Editor’s Note: The potency selection guidelines in this article are a collection of personal views of various authors and are based on individual experiences. These are not definite indications for the use of any potency and some of the guidelines might not get approval from many modern homeopaths. These guidelines can add to our understanding of the complex issue of homeopathic posology but should not be followed blindly in any case.
In acute diseases 1M and 10M are the most useful. From 10M to the MM are all useful for all ordinary chronic diseases in persons not so sensitive.
In persons suffering from chronic sickness and not so sensitive, the 10M may first be used, and continued without change so long as improvement lasts; then the 50M will act precisely in the same manner, and should be used so long as the patient makes progress toward health; them the CM may be used in the same manner, and the DM and MM in succession. By this use of the series of potencies in a given case, the patient can be held under the influence of the similimum, or a given remedy, until cured. …… (Kent)
The more similar the remedy, the more clearly and positively the symptoms of a patient take on the peculiar and characteristic form of the remedy, the greater the susceptibility to that remedy, and the higher the potency required.
Generally speaking, susceptibility is greatest in children and young, vigorous persons, and diminishes with age. Children are particularly sensitive during development, and the most sensitive organs are those which are being developed. Therefore the medicines which have a peculiar affinity for those organs should be given in the medium or higher potencies.
The higher potencies are best adopted to sensitive persons of the nervous, sanguine or choleric temperament; to intelligent, intellectual persons, quick to act and react; to zealous and impulsive persons.
If the potency is too high its action may be too deep and far reaching, and the reaction too great for the weakened vital power to carry on. Such remedies as Sulphur, Calcarea carbonica, Mercurius, Arsenic and Phosphorus, given in the 50M or CM potencies, have sometimes hastened tubercular or tertiary syphilis cases into the grave. In beginning treatment of such suspicious or possibly incurable cases it is better to use medium potencies, like the 30th or 200th and go higher gradually, if necessary, as treatment progresses and the patient improves… (S. Close)
When the symptoms of a case clearly indicate one remedy, whose characteristic symptoms correspond closely to the characteristic symptoms of the case, we give high potenciesâ€”thirtieth, two hundredth, thousandth, or higher according to the prescriber’s degree of confidence and the contents of his medicine case. …………………. (Jahr)
If a case seems relatively curable and free of physical pathology, higher initial potencies may be tried, ranging from 30 to CM. The primary guiding principle here is the degree of certainty which the homoeopath has about the remedy. If the medicine seems very obvious and covers the case very well, a very high potency may be given in a person with a curable system. If the remedy is not so clear, it is better to begin with a potency closer to 30. …………………………………… (George Vithoulkas)
In children with acute ailments (because their defensive mechanisms are quite strong), it is best not to give potencies lower than 200; thus 200 to CM potencies can be given, depending upon certainty of the medicine for acute ailments.
An M.D with a few years’ experience in homoeopathy attempted to treat a child suffering from severe mental disorders. The patient had received approximately fifteen remedies, some of which had partial actions and others of which had no action. The case was sent to me and the case taken during the initial interview showed clearly Veratrum Album, which had been given only as the tenth prescription amidst a variety of others. Based upon this initial interview, Veratrum Album 50M (it is best to with go high potencies if possible in such cases) was given again with instructions to wait after that for a full three months in order to fully evaluate the direction of the remedy……………………………….(George Vithoulkas)
From 30th to 10M will be found those curative powers most useful in very sensitive women and children.
In sensitive women and children, it is well to give the 30th or 200th at first, permitting the patient to improve in a general way, after which the 1M may be used in similar manner. After improvement with that ceases, the 10M may be required.
Some patients are very sensitive to the highest potencies and are cured mildly and permanently by the use of 200th or 1000th. There are other individuals who are torn to pieces by the use of the highest potencies.
Patients who have heart disease, or who are suffering from phthisis are apt to have their sufferings increased and the end hastened by the higher potencies; they do better under 30th or 200th.
If you strike too high she is not sensitive, it is not sufficient. Keep to the mild potency so long as it works. It is not well to jump too many degrees. From the crude to 10M there is a range of degrees in ordinary persons. . (Kent)
A single dose of the appropriate nosode (In a case, which is not at all susceptible to the indicated remedy) in a moderately high potency, will sometimes clear up a case by bringing symptoms into view which will make it possible to select the remedy required to carry on the case. ……………………………………… (Stuart Close)
A correctly chosen remedy given in too low or sometimes too high a potency, or in too many doses, may cause an aggravation of the existing symptoms as to endanger the life of the patient; especially if the patient be a child or a sensitive person and if a vital organ, like the brain or lung be affected. Belladonna in the third or sixth potency, given in too frequent doses in a case of meningitis, for example, may cause death from over-action; whereas the thirtieth or two hundredth potency given in single dose or in doses repeated only until some change of symptoms is noticed, will speedily cure. Phosphorus 3rd or 6th in pneumonia under similar circumstances may rapidly cause death. The low potencies of deeply acting medicines are dangerous in such cases in proportion to their similarity to the symptoms. ……………………………. (Stuart Close)
Oversensitive patients present a unique problem for potency selection. There are patients who are excessively “nervous” reactive to all physical and emotional stimuli, usually lean and quick in their movements, restless, sensitive to odors and noise and light, and frequently suffering strongly from exposure to chemicals in the environment or food. Such people are very reactive both to low potencies (on physical level) and high potencies (on electrodynamic level). Consequently, it is better to restrict initial prescriptions to 30 or 200 in such patients; depending upon their reaction, later potencies might go higher or lower. But initially at least, 30 or 200 are the best selections for oversensitive patients. …(George Vithoulkas)
On the other hand, another young person comes to you with a similar complaint, but you cannot decide whether she needs Pulsatilla or Sulphur. You finally decide upon Pulsatilla after many hours of careful study; in this instance, you would tend to give only a 30 or 200 for the initial prescription because of the lack of clarity.
In still another case with a skin eruption, you may see clearly that Pulsatilla is indicated. Yet the patient reports that she able keep her skin eruption under control by using cortisone ointment “only” twice a week. Further you observe that there are other weaknesses of the organismâ€”a weak vitality, the patient is easily tired, easily affected by chemicals in the environment. In this type of case you would not give a potency higher than 200; otherwise you may witness an unnecessary prolonged aggravation.
If the patient is elderly, chronically weakened, or even if severely weakened by the acute ailment (for example, if it has developed into a severe pneumonia), a 200 potency would be preferable for the initial prescription, even if the remedy is quite obvious. …(George Vithoulkas)
Sometimes very sensitive patients will do well on a high potency if they have been prepared for it by the use of a lower one. (connect sentences) I have seen Sulphur and Phosphorus act so strongly that I have regretted it. In lung cases, consider whether she has lung space enough to make recovery probable. If she can bear it, give it in low potency, but do not give it if there is not lung space enough to warrant it. ……. (Kent)
Where the symptoms are not clearly developed and there is an absence or scarcity of characteristic features; or where two or three remedies seem about equally indicated, susceptibility and reaction may be regarded as low. We give, therefore, the remedy which seems most similar, in a low (third to twelfth) potency. …………………. (Jahr)
Lower potencies and larger and frequent doses correspond better to torpid and phlegmatic individuals, dull of comprehension and slow to act; to coarse fibered, sluggish individuals of gross habits; to those who possess great muscular power but who require a powerful stimulus to excite them. Such persons can take with seeming impunity large amounts of stimulants like whisky, and show little effect from them. When ill they often require low potencies, or even sometimes material doses. …………(Stuart Close)
If the grade of the disease is low, and the power of reaction low, the remedy must be given low. Thus we find, in such cases, that the symptoms of the patient are usually of a low order; common, pathological symptoms; organ symptoms; gross terminal symptoms; symptoms that correspond to the effects of crude drugs in massive toxic doses. The finer shadings of symptoms belonging to acute conditions, in vigorous sensitive patients, do not appear. Potentized medicines will not act. The case has passed beyond that stage, and finer symptoms with it. Yet the symptoms remain and the almost hopeless conditions they represent, are still within the scope of the homoeopathic law; and they sometimes yield to its power, when the related law of posology is rightly understood and applied.
People who are accustomed to long and severe labour out-of-doors, who sleep little and whose food is coarse, are less susceptible. Persons exposed to continual influence of drugs, such as tobacco workers and dealers; distillers and brewers and all connected with the liquor and tobacco trade; druggists, perfumers, chemical workers, etc. often possess little susceptibility to medicines and usually require low potencies in the illnesses.
The seat, character and intensity of the disease has some bearing upon the question of the dose. Certain malignant and rapidly fatal diseases, like cholera, may require material doses or low potencies of the indicated remedy.
Occasionally a case will be met which is not at all susceptible to the indicated remedy. Hahnemann has recommended in such cases, the administration of Opium, in one of the lowest potencies, every eight or twelve hours until some signs of reaction are perceptible. By this, he says, the susceptibility is increased and the new symptoms of the diseases are brought to light. Carbo-veg, Laurocerasus, Sulphur and Thuja are other remedies suited to such conditions. They sometimes serve to arouse the organism to reaction so that indicated remedies will act. ……….(S. Close)
There are certain types of cases in which relatively low potencies should be used¯ at least initially. Patients who have weak constitutions, old people, or very hypersensitive people should initially be given potencies ranging, roughly, from 12x to (space)200. The reason for this is that higher potencies can over stimulate the weakened defense mechanism, resulting in unnecessary powerful aggravations.
Children who are suffering from severe problems should generally be given low potencies. An infant with severe eczema or psoriasis is likely to have a severe aggravation if given a high potency. Consequently, such cases might be given just a few doses (say daily) of a 12x, or just one dose of a 30 or 200.
Generally, cases with known malignancy should not initially be given potencies above200. If a case is merely suspected to have a malignant or premalignant condition, the initial prescription should not be higher than 1M. Again such potency restriction is in order to avoid unnecessary powerful physical aggravations, which require considerable experience to manage. ……………… George Vithoulkas)
Excerpted from : The Appropriate Potency by Dr. Mir Zahed
Dr. Zahed in an honorary lecturer at the Homoeopathic Academy of Niagara- Canada. He has authored the following books:
1. How to Understand the Homoeopathic Materia Medica.
2. Case Taking in the Light of Organon.
3. The Appropriate Potency.