Application of Homeopathic Remedies

The commonly used delivery system for homeopathic remedies is the oral application. However, Hahnemann had used and recommended other application methods, which he found to be useful and effective after many years of study and practical experience. For:

"Every part of our body that possesses the sense of touch is also capable of receiving the influences, and of propagating their power to all other parts".

§ 289 Organon Fifth Edition

Oral application

Remedies are usually put into the mouth in the form of globules, liquids, tablets or powders, as the mouth and tongue are the most susceptible parts for medicinal impressions. They can either be taken as dry doses or in water solution.

Hahnemann recommended the single unit dry dose in the fourth edition of the Organon, usually one, two or a few poppy seed size pills. The dose is not repeated as long as it is acting and the patient improving even in the slightest manner. Hahnemann wrote:

"Such a globule, placed dry upon the tongue, is one of the smallest doses for a moderate recent case of illness. Here but few nerves are touched by the medicine".

§ 272  Organon  Sixth Edition

To apply medicines in water on 1,2 or 3 consecutive days was an exception, limited to acute and some chronic diseases in strong constitutions (vide § 127 Organon fourth edition).

The general application of the water solution was introduced in the fifth edition of the Organon, in 1833, with the intention of minimizing the dose further and  avoiding aggravations. It allowed for adjusting the dose to the patient's susceptibility and sensitivity, and modifying the dose by means of prior successions, so that the vital force could accept them without resistance. The best selected homeopathic remedy can best extract the morbid disorder from the vital force and in chronic disease extinguish the same, only if applied in several different forms as written in § 247 Organon. Hahnemann wrote about the water solution:

"A similar globule, crushed with some sugar of milk and dissolved in a good deal of water (§ 247) and stirred well before every administration will produce a far more powerful medicine for the use of several days. Every dose, no matter how minute, touches, on the contrary, many nerves".

§ 272  Organon  Sixth Edition

The water solution makes the remedy much stronger as it touches many more nerves. Yet the dose can be made considerably less strong than the dry pellet as only a part of the solution of the dissolved globule can be applied. The diminution of the dose essential for homeopathic use, will also be promoted by diminishing its volume.

Initially Hahnemann prepared the liquid dose in the way that the solution was always prepared anew, with one globule before its repetition. In this way the patient was taking multiple doses of the remedy.

With the introduction of the plussing-method the solution is prepared only once, which is taken then in divided or split doses over a period of time. This keeps the dose very small and allows one to modify the dose before its repetition. It is rarely necessary to use more than one globule to prepare the solution as Hahnemann writes in § 248 Organon sixth edition.

With the introduction of the water solution Hahnemann also changed his instructions regarding the repetition of the dose. He advised that any striking progressive improvement precludes the repetition of the remedy as cure is already taking place at a maximum rate. In these cases a single dose is applied and the remedy only repeated when amelioration ceases. However, in only slowly improving cases he recommended to “repeat the remedy at suitable intervals if necessary” to speed the cure. The adjunct "IF NECESSARY" implies the individualization of the dose and precludes their mechanical application and repetition to avoid aggravations and accessory symptoms. He also points out that only EXPERIENCE can teach the most suitable intervals for each individual.

With the application of the water solution in split and modified doses, the period can be diminished to one-half, one-quarter, and even still less, if all conditions prescribed in § 246 Organon fifth and sixth edition are met. The fifth edition refers to the application of centesimal potencies whereas the sixth edition refers to LM (or Q) potencies.

Centesimal potencies can be given dry or in water solution, but should be given in water solution due to the superiority of this application  method. If applied dry the homeopath has to follow the instructions given in the fourth edition of the Organon. Then the dose has only to be repeated if the action of the remedy ceases completely and the patient does not improve anymore in the slightest manner. Here the homeopath has to wait out the aggravation after the application of the remedy, then to wait for any improvement, and then for the relapse to repeat the remedy. LM potencies, which Hahnemann introduced around the year 1840, are to be given in water as a matter of principle.

The globule or liquid should be put into a clean mouth. Globules are best dissolved under the tongue. Although the stomach is also receptive for the action of medicines, they should preferably not be swallowed but dissolved in the mouth, as its lining membrane is more susceptible to medicinal impressions.

No foods or drinks should be taken 15 minutes before and after, and the patient should not brush his teeth or smoke shortly before and after. However, experience shows that medicines also act if taken together with food. But the risk of interference with the action of homeopathic remedies is less when given in water solution, especially LM's. Drinking immediately after the oral intake of the remedy should be avoided by all means as the increased fluid may alter the dose.

Olfactation and Inhalation

“Besides the tongue, mouth and stomach, which are most commonly affected by the administration of medicine, the nose and respiratory organs are receptive of the action of medicines in fluid form by means of olfaction and inhalation through the mouth”.

§ 284 Organon Sixth Edition

Hahnemann noticed that the membrane lining the nose and respiratory tract are also highly susceptible to medicines. He was aware that the action of medicines upon the living human body "spreads out from the point of the sensitive fibers provided with nerves whereto the medicine is first applied with such inconceivable rapidity and so universally through all parts of the living body, that this action of the medicine must be denominated a spirit-like (a dynamic, virtual) action" (vide § 288 Organon Fifth edition).

Although he already wrote in the first edition of the Organon that the nose is also susceptible to medicines, he only recommended olfactation explicitly for very sensitive patients in the fourth edition and describes its application in most detailed form in § 288 Organon, fifth edition.

He experimented with olfactation at a time when he was unsatisfied with the previous delivery systems and was in search of a new delivery system to complement the centesimal's, to overcome aggravations and especially to cure advanced chronic diseases. These proved to be the most difficult to cure with centesimal potencies, as the low C potencies often did not act deeply enough to stimulate a curative secondary healing reaction, whereas the higher C potencies caused too strong primary actions of the remedy and aggravations.

In §288 Organon, 5th edition, Hahnemann wrote that olfactation is much preferable to administering the medicine by the mouth as it produces a salutary influence on the vital force in the mildest yet most powerful manner.

"It is especially in the form of vapor, by olfaction and inhalation of the medicinal aura that is always emanating from a globule impregnated with a medicinal fluid in a high development of power, and placed, dry, in a small phial, that the homeopathic remedies act most surely and most powerfully... All that homeopathy is capable of curing ... will be most safely and certainly cured by this olfaction... I have become convinced (of what I never could previously have believed) that by this olfaction the power of the medicines is exercised upon the patient in, at least, the same degree of strength, and that more quietly and yet just as long as when the dose of medicine is taken by the mouth".

§ 288 Organon Fifth edition

To perfect the delivery system Hahnemann experimented further with olfactation, using more dilution glasses, less succussions, proving new remedies and new potency systems until he finally discovered the LM potencies which gave him the most satisfactory results, being the most powerful potencies yet, and mildest in action. He viewed them as being superior to olfactation in the average patient, but continued to use olfactation depending on circumstances.

The olfactation method is of special value for hypersensitive, in order to avoid aggravations, and if the remedy cannot be taken orally, for example if the jaws are clenched or the patient is unconscious.

At least one of the nostrils should be free of any obstruction when olfactation is used. The globule is placed, dry, in a small phial and moistened with a drop of water. The patient holds the open mouth of the phial in one nostril and inspires the air out of it into himself. If he wishes to give a stronger dose he shall smell in the same manner with the other nostril, more or less strongly, according to the strength it is intended the dose should be. Sensitive patients may only need to use one nostril and take just a small sniff. In little children it may be applied close to their nostrils whilst they are asleep. Olfactation can also be used if the patient is destitute of the sense of smell.

To ensure the modification of each dose before its repetition a water solution of the globule might be prepared in the same way as when giving it in liquid form, and the bottle be used for olfactation.  Regarding the repetition of the dose, Hahnemann advises that "the intervals at which the olfaction should be repeated should not be shorter than in the ingestion of the material dose by the mouth" (vide § 288 Organon fifth edition).

Inhalation is different from olfactation in the way that the phial is held before the open mouth instead of nostrils, and can be used if olfactation is not possible.

"Should both nostrils be stopped up by coryza or polypus, the patient should inhale by the mouth, holding the orifice of the phial betwixt his lips".

§ 288 Organon Fifth Edition

External applications

The skin also allows the remedy to penetrate quickly, and the more sensitive the parts are, the more susceptible to medicinal impressions.

“But the whole remaining skin of the body clothed with epidermis, is adapted to the action of medicinal solutions, especially if the inunction is connected with simultaneous internal administration”.

§ 284 Organon Sixth edition

Hahnemann recommended in the sixth edition of the Organon that the indicated remedy can be given internally in conjunction with external application on the healthy skin, whereas external applications on affected parts are to be avoided in general.

Local applications are originally based on the theory that the outward manifestations represent the disease itself, so that only these have to be removed to cure the patient. With Hahnemann's doctrine of the vital force and the proclamation that local manifestations, like any other signs and symptoms, were but the outward expression of the internal disease, the view of external applications also changed. Hahnemann clearly explains the purpose of local manifestations:

"The presence of the local affection thus silences, for a time, the internal disease, though without being able either to cure it or to diminish it materially. The local affection, however, is never anything else than a part of the general disease, but a part of it increased all in one direction by the organic vital force, and transferred to a less dangerous (external) part of the body, in order to allay the internal ailment".

§ 201 Organon Sixth edition

No external manifestation, not occasioned by some important injury from without, can arise, persist or even grow worse without some internal cause, without the co-operation of the whole organism. Hence the local removal of outward manifestations does not cure the underlying cause and even rouses the internal disease and drives the disease deeper to more vital organs.

Local manifestations indicate to us the state of the internal disease, and if this is cured by means of internal remedies then the local affection is cured at the same time. But if the local affection is only removed locally then the "internal treatment indispensable for the complete restoration of the health remains in dubious obscurity" (vide § 198 Organon sixth edition). This will render it more difficult to find the perfectly homeopathic remedy if it has not yet been discovered.

Therefore Hahnemann wrote:

"It is not useful, either in acute local diseases of recent origin or in local affections that have already existed a long time, to rub in or apply externally to the spot an external remedy, even though it be the specific and, when used internally, salutary by reason of its homeopathicity, even although it should be at the same time administered internally".

§ 194 Organon Sixth edition

To employ the indicated remedy not only internally, but also externally on affected parts, is also quite inadmissible, because then the local manifestation will usually be annihilated sooner than the internal disease. The premature disappearance of the local manifestation will render it difficult or even impossible to determine if the general disease is destroyed also.

This also holds true for local maladies which have been caused by external injury a short time previously. Hahnemann writes in § 186 Organon Sixth edition, that if the lesion is very trivial and the damage is without particular significance, it would be of no great moment and hence no treatment necessary at all. If, however, maladies are severe and of any importance whatsoever, then they draw the entire living organism into sympathy. Therefore, the whole living organism requires, as it always does, active dynamic aid to put it in a position to accomplish the work of healing.

Even though many homeopaths advocate local creams of Arnica or Calendula, taking the indicated remedy internally is all that is needed to cure, and the disease will always yield to this. Hahnemann still recommended in the Materia Medica Pura to apply Arnica also externally in severe bruises, and wrote ( until the 3rd edition of the Organon), that the externally applied remedy also has to be the internally indicated remedy for the overall condition of the disease. However, since the fourth edition of the Organon he generally wrote that it is neither useful in acute local diseases of recent origin nor in local chronic affections to apply an external remedy.

Hahnemann does recommend for very old chronic diseases the external application of the remedy in solution directly on healthy areas of the skin, while taking the oral solution at the same time, to intensify the impact and speed the cure.

"In this way, the cure of very old disease may be furthered by the physician applying externally, rubbing it in the back, arms, extremities, the same medicine he gives internally and which showed itself curatively. In doing so, he must avoid parts subject to pain or spasm or skin eruption".

§ 285 Sixth Edition

Still, the principle of the minimum dose should not be lost sight of, and the dose is to be individualized and adjusted according to the reaction of the patient.

A word on the local manifestations of Hahnemann's basic miasms

Hahnemann clearly indicates in the Organon that also the primary and secondary symptoms of the three basic miasms are never to be treated by local remedies. Since diseases in general are but dynamic attacks upon the life principle, with nothing material lying at their base, no materia peccans, there is nothing material to take away. The homeopath has to cure the great miasms on which they depend, whereupon its primary, as also its secondary symptoms vanish all by themselves except in some cases of long-standing sycosis (vide § 205 Organon sixth edition). Therefore, figwarts, when they have remained untreated for a long time, constitute the only exceptions for local treatment of external maladies. These must be treated with the external application of their specific medicine at the same time as it is used internally, in order to effect a complete cure (vide § 282 Organon Sixth edition).

But whilst he still recommended in The Chronic Diseases pure juice pressed from the green leaves of Thuja, mixed with an equal quantity of alcohol, and in the most longstanding and difficult cases to moisten the larger figwarts every day with the mild solution, he requires the external application of their specific medicine in the sixth edition of the Organon (which was written afterwards!). With specific medicine he regularly refers to the medicine indicated according to the totality of characteristic symptoms in the sixth edition of the Organon.

Remember that Hahnemann said:

“Every external treatment of such local symptoms ... has been the most prolific source of all the innumerable named or unnamed chronic maladies under which mankind groans; it is one of the most criminal procedures the medical world can be guilty of, and yet it has hitherto been the one generally adopted, and taught from the professional chairs as the only one.”

§ 203 Organon Sixth edition

As the epidermis is less sensitive to medicinal impressions than the mouth and tongue, the skin method is also applicable for hypersensitives, so that the remedy is given exclusively on the skin. Medicines can also be applied on the healthy skin if oral intake is not possible. The solution is prepared in the same way as when taken orally and the amount used, usually drops, suited to the sensitivity of the patient.   

Breast milk

"The power of medicines acting upon the infant through the milk of the mother or wet nurse is wonderfully helpful. Every disease in a child yields to the rightly chosen homeopathic medicines given in moderate doses to the nursing mother and so administered, is more easily and certainly utilized by these new world-citizens than is possible in later years".

§ 284 Organon Sixth edition

The mother or wet nurse receives the remedy and through her milk it acts on the child very quickly and mildly. This however raises the question how to proceed if mother and child need a different remedy and whether their treatment will interfere which each other. Dr. Proceso Sánchez Ortega wrote an interesting note on this point[1]: "So to speak, the child is the continuation of the mother with other medicines during the lactation period. The requirements of the child let us know more about the requirements of the mother. The symptoms of the child are quasi the symptoms of the mother, expressed in the child which is "one's own flesh and blood"... Often it is not necessary to ask the mother for her ailments but it does suffice to take the history of the child, as it has been observed, before the child were born. The constitutional symptoms of the mother agree with those of the child, therefore the remedy acts in mother and child likewise. .. The remedies for mother and child are never incompatible." Some homeopaths support this view that mother and child are a unit at the time of pregnancy and nursing, and that the mother's remedy will be the baby's remedy for this period of time. Others argue that both may manifest a different remedy picture, and one should apply the respectively indicated remedies directly to them. As individuals are most susceptible to their simillimum and usually do not react strongly to remedies which are not truly similar, interference should be minimal. However, large doses and too frequent unnecessary repetition might cause proving symptoms, as always, or a dissimilar aggravation if the remedy is not indicated. This is surely an interesting field for research and I welcome any comments.

References

Y.R.Agrawal, What a homeopath should know, Delhi, 1992

H.A.Roberts, The principles and art of cure by homoeopathy, New Delhi, 2006

S.Hahnemann, Organon der Heilkunst, New York, 1999

P.S.Ortega, Die Lehre der Homöopathie, Stuttgart, 2002

L.d. Schepper, Achieving and maintaining the simillimum, New Delhi, 2006

L.d.Schepper, Hahnemann revisited, New Delhi, 2006

B.Luft/M.Wischner, Organon-Synopse, Heidelberg, 2001

David Little's online course at www.simillimum.com

Katja Schütt (Germany)

KatjaSchutt@yahoo.com