ONE of the most difficult problems facing the homoeopathic physician is just how to employ the remedy when selected. This involves such matters as the size of the dose, the frequency of repetition and the most suitable potency.
Size of dose has to be taken into account only when prescribing Mother Tinctures or the low decimal potencies of poisonous substances such a BELLADONNA, CUPRUM ARSENICOSUM, STRYCHNINUM. These so-called poisons lose their toxicity when potentised, becoming valuable therapeutic agents.
The frequency of repetition of the chosen remedy depends on the acuteness of the situation. Where the symptoms are severe, the onset sudden, and the progress of the illness rapid, repetition may be called for every quarter of an hour, every half hour or every hour, as seems indicated until there is definite evidence of improvement.
The rule is not to give further doses as long as the improvement is maintained. A recurrence of similar symptoms would call for repetition of the remedy, perhaps in a higher potency. The development of fresh symptoms would demand a fresh assessment of the case and probably the selection of a different remedy.
If the correct remedy has been selected there should be evidence of improvement in the patient’s condition after 24 to 36 hours, if not sooner. If none is apparent the case should be reassessed and a change to another remedy considered.
It is wise to avoid the use of potencies higher than 30 in handling acute exacerbations or in initial homoeopathic treatment in “sensitives”, that is, the allergic type of person who may give a history of asthma, hay fever, urticaria, skin rashes, migraine or sensitivity in some other respect.
In such persons it is best to employ the lower potencies, say 3 or 6 or 12, even though the condition may appear acute.
In employing remedies in potency the size of the dose is immaterial. Increase in effectiveness is obtained by repetition at intervals as just mentioned, not by giving several tablets or powders as the case might be, simultaneously.
A method of administration sometimes employed is to dissolve a few medicated granules in a half tumbler of water and order a small quantity to be taken at specified intervals.
In this case, however, the glass used would also absorb the potency and should not be used with a different remedy. This retention of potency energy by the glass phial or other container entails care in storage. The remedy must be kept in the original container and the stopper, or screw top only removed for the shortest time possible.
The questions that have to be considered in giving a homoeopathic remedy are :
The most suitable potency ;
The appropriate number of doses to be given in what may be termed a unit treatment ;
The advisable interval between each dose ; and
When, if at all, to repeat the remedy, or give another.
These several points have further to be considered in relation to the degree of metabolic disturbance present in the body and the level, plane or sphere of intended action of the remedy.
In acute disease, that is, recently acquired metabolic disturbance with a tendency to natural cure, the indication is probably for the employment of the higher potencies, 30 and upwards. It appears that the higher the potency the more rapid the response.
This is of obvious advantage, for the sooner the active disease process is brought under control the less damage is likely to result to tissues and the less disturbance to function.
Remarkable results have on occasion been achieved in acute states with a single dose in high potency-10m or Cm. The employment of these very high potencies demands a degree of skill that can only be acquired by much experience and extensive knowledge of the materia medica. More usually some five or six doses of a moderately high potency will be given-30, 200 or 1m.
It must be realised, however, that an acute illness is often a flare-up of a more deep-seated chronic condition of disorder in the body.
Again the illness may be of the chronic type persisting over a long period. In this case more prolonged treatment may be necessary and may entail the employment of more than one remedy given in sequence.
Chronic Disease Problems:
Chronic disease present its own problems in the matter of how best to administer the remedy, it also presents a dual problem.
On the one hand there is a long-standing deep-seated and wide- spread disease state in the body, and on the other there are its more advanced and more localised manifestations. These latter denote a considerable degree of organ or tissue damage responsible for much of the more obvious symptomatology in the case.
Remedies prescribed on the basic of the picture presented by these symptoms are probably best given in low potency-3x or 6, or measured doses of tincture-and may need to be continued for varying periods, one or two doses being taken daily.
This procedure will probably leave the underlying chronic disease uncured and something more is needed ; treatment which can be effective at a deep level or in a more widespread sphere.
This effect can often be provided by the remedy which fits the constitutional type of the patient, or one which is indicated by research into the past history of the patient.
The usual plan is to give this remedy in high potency, e.g. 200 1m. 10m, and in single dose, and to watch the effect over a period of two or three weeks. Some physicians prefer in this type of case to start treatment with a 30 potency, say three doses spread over 24 hours.
In any case should improvement be evidenced by an increase in the sense of well-being in the patient the remedy should not be repeated.
The return of symptoms, a slipping back, will call for repetition of the remedy, possibly in higher potency if the improvement has been short-lived.
There is no hard and fast rule. Experience will be the best guide. High potencies should be a voided in very gravely ill patients, also in hypersensitive allergic individuals. Otherwise aggravation may occur with associated distress, and may even prove alarming.
The temptation to repeat remedies one after the other in quick succession and in high potency must be sedulously resisted. This form of polypharmacy may easily produce a most confusing picture or drug-induced symptoms plus original disease symptoms, all mixed up, and render accurate prescribing well-nigh impossible.
Over-medication is possible in homoeopathy as well as in other forms of prescribing.
The aim is always to achieve the maximum degree of improvement with the minimum amount of medication adequate for the purpose. This is especially the case when employing high potencies. If low potencies are used on account of localised and advanced pathology and given in repeated doses a careful watch must be kept for possible accidental provings.
In general, it may be said that high potencies appear to be indicated when choosing the remedy on the psychological plane or according to constitutional features, and in relation to acute metabolic disturbances ; and that remedies prescribed in the low potency ranges have their chief value when it is desired to influence reparative tissue reaction in a localised sphere or at a superficial level.
A great difficulty that often arises in these days of over- medication with modern drugs is that the patient’s capacity for responding to the homoeopathically chosen remedy is liable to be seriously interfered with. To counteract such drug-effects it is recommended to give a few doses of either NUX VOMICA, PHOSPHORUS, PULSATILLA or SULPHUR.
Where definite side-effects have been caused by one or another synthetic preparation these can sometimes be alleviated by a few doses of a potency of the specific drug. In allergic ailments where a definite allergen can be traced as the causal factor, a potency of the same can be prepared and used in treatment.
Potencies of the corresponding Nosode can be used prophylactically in the case of contacts with infectious diseases such as measles mumps, etc.
An accepted plan is to give three doses of the “30th” potency in a twenty-four hour period, followed a week later by a further single dose. Even if an attack is not entirely prevented it will probably be rendered less severe by this precaution.
The range of usefulness of homoeopathy is very wide and ever expanding. It must also be constantly reviewed in relation to the changing pattern of modern living and prevalent disease.
The art of homoeopathic prescribing can only be acquired by constant practice but it brings great rewards to patient and physician alike.
Science in almost every field is still only at the threshold of discovery. This is especially so in the field of life processes, of what is actually going on in and around living cells and sentient personalities.
It is in this field, the science of the whole man which is the chief concern of the homoeopath. The search for deeper and more exact knowledge must go on.