper small size dose he is NOT speaking of the infinitesimal amount of medicine found in a potentized medicine. He already spoke of the potency factor in condition 2. The idea that the size of the dose makes no difference in the action of a remedy was the mistaken idea of James Kent. I respect Kent for all his good work but he had this one wrong.
4. Repeat the *split-dose* of the medicinal solution at the proper intervals to speed the cure of slow moving cases. These repetition must be individualized according to one's experience. These repetitions could be daily, alternate days, every third day, every fourth day, once a week, etc.
5. The medicinal solution should be sucussed just prior to administration so that the vital force never receives the same exact potency twice in succession. This also helps to prevent the antagonistic counter actions of the vital force sometimes witness with the repetition of the dry dose. The small dose and succussing the solution are very important as they make the remedy more acceptable to the vital force

Once all these five conditions are met it is possible to speed the cure of protracted cases that only slowly improve on a single dose or a short series of three doses. In this way, the Hahnemann advanced 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 Paris. In Hahnemann’s Doses of Medicine in The Lesser Writings, Croserio said that Hahnemann would "diminish the dose or stop the medicine" as soon as he observed medicinal action. He also noted that Hahnemann often gave single dose of olfactions followed by at least one week of placebos. Single dose olfactions are very common in the Paris casebooks right up Hahnemann's death in 1843. In my review of the microfiches of the Paris casebooks I found that the Founder often stopped his medicines, gave placebos, and waited and watched for one or two weeks. In some cases he even waited even longer before giving a remedy again.

THE PARIS CASEBOOKS SHOW THAT HAHNEMANN TENDED TO GIVE SINGLE DOSE OLFACTIONS FOLLOWED BY PLACEBOS OR A SHORT SERIES OF DOSES OF THE ORAL SOLUTION INTERSPERSED WITH OR FOLLOWED BY PLACEBOS. The most common "alteration" and "second remedy" Hahnemann used was a placebo. In theChronic Diseases he wrote "I considered the sugar of milk thus used an invaluable gift of God." The placebo was Hahnemann's "secret simillimum" which he used to "please" the patient and control the case.  Hahnemann saw most of his patients at least every week or two and constantly alternated between medicinal doses and placebos.

Hahnemann often gave a series of doses for one or two weeks and then he gave a series of placebos and waited and watched for some time. I could not find one case in the Paris casebooks where Hahnemann gave the LM potency daily for weeks, months and years!  Hahnemann used almost as much placebo as medicine. This is a fact that is not explained in the 6th Organon. When this omission is combined with a superficial reading of aphorism 246 and 248 the outcome is over medication on a grand scale. This is a grand mistake. Hahnemann individualized all his treatments and adjusted his remedy schedules to suit the time and circumstances. These are the historical facts.

There is a tendency for individuals to fall into extremes in posology. On the one hand there are those who always give the single dose and wait and watch even if the patient is only slowly improving and those who are repeating the remedy daily no matter what the reaction. Hahnemann's advanced methods are a perfect balance between knowing how to wait and watch during a strikingly increasing improvement and when to act and observe by repeating the remedy at suitable intervals to speed the cure of a slow moving case. This is the middle path that transcends the extremes of the exclusive single dose and the mechanical repetition of remedies. Individualization provides the best of both worlds. I would recommend that those using the C and LM potency in medicinal solution experiment in the proper manner and let the results speak for themselves.

Similia Minimus

Sincerely, David Little.