Some persons only use the dry dose and some persons only use the medicinal solution. In truth, even in the 6th Organon Hahnemann reviews the use of the dry dose (§272), oral medicinal solution (§246) and olfaction (§248). All of these methods are effective on their own levels. Although Hahnemann emphasized his preference for the medicinal solution and split-doses he did not completely rule out the use of the dry dose. In my study of the Paris casebooks I have found only 1 case where Hahnemann appears to have given the patient a dry dose. This shows that even in his final years he had not completely rejected the dry dose although he opined the medicinal solution offers the practitioner many more options. This is because the liquid dose can be succussed prior to administration in such a manner that the patient never receives the exact same potency twice in a succession. The liquid dose can also be adjusted in a number of ways that are not possible with the dry dose. This does not mean, however, that the dry dose is invalid in its own paradigm. The techniques of the 4th, 5th and 6th Organon are all valid on their own levels and it is best to understand the methods of all three editions.
Hahnemann’s action-reaction model also has important ramifications in the areas of posology and case management. There are some who imagine that all actions observed after the administration of the homoeopathic remedy are the reaction of the vital force. For this reason, they think “every reaction is a good reaction” as if one can do no wrong. This modern concept, however, is not the case. Too much primary action of the remedy causes unnecessary aggravations while too much secondary action produces antagonistic counter actions of the vital force. The reason for these excessive responses is usually hypersensitivity and over medication. Samuel Hahnemann worked his entire career to overcome these excessive actions and make the homoeopathic cure as rapid, gentle and permanent as possible. To practice Homoeopathy in a safe and effective manner it is important to understand all the major remedy responses.
There are five major remedy reactions i.e. a smooth amelioration; a similar aggravation; a dissimilar aggravation; accessory symptoms; and a natural healing crisis. A smooth amelioration is a sign that the dose, potency, remedy and repetition (if necessary) are harmonious. A similar aggravation is a sign that the remedy is correct but the patient has been given too large a dose, too high a degree of potency or the remedy has been repeated when it is not needed. A dissimilar aggravation is the production of new and troublesome symptoms not appertaining to the disease under treatment. This is the sign of a wrong remedy. Accessory symptoms are medicinal side-actions of the remedy caused by a partial simillimum. In this case, the patient may improve in one area but new symptoms appear in other areas changing the natural symptom pattern. A similar aggravation, dissimilar aggravations and accessory symptoms are caused by the primary action of the remedy.
A natural healing crisis is the movement of the symptoms from within to without, from above to below and the appearance of old symptoms in accordance with Hahnemann’s direction of cure commonly called Hering’s laws. A natural healing crisis may also be accompanied by an increase in the action of the organs of elimination producing a discharge, skin eruptions, sweats, profuse urination, excessive stool, etc. This type of eliminatory symptoms should pass quickly and be followed by an increase of the sense of well-being and more vitality. If they are more prolonged and stronger than the original complaints then this is a form of similar aggravation due to over medication. A natural healing crisis is caused by the secondary curative action of the vital force. Excessive counter actions of the vital force are idiosyncratic reactions due to over medication where the patient seems almost “allergic” to the remedy and a cacophony of contradictory and confusing symptoms take place.
Every homoeopath should be aware of this action-reaction phenomena but the truth is that this area of practice has been overlooked by many teachers. I am constantly contacted by patients who experience strong aggravations that last for months. Many of these patients are told this is a “good sign” yet many experience new troublesome symptoms for long periods. Even a similar aggravation caused by the right remedy but wrong posology can cause prolonged actions that drain vitality. If the primary action is too strong for too long it drains so much vitality that there will be little or no curative secondary action. The patient may take on medicinal “proving” symptoms that last for life if not corrected. Each of these negative responses demands a specific case management procedure that produces a corrective action in a timely fashion. If you have not been taught about all these responses in school or by your teachers, then it is time you learned about them through a study of the classical literature. It is important to seek out teachers who understand these clinical realities.
In the Organon Hahnemann taught that the sensitivity of a patient may vary on a scale from 1 to 1000 (§281). This means that potencies that will not even affect a number 1 hyposensitive will cause severe long lasting aggravations in a number 1000 hypersensitive. At the same time, it is important to study the predisposition of the constitution; the nature, stage and magnitude of the disease; the nature of the remedy; as well as the state of the vital force and vitality. There are also other attendant factors such as the age, sex and environmental influences that may play a role in potency selection. The totality of these factors must be taken into consideration when selecting the delivery system, size of the dose, the degree of potency, and the repetition of the remedy. This is the basis of the traditional method that originated with Hahnemann and has been enhanced by generations of classical homoeopaths.
Today there are those who are teaching a hierarchical method of potency selection based on the level of the symptoms. Potencies like the 6C are used based on the name of the disease. Potencies like the 30C are used based on the facts related to the disease state. Cases that are on the emotional level receive the 200C while cases based on delusions receive the 1M. If the case is based on a vital sensation the patient receives the 10M. If the case demonstrates the level of energy the patient receives the 50M, etc. In this hierarchical analysis the individual sensitivity of the patient, the nature, stage and magnitude of the disease, the condition of the vital force, and the nature of the remedy is not taken into consideration. This method is being taught to new students who have little or no clinical experience with the classical methods of potency selection.
It is a clinical fact that many of the most hypersensitive patients are those who are suffering from emotional problems and delusions of various sorts. They are so sensitive that they feel emotions too strongly and tend to imagine all sorts of things! Just because a patient says “I feel” several times does not necessarily mean that they need a 200C. Just because the case includes a characteristic delusion does not necessarily mean they need a 1M. Even if you have found a grand sensation that appears to tie together all the symptoms, this does not necessarily mean that one must give the 10M. What if the patient is the 1000 degree hypersensitive, suffers from advanced pathology in the vital organs, has an unstable vital force and is very weak at the same time? Should we still give such a patient the highest potencies?
I have spoken to many persons that have been aggravated for months with no improvement by such methods. This is because the most important factor in the selection of the potency is the individual sensitivity of the patient followed by the nature, stage and magnitude of the disease and the condition of the vital force, etc. The hierarchy of the symptoms may be one feature in assessing the potency but to use such a method in isolation from the totality of other factors that affect potency selection is insufficient. Once again a new method may provide insights but they should not be used in isolation from the traditional techniques that broaden the foundation and make the prescription safe.
BRINGING IT ALL TOGETHER
It has become apparent in this discourse that the classical Homoeopathy introduced by Samuel Hahnemann and the first generation represent the starting point of many techniques that evolved in later periods. The Founder’s clinical technique was a system of flexible response that included a wide number of applications depending on the cause, symptoms, time and circumstances. The Founder used single remedies over a longer period of time, alternations, tandem remedies, intercurrents and a series of remedies as well as acute remedies, chronic remedies, anti miasmatic remedies, and prophylactic medicines whenever necessary. Therefore, the uses of acute, chronic and preventative remedies all find their origin in the work of Samuel Hahnemann. Techniques like Burnett’s ladder where a series of remedies is used in complex cases and Kent’s long-term use of a constitutional (chronic) remedy, all have their seed in the works of Samuel Hahnemann. The alternations used by Boenninghausen, and the chronic intercurrents used by Hering, all find their roots in the works of Samuel Hahnemann. Speaking in terms of the three kingdoms, the elements of the periodic table and using synthetic prescriptions are all branches of the works of Samuel Hahnemann. Since all those following the cardinal principles share the same family tree, why isn’t there more unity in the homoeopathic community?
Why do those who like to use constitutional remedies disapprove of those who use acute remedies? Why do those who use one remedy over a longer period of time criticize those who use a sequence of remedies when necessary? Why do those who use curative remedies disapprove of those who use preventative remedies? Why do some say Homoeopathy treats the disease not the patient and others say Homoeopathy treats the patient not the disease when the patient and the disease are a functional unity? Why do some say that the vital force cures while others say only the remedy cures when Hahnemann taught that it is the interplay of the primary action of the remedy and secondary action of the vital force that heal? Why do some insist on a one-sided monism while others proclaim a rigid dualism when there is unity of purpose in the one and the many? Why do some always treat the whole patient at once while others treat everyone in layers when both methods are useful depending on the time and circumstances? Why do all these one-sided dichotomies exist?
Why do some say we should use only low potencies and other say we should use high potencies when Hahnemann used from low to high potencies depending on the sensitivity of the patient and the nature of the disease state? Why do some say the C potency is the best while others claim the LM potency is superior when Hahnemann used both side by side in his last years? Why do some only use a single dose and others only use a series of doses when Hahnemann taught the proper time to use the single dose and the proper time to repeat the remedy to speed the cure? Why are some using only old methods and some only using new methods, when a combination of the two is the best way forward? Why is it that human beings like to take a whole truth and break it into two halves and turn one side against the other?
If one investigates the true “classics” they will find the source of the best of the new methods. They will find that these ideas grew into many schools of practice but they all have their basis in the classical period of Homoeopathy. Knowledge of the source has vanished because we have lost our roots. We have depended too much on second hand information instead of seeking the true genesis. We have listened to what popular teachers opine without thinking for ourselves. We have taken our knowledge for granted without asking the proper questions. We have followed trends and fads while ignoring the time-tested traditional techniques. Why are so many persons seeking to change a classical system that they never really learned in the first place?
It is my heartfelt advice that everyone studies the Organon, The Chronic Diseases and The Lesser Writings very closely. At the same time, study the history of Homoeopathy and all the eyewitness accounts and letters in publication. Build the strongest possible foundation in the works of Hahnemann, Boenninghausen, Hering, Jahr, T.F. Allen, H.C. Allen, Kent, Boger, Whitmont and others. Learn how to use the repertory and materia medica well and study the characteristics of the most proven remedies daily. Base your homoeopathic house on the bedrock of the classical tradition rather than the shifting sands of fashion, so that when the winds and rains of clinical realities blow, your practice will not fall down! If one harmonizes the classical and contemporary methods one has a solid basis from which to reach for the sky without losing one’s balance.
I have taken the time to write this rather lengthy discourse because I really care about Homoeopathy. I do not consider myself to be an innovative master or an advanced practitioner. I am just a well trained homoeopath in the traditions of Hahnemann and the subsequent generations. Over the years I have learned more from my failures than I have from my successes as I search for the most rapid, gentle and permanent method of cure. It was my cases that did not go well that drove me to study the various editions of the Organon in depth and to dig deeply into the classical period. In this fertile ground I found the answers I was looking for, and for over a quarter century, I have done my best to bring these methods up to date for our times. It was in Hahnemann that I found the truths that unified all the schools of Homoeopathy. This is why I have written a 6 volume 4000 page textbook called the Homoeopathic Compendium, which will be in print in the not too distant future. As I near the September of my years I look to the next generation as they are the ones that will carry the torch of the healing arts forward. In my heart I know the Medicine of the Future will be safe in their hands and true classical Homoeopathy will never be lost.
Sincerely, David Little