Proper dosing strategies, as per Hahnemann, is something that most of us are in the dark about. How people are dosing is generally something they’re making up as they go along or something they’re picking up casually at case conferences. I am trying to do something about that! I often get clients from other homeopaths, who had the right remedy, but just couldn’t keep the case moving because of bizarre dosing strategies that have no reflection in classical homeopathy!
Words in brackets [ ] represent my summary of The Organon’s exasperating run-on sentences! Though this doesn’t speak to every question or cover every contingency in a case, it’s at least a start:
§ 246 Sixth Edition
Every perceptibly progressive and strikingly increasing amelioration during treatment is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever, because all the good the medicine taken continues to effect is now hastening towards its completion.
[A striking improvement precludes further dosing! Stop dosing! Wait! The improvement continues. If a patient has made noticeable improvement after a dose of a remedy, stop giving it! The remedy continues to work on its own. Needless to say, if the case stalls, the improvement stops or relapses, give another dose.]
This is not infrequently the case in acute diseases
[especially if you’re dealing with an acute disease]
but in more chronic diseases, on the other hand, a single dose of an appropriately selected homoeopathic remedy will at times complete even with but slowly progressive improvement and give the help which such a remedy in such a case can accomplish naturally within 40, 50, 60, 100 days.
[In a chronic case, however, a single dose may cure in a month to three months’ time.]
This is, however, but rarely the case; and besides, it must be a matter of great importance to the physician as well as to the patient that were it possible, this period should be diminished to one-half, one-quarter, and even still less, so that a much more rapid cure might be obtained.
[While a single dose may cure a patient with chronic disease in one to three months, this is entirely too long for a person to have to wait to be cured. A patient is entitled to expect a cure in much less time.]
And this may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions
[Here’s how I’ve learned to do that]:
firstly, if the medicine selected with the utmost care was perfectly homoeopathic; secondly, if it is highly potentized, dissolved in water and given in proper small dose that experience has taught as the most suitable in definite intervals for the quickest accomplishment of the cure but with the precaution, that the degree of every dose deviate somewhat from the preceding and following in order that the vital principle which is to be altered to a similar medicinal disease be not aroused to untoward reactions and revolt as is always the case1 with unmodified and especially rapidly repeated doses.
[Put your correctly-chosen, homeopathic remedy (a few pellets) in a half-filled bottle of spring water, succuss the bottle a few times before each dose; “succuss” means pound the bottle into your opposite palm; see this video which shows you what I’m talking about. It’s on youtube.com and it’s called “How To Make A Remedy Solution Bottle”:
There is just one warning I have about the video: the homeopath is not using disposable cups, bottles and spoons. This is a mistake, so, don’t you do it! Don’t use the good glassware, etc., buy plastic bottles, plastic spoons, straws, cups, etc. A dose is a sip or a swallow from the bottle–at “intervals” but not so frequently that you cause an aggravation, and make sure the dose itself isn’t so large in size that it, too, causes an aggravation. Base your repetitions on what the previous dose achieved–if there was a perceptible improvement, no repetition is necessary! If there was an aggravation, an improvement may follow so, wait until you see where the case is going to land before dosing again. When improvement stops, dose again. Always succuss your bottle roughly 5 times before each dose.]
What I said in the fifth edition of the Organon, in a long note to this paragraph in order to prevent these undesirable reactions of the vital energy, was all the experience I then had justified. But during the last four or five years, however, all these difficulties are wholly solved by my new altered but perfected method. The same carefully selected medicine may now be given daily and for months, if necessary in this way, namely, after the lower degree of potency has been used for one or two weeks in the treatment of chronic disease, advance is made in the same way to higher degrees, (beginning according to the new dynamization method, taught herewith with the use of the lowest degrees).
[We can avoid aggravations by starting with the lowest potencies, given daily if need be, and raising the potency by degrees after one or two weeks time.]
Now, how do you raise the potency? By “plussing” the remedy bottle–the Remedy Solution Bottle: pour 90% of your bottle down the drain. Refill half way with spring or distilled water, not tap water unless it goes through a filter, succuss 40 times, and you will then have the next higher potency. For example, your 30C will be a 31C. Go back to succussing 5 times before each dose as before–and don’t add more pellets!!! OK? Did everybody hear that?
§ 247 Sixth Edition
It is impractical to repeat the same unchanged dose of a remedy once, not to mention its frequent repetition (and at short intervals in order not to delay the cure).
[Don’t give repeated dry doses! (That means, don’t dose with pellets over and over again.)]
The vital principle does not accept such unchanged doses without resistance, that is, without other symptoms of the medicine to manifest themselves than those similar to the disease to be cured
[Your immune system doesn’t accept unchanged, unaltered doses! It’s the reason why your 2.5 mg. of Valium eventually stopped working; your body just ignores it after a while, or may even be aggravated by it (side effects). Giving the exact same dose of a remedy or medicine over and over again can cause “provings” or aggravations, you have to raise the potency before each dose by succussing the remedy (water) bottle, and by doing so, repeated doses will not become sources of aggravation as time goes on. Remember, “succussing” is just a fancy way of “shaking” the bottle. You can simply shake it a number of times if you can’t remember what “succussion” is.]
, because the former dose has already accomplished the expected change in the vital principle and a second dynamically wholly similar, unchanged dose of the same medicine no longer finds, therefore, the same conditions of the vital force. The patient may indeed be made sick in another way by receiving other such unchanged doses, even sicker than he was, for now only those symptoms of the given remedy remain active which were not homoeopathic to the original disease, hence no step towards cure can follow, only a true aggravation of the condition of the patient.
[Hahnemann is saying that if you give unchanged doses over and over again–as in giving remedies in pellet-form over and over again, or giving remedies in water, unsuccussed and/or unstirred over a and over again, you will wind up “proving” the remedy.
“Proving” is a word we use in homeopathy for what happens when you take so many doses of a remedy that the remedy “imprints” itself on you and you become the remedy. For instance, over-dose on the remedy Aconite (our remedy for acute fright) and you might become very fearful and anxiety-ridden.
Don’t repeat a remedy that’s already working!!!!! If it’s working, do nothing! As soon as you see a striking improvement in your case, stop dosing! Only repeat if a relapse ensues. If you’ve taken a very low potency like a 6C, a striking improvement may not occur right away. You might have to take it 3 times a day for a few days before you observe over fifty percent improvement; but when you do see it, take the remedy less often. As a general rule, take the remedy less and less often as you get better. But if you start to relapse, return to your original dosing schedule.]
But if the succeeding dose is changed slightly every time, namely potentized somewhat higher (§§ 269-270) then the vital principle may be altered without difficulty by the same medicine (the sensation of natural disease diminishing)
[Put the remedy in water and succuss the bottle before each dose and you’ll be less likely to cause an aggravation or proving and more likely to keep the case moving forward.]
and thus the cure brought nearer.1
1 We ought not even with the best chosen homoeopathic medicine, for instance one pellet of the same potency that was beneficial at first, to let the patient have a second or third dose, taken dry.
[Don’t repeat dry (pellet) doses if the first dose was successful! (I did this on a few occasions and completely cancelled the remedy out; and by that I mean, I antidoted a remedy that was actually working by repeating the remedy too soon.)]
In the same way, if the medicine was dissolved in water and the first dose proved beneficial, a second or third and even smaller dose from the bottle standing undisturbed, even in intervals of a few days, would prove no longer beneficial, even though the original preparation had been potentized with ten succussions or as I suggested later with but two succussions in order to obviate this disadvantage and this according to above reasons.
[Even if the remedy is in a water bottle or cup, don’t give a second or third dose of it in an unstirred, unsuccussed, or unshaken manner! You will cause just the same reaction as if you had repeated dry pellets over and over again as stated above.]
But through modification of every dose in its dynamization degree, as I herewith teach, there exists no offence, even if the doses be repeated more frequently, even if the medicine be ever so highly potentized with ever so many succussions. It almost seems as if the best selected homoeopathic remedy could best extract the morbid disorder from the vital force and in chronic disease to extinguish the same only if applied in several different forms.
§ 248 Sixth Edition
For this purpose, we potentize anew the medicinal solution1 (with perhaps 8, 10, 12 succussions) from which we give the patient one or (increasingly) several teaspoonful doses, in long lasting diseases daily or every second day, in acute diseases every two to six hours and in very urgent cases every hour or oftener.
[To keep the case moving forward, succuss the remedy solution bottle with, perhaps, 5, 8 or 10 succussions before each dose. The size of the dose would be one teaspoon at first (or one sip), and increasing in size going forward, once a day or once every other day (remember, this is chronic disease and you’re starting with the lowest potencies to avoid “provings” and aggravations.
Don’t blindly give the remedy every day if the dose reacts too strongly on your patient, you have to do something to alleviate that if it happens–lower the number of succussions, go to half a tsp., go to every other day or every third day, etc. Also, use disposable cups and spoons when working with remedies, don’t use the good glassware and the good silverware because the remedy sticks to everything it touches–if it didn’t, it wouldn’t stick to the blank sugar pellets! People think that the remedy is IN the pellets, no, it’s ON the pellets! It’s dropped on the pellets and they’re left to dry. See my FAQ article on my website for more information about this.)
In acute disease, however, your dosing schedule is different–every two to six hours or even more frequently if need be. You also need not adhere to the rule about starting the case with the lowest potencies; but always remember, every striking improvement precludes further dosing–that doesn’t mean you should not resume dosing if the improvement wears off. Try to keep the case moving forward without aggravating is the thrust of the argument Hahnemann is making here.
Have you ever watched a soccer game? What do soccer players do? They “dribble” the ball down field in a series of short kicks, isn’t that right? Why do they do that? So they don’t lose control of the ball! One big powerful kick, though impressive, will surely result in the ball being stolen by the other team! Remember, we’re talking about chronic disease here.
In acute disease, you can give one big strong kick (a 200C or a 1M potency), score a goal, and Wham! Problem solved! Why? In acute disease, the field is clear! Let me repeat that. In acute disease, the field is clear, no one’s gonna steal the ball.
In chronic disease, the field is swarming with opposing players blocking and obstructing everywhere you turn! What are these obstructions? Compromised organs and systems, multiple diseases, prescription drug interference, low vitality, just to name a few; so, we need to deliver the remedy in “short kicks” to keep the ball close to us–small doses repeated often, a 6C three times a day, for example, so you always know where the ball is; you can manage a case this way, there’s no management if you’re just giving one dose of a high potency, like throwing a “Hail-Mary pass”, crossing your fingers and hoping for the best. Do you know what a hail-mary pass is in football? The clock is running out, your only hope is to throw a long pass to the goal line and hope that the player who catches it is on your team! This is how most homeopaths prescribe–a high potency, one dose, and pray! Hahnemann is cautioning against this “strategy”!]
Thus in chronic diseases, every correctly chosen homoeopathic medicine, even those whose action is of long duration, may be repeated daily for months with ever increasing success.
[He’s saying, in chronic disease, the daily dosing in low potency is the preferred way.]
If the solution is used up (in seven to fifteen days) it is necessary to add to the next solution of the same medicine if still indicated one or (though rarely) several pellets of a higher potency with which we continue so long as the patient experiences continued improvement without encountering one or another complaint that he never had before in his life.
[He’s saying here, when you finish your bottle, and you still need the same remedy, go to the next potency. You can do that by starting a new Remedy Solution bottle with new pellets from the next potency (for example, if you were taking a 6C, you can order the 9C and 12C of the same remedy and be ready to make a new water bottle with the higher potency when the previous bottle is finished.) Or, you can raise the potency by yourself just by emptying out 90 percent of your bottle, refilling with water half way, and succussing 40 times. That will bring your 6C up to a 7C.]
For if this happens, if the balance of the disease appears in a group of altered symptoms then another, one more homoeopathically related medicine must be chosen in place of the last and administered in the same repeated doses, mindful, however, of modifying the solution of every dose with thorough vigorous succussions, thus changing its degree of potency and increasing it somewhat.
[When new symptoms appear in the case, stop the remedy; a new remedy that matches these new symptoms may be needed at this time.]
On the other hand, should there appear during almost daily repetition of the well indicated homoeopathic remedy, towards the end of the treatment of a chronic disease, so-called (§ 161) homoeopathic aggravations by which the balance of the morbid symptoms seem to again increase somewhat (the medicinal disease, similar to the original, now alone persistently manifests itself). The doses in that case must then be reduced still further and repeated in longer intervals and possibly stopped several days, in order to see if the convalescence need no further medicinal aid.
[When the remedy is no longer needed, “aggravations” may occur. It might look like the original symptoms are coming back! This is your cue to stop dosing and watch and see what happens. If health is evident after the aggravation wears off, the remedy is no longer needed. “Proving” symptoms are not aggravations of your case but symptoms of the remedy itself. For instance, Nat-mur is homeopathic salt; so, a nat-mur proving symptom might be a craving for salt.]
The apparent symptoms (Schein – Symptome) caused by the excess of the homoeopathic medicine will soon disappear and leave undisturbed health in its wake. If only a small vial say a dram of dilute alcohol is used in the treatment, in which is contained and dissolved through succussion one globule of the medicine which is to be used by olfaction every two, three or four days, this also must be thoroughly succussed eight to ten times before each olfaction.
[Even in olfaction (dosing by sniffing the remedy bottle), you have to succuss the bottle before each dose.]
1 Made in 40, 30, 20, 15 or 8 tablespoons of water with the addition of some alcohol or a piece of charcoal in order to preserve it. If charcoal is used, it is suspended by means of a thread in the vial and is taken out when the vial is succussed. The solution of the medicinal globule (and it is rarely necessary to use more than one globule)
[It’s rarely necessary to use more than one pellet when you’re putting the remedy into a water bottle.]
of a thoroughly potentized medicine in a large quantity of water can be obviated by making a solution in only 7-8 tablespoons of water and after thorough succussion of the vial take from it one tablespoon and put it in a glass of water (containing about 7 to 8 spoonfuls), this stirred thoroughly and then given a dose to the patient. If he is unusually excited and sensitive, a teaspoon of this solution may be put in a second glass of water, thoroughly stirred and teaspoonful doses or more be given. There are patients of so great sensitiveness that a third or fourth glass, similarly prepared, may be necessary.
[Going to the first cup, going to the second cup, etc. for patients who are hyper-sensitive to the remedy: When your patient is hypersensitive, succuss your bottle, pour a tsp. from the bottle into a plastic cup of water, stir and then give a tsp. dose. That’s a dose from “the first cup”. If even this dose aggravates, take a tsp. from the first cup, and add it to a second cup, stir, and give a dose from the second cup. Again, this is shown in the video shown previously. Here it is again:
There’s no limit to the number of cups a hypersensitive person may need to go to in order to keep from aggravating. But you know what? I have a much easier way of doing this! Fill up a cup with cold water from the sink, add a capful from your remedy bottle to the cup. (Succuss your bottle first, of course.) Now, dump the cup out and refill 6 times, now, take a sip. This is how you have to dose with sensitive patients.]
Each such prepared glass must be made fresh daily. the globule of the high potency is best crushed in a few grains of sugar of milk which the patient can put in the vial and be dissolved in the requisite quantity of water.
Every medicine prescribed for a case of disease which, in the course of its action, produces new and troublesome symptoms not appertaining to the disease to be cured, is not capable of effecting real improvement,1 and cannot be considered as homoeopathically selected; it must, therefore, either, if the aggravation be considerable, be first partially neutralized
[An aggravation that is considerable must be antidoted! Don’t tell your patient, “You just have to wait it out!”]
as soon as possible by an antidote before giving the next remedy chosen more accurately according to similarity of action; or if the troublesome symptoms be not very violent, the next remedy must be given immediately, in order to take the place of the improperly selected one.2
See my FAQ article and scroll down to “How To Stop An Aggravation”.
[Back to Hahnemann: If the aggravation isn’t bad, but consists of symptoms that aren’t similar to the case but are new and troublesome (most likely a “proving”), give a better-selected remedy to replace it right away!]
1 As all experience shows that the dose of the specially suited homoeopathic medicine can scarcely be prepared too small to effect perceptible amelioration in the disease for which it is appropriate (§§ 275-278), we should act injudiciously and hurtfully were we when no improvement, or some, though it be even slight, aggravation ensues, to repeat or even increase the dose of the same medicine, as is done in the old system, under the delusion that it was not efficacious on account of its small quantity (its too small dose). Every aggravation by the production of new symptoms – when nothing untoward has occurred in the mental or physical regimen – invariably proves unsuitableness on the part of the medicine formerly given in the case of disease before us, but never indicates that the dose has been too weak.
[Any aggravation involving new symptoms means you picked the wrong remedy; so, don’t keep giving it! Just a caution here: Sometimes a new symptom is actually what we call “exteriorization”, meaning your complaint is “moving out” to the periphery. You’ll know that this is what’s happening if you feel better “on the inside” or at a deeper level. Just wait, then.]
2 The well informed and conscientiously careful physician will never be in a position to require an antidote in his practice if he will begin, as he should, to give the selected medicine in the smallest possible dose.
[The homeopath won’t find himself scrambling around in crisis looking for antidotes if he would only start the case with the smallest appropriate dose.]
Like minute doses of a better chosen remedy will re-establish order throughout.
When … it is evident, in urgent cases after the lapse of only six, eight or twelve hours, that [the practitioner] has made a bad selection in the medicine last given, in that the patient’s state is growing perceptibly, however slightly, worse from hour to hour, by the occurrence of new symptoms and sufferings, it is not only allowable for him, but it is his duty to remedy his mistake,
[If the homeopath has made the patient worse by his selected remedy, he has to do something about it, he can’t just let this downward turn go on unabated. He has to give an appropriate remedy to turn the case around or give an antidote.]
by the selection and administration of a homoeopathic medicine not merely tolerably suitable, but the most appropriate possible for the existing state of the disease (§ 167).
Elaine Lewis, D.Hom., C.Hom.
Elaine takes online cases. Write to her at [email protected]
Visit her website: https://ElaineLewis.hpathy.com