Prescribing on the basis of Potency, Repetition and Placebo

Homoeopathy is the outcome of a genuine desire to cure human sufferings gently, quickly and permanently based on rational principles. Dr. Hahnemann found out the truth about "Sickness of the individual", "What is to be cured?", "Law of cure: Known as Similia Similibus Curenter", "Vital dynamis: The natural power of healing which is now known as power of resistance", "Chronic miasms which form obstruction to cure", and "How to select the Simillimum which enables to restore the vital disorder". All these discoveries, problems and their solutions are provided in his great classics "The Organon of Medicine".

The discovery of "Medicinal power" through potentization is one of the greatest wonder of homoeopathy. Without this discovery, science and art of homoeopathy could not reach its present state of development. Dr. Hahnemann was able to demonstrate the development of hidden power in the potentized medicines which were considered to be inert in the crude form. Drugs like gold, silicea, lycopodium, platinum etc., which are considered inert by other system of medicines even today have been used effectively in highly potentized form by homoeopaths all over the world. This discovery was based on the findings that inert substances are coated above after potentization to 3rd Centesimal scale of potency become active and capable of influencing the vital dynamis of patients as well as the susceptible persons known as provers.

Dr. Hahnemann proved first Cinchona on himself in order to find out how it cures ague fever which was rampant in those days and it was the specific remedy used by most of the physicians of Europe. He also started giving crude forms of drugs in the beginning but later found out that similar drugs ion large doses produce harmful effects, hence, he started giving diluted drugs in water as dilution reduces the poisonous action of the drugs. Then he started successing the diluted drugs and found that successions raised the medicinal powers of the drugs.

Slowly and steadily, Dr. Hahnemann thus discovered the centesimal method and later on 50 centesimal method of potentization. The 5th edition of the Organon was published in 1833 in which he advocated the use of centesimal scale of potencies of homoeopathic drugs. It consisted of the following three main processes:

1. n case of drugs soluble in alcohol: One drop of mother tincture was diluted with 99 drops of alcohol to prepare 1st centesimal potency which is expressed as 1C. In case of drugs insoluble in alcohol: one grain of the drug is triturated with 99 grains of sugar o milk in morter with pestle.
2. 10 to 50 successions were advised for potentization in drugs dissolved in alcohol. In case of drugs triturated with sugar of milk, 10 to 20 minutes were taken to rub the drug each way to pulverize it till the powder becomes uniform. This method of pulverization is used in producing each higher potency from 1st centesimal potency.
3. For next higher potency 1 part of the drug is taken and is mixed with 99 parts of water or alcohol and successed 10 to 50 times to raise to the next centesimal potency.

In case of trituration of the drug for the net higher potency one part of the drug is rubbed with 99 part of sugar of milk, for 10 to 20 minutes so that it may become uniform and the next potency is stored separately with the label of next higher potency.

After 3rd centesimal potency all kinds of drugs can be raised to next higher potency in alcohol or water in the above mentioned manner as the non soluble drug also become soluble in water or alcohol.

Preparation of 50 millesimal scale of potencies

Around 1840 the preparation of potencies were modified again and the 50 millesimal scale of preparing the potencies was evolved about 3 to 4 yrs before the death of Dr. Hahnemann. The advantages of this new scale was provided by Hahnemann in his 6th edition of Organon are:

1. They are less liable to produce medicinal aggravations even in highly sensitive patients.
2. They can be repeated everyday in acute as well as chronic diseases raising the potency gradually according to the response of the medicine on the patient.
3. They have a milder, quicker and more permanent action than the centesimal scale of potencies.

For preparing the 50 millesimal scale of potencies 3C of the centesimal scale is taken as the mother tincture of the next higher potency. In one drop of this mother tincture add 500 drops of dilutent containing alcohol and water in the proportion of 1:4. Hence the strength of mother tincture 1/500000000 i.e. 50 millesimal potency.

The 6th edition of Organon was published by William Boericke in December 192, 80 yrs after the discovery of 50 millesimal scale of potencies. During this period homoeopaths were using centesimal scale of potencies which included all big names in homoeopathy like Herring and Kent who achieved marvelous results. Even now majority of homoeopaths throughout the world are using centesimal scale of potency.

Dr. Pierr Schmidt of Geneva, Dr. Kunzli & Charles Phaud of Lusanne and Dr. Raman Lal Patel from India were among the pioneers of homoeopathy who used 50 millesimal scale of potencies and published their results.

Decimal Scale of Potencies

This was introduces by Schussler who discovered Biochemic treatment on the basis of tissue remedies. While the organopathic drugs have affinity for the organs of the body, the tissue salts supply Biochemic deficiency which produces diseases. Unlike homoeopathic drugs they were not prove and selected on the basis of the Law of similars but were selected on the basis of experience of Schussler and other pioneers of biochemic system of therapy. Any deficiency in the organic salts must of necessity cause a disturbance in the organism i.e. cause organic matter to become nonfunctional and thrown out through the skin or some orifice or membrane of the body. If these organic or biochemic tissue salts are supplied in optimum doses the balance is restored and the patients recovers from his illness.

Dr. Schussler found the decimal scale of potency in which the tissue salts are triturated in the ration of 1/10. They may be given from 1x to 200x on the basis of specific indication of the biochemic deficiency. Generally 3x to 12x triturations are used fro the treatment of acute diseases in biochemistry. Dr. Schussler discovered 12 biochemic tissue remedies which were:

1. Calcarea Phos,
2. Calcarea Fluor,
3. Calcarea Sulph,
4. Ferrum Phos,
5. Kali Mur,
6. Kali Phos,
7. Kali Sulph,
8. Magnesia Phos,
9. Natrum Mur,
10. Natrum Phos,
11. Natrum Sulph,
12. Silicea

Selection & Repetition of Potencies

Different authors provide different details regarding selection and repetition of potencies. Till today this is a debatable issue. I will try to put down the rule and the exception about the potencies of remedies from the literature. There are three factors which helps one in determination of potencies. Ultimately it is one's own experience which enables one to select potency, its repetition and use of placebo.

Nature of Disease

According to homoeopathy there are three kinds of diseases.

1. Acute Curable Diseases
2. Chronic Curable Diseases
3. Incurable or Fatal Diseases

Acute Curable Diseases: These are of two types 1) Mild and 2) Severe form of sickness. The Mild sickness need low and medium potencies in single or repeated doses according to short acting or long acting property of the remedy.

The Severe form of sickness need high potency single or plus doses. In acute cases when the condition is changed and the new situation arises once should consider the change of remedy as well as change of remedy, whether to resolve to low or high potency. In some cases where the tissue pathology persists low potencies are indicated; but if the symptoms are mental and functional high potency alone lead to cure.

Chronic Curable Diseases: Dr. Peterson considered two phases of chronic sickness. 1)Acute phase of chronic disease medium or high potency according to mildness or severity of the disease as in acute cases. 2) In chronic cases where pathological changes have taken place establishing eruptions, discharges and indurations without generals or the individualizing symptoms (pointers) need low potency in frequent doses. But if the individualizing symptoms are present we must begin with 30 potency and follow the octave system of Dr. Kent.

Incurable or Fatal Disease: In these cases potency problem does not arise. In such cases the exact Simillimum is forbidden. One should select some palliative or biochemic remedies in low potencies to safe guard against severe aggravations and death.

Susceptibility of the Sick Patient

The second most important factor in the potency problem is generally susceptibility or response of the sick person. We found that there are 3 kinds of susceptibilities found in sick persons.

1. Hyper susceptible (Allergic) people need high and highest potencies. Those who take homoeopathic remedies are found to acquire this state.
2. Hypo susceptible persons need low potencies in frequent doses. Persons who are in the habit of taking crude drugs, stimulants and narcotics require low potencies.
3. Peculiarly susceptible sick people are rare. They respond to a certain potency alone.

Nature of the remedy

The third most important factor in the potency problem is the specific dynamic nature of the remedy selected. Some remedies act best when given in high potencies like Polycrests and nosodes. Most of the homoeopathic remedies act in medium and low potencies but there are many remedies that act best in mother tincture in drop doses. Some medicines act best in triturations like Ars. Iod., Thyrodinum, Uranium Nitricum etc. It is also found in literature that action of the same remedy may vary in different potency. For example, the higher potencies of Heper Sulph may abort suppuration and lower potencies promote it. Thus, it has been found that remedies act on three planes: 1) Organopathic, 2) Biochemic & 3) Dynamic.

In organopathic plane the symptoms and signs of diseased organs predominate which corresponds to the remedies. In this plane the drug acts best in tincture in drop doses, for example, Orinthogalum Umb Q in duodenal ulcer, Ceanothus Am Q in enlargement of spleen etc.

In biochemic plane the symptoms and signs of the tissue organs and blood predominate. The symptoms belonging to the lesion of the disease are considered for finding out the Simillimum. When the biochemic symptoms guide us to select a remedy we can use both low medium or high potency according to the acuteness of disease.

In dynamic plane the symptoms and signs of the sick person predominates. These symptoms belong to the Generals (Kent) or to Totality of Symptoms (Boenninghausen). When such symptoms lead us to select a remedy we can go for high and highest potencies. In such cases the homoeopathicity of the remedy is greatest and hence it is ideal condition for a high potency in a single dose.

Repetition & Placebo

Dr. Hahnemann and other pioneers of homoeopathy observed during their practice the rules and regulations regarding repetition of doses of homoeopathy remedies and placebo. These rules and regulations are very important for avoiding spoiling of cases and correctly piloting the patent to complete recovery. 

The cardinal principles of homoeopathy as laid down by Dr. Hahnemann are:

1. Prescribe only the proved remedies
2. Prescribe the Simillimum
3. Prescribe the single dose so long as its beneficial effects continue
4. Prescribe the remedy more frequently and rapidly advancing acute disease and less frequently in slowly advancing acute diseases.
5. In chronic diseases give repeated doses of 50 millesimal potencies every day for a week and then changed to the next higher potency for another week and so on till the complete recovery takes place or homoeopathy aggravation occurs, Stop repeating the millesimal potency once the aggravation occurs but placebo may be given ( Note: you can use the same method with centesimal scale potencies too - Dr. Sahni BS).
6. Dr. Kent advices to repeat centesimal potencies in chronic cases on the basis of octave series of potencies consisting of 30,200,1M, 50M, CM, DM & MM. And to repeat each of these potencies only twice before the next high potency is given. This method was called by Dr. Kent as "Series & Degrees" potencies which enable the vital dynamis full power to eradicate the sickness of the individual.
7. Dr. Burnett and other pioneers of homoeopathy find the similar remedy to the illness of the sick individual; highest the potency may be prescribed without repetition and will take its own time to cure the patient if there are no complications or obstruction to cure.
8. Dr. Tyler is of the opinion that single dose may be only one dose or two doses repeated at short interval or even three doses repeated at short interval coz our aim of single dose to stimulate the vital dynamis to produce antibodies for complete immunization as the homoeopathic remedy acts like and antigen or allergen.

Updated on: 01 Feb 2010