Homeopathy Papers

Hahnemann’s Search For The Perfect Potency

Dr. Pitcairn draws on his 30 years of practice to sort out the questions of potency and mode of delivery.

Abstract: Hahnemann did not start with the idea of potency. He began with using similar medicines and that is what he did for some time (8 years), until he recognized a problem. He observed that the similar medicine cured, but at times with unnecessary suffering and it was his experiments in reducing the dose that led to the idea of potency – this process of diluting the medicine with his succussion method actually seemed to make the medicine more effective (more potent) in curing his patients. It was his continued exploration of how the medicines could be best prepared that occupied him through the rest of his life, culminating in the introduction of the LM potencies. In this talk we explore Hahnemann’s ideas about dilution and the form of remedy administration (wet, dry and slightly damp) as related to the treatment of the patient. We will also see how other homeopaths related to these factors and what their experiences were, in particular how Kent attempted to solve the same problem by looking beyond homeopathy.

I have been in the position, as a teacher of homeopathy, to see many cases of other practitioners. I have observed the tendency, the last few years, of what I consider excessive concern about the potency and form of remedy administration in cases in which the wrong remedy is being used. In other words, in situations in which the remedy should be changed, instead the interpretation is that the remedy is correct and the way of administration is what should be adjusted. This paper addresses this issue and gives my perspective on this, based on my 30 years of experience and also the experience of other practitioners – notably Kent and Jahr.

The student of homeopathy has enough challenges, you would think. Yet, after the prescription has been made, they are often confronted with the additional challenge of having to decide among the many options that have developed of late as to how to administer the remedy. Shall we use one or several pellets? Shall the remedy be dissolved in water or given dry? If dissolved in water, should I give it once or more than once? If more than once, should it be succussed before each dose? Or diluted further? If diluted further, how much water should I use to do it? Does it matter how many times I succuss it? How about using the C potencies vs. the LM potencies? And on and on it goes.

Here is an example of an exchange between two practitioners that demonstrates the complexity and confusion that arises. In regard to advising on a case and making an assessment of the medicine being used, this advice was given:

Practitioner 1: “I agree with your assessment at this time, except for your decision to give just a single dose of the remedy. It would be hard to judge just a single dose, especially with the way he has reacted to this remedy. He does not have the kind of reaction that (shows us it is curative) but just an “inching towards better” type of reaction. So one dose will not clear up the confusion. What I would do is try daily doubly diluted doses until he clearly worsens or does not improve. Then we will be sure one way or the other and can move on if need be.”

Practitioner 2: “Thanks for your continuing help. Just to make sure I’ve got it right – you suggest going back to daily (vs EOD) dosing when his forward momentum wanes. I have been making the stock solution with 1 pellet in 8 Tbsp water and having the owner put 1 Tbsp into 1/2 cup water and give 1 cc orally. So now, she will instead take a Tbsp from the first diluted glass and put it into a 2nd glass of 1/2 cup water and then give 1 cc. Correct?”

Why has this become a topic of confusion? Why are there so many different opinions about how to give the medicine? I take this position – there is uncertainty about how to give the medicine because Hahnemann was uncertain himself in how to do it. He spent much of his active professional life trying to solve this problem – and unsuccessfully.

Two basic concepts

Let’s start with this. There are two very general concepts at the base of homeopathy and these are the use of the similar medicine and the concept of potency. The latter word, potency, refers specifically to the observation that Hahnemann made, that in preparing the medicine by dilution and succussion it appeared that the medicine became more “potent”, e.g., as in the dictionary definition “having great power, influence, or effect”. This was a clinical observation and is one that has been confirmed by other homeopaths.

There are two sides to this:

1. The medicine that is close to crude form can be too powerful in effect (not just healing effect but also aggravations of the disease).

2. The medicine diluted, succussed, and given in small dose acts more smoothly and curatively without unpleasant side-effects (thus more potent).

The remedy in crude form can act excessively.

One of the most interesting presentations of how the crude drug can have excessive effect (though still curing) is in Burnett’s 50 Reasons For Being A Homeopath, Reason no. 1.

“A number of years ago, on a dull dreary afternoon, which I had partly occupied at B Hospital with writing death certificates, I suddenly rose and felt something come over me, for the fiftieth time at that period. I hardly knew what, but it grew essentially out of my unsatisfactory clinical results. I had been an enthusiastic student of medicine originally, but an arrantly sceptic professor quite knocked the bottom out of all my faith in physic, and overmuch hospital work and responsibilities, grave beyond my age and experience, had squeezed a good deal of the enthusiasm out of me.

After pacing up and down the surgery, I threw myself back into my chair and dreamily thought myself back to the green fields and the early bird’s-nesting and fishing days of my childhood. Just then a corpse was carried by the surgery window, and I turned to the old dispenser, and enquired in a petulant tone, “Tim, who’s that dead now? ” “Little Georgie, Sir.” Now little Georgie was a waif who belonged to nobody, and we had liked him and had kept him about in odd beds, as one might keep a pet animal. Everybody liked little Georgie ; the most hardened old pauper would do him a good turn, and no one was ever more truly regretted than he. It all came about in this way : One day I wanted a bed for an acute case, and I ordered little Georgie out of his bed in a warm, snug corner, to another that was in front of a cold window ; he went to it, caught cold, had pleurisy, and Tim’s reply gives the result. Said I to myself: If I could only have stopped the initial fever that followed the chill by the window, George had probably lived. But three medical men besides myself had treated Georgie – all in unison – and all hospital men; still pleurisy followed the fever, dropsy followed the pleurisy, and poor little Georgie died. Georgie was no more, and I FELT SURE HE NEED NOT HAVE DIED, and this consciousness nearly pressed me down into the earth.

That evening a medical friend from the Royal Infirmary turned up to dinner with me, and I told him of my trouble, and of my half determination to go to America and turn farmer: at least I should be able to lead a wholesome, natural life. He persuaded me to study Homoeopathy first, and refute it, or, if apparently true, to try it in the hospital. After many doubts and fears – very much as if I were contemplating a crime – I procured Hughes’s ” Pharmacodynamics ” and ” Therapeutics,” which my friend said were a good introduction to Homoeopathy. I mastered their main points in a week or two, and came from a consideration of these to the conclusion either that Homoeopathy was a very grand thing indeed, or this Dr Hughes must be a very big ……. No, the word is unparliamentary. You don’t like the word? Well, I do, it expresses my meaning to a T ; on such an important subject there is for me no middle way, it must be either good clear God’s truth, or black lying.

I was full of fever on account of Georgie’s fate, so studied the Homoeopaths thereon, and found that they claimed to cut short simple fever with Aconite. Ah, thought I, if that be true, Aconite would have saved little Georgie if given it in time at the very onset. Well, feverish colds and chills were common enough just then, and I had, moreover, a ward where children thus taken ill were put till their diseases had declared themselves, and then they were drafted off to the various wards, for that purpose provided, with Pneumonia, Pleurisy, Rheumatism, Gastritis, Measles, as the case might be.

I had some of Fleming’s Tincture of Aconite in my surgery, and of this I put a few drops into a large bottle of water and gave it to the nurse of said children’s ward, with instructions to administer of it to all the cases on the one side of the ward as soon as they were brought in. Those on the other side were not to have the Aconite solution, but were to be treated in the authorized orthodox way, as was theretofore customary. At my next morning visit I found nearly all the youngsters on the Aconite side feverless, and mostly at play in their beds. But one had the Measles, and had to be sent to the proper ward: I found Aconite did not cure Measles. The others remained a day or two, and were then returned whence they had originally come. Those on the non-aconite orthodox side were worse, or about the same, and had to be sent into hospital – mostly with localized inflammations, or catarrhs, measles, etc. And so it went on day after day, day after day: those that got Aconite were generally convalescent in twenty-four or forty-eight hours, except in the comparatively seldom cases where the seemingly simple chill was the prodromal stage of a specific disease such as measles, scarlatina, rheumatic fever : these were barely influenced by the Aconite. But the great bulk of the cases were all genuine chills, and the Aconite cured the greater part right off, though the little folks were usually pale, and had perspired, as I subsequently learned, needlessly much.

I had told the nurse nothing about the contents of my big bottle, but she soon baptized it “Dr Burnett’s Fever Bottle.” For a little while I was simply dumbfounded, and I spent much of my nights studying homoeopathy. I had no time during the day. One day I was unable to go my usual rounds through the wards. In fact I think I was absent two days from Saturday till Tuesday, and on entering the said children’s ward the next time in the early morning, the nurse seemed rather quiet, and informed me, with a certain forced dutifulness, that all the cases might, she thought, be dismissed. “Indeed,” said I, “How’s that ? ” ” Well, Doctor, as you did not come round on Sunday and yesterday, I gave your fever medicine to them all and, indeed, I had not the heart to see you go on with your cruel experiments any longer. You are like all the young doctors that come here – you are only trying experiments! ” I merely said, “Very well, nurse, give the medicine in future to all that come in.” This was done till I left the place, and the result of this Aconite-medication for chills and febricula was usually rapid defervescence, followed by convalescence.

An interesting story and the purpose in telling it is to show how the Aconitum tincture use resulted in strong signs of reaction, reactions that were not necessary for a cure.

It was Hahnemann’s same experience that stimulated his search for the best form of the medicine and the best way to deliver it. It was clinical experience and observation that moved Hahnemann in this direction. What I suggest in this paper is that Hahnemann worked on this his entire life without solving this puzzle of the best potency and the best method of administration.

Why the dose question was of interest to Hahnemann.

Let’s summarize what prompted Hahnemann to investigate this so thoroughly.

1. The patient is as sensitive to the medicine as to the disease.

2. If the medicine is used too much or in too crude a form then we can actually make the symptoms worse, what appears to be an aggravation of the patient’s condition or what Kent referred to as an aggravation of the disease.

3. If the dose is made smaller and if it is also succussed or triturated, then the power of the medicine to heal looks to be enhanced, while at the same time the primary effect of the medicine (that part which causes excessive action) is reduced, made minimal.

When Hahnemann turned to the potency question.

It is sometimes difficult for us to realize how the work Hahnemann did unfolded over time. We read (or study) the principles of practice as if they are one integrated whole, yet it did not arise this way. The first major insight was the importance of the similar remedy in bringing back health. This was confirmed by practice and, indeed, developed and defined much more clearly as the years went by. In the last edition of the Organon it has become a major part of the book in which the emphasis is on understanding the difference between curative action and palliation or suppression (the discussions of similar vs. non-similar medicines, paragraphs 22 to 71).

Once this principle was established Hahnemann considered it completely reliable like a natural law of nature. The challenge to this was the recognition of patients with chronic disease for which the usual way of using similar medicines was not followed by success. Yet it is revealing that Hahnemann did not lose confidence in the law of similarity in spite of having these difficult patients.

His adherence to the basic principle of the similar medicine is most evident in the beginning of the book on the Chronic Diseases, in which he introduces the topic of the failure of the usual way of treating patients.

From the Chronic Diseases.

“Using the more natural treatment, Homeopathic physicians have frequently been able in a short time to remove the chronic disease which they had before them, after examining it according to all the symptoms perceptible to the senses; and the means of cure were the most suitable among the Homeopathic remedies, used in their smallest doses which had been so far proved as to their pure, true effects. And all this was done without robbing the patient of his fluids and strength, as is done by the allopathy of the common physicians; so that the patient, fully healed, could again enjoy gladsome days. These cures indeed have far excelled all that allopathists had ever -in rare cases- been able to effect by a lucky grab into their medicine chests.”

“The complaints yielded for the most part to very small doses of that remedy which had proved its ability to produce the same series of morbid symptoms in the healthy body; and, if the disease was not altogether too inveterate and had not been too much and in too great a degree mismanaged by allopathy, it often yielded for a considerable time, so that mankind had good reason to deem itself fortunate even for that much help, and, indeed, it often proclaimed its thankfulness. A patient thus treated might and often did consider himself in pretty good health, when he fairly judged of his present improved state and compared it with his far more painful condition before Homeopathy had afforded him its help”.

“Of this kind were the cures of diseases caused by a psora not yet fully developed, which had been treated by my followers with remedies which did not belong to the number of those which, later, proved to be the chief anti-psora remedies; because these remedies were not yet known. They had been merely treated with such medicines as Homeopathically best covered and temporarily removed the then apparent moderate symptoms, thus causing a kind of a cure which brought back the manifest psora into a latent condition and thus produced a kind of healthy condition, especially with young, vigorous persons, such as would appear as real health to every observer who did not examine accurately; and this state often lasted for many years. But with chronic diseases caused by a psora already fully developed, the medicines which were then known never sufficed for a complete cure, any more than these same medicines suffice at the present time.”

“Even some gross errors of diet, taking cold, the appearance of weather especially rough, wet and cold or stormy, or even the approach of autumn, if ever so mild, but, more yet, winter and a wintry spring, and then some violent exertion of the body or mind, but particularly some shock to the health caused by some severe external injury, or a very sad event that bowed down the soul, repeated fright, great grief, sorrow and continuous vexation, often caused in a weakened body the re-appearance of one or more of the ailments which seemed to have been already overcome; and this new condition was often aggravated by some quite new concomitants, which if not more threatening than the former ones which had been removed homeopathically were often just as troublesome and now more obstinate.

“This would be especially the case whenever the seemingly cured disease had for its foundation a psora which had been more fully developed. When such a relapse would take place the Homeopathic physician would give the remedy most fitting among the medicines then known, as if directed against a new disease, and this would again be attended by a pretty good success, which for the time would again bring the patient into a better state. In the former case, however, in which merely the troubles which seemed to have been removed were renewed, the remedy which had been serviceable the first time would prove less useful, and when repeated again it would help still less. Then perhaps, even under the operation of the Homeopathic remedy which seemed best adapted, and even where the mode of living had been quite correct new symptoms of disease would be added which could be removed only inadequately and imperfectly; yea, these new symptoms were at times not at all improved, especially when some of the obstacles above mentioned hindered the recovery.”

“Some joyous occurrence, or an external condition of circumstances improved by fortune, a pleasant journey, a favorable season or a dry, uniform temperature, might occasionally produce a remarkable pause of shorter or longer duration in the disease of the patient, during which the Homeopath might consider him as fairly recovered; and the patient himself, if he good-naturedly overlooked some passable moderate ailments, might consider himself as healthy. Still such a favorable pause would never be of long duration, and the return and repeated returns of the complaints in the end left even the best selected Homeopathic remedies then known, and given in the most appropriate doses, the less effective the oftener they were repeated. They served at last hardly even as weak palliatives. But usually, after repeated attempts to conquer the disease which appeared in a form always somewhat changed, residual complaints appeared which the Homeopathic medicines hitherto proved, though not few, had to leave uneradicated, yea, often undiminished. Thus there ever followed varying complaints ever more troublesome, and, as time proceeded, more threatening, and this even while the mode of living was correct and with a punctual observance of directions. The chronic disease could, despite all efforts, be but little delayed in its progress by the Homeopathic physician and grew worse from year to year.

“This was, and remained, the quicker or slower process in such treatments in all non-venereal, severe chronic diseases, even when these were treated in exact accordance with the Homeopathic, art as hitherto known. Their beginning was promising, the continuation less favorable, the outcome hopeless.”

Nevertheless this teaching was founded upon the steadfast pillar of truth and will evermore be so (Hahnemann’s emphasis). The attestation of its excellence, yea, of its infallibility (so far as this can be predicated of human affairs), it has laid before the eyes of the world through facts.”

Hahnemann’s positions on potency.

We see from this a tremendous confidence on Hahnemann’s part as to the correctness in using similar medicines to cure. He does not appear to have deviated from that. It is quite the different story when it comes to potency and administration. In contrast to the dependancy he had on this principle of similarity he never came to the same confidence in respect to potency and dosing. We see in his writings a continued experimentation with this his entire professional life, until death finally stopped him. Hahnemann started investigating the potency problem about 8 years after discovering the principle of similarity and worked with this conundrum for decades. We could make the assumption that the last suggestion of his, the use of the LM potencies, was the one he was satisfied with but that is an unlikely conclusion. The pattern was constant tinkering – until he could experiment no more.

At first H. tried the idea of starting “high” (for him) and then working down, like starting with 15c, then 12c, and so on. Another method was to go higher, up to 30c though he was not a fan of going higher than this – waiting for Kent and others to push the envelope. Much attention in his writings is given to advice on how to manage the excessive reactions after the medicine is given – about not repeating too soon especially. Basically he found it was best not to irritate the life force by giving the medicine repeatedly so that there was too much influence, or mistuning, of the patient. If this was done, the risk was there of both unnecessary reactions and discomfort for the patient.

Without going into an exhaustive depiction of all the methods he tried, the point to make here is that he was always trying to make it better. He had the idea, and stuck with it, that the patient could be cured gently and was always trying to make this a practical clinical reality.

The final development, as described in the 6th edition of the Organon, was the LM potencies. Put simply, he changed from making a 1:100 dilution to a 1:50,000 dilution between each step of preparation. It was his idea that the “potency” was developed more gently by doing this. In addition, and an essential part of this method, was that the medicine was given in water, succussed and diluted before each dose. Again, he thought that this method would allow the life force to accept more frequent exposures to the medicine.

Note that at this point in Hahnemann’s work he is saying that the C potencies were simply too powerful in some patients and that was a factor of how they were made, the 100:1 dilution steps instead of 1:50,000.

In footnote 270f, 6th edition of the Organon, Wenda O’Reilly edition:

“In earlier instructions, I specified that a whole drop of a liquid in a given potency be added to 100 drops of wine spirit for higher potentization. But meticulous experiments have convinced me that this proportion of the dilution medium to the medicine being dynamized (100:1) is much too narrowly limited to develop the powers of the medicinal substance and to a high degree, by means of a large number of succussions, unless one uses great force.”

“With a ratio of the dilution medium to the medicine as low as 100:1, very many impacts by means of a powerful machine, as it were, are forced in. As a result, medicines arise that, especially in the higher degrees of dynamization, almost instantaneously but with stormy – indeed dangerous – intensity, impinge on patients (especially delicate ones) without bringing about an enduring, gentle counter-action of the life principle.”

Hahnemann’s “final” answer.

Many practitioners assume or have concluded that the LM potency method was the breakthrough or the very best method to use. After all, this is what Hahnemann said. As I indicated earlier this could be the case or it might be that he died then and could not go further with experimentation. My thought is that it is the latter. However, before we go into that, let’s look at two major methods that are proposed for giving medicines (and I am ignoring some lesser used methods like alternating remedies, using ascending potencies over a period of days, or remedies for all past injuries and illnesses) – these are the LM method and giving the remedy in water (plussing).

The LM potency method.

This is the method described in the 6th edition of the Organon and it is quite a departure from how remedies were made and administered before. I have already described the essential principles – the greater dilution steps and the succussion and dilution before each dose. Hahnemann goes on at some length about the disadvantages of using the C potencies because he thinks the dilution steps might be too close together and this causes too much effect on the patient, especially if the remedy repeated. So he advises not using the C potencies but rather the LM dilutions and to administer according to the instructions in the 6th edition which alter the potency before each dose.

I began using the LM potencies in the 1970’s, making them myself at first. Since that time I have used them off and on in a variety of cases. I tend to use them much less now for a simple reason: I could not see any advantage. After many cases over the years, I could not see a clear or dramatic difference in how the patient progressed if that patient was to receive one dose of dry pellets or to be on repeated LM potencies. This is not what you will hear from others. Many people say that the LM potencies are far superior. I will reply to that from my own experience.

The majority of cases that I have some knowledge of, that are using the LM method, are using remedies that are not the similimum. Thus the interpretation of the action of the LM remedy is difficult to assess. This is primarily because the remedy is being repeated and this is the major weakness of the method. When a remedy is repeated, the primary action of the repeated medicine will alter the patient’s condition – usually palliatively. Thus the patient changes and there is some improvement but this improvement is not part of a curative response.

Many veterinarians will then interpret what is happening as “the correct remedy but the wrong method of administration” and there is much attention given (as described at the beginning of this paper) to finding the ideal set of conditions in which to administer the treatment. This especially takes the form of quantity – how many drops or spoonfuls to give, or dilutions – how many subsequent glasses of dilution to use (subsequent to succussion and before each dose). There can be subcategories within this, like how much water to have in each glass, how may succussions or stirrings to use, and so on.

But basically the situation is this: No matter how much succussion or dilution you do, no matter how much you fiddle with amounts, the non-curative remedy does not become the similimum because of being in water, diluted or succussed.

So we have touched on the downside of using the LM potencies. The incorrect remedy can be used coupled with repetition of that wrong remedy. This is how many cases become confused and altered and difficult to interpret. Along with this is that one will find that cases vary in how they respond to the LM treatment, some able to take it daily and others very infrequently, so we are back to the same situation of not having the perfect method that can be used routinely, as a standard method.

Giving the medicine in water – “plussing”.

More popular than using the LM potencies is dissolving them in water and then doing a stirring or succussion or shaking before each dose. This can be coupled with also diluting the medicine into one or more glasses as well. This is much like the LM method but it is done with the C potencies. I think this is the most popular method used.

What can we say about this method? First of all it is using the C potencies and repeating them – which of course is what Hahnemann suggested we not do. Secondly, we have the same issue of repetition which is the single most important factor that gets practitioners into trouble with cases. So we can have over-action of the C potencies, or we can have use of a remedy that is not the best choice and the repetition of it resulting in palliation or suppression.

I refer back to Hahnemann’s objection to the C potencies (quoted from the Organon before). His objection was in the way that the C potencies were prepared and the number of succussions they were given. Specifically that a 100:1 dilution was used to make them and that if a large number of successions used (add “forcefully” he says), then that medicine became too powerful in its effect.

So in the “plussing” method we have the worst of both – the C potencies are still being used, they are being repeated, and the number of succussions continually increased. Obviously not in alignment with Hahnemann’s advice. This method of giving the C remedies in water is one that I did also over a number of years – mostly when the LM potency was not available to me. I did not find advantage with it, in fact, often excessive action of the remedy especially when it was not the similimum.

“What about the advantage of putting the remedy in water?” some will ask, as there is much advice along the lines that the dry pellets are too strong and the remedy in water is more gentle or more potent. People will swear they see this but, again, what I have seen in cases is that they are discounting the factor of repetition. It goes like this:

“I gave the remedy dry, 30c potency, and it did not have much effect, but next I dissolved it in water and it acted well” or words to that effect. What they are discounting is the comparison of giving it dry twice. In other words it may as well have been the second dose that made the difference rather than it was in liquid.

Be that as it may, my experience has been consistently that there is little or no difference in effect if the remedy is dissolved first in water. I base this on 30 years homeopathic experience and I will draw on two other practitioners with experience that will underscore this.

From James Kent, MD:

“It never matters whether the remedy is given in water in spoonful doses or given in a few pellets dry on the tongue – the result is the same. It has been supposed by some that by giving one or two small pellets that a milder effect would be secured, but this is a deception. The action or power of one pellet, if it acts at all, is as great as ten. If a few pellets be dissolved in water, and the water is given by the tea spoon full, each teaspoonful will act as powerfully as the whole of the powder if given at once, and the whole quantity of water if drank at once will have no greater curative or exaggerative power than one teaspoonful. When medicine is given at intervals the curative power is increased and may be safe if it is discontinued with judgment. When a positive effect has been obtained the medicine should always be discontinued and the greatest mischief may come from continuing to give it.”

Even more definite about this is Jahr, in his book on his experiences of 40 years of homeopathic practice:

“Except in acute febrile inflammations of internal organs, I have thus in all cases where the remedy was really adapted to the disease, even in the most violent attacks of spasms, diarrhea, vomiting, hemorrhages, etc. obtained in the latter as well as at any former period of my practice, a favorable change in the symptoms much more speedily by means of 2 globules dry on the tongue then by means of spoonful doses of a watery solution.”

“..I consider the use of globules in a single dose, with very few well defined exceptions, a method of practice that cannot be sufficiently commended, of whose advantages anyone who is willing to try it and knows how to select the appropriate remedy (my italics), can easily convince himself by actual experience.”

“…it should be remembered that if, with the exception of a few cases, 2 or 3 globules do not effect the least favorable change in the condition of the patient within a proportionately requisite period of time, 2 or 3 globules of a better chosen remedy will do more good than stronger and more frequently-repeated doses of the former.”

Note that in this discussion Jahr does set the condition of the practitioner that “knows how to select the appropriate remedy”, this being the key to progress.

What we have so far.

Let’s summarize what we have covered. The points I am making here are:

1. Hahnemann was trying to find a way to give the medicine in the most effective and gentle way.

2. He worked on this his entire professional career, up to the time of his death.

3. The LM method of remedy preparation was his latest but he was not able to gain much experience with it as he did not live long enough (his remedy case at his death contained mostly C potencies).

4. Experience with the LM potencies has shown that the repetition of remedy has the disadvantage of a higher incidence of palliation that is not recognized.

5. The hybrid “plussing” method is not from Hahnemann but based on a misunderstanding of the developing LM method. It actually uses potencies Hahnemann tells us to avoid and adds more succussions to the preparation in a way that Hahnemann tells us is dangerous.

6. The experience of experienced homeopaths, is that there is no advantage of giving the remedy in liquid form vs. as dry pellets.

Hahnemann’s “final” advice on choosing potency, again.

Hahnemann actually does give us his final advice in the 6th edition of the Organon in the section entitled “How to chooses the best size of dose”, paragraph 278:

“The question arises: what is the most appropriate degree of smallness for certain as well as gentle help? How small would the dose of each single, homeopathically selected medicine have to be for the best cure in each individual case of disease? It is easy to realize that no theoretical conjecture can solve the problem of determining, for each medicine in particular, what dose will suffice for homeopathic curative purposes, yet still be so minute that the gentlest and most rapid cure will be attained. Speculating intellect and subtle sophistry give no information about it. It is also impossible to record all conceivable cases in a table in advance. Only pure experiment, careful observation of the excitability of each patient, and correct experience can determine the best dose in each particular case (Hahnemann’s italics).”

So after all the discussion about methods of remedy preparation and doing it comes to this – it has to be determined in each patient by experiment!

Why is the potency question so difficult to solve?

It is my opinion that Hahnemann did not solve this and in the paragraph quoted above he is admitting this in a way. But the question remains – why is this so difficult to figure out? I think there is a thread that runs through all of this that brings the problem into focus. That is, each patient is different in what they need or what they can optimally respond to. What is it that underlies this difference? It is susceptibility. This word susceptibility is used to refer to why the patient has become ill in the first place and also to their capacity to be affected by the medicine used. Let’s put this another way. Why are we susceptible at all? What is the factor? Why does it vary so much?

We will understand the difficulty if we acknowledge that the understanding of susceptibility lies outside the province of homeopathy. It has to do with factors that are not explained by the homeopathic method and philosophy. Yes, we can say that we become ill because of the miasms, or stress, or deprivation. But these are not really answers so much as conditions necessary for illness to develop. That is, there is a difference between “cause” and “necessary conditions”. As an example, to have a fire you must have fuel, say dry wood, available for burning. This is a necessary condition. Yet the cause may be a match or lightning.

An interesting passage in the Organon highlights this. Hahnemann makes clear his opinion that disease is not a material condition (though material effects are seen as secondary expressions of the mistuning of the life force), that the life force or principle is a spiritual entity not a material one. On page 37 of the Introduction (O’Reilly edition) he says “the disease-affected life force is the engenderer of the self-manifesting disease”, then follows that statement further down (same page) with “The life force, that glorious power innate in the human being, was ordained to conduct life in the most perfect way during its health (Hahnemann’s italics). The life force, which is equally present in all parts of the organism is the untiring mainspring of all normal natural bodily functions. It was not at all created for the purpose of helping itself in diseases… (my emphasis).

Hahnemann is saying to us that the disease state is unnatural, not in the plan, so to speak. So where does it come from then? Once we ask this question we leave homeopathy. Hahnemann did not speculate in a metaphysical way, yet it is clear that the direction he was pointing to was away from material causes towards non-material or “spiritual” causes. Nonetheless he did not, as far as we know, go there. Perhaps in private discussion he did, then again perhaps he had no interest in that direction.

There are many questions left unanswered by Hahnemann and, indeed, by the work of homeopathy. Questions like: What are the miasms? How did they originate? How are they maintained? Where do they live? How does a person become susceptible to them? Are animals susceptible naturally or is it because of their association with people? And so on. These kinds of questions are outside the realm of homeopathy and would usually be categorized as metaphysical – meaning beyond material explanations.

It would seem that few homeopaths have tried to penetrate these questions. One that is notable is James Kent, MD. More than anyone else (in my opinion) he understood Hahnemann’s work and his ideas. He could see what they were pointing to and was willing to see if he could find answers. His way was to study the writings of the philosopher/metaphysician Emmanual Swedenborg who was an important figure of the time, much like someone like Deepak Chopra or Eckhart Tolle is today. Swedenborg identified the source of susceptibility (and therefore diseases) as coming from consciousness – specifically the content of our desires and our intentions. That we are self-centered, for example, leads to a susceptibility to certain disturbances. Kent studied this and thought it might be a possible extension of the understanding of homeopathy, that the realization that susceptibility originated in our consciousness could bring us to actions that worked to diminish this. These thoughts of Kent did not change how he did homeopathy but it did have effects in how he wrote about it. Thus you will see references to our “will” or about moral factors. Whether Kent was on the right track or not is yet to be decided but it is interesting that Kent has been criticized as being “too spiritual” or bringing something into homeopathy that does not belong there.

In summary.

So what are we left with? I will summarize this talk by saying that the excessive attention given to the mode of remedy administration is a misplaced emphasis that should instead be given to developing the ability to find the correct remedy. In addition, that the concern about “wet vs. dry” is a red herring that takes the student in a direction of increasing and unnecessary complexity and confusion.

The basic factor that underlies the varying responses to remedy administration —this being the susceptibility of the patient – at the present time lies outside the province of homeopathy. I will predict that the question of “best potency” and “best method of administration” will never be satisfactorily resolved by homeopathic practice in its present form and we will be left, always, with the advice of Hahnemann that “it is determined by experiment with the individual patient”.

About the author

Richard H. Pitcairn

Dr. Richard Pitcairn graduated from veterinary school in 1965, from the University of California at Davis, California, and worked on a PhD degree emphasizing the study of viruses, immunology and biochemistry. Working in a mixed practice he saw a wide variety of health problems, but to his disappointment, did not see the results that he expected using the treatments learned in veterinary school. He became interested in alternative medicine, nutrition and homeopathy. He found homeopathy to be intellectually complete and satisfying, and after studying and using it for some 20 plus years, has had remarkable success. Since 1992 he has taught a yearly course, The Professional Course in Veterinary Homeopathy, to train animal doctors in homeopathy.
Dr. Pitcairn was a founding member of the Academy of Veterinary Homeopathy and also served as its president. With Susan Pitcairn he wrote two editions of Natural Health for Dogs and Cats, a classic in the field, which sold over 350,000 copies.


  • Very Well Written. I agree with everything you have written! There is alot of confusion among Homeopaths as to the “right” way and alot of people become fanatical about their method being the “right” method. Experience and seeing with unprejudiced eyes is the final arbiter of truth. Thanks for sharing your experience and insights!

  • as i’ve mentioned earlier too on a few ocassions, the potency, size of doses and the duration of these doses is a bit unresearched in a way, as opinions differ from practitioner to practitioner.
    Perhaps there is no hard and fast rules for this!

  • Dr Hahnemann had shown us a way-its up to all Homeopaths to just follow all these and sit across in seminars and put their own findings .
    we have an advantage – of OBSERVATION for all that we do.
    we should delete the following , potency is confusing, un researched , we are to be unprejudiced,
    Let’s put our observation of what we are doing in our practice, discuss it, we would see the results.



  • Hahnemann showed the relevance and necessity of potentizing remedies in order to overcome strong disease. I agree however that he did not solve the matter of finding the best way to do this.

    I do not agree that it has not since been solved.

    That was done more recently by Dr Joe Rozencwajg, NMD, and was published here in Hpathy. See:
    * Hpathy Sept 16 2008 “Removing the Guesswork from Potency Selection” and
    * Hpathy Sept 17 2009, “The Fibonacci Potencies Series: update, discussion and conclusions.”
    * Subsequently, there is his book on the subject: “The Potency: Advanced Prescribing in Homeopathy”

    I’ve used this F series for potency since it was first made available, and it has led to a leap in successes and speed of healing, and makes all other options totally obsolete.

    My first paper mentioning my experience with the use of this potency approach, is also published in Hpathy, in my article on improved rate of success with Feline Infectious Peritonitis which contrasts success before and after I started using F series. (I no longer use anything else, there’s no point.) See:
    * Hpathy Nov 2009 “Feline Infectious Peritonitis (FIP): Case Management and Suggested New Rubrics Developed From 500 Cases.”

    Further, although Pitcairn writes as if he speaks for all homeopaths on the matter of dry versus wet, this is not so. [He states “6. The experience of experienced homeopaths, is that there is no advantage of giving the remedy in liquid form vs. as dry pellets.”]
    This is totally untrue and when working with very severe chronic cases such as FIP, lymphoma, and some other fast moving illnesses in cats to name a few examples, this becomes very clear very quickly.
    Having the remedy in water is essential in cases where speed of medication must be optimized in order for the rate of damage by disease to be overcome faster than it can destroy its victim. there is no way to do that with solid remedy and I have yet to see the advantage of solid anywhere other than for emergency use where the fastest remedy application is whatever is most quickly to hand for the snake bite or other emergency.
    Indeed Hahnemann explained it well. The body dislikes two doses in a row of the same potency as occurs in solid dosing. Aqueous remedy allows for faster repetition of doses as needed to make faster progress in a case.
    Dry dosing repeated will either aggravate or antidote if given before the first dose is worn off, and if one waits for the first dose to be fully worn off, the disease will win the race in the kind of cases I work with.

    So it may not matter much in a slow case where one can afford to waste time, but there is none to be wasted in a lot of dire diseases and that is where the clear efficacy of aqueous dosing becomes …clear as water:-)

    FInally, Pitcairn says:
    “The basic factor that underlies the varying responses to remedy administration —this being the susceptibility of the patient — at the present time lies outside the province of homeopathy.”

    I feel this shows lack of understanding of the complexity of advanced homeopathy practice. Responses to remedy administration are to me, by definition, part of homeopathy.
    There are many complex factors that determine how a specific individual responds, and that is so even when one can know that the remedy selected is an excellent simillimum. These factors include among others, the age, strength and general health of the individual, the degree of damage to the immune system ad especially the thymus, the quality of nutrition in the case history, any epigenetic changes during the lifetime or inherited, and any genetic predisposition (for example red furred cats are less capable of handling toxins as are those closer to the wild like Bengals and Savannahs.)
    These things are not outside homeopathy. They are an integral part of it, though we use different terms in homeopathy. The individual’s “innate constitutional type” is the homeopathic key to what allopathy calls genetic susceptibility and miasms are the homeopathic key to what allopathy calls epigentics. But it is al relevant, and a homeopath fro cats who fails to adjust remedy dosing when a red cat is presented, or to ensure to help with liver support for detoxification is a natural part of the *homeopathic* case, is not doing their due diligence in homeopathy.

    An advanced illness case will need individual dosing schedule – and that will apply no matter how well the remedy, potency and dose size is selected. It takes skill and good training to know how to judge this and how to explain it to the client – how to *observe* response to remedy and know what is positive and when it wears off and thus indicates the readiness fro a new dose.

    I thus respectfully disagree with the ideas presented in this article.

    Irene de Villiers, B.Sc AASCA MCSSA D.I.Hom/D.Vet.Hom.
    P.O. Box 4703 Spokane WA 99220.
    http://www.angelfire.com/fl/furryboots/clickhere.html (Veterinary Homeopath.)
    “Man who say it cannot be done should not interrupt one doing it.”

    • Irene,
      Thanks for the reply.
      I will respond to a couple of points you bring up.

      WET VS. DRY
      In regard to dosing wet vs. dry, for what it is worth, I am speaking from over 40 years of experience treating animals (and some people — family, friends). I have done careful comparisons of the two methods over the years, as careful as I could arrange, and my opinion comes from this.

      As to the question of susceptibility, Hahnemann does not go into this. He does describe it as being necessary, though he does not use the word “susceptibility.” In aphorism 31, he says —
      “The—partly psychical and partly physical—inimical potences in life on earth (which we call disease malignities) do not possess an absolute power to morbidly mistune the human condition. We become diseased by them only when our organism is just exactly and sufficiently disposed and laid open to be assailed by the cause of disease that is present and to be altered in its condition, mistuned and displaced into abnormal feelings and functions. Hence these inimical potences do not make everyone sick every time.”
      So here he is saying that you must be susceptible to be affected by anything. If you would say that the susceptibility comes from the miasms, that begs the question because we have to consider why there is susceptibility to miasms, as not everyone is. To say it hinges on age, or nutrition, how strong they are is also contradicted by many, many examples of people living lives we would not approve of, and yet never becoming ill. On the other hand, you can be living a very healthy life (by our standard) and become quite ill. And so on.
      So it is not obvious where there is this difference. Yes, we can have our own ideas about if and they may be correct. An example is from my study of Hahnemann’s writings, the Introduction of the 6th edition, pages 36 and 37. There he tells us the life force is not the best healer of diseases, that the methods it uses should not be imitated by doctors. The part that has the most significance to me is this paragraph (page 37) —
      “The life force, that glorious power innate in the human being, was ordained to conduct life in the most perfect way during its health. The life force, which is equally present in all parts of the organism (in the sensible as well as the irritable fiber) is the untiring mainspring of all normal natural bodily functions. It was not at all created for the purpose of helping itself in diseases nor for exercising a medical art worthy of imitation.”
      Why would it not be created to deal with disease? Hahnemann tells us there is Diving Providence providing the way to deal with this. Why would not, then, the life force be given the means to work with this challenge”
      My thought is that Hahnemann is telling us that when the life force was created, there was no disease in existence. We created that later.

      Well, some more ideas. An interesting study, wouldn’t you say?

  • It is clear that Dr.Richard Pitcairn is a very close prescriber and his experience counts much. There’s no difference between dry and wet dosing. There can’t be. As soon as a dry globule in put in the mouth, it is dissolved in saliva & becomes wet dose only. Since the potencised remedy is absorbed from the mucus membrane itself & not from the stomach, insisting that the remedy dissolved in water is more effective than dry globules, lacks any logical explanation. (there are more compelling reasons for this conclusion but this one is the simplest)

    As he observed rightly that the excessive emphasis given to the mode of administration is actually due to an inability to select the right remedy
    His opinion is valuable.
    I appreciate Dr. Pitcairn. Even his other observations are quite acceptable and scientific.

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