Homeopathy Papers Organon & Philosophy

Potency Selection Guidelines by Dr. Hahnemann

4th Edition of Organon of Medicine (1829)
Aphorisms 248 – 251
Aphorisms 270, 272, 275, 276, 281-286

5th Edition of Organon of Medicine (1833)
Aphorisms 246-249
Aphorisms 275-279
Aphorisms 284- 288

6th Edition of Organon of Medicine (1842)
Aphorisms 254 – 249
Aphorisms 272, 275 – 278, 280, 281, 284

Chronic Diseases (1828-1830)
Pages 125-127, 130, 156, 157, 159

Guidelines in 4th Edition of Organon of Medicine (1829)

All emphasis (bold/italic/underline) and summary notes by Dr. Manish Bhatia

§ 248. The dose of the same medicine should be repeated until a cure is effected, or until it ceases any longer to afford relief; in the latter alternative, the remnant of the disease, with its altered group of symptoms, will require another homoeopathic remedy.

Summary Notes

§ 249. Every medicine which, in the course of its operation, produces new symptoms that do not appertain to the disease to be cured, and that are annoying, is incapable of procuring real amendment,* and cannot be considered as homoeopathically chosen. If the deterioration of symptoms be important, the effect of the medicine must be extinguished, in part, without delay, by means of an antidote, before another and more homoeopathic remedy is given, or if the new symptoms be not violent, the other remedy must be immediately given, to take the place of that which has been so unfitly chosen.

* All experience teaches us, that scarcely any homoeopathic medicine can be prepared in too minute a dose to produce perceptible benefit in a disease to which it is adapted (§ 161. 279). Hence it would be an improper and injurious practice, when the medicine produces no good effect, or an inconsiderable exacerbation of the symptoms, after the manner of the old school, to repeat or increase the dose under the idea that it cannot prove serviceable on account of its minuteness. Every exacerbation caused by new symptoms, when nothing injurious has occurred with regard to diet or mental impressions, always proves the unsuitableness of the medicine previously given, but never indicates the weakness of the dose.

Summary Notes

  • If a remedy produces new symptoms during treatment, it cannot be considered the simillimum.
  • If the new symptoms are mild, reassess the case and give the right remedy immediately.
  • If the new symptoms are severe, first antidote the wrong remedy and then reassess the case and give the right remedy.

§ 250. When in urgent cases, after the lapse of six, eight, to twelve hours, it becomes manifest to the observant physician who has accurately investigated the character of the disease, that he has made a false selection of the remedy last administered, when, during the appearance of new symptoms, the disease becomes, though slightly, yet evidently worse from hour to hour, it is not only admissible, but duty renders it imperative on him to rectify the mistake he has made, and administer another homoeopathic remedy not only tolerably, but the best possibly adapted to the morbid condition at the time (§ 167).

Summary Notes

  • In emergency cases or in cases regressing rapidly, the physician should not wait even if new symptoms have appeared. He should reassess the case and give the right remedy immediately without waiting.

§ 251. There are some medicines, for example, Ignatia amara, Bryonia, Rhus, and sometimes Belladonna, whose power of changing the human economy chiefly consists in the production of alternate effects—a kind of primary symptoms, partly in opposition to each other. If the physician find no improvement after the strict homoeopathic selection and administration of one of these remedies (in acute cases, after a few hours), then by repeating it in the same dilution, he will quickly obtain the desired effect.*

* As I have explained more circumstantially in the introduction to the article Ignatia (Mat. Medorrhinum vol. ii.)

Summary Notes

  • If you are very sure of your remedy selection but the patient does not react to your first dose, repeat the same medicine in the same dose again and you will most likely see a positive reaction, esp. when your remedy has some alternating action.

§ 252. But if in a chronic disease (psoric) the most homoeopathic remedy (anti-psoric), administered in the smallest and most suitable dose, does not produce an amendment, it is a sure sign that the cause which keeps up the disease still exists, and that there is something either in the regimen or condition of the patient that must be first altered before a permanent cure can be effected.

Summary Notes

  • But if you still fail to produce a positive reaction from the right remedy in a chronic case, look for a maintaining cause which might be working as an obstruction to cure.

§ 253. In all diseases, particularly those which are acute, the state of mind and general demeanor of the patient are among the first and most certain of the symptoms (which are not perceived by everyone) that announce the beginning of any slight amendment or augmentation of the malady. If the disease begins to improve, though in ever so slight a degree, the patient feels more at ease, he is more tranquil, his mind is less restrained, his spirits revive, and all his conduct is, so to express it, more natural. The very reverse takes place where there is only a slight increase; an embarrassment and helplessness, which call for commiseration, are observable in the mind and temper of the patient, as well as in all his actions, gestures, and postures—something both remarkable and peculiar which cannot escape the eye of an attentive observer, but which it would be difficult to describe in words.*

* In order to have a determinate rule for the moderate development of power of the fluid medicines, multiplied experience and observation have led me to retain two shakes for every vial, in preference to a greater number, which had previously been used, but which developed the energy in too great a degree. On the contrary, there are homoeopathists who, in their visits to the sick, carry about their persons the medicines in a fluid state, which, they nevertheless affirm, do not in time become increased in energy by the frequent agitation to which they are thus subjected. This declaration, however, betrays on their part the want of a talent for accurate observation. I dissolved a grain of natron in half an ounce of a mixture of water and a little alcohol, poured the solution into a vial, which was thereby filled two-thirds, and shook it uninterruptedly for half an hour. By this agitation, the fluid attained an energy equal to that of the thirtieth dilution.

Summary Notes

  • In all disease, but especially in acutes, after the administration of the right remedy, the first change that will be noticed is that the energy levels of the patient will increase and the patient will feel more relaxed, more at peace and less anxious.
  • Hahnemann though that 10 or more strokes/succussions between each dilution raises the potency too much and he settled at two strokes between each dilution.

§ 270. If two drops of a mixture of equal parts of alcohol and the recent juice of any medicinal plant (see § 267) be diluted with ninety-eight drops of alcohol in a vial capable of containing one hundred and thirty drops, and the whole twice shaken together, the medicine becomes exalted in energy (potenzirt) to the first developement of power, or, as it may be denominated, the first potence. The process is to be continued through twenty-nine additional vials, each of equal capacity with the first, and each containing ninety-nine drops of spirits of wine; so that every successive vial, after the first, being furnished with one drop from the vial or dilution immediately preceding (which had just been twice shaken), is, in its turn, to be shaken twice,” remembering to number the dilution of each vial upon the cork as the operation proceeds. These manipulations are to be conducted thus through all the vials, from the first up to the thirtieth or decillionth developement of power (potenzirte Decillion-Verdünnung, X.), which is the one in most general use.

Summary Notes

  • Two strokes are to be used to prepare each potency in centesimal scale.
  • 10C was the potency that he most often used at this time.

§ 272. In no instance is it requisite to employ more than one simple medicinal substance at a time.*

* have been made by some homoeopathists in cases where, imagining that one part of the symptoms of a disease required one remedy, and that another remedy was more suitable to the other part, they have given both remedies at the same time, or nearly so; but I earnestly caution all my adherents against such a hazardous practice, which never will be necessary, though, in some instances, it may appear serviceable.

Summary Notes

  • Give a single remedy at any given time.

§ 275. The appropriation of a medicine to any given case of disease does not depend solely upon the circumstance of its being perfectly homoeopathic, but also upon the minute quantity of the dose in which it is administered. If too strong a dose of a remedy, that is even entirely homoeopathic, be given, it will infallibly injure the patient, though the medicinal substance be of ever so salutary a nature; the impression it makes is felt more sensibly, because, in virtue of its homoeopathic character, the remedy acts precisely on those parts of the organism which have already been most exposed to the attacks of time natural disease.

Summary Notes

  • A medicine becomes the simillimum for a case not just by covering the symptoms of the case but also when given in the right dose (potency and quantity).
  • Even a right remedy, given in too high a dose will harm the patient.

§ 276. Even a homoeopathic medicine is, on this account, always injurious when given in too large a dose, and hurtful to the patient in proportion to the extent of the quantity administered. But the increase of the dose itself is also prejudicial in the same degree as the remedy is more homoeopathic; and a strong dose of such a medicine would do more harm than the dose of all allopathic medicinal substance (which bears no analogy whatever to the disease) of equal strength; for, in that case, the homoeopathic aggravation (5 157-160)—that is to say, the artificial malady, which is very analogous to the natural one excited by the remedy in the most suffering parts of the organism—is carried to a height that is injurious (§ 246, note); whereas, if it had been confined within proper limits, it would have effected a gentle, prompt, and certain cure. It is true the patient no longer suffers from the primitive malady which has been homoeopathically destroyed, but he suffers so much more from the medicinal one which was much too powerful, and from unnecessary debility.

Summary Notes

  • If the right medicine is given in a very large dose (potency or quantity), it will create strong homeopathic aggravation.

§ 281. All diseases have an extraordinary tendency to undergo a change when operated upon by the influence of homogeneous medicinal agents. There is no patient, however robust his constitution may be, who, if attacked merely by a chronic disease, or by what is called a local malady, does not speedily experience a favourable change in the suffering parts after having taken the appropriate homoeopathic remedy in the smallest dose possible. In short, the effects of this substance will make a greater impression on him than they would upon a healthy child twenty-four hours after its birth. How insignificant and ridiculous is mere theoretic incredulity, when opposed to the infallible evidence of facts!

§ 282. However feeble the dose of a remedy may be, provided it can in the slightest degree aggravate the state of the patient homoeopathically provided it has the power of exciting symptoms similar to those of the primitive disease, but rather more intense, it will, in preference, and almost exclusively, affect those parts of the organism that are already in a state of suffering, and which are strongly irritated and predisposed to receive any irritation analogous to their own. Thus an artificial disease rather more intense is substituted in the place of the natural one. The organism no longer suffers but from the former affection, which, by reason of its nature, and the minuteness of the dose by which it was produced, soon yields to the efforts of the vital force to restore the normal state, and thus leaves the body (if the disease was an acute one) free from suffering that is to say, in a healthy condition.

§ 283. To proceed, therefore, in a manlier conformable to nature, the true physician will only administer a homoeopathic remedy in the precise dose necessary to exceed and destroy the disease to which it is opposed, so that if by one of those errors, pardonable to human frailty, he had made choice of a remedy that was inappropriate, the injury that might result from it would be so slight that the development of the vital force, and the administration of the smallest close of another remedy more homoeopathic, would suffice to repair it.

§ 284. The effects of a dose are by no means diminished in the same proportion as the quantity of the medicinal substance is attenuated in the homoeopathic practice. Eight drops of a tincture taken at once do not produce upon the human body four limes the effect of a dose of two drops ; they merely produce one that is nearly double. In the same manner the single drop of a mixture, composed of one drop of a tincture and ten of a liquid void of all medicinal properties, does not produce ten limes the effect that a drop ten times more attenuated would produce, but merely an effect that is scarcely double. The progression continues according to this law, so that a single drop of a dilution, attenuated in the highest degree, ought, and does in fact, produce a very considerable effect.*

* Suppose, for example, that one drop of a mixture containing the tenth of a grain of any medicinal substance produces art effect = a; a drop of another mixture containing merely a hundredth part of a grain of this same substance will only produce an effect= a/2; if it contains a ten thousandth part of a grain of medicine, the effect will be = a/4; if a millionth, it will be = ; and so on progressively, to an equal volume of the doses, the effects of the remedy on the body will merely be diminished about one half each time that the quantity is reduced nine tenths of what it was before. I have often seen a drop of the tincture of Nux vomica at the decillionth degree of dilution, produce exactly half the effect of another at the quintillionth degree, when I administered both one and the other to the same individual, and under the same circumstances.

§ 285. By diminishing the volume of the dose, the power of it is also diminished—that is to say, when instead of one entire drop of attenuated tincture merely a fraction of this drop be administered,* the object of rendering the effect less powerful. is then very perfectly attained. The reason of this may be easily conceived: the volume of the dose being diminished it must necessarily follow that it will touch a less number of the nerves of the living organism, by contact with which, it is true, the power of the medicine is communicated to the whole body, but it is transmitted in a smaller degree.

* The best mode of administration is to make use of small globules of sugar, the size of a mustard seed ; one of these globules having imbibed the medicine, and being introduced into the vehicle, forms a close containing about the three hundredth part of a drop, for three hundred of such globules will imbibe one drop of alcohol ; by placing one of those on the tongue, and not drinking anything after it, the dose is considerably diminished. But if the patient is very sensitive, and it is necessary to employ the smallest dose possible, and attain at the same time the most speedy results, it will be sufficient to let him smell once. (See § 288, note).

Summary Notes

  • Small, mustard seed size sugar pills are the best mode for administering a remedy.
  • One such globule will comprise one dose.
  • If the patient is oversensitive, he can just smell one such globule.

§ 286. For the same reason, the effect of a homoeopathic dose is increased when we augment the quantity of the liquid in which it is dissolved to administer it to the patient ; but then the remedy comes in contact with a much more extended surface, and the nerves that feel its effects are far more numerous. Although theorists have asserted that the extension of a medicine in liquid weakens its action, experience proves the reverse, at least as far as regards homoeopathic remedies.*

* Only wine and alcohol, which are the most simple of all excitants, lose a portion of their heating and exciting power when they are attenuated in a large quantity of water.

Summary Notes

  • The quality of the homeopathic medicine increases with the dilution.

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Guidelines in 5th Edition of Organon of Medicine (1833)

All emphasis (bold/italic/underline) and notes by Dr. Manish Bhatia

§ 246 Fifth Edition

On the other hand, the slowly progressive amelioration consequent on a very minute dose, whose selection has been accurately homoeopathic, when it has met with no hindrance to the duration of its action, sometimes accomplishes all the good the remedy in question is capable from its nature of performing in a given case, in periods of forty, fifty or a hundred days. 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. And this may be very happily affected, as recent and oft-repeated observations have shown, under three conditions: firstly, if the medicine selected with the utmost care was perfectly homoeopathic; secondly, if it was given in the minutest dose, so as to produce the least possible excitation of the vital force, and yet sufficient to effect the necessary change in it; and thirdly, if this minutest yet powerful dose of the best selected medicine be repeated at suitable intervals,1 which experience shall have pronounced to be the best adapted for accelerating the cure to the utmost extent, yet without the vital force, which it is sought to influence to the production of a similar medicinal disease, being able to feel itself excited and roused to adverse reactions.

Summary Notes

  • A single dose may be able to bring about a cure in chronic cases IF its action continues unhindered for many months.
  • BUT this happens only rarely. A single dose is often not sufficient to cure chronic diseases.
  • The medicine should be repeated to hasten the cure. After all, the ideal cure has to be rapid (aph 2).
  • The medicines should not be repeated blindly. They should only be repeated at suitable intervals.

Footnote to Aph 246 in 5th edition

1 In the former editions of the Organon I have advised that a single dose of a well-selected homoeopathic medicine should always be allowed first fully to expend its action before a new medicine is given or the same one repeated – a doctrine which was the result of the positive experience that neither by a larger dose of the remedy, which may have been well chosen (as has been again recently proposed, but which would be very like a retrograde movement), nor, what amounts to the same thing, by several doses of it given in quick succession, can the greatest possible good be effected in the treatment of diseases, more especially of chronic ones; and the reason of this is, that by such a procedure the vital force dose not quietly adapt itself to the transition from the natural disease to the similar medicinal disease, but is usually so violently excited and disturbed by a larger dose, or by smaller doses of even a homoeopathically chosen remedy given rapidly one after the other, that in most cases its reaction will be anything but salutary and will do more harm than good. As long as no more efficacious mode of proceeding than that then taught by me was discovered, the safe philanthropic maxim of sin non juvat, modo ne noceat, rendered it imperative for the homoeopathic practitioner, for whom the weal of his fellow-creatures was the highest object, to allow, as a general rule in diseases, but a single dose at a time, and that the very smallest, of the carefully selected remedy to act upon the patient and, moreover, to exhaust its action. The very smallest, I repeat, for it holds good and will continue to hold good as a homoeopathic therapeutic maxim not to be refuted by any experience in the world, that the best doses of the properly selected remedy is always the very smallest on in one of the high potencies (X), as well for chronic as for acute as for acute diseases – a truth that is the inestimable property of pure homoeopathy and which as long as allopathy and the new mongrel sect, whose treatment is a mixture of allopathic and homoeopathic processes is not much better continues to gnaw like a cancer at the life of sick human beings, and to ruin them by large and ever larger doses of drugs, will keep pure homoeopathy separated from these spurious arts as by an impassable gulf.

On the other hand, however, practice shows us that though a single one of these small doses may suffice to accomplish almost all that it was possible for this medicine to do under the circumstances, in some, and especially in slight cases of disease, particularly in those of young children and very delicate and excitable adults, yet that in many, indeed in most cases, not only of very chronic diseases that have already made great progress and have frequently been aggravated by a previous employment of inappropriate medicines, but also of serious acute diseases, one such smallest dose of medicine in our highly potentized dynamization is evidently insufficient to effect all the curative action that might be expected from that medicine, for it may unquestionably be requisite to administer several of them, in order that the vital force may be pathogenetically altered by them to such a degree and its salutary reaction stimulated to such a height, as to enable it to completely extinguish, by its reaction, the whole of that portion of the original disease that it lay in the power of the well-selected homoeopathic remedy to eradicate; the best chosen medicine in such a small dose, given but once, might certainly be of some service, but would not be nearly sufficient.

But the careful homoeopathic physician would not venture soon to repeat the same dose of the same remedy again, as from such a practice he has frequently experienced no advantage, but most frequently, on close observation, decided disadvantage. He generally witnessed aggravation, from even the smallest dose of the most suitable remedy, which he has given one day, when he repeated the next day and the next.

Now, in cases where he was convinced of the correctness of his choice of the homoeopathic medicine, in order to obtain more benefit for the patient than he was able to get hitherto from prescribing a single small dose, the idea often naturally struck him to increase the dose, since, for the reason given above, one single dose only should be given; an, for instance, in place of giving a single very minute globule moistened with the medicine in the highest dynamization, to administer six, seven or eight of them at once, and even a half or a whole drop. But the result was almost always less favourable than it should have been; it was often actually unfavourable, often even very bad – an injury that, in a patient so treated, is difficult to repair.

The difficulty in this case is not solved by giving, instead, lower dynamizations of the remedy in a large dose. Thus, increasing the strength of the single doses of the homoeopathic medicine with the view of effecting the degree of pathogenic excitation of the vital force necessary to produce satisfactory salutary reaction, fails altogether, as experience teaches, to accomplish the desired object. This vital force is thereby too violent and too suddenly assailed and excited to allow it time to exercise a gradual equable, salutary reaction, to adapt itself to the modification effected in it; hence it strives to repel, as if it were an enemy, the medicine attacking it in excessive force, by means of vomiting, diarrhoea, fever, perspiration, and so forth, and thus in a great measure it diverts and renders nugatory the aim of the incautious physician – little or no good towards curing the disease will be thereby accomplished; on the contrary, the patient will be thereby perceptibly weakened and, for a long time, the administration of even the smallest dose of the same remedy must not be thought of if we would not wish it to injure the patient.

But it happens, moreover, that a number of the smallest doses given for the same object in quick succession accumulate in the organism into a kind of excessively large dose, with (a few cases excepted) similar bad results; in this case the vital force, not being able to recover itself betwixt every dose, though it be but small, becomes oppressed and overwhelmed, and thus being incapable of reacting in a salutary manner, it is necessitated passively to allow involuntary the continuance of the over-strong medicinal disease that has thus been forced upon it, just in the same manner as we may every day observe from the allopathic abuse of large cumulative doses of one and the same medicine, to the lasting injury of the patient.

Now, therefore, in order, whilst avoiding the erroneous method I have here pointed out, to attain the desired object more certainly than hitherto, and to administer the medicine selected in such a manner that it must exercise all its efficacy without injury to the patient, that it may effect all the good it is capable of performing in a given case of disease, I have lately adopted a particular method.

I perceived that, in order to discover this true middle path, we must be guided as well by the nature of the different medicinal substances, as also by the corporeal constitution of the patient and the magnitude of the disease, so that – to give an example from the use of sulphur in chronic (psoric) diseases – the smallest dose of it (tinct, sulph. X°) can seldom be repeated with advantage, seen in the most robust patients and in fully developed psora, oftener than every seven days, a period of time which must be proportionally lengthened when we have to treat weaker and more excitable patients of this kind; in such cases we would do well to give such a dose only every nine, twelve, or fourteen days, and continue to repeat the medicine until it ceases to be of service. We thus find (to abide by the instance of sulphur) that in sporic diseases seldom fewer than four, often however, six, eight and even ten doses (tinct. sulph. X°) are required to be successively administered at these intervals for the complete annihilation of the whole portion of the chronic disease that is eradicated by sulphur – provided always there had been no previous allopathic abuse of sulphur in the case. Thus even a (primary) scabious eruption of recent origin, though it may have spread all over the body, may be perfectly cured, in persons who are not too weakly, by a dose of tinct sulph. X° given every seven days, in the course of from ten to twelve weeks (accordingly with ten or twelve such globules), so that it will seldom be necessary to aid the cure with a few doses of carb. veg. X° (also given at the rate of one dose per week) without the slightest external treatment besides frequent changes of linen and good regimen.

When for other serious chronic diseases also we may consider it requisite, as far as we can calculate, to give eight, nine or ten doses of tinct. sulph. (at X°) it is yet more expedient in such cases, instead of giving them in uninterrupted succession, to interpose after every, or every second or third dose, a dose of another medicine, which in this case is next in point of homoeopathic suitableness to sulphur (usually hep. sulph.) and to allow this likewise to act for eight, nine, twelve or fourteen days before again commencing a course of three doses of sulphur.

But it not infrequently happens that the vital force refuses to permit several doses of sulphur, even though they may be essential for the cure of the chronic malady and are given at the intervals mentioned above, to act quietly on itself; this refusal it reveals by some, though moderate, sulphur symptoms, which it allows to appear in the patient during the treatment. In such cases it is sometimes advisable to administer a small dose of nux vom. X°, allowing it to act for eight or ten days, in order to dispose the system again to allow succeeding doses of the sulphur to act quietly and effectually upon it. In those cases for which it is adapted, puls. X° is preferable.

But the vital force shows the greatest resistance to the salutary action upon itself of the strongly indicated sulphur, and even exhibits manifest aggravation of the chronic disease, though the sulphur be given in the very smallest dose, though only a globule of the size of a mustard seed moistened with tinct. sulph X° be smelt, if the sulphur have formerly (it may be years since) been improperly given allopathically in large doses. This is one lamentable circumstance that renders the best medical treatment of chronic disease almost impossible among the many that the ordinary bungling treatment of chronic diseases by the old school would leave us nothing to do but to deplore, were there not some mode of getting over the difficulty.

In such cases we have only to let the patient smell a single time strongly at a globule the size of a mustard seed moistened with mercur metall. X, and allow this olfaction to act for about nine days, in order to make the vital force again disposed to permit the sulphur (at least the olfaction of tinct. sulph. X°) to exercise a beneficial influence on itself – a discovery for which we are indepted to Dr. Griesselich, of Carlsruhe.

Summary Notes

  • A single dose may prove curative in some cases (not all).
  • A single dose is more likely to prove curative when the disease is slight (functional/not grave/no advanced pathology).
  • A single dose is more likely to prove curative in young children and delicate, excitable young adults who do not suffer from very serious chronic disease.
  • In serious acute diseases, advanced chronic diseases and in cases which have received lot of inappropriate (allopathic) treatment, a single dose will not be enough to cure.
  • In such cases, a single dose may bring some relief but will not prove curative.
  • One should not repeat the same remedy in the same potency very soon. (Give a gap of few days in such cases). Repetition of same remedy in same potency will bring about homeopathic aggravation.
  • To increase the dose, DO NOT increase the number of pills or do not give liquid drop of medicine.
  • Frequently repeated small doses act like a very large dose and the vital force is overwhelmed by them. Hence curative reaction is not brought about even when the remedy is right.
  • To decide the dose and repetition for a case we must take into consideration the nature of the medicinal substance (plant/animal/mineral etc.), the constitution of the patient (susceptibility/vitality) and the severity, intensity and nature of the disease.
  • There should always be a gap of some days before repeating the medicine in same potency, say 7 days or more. The interval should be more for cases with low vitality and for those who are oversensitive. The medicine should be repeated in such manner till it stops working.
  • Such repetition may work better, if after a couple of doses of the right remedy, another remedy (second in line) is given and allowed to act for a few weeks. For instance, while giving Sulphur, Hepar-sulph may be given in between. Please note that this may not be necessary if we are modifying the dose each time by using water potencies.
  • Sometimes the vital force does not respond to repetition of the same medicine in the same potency. In such cases some other medicine like Nux-vomica may be given intermittently.

§ 247 Fifth Edition

Under these conditions, the smallest doses of the best selected homoeopathic medicine may be repeated with the best, often with incredible results, at intervals of fourteen, twelve, ten, eight, seven days, and, where rapidity is requisite, in chronic diseases resembling cases of acute disease, at still shorter intervals, but in acute diseases at very much shorter periods – every twenty – four, twelve, eight, four hours, in the very acutest every hour, up to as often as every five minutes, – in every case in proportion to the more or less rapid course of the diseases and of the action of the medicine employed, as is more distinctly explained in the last note.

Summary Notes

  • In very acute/emergency conditions, repeat every few minutes.
  • In acute cases and acute aggravation of chronic cases, repeat after every few hours.
  • In chronic cases repeat after approximately one to two weeks
  • Do remember the note above that to decide the dose and repetition for a case we must take into consideration the nature of the medicinal substance (plant/animal/mineral etc.), the constitution of the patient (susceptibility/vitality) and the severity, intensity and nature of the disease.

§ 248 Fifth Edition

The dose of the same medicine may be repeated several times according to circumstances, but only so long as until either recovery ensues, or the same remedy ceases to do good and the rest of the disease, presenting a different group of symptoms, demands a different homoeopathic remedy.

Summary Notes

  • The same medicine (and same dose) should not be repeated if –
    • Patient starts recovering.
    • Medicine stops working.
    • Symptom picture changes, demanding another remedy.

§ 249

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 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

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.

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. Like minute doses of a better chosen remedy will re-establish order throughout.

Summary Notes

  • If a medicine produces medicinal symptoms, then it is not the simillimum
  • In such case, if the medicinal symptoms are severe, an antidote should be given.
  • If medicinal symptoms are not severe, another remedy should be given.

§ 275 Fifth Edition

The suitableness of a medicine for any given case of disease does not depend on its accurate homoeopathic selection alone, but likewise on the proper size, or rather smallness, of the dose. If we give too strong a dose of a medicine which may have been even quite homoeopathically chosen for the morbid state before us, it must, notwithstanding the inherent beneficial character of its nature, prove injurious by its mere magnitude, and by the unnecessary, too strong impression which, by virtue of its homoeopathic similarity of action, it makes upon the vital force which it attacks and, through the vital force, upon those parts of the organism which are the most sensitive, and are already most affected by the natural disease.

§ 276 Fifth Edition

For this reason, a medicine, even though it may be homoeopathically suited to the case of disease, does harm in every dose that is too large, the more harm the larger the dose, and by the magnitude of the dose it does more harm the greater its homoeopathicity and the higher the potency1 selected, and it does much more injury than any equally large dose of a medicine that is unhomoeopathic, and in no respect adapted (allopathic) to the morbid state; for in the former case the so-called homoeopathic aggravation (§§157-160) – that is to say, the very analogous medicinal disease produced by the vital force stirred up by the excessively large dose of medicine, in the parts of the organism that are most suffering and most irritated by the original disease – which medicinal disease, had it been of appropriate intensity, would have gently effected a cure – rises to an injurious height;2 the patient, to be sure, no longer suffers from the original disease, for that has been homoeopathically eradicated, but he suffers all the more from the excessive medicinal disease and from useless exhaustion of his strength.

1 The praise bestowed of late years by some few homoeopathists on the larger doses is owing to this, either that they chose low dynamizations of the medicines to be administered, as I myself used to do twenty years ago, from not knowing any better, or that the medicines selected were not perfectly homoeopathic.

2 See note to §246

§ 277 Fifth Edition

For the same reason, and because a medicine, provided the dose of it was sufficiently small, is all the more salutary and almost marvellously efficacious the more accurately homoeopathic its selection has been, a medicine whose selection has been accurately homoeopathic must be all the more salutary the more its dose is reduced to the degree of minuteness appropriate for a gentle remedial effect.

Summary Notes

  • The more similar a remedy, the higher the potency, lesser the dose.

§ 278 Fifth Edition

Here the question arises, what is this most suitable degree of minuteness for sure and gentle remedial effect; how small, in other words, must be the dose of each individual medicine, homoeopathically selected for a case of disease, to effect the best cure? To solve this problem, and to determine for every particular medicine, what dose of it will suffice for homoeopathic therapeutic purposes and yet be so minute that the gentlest and most rapid cure may be thereby obtained – to solve this problem is, as may easily be conceived, not the work off theoretical speculation; not by fine-spun reasoning, not by specious sophistry can we expect to obtain the solution of this problem. Pure experiment, careful observation, and accurate experience can alone determine this; and it were absurd to adduce the large doses of unsuitable (allopathic) medicines of the old system, which do not touch the diseased side of the organism homoeopathically, but only attack the parts unaffected by the disease, in opposition to what pure experience pronounces respecting the smallness of the doses required for homoeopathic cures.

§ 279 Fifth Edition

This pure experience shows UNIVERSALLY, that if the disease do not manifestly depend on a considerable deterioration of an important viscus (even though it belong to the chronic and complicated diseases), and if during the treatment all other alien medicinal influences are kept away from the patients, the dose of the homoeopathically selected remedy can never be prepared so small that it shall not be stronger than the natural disease, and shall not be able to overpower, extinguish and cure it, at least in part as long as it is capable of causing some, though but a slight preponderance of its own symptoms over those of the disease resembling it (slight homoeopathic aggravation, (§§ 157-160) immediately after its ingestion.

Summary Notes

  • As long as there is no advanced pathology in any organ and the patient is not taking any other (allopathic) drug, the least amount of dose (not potency) will suffice to bring a curative reaction (does not mean that a single dose will cure, repetition may be required).

§ 284 Fifth Edition

The action of a dose, moreover, does not diminish in the direct ratio of the quantity of material medicine contained in the dilutions used in homoeopathic practice. Eight drops of the tincture of a medicine to the dose do not produce four times as much effect on the human body as two drops, but only about twice the effect that is produced by two drops to the dose. In like manner, one drop of a mixture of a drop of the tincture with ten drops of some un-medicinal fluid, when taken, will not produce ten times more effect than one drop of mixture ten times more attenuated, but only about (scarcely) twice as strong an effect, and so on, in the same ratio – so that a drop of the lowest dilution must, and really does, display still a very considerable action.1

1 Supposing one drop of a mixture that contains 1/10 of a grain of medicine produces an effect = a; one drop of a more diluted mixture containing 1/100th of a grain of the medicine will only produce an effect = a/2; if it contain 1/10000th of a grain of medicine, about = a/4; if it contain 1/100000000th of a grain of medicine it will produce and effect = a/8; and thus it goes on, the volume of the doses being equal, with every (perhaps more than) quadratic diminution of the quantity of medicine, the action on the human body will be diminished each time to only about one-half. I have very often seen a drop of the decillion-fold dilution of tincture of nux vomica produce pretty nearly just half as much effect as a drop of the quintillion-fold dilution, under the same circumstances and in the same individual.

Summary Notes

  • If you prepare a solution of Nux vom (or any other medicine) in 100 ml, its strength will be half the strength of a dilution prepared in 10 ml. It will not be one-tenth, it will be half. What this basically means is that on diluting a medicine, its strength does not go down in direct proportion to the dilution.

§ 285 Fifth Edition

The diminution of the dose essential for homoeopathic use, will also be promoted by diminishing its volume, so that, if, instead of a drop of a medicinal dilution, we take but quite a small part1 of such a drop for a dose, the object of diminishing the effect still further will be very effectually attained; and that this will be the case may be readily conceived for this reason, because with the smaller volume of the dose but few nerves of the living organism can be touched, whereby the power of the medicine is certainly also communicated to the whole organism, but it is a weaker power.

1 For this purpose it is most convenient to employ fine sugar globules of the size of poppy seeds, one of which imbibed with the medicine and put into the dispensing vehicle constitutes a medicinal dose, which contains about the three hundredth part of a drop, for three hundred such small globules will be adequately moistened by one drop of alcohol. The dose is vastly diminished by laying one such globule alone upon the tongue and giving nothing to drink. If it be necessary, in the case of a very sensitive patient, to employ the smallest possible dose and to bring about the most rapid result, one single olfaction merely will suffice (see note to §288).

§ 286 Fifth Edition

For the same reason the effect of a homoeopathic dose of medicine increases, the greater the quantity of fluid in which it is dissolved when administered to the patient, although the actual amount of medicine it contains remains the same. For in this case, when the medicine is taken, it comes in contact with a much larger surface of sensitive nerves responsive to the medicinal action. Although theorists may imagine there should be a weakening of the action of dose of medicine by its dilution with a large quantity of liquid, experience asserts exactly the opposite, at all events when the medicines are employed homoeopathically.1

1 It is only the most simple of stimulants, wine and alcohol, that have their heating and intoxicating action diminished by dilution with much water.

Summary Notes

  • Medicinal solutions (not liquid potencies) work better in comparison to the dry dose because the medicine in liquid form comes in contact with a much greater number of nerves.

§ 287 Fifth Edition

But in this increase of action by the mixture of the dose of medicine with a larger quantity of liquid (before its ingestion), the result is vastly different whether the mixture of the dose of medicine with a certain quantity of liquid is performed merely superficially and imperfectly, or so uniformly and intimately1 that the smallest portion of the diluting fluid received the same quantity of medicine in proportion as all the rest; for the latter becomes much more medicinally powerful by the diluting mixture than the former. From this every one will be able to judge for himself how to proceed with the regulation of the homoeopathic medicinal doses when he desires to diminish their medicinal action as much as possible, in order to make them suitable for the most sensitive patients.2

1 By the word intimately I mean this: that when, for instance, the drop of a medicinal fluid has been shaken up once with one hundred drops of spirits of wine; that is to say, the phial containing both, held in the hand, has been rapidly moved from above downwards with a single smart jerk of the arm, there certainly ensues a thorough mixture of the whole, but with two, three, ten and more such strokes, this mixture becomes much more intimate; that is to say, the medicinal power becomes much more potentized, and the spirit of this medicine, so to speak, becomes much more unfolded, developed and rendered much more penetrating in its action on the nerves. If, then, the required object we wish to attain with the low dilutions be the diminution of the doses for the purpose of moderating their powers upon the organism, we would do well to give no more than two such succussion-jerks to each of the twenty, thirty, etc., dilution phials, and thus to develop the medicinal power only moderately. It is also advisable, in attenuating the medicine in the state of dry powder by trituration in a porcelain mortar, to keep within certain limits, and, for example, to triturate strongly, for one hour only, one grain of the crude entire medical substance, mixed with the first hundred grains of milk-sugar (to the 1/10000th attenuation) likewise only for one hour, and to make the third attenuation (to 1/1000000) also by one hour of strong trituration of one grain of the previous mixture with one hundred grains of milk-sugar, in order to bring the medicine to such an attenuation that its development of power shall remain moderate. A more exact description of this process will be found in the prefaces to Arsenic and Pulsatilla in the Materia Medica Pura.

2 The higher we carry the attenuation accompanied by dynamization (by two succussion strokes), with so much the more rapid and penetrating action does the preparation seem to affect the vital force and to alter the health, with but slight diminution of strength even when this operation is carried very far, – in place, as is usual (and generally sufficient) to X when it is carried up to XX, L, C, and higher; only that then the action always appears to last a shorter time.

Summary Notes

  • With liquid solutions, the strength of the dose can be moderated to suit individual needs, by changing the amount of dilution and or number of succussions given.
  • If the medicine is diluted and dynamized simultaneously, the action of the medicine becomes more rapid and penetrating with each successive potentization.
  • BUT if the medicine is dynamized without successive dilution, the medicine works for a shorter time.

§ 288 Fifth Edition

The action of medicines in the liquid from1 upon the living human body takes place in such a penetrating manner, spreads out from the point of the sensitive fibers provided with nerves whereto the medicine is first applied with such inconceivable rapidity and so universally through all parts of the living body, that this action of the medicine must be denominated a spirit-like (a dynamic, virtual) action.

1 It is especially in the form of vapour, by olfaction and inhalation of the medicinal aura that is always emanating from a globule impregnated with a medicinal fluid in a high development of power, and placed, dry, in a small phial, that the homoeopathic remedies act most surely and most powerfully. The homoeopathic physician allows the patient to hold the open mouth of the phial first in one nostril, and in the act of inspiration draw the air out of it into himself and then if he wished to give a stronger dose, smell in the same manner with the other nostril, more or less strongly, according to the strength it is intended the dose should be, he then corks up the phial and replaces it in his pocket case to prevent any misuse of it, and unless he wishes it he has no occasion for an apothecary’s assistance in his practice. A globule of which ten, twenty or one hundred weigh one grain, impregnated with the thirtieth potentized dilution, and then dried, retains for this purpose all its power undiminished for at least eighteen or twenty years (my experience extends this length of time), even though the phial be opened a thousand times during that period, if it be but protected from heat and the sun’s light. Should both nostrils be stopped up by coryza or polypus, the patient should inhale by the mouth, holding the orifice of the phial betwixt his lips. In little children it may be applied close to their nostrils whilst they are asleep with the certainty of producing an effect. The medicinal aura thus inhaled comes in contact with the nerves in the walls of the spacious cavities it traverses without obstruction, and thus produces a salutary influence on the vital force, in the mildest yet most powerful manner, and this is much preferable to every other mode of administering the medicament in substance by the mouth. All that homoeopathy is capable of curing (and what can it not cure beyond the domain of mere manual surgery affections?) among the most severe chronic diseases that have not been quite ruined by allopathy, as also among acute disease, will be most safely and certainly cured by this olfaction. I can scarcely name one in a hundred out of the many patients that have sought the advice of myself and my assistant during the past year, whose chronic or acute disease we have not treated with the most happy results, solely by means of this olfaction; during the latter half of this year, moreover, I have become convinced (of what I never could previously have believed) that by this olfaction the power of the medicines is exercised upon the patient in, at least, the same degree of strength, and that more quietly and yet just as long as when the dose of medicine is taken by the mouth, and that, consequently, the intervals at which the olfaction should be repeated should not be shorter than in the ingestion of the material dose by the mouth.

Guidelines in 6th Edition of Organon of Medicine (1842)

All emphasis (bold/italic/underline) and notes by Dr. Manish Bhatia

§ 245 Sixth Edition

Having thus seen what attention should, in the homoeopathic treatment, be paid to the chief varieties of diseases and to the peculiar circumstances connected with them, we now pass on to what we have to say respecting the remedies and the mode of employing them, together with the diet and regimen to be observed during their use.

Every perceptibly progressive and strikingly increasing amelioration in a transient (acute) or persistent (chronic) disease, 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 new hastening towards its completion. Every new dose of any medicine whatsoever, even of the one last administered, that has hitherto shown itself to be salutary, would in this case disturb the work of amelioration.


Summary Notes

  • Whenever there is a striking or marked amelioration, DO NOT repeat the medicine, as long as the amelioration lasts.

§ 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. This is not infrequently the case in acute diseases, 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. 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. And this may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions: 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.

1 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).


Summary Notes

  • A single dose may often bring about striking improvement in acute cases.
  • But in chronic cases, it is often not enough to prescribe a single dose.
  • The most rapid cure can be attained in chronic cases if –
    • The medicine selected is perfectly similar
    • The medicine is dissolved in water to prepare the dose.
    • The medicine is repeated at suitable intervals
  • The dose should be altered every time. No two doses should be alike. Slight difference should be made by succussing the medicine every time.
  • This alteration of dose can be done with LM scale. After using one potency for a week or two, advance should be made to subsequent potency in LM scale.

§ 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). 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, 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. 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) 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. 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. But through modification of every dose in its dynamiztion 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.


Summary Notes

  • If a medicine is repeated in the same potency and dose then medicinal symptoms will appear.
  • Medicines, even highly potentized, can be repeated frequently if the dose is varied each time.


§ 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. 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. 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. 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. 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. 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.

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) 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. 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.


Summary Notes

  • Method 1 to prepare & give medicinal solution.
    • Take one (or more, if required) globule of the indicated remedy, crush it in a few grains of sugar of milk.
    • Put it in a glass vial and add 120 ml (8 tablespoons) to 600 ml (40 tablespoons) water depending upon the amount and strength of solution required.
    • Add to it some alcohol as a preservative.
    • Succuss the bottle vigorously.
    • Give 1 to 2 teaspoons from this bottle as one dose.
    • Succuss the bottle twice before each dose.
  • Method 2 to prepare medicinal solution.
    • This method removes the need for large bottles and lots of liquid solution.
    • Take one (or more, if required) globule of the indicated remedy, crush it in few grains of sugar of milk.
    • Put it in a glass vial with approx. 100 ml (7-8 tablespoons) water.
    • Add to it some alcohol as a preservative.
    • Succuss the bottle vigorously.
    • Take a glass with 100 ml water and Put 1 spoon (15 ml) solution from the bottle in it.
    • Stir and give 1 to 2 teaspoons from this glass as one dose.
    • Succuss the bottle twice before each dose.
    • If the patient is very sensitive, put 1 spoonful from the first glass in a second glass of 100 ml water. Stir and give the dose from the second glass. Dilute further for more sensitive patients.
  • In chronic cases, repeat in such fashion daily or on alternate days; in acute diseases, every 2 to 6 hours; in emergency or very acute cases, every hour or even every few minutes.
  • Once one bottle of medicinal solution is finished, prepare the next bottle with a globule of higher potency.
  • Repeat the same medicine in increasing dynamization as long as the patient continues to improve.
  • If new symptoms (medicinal) are experienced, medicine should be stopped and case reassessed.
  • If after a considerable period of improvement, the patient experiences a homeopathic aggravation, stop the medicine. Most likely the aggravation will subside in a few days and the patient will be cured.
  • Method for olfaction
    • Take a 1 dram glass vial and fill it with dilute alcohol.
    • Put 1 crushed globule in it and sucuss vigorously.
    • Smell the bottle every 2 to 4 days. Sucuss 10 times before each olfaction.

§ 249 Sixth Edition

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 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

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.

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. Like minute doses of a better chosen remedy will re-establish order throughout.


Summary Notes

  • If a medicine produces medicinal symptoms, then it is not the simillimum
  • In such case, if the medicinal symptoms are severe, an antidote should be given.
  • If medicinal symptoms are not severe, another remedy should be given.

§ 272 Sixth Edition

Such a globule,1 placed dry upon the tongue, is one of the smallest doses for a moderate recent case of illness. Here but few nerves are touched by the medicine. A similar globule, crushed with some sugar of milk and dissolved in a good deal of water (§ 247) and stirred well before every administration will produce a far more powerful medicine for the use of several days. Every dose, no matter how minute, touches, on the contrary, many nerves.

1 These globules (§ 270) retain their medicinal virtue for many years, if protected against sunlight and heat.


§ 275 Sixth Edition

The suitableness of a medicine for any given case of disease does not depend on its accurate homoeopathic selection alone, but likewise on the proper size, or rather smallness, of the dose. If we give too strong a dose of a medicine which may have been even quite homoeopathically chosen for the morbid state before us, it must, notwithstanding the inherent beneficial character of its nature, prove injurious by its mere magnitude, and by the unnecessary, too strong impression which, by virtue of its homoeopathic similarity of action, it makes upon the vital force which it attacks and, through the vital force, upon those parts of the organism which are the most sensitive, and are already most affected by the natural disease.


§ 276 Sixth Edition

For this reason, a medicine, even though it may be homoeopathically suited to the case of disease, does harm in every dose that is too large, the more harm the larger the dose, and by the magnitude of the dose and in strong doses’ it does more harm the greater its homoeopathicity and the higher the potency1 selected, and it does much more injury than any equally large dose of a medicine that is unhomoeopathic, and in no respect adapted to the morbid state (allopathic).

Too large doses of an accurately chosen homoeopathic medicine, and especially when frequently repeated, bring about much trouble as a rule. They put the patient not seldom in danger of life or make this disease almost incurable. They do indeed extinguish the natural disease so far as the sensation of the life principle is concerned and the patient no longer suffers from the original disease from the moment the too strong dose of the homoeopathic medicine acted upon him but he is in consequence more ill with the similar but more violent medicinal disease which is most difficult to destroy.2

1 The praise bestowed of late years by some homoeopathists on the larger doses is owing to this, either that they chose low dynamizations of the medicine to be administered (as I myself used to do twenty years ago, from nor knowing any better), or that the medicines selected were not homoeopathic and imperfectly prepared by their manufacturers.

2 Thus, the continuous use of aggressive allopathic large doses of mercurials against syphilis develops almost incurable maladies, when yet one or several doses of a mild but active mercurial preparation would certainly have radically cured in a few days the whole venereal disease, together with the chancre, provided it had not been destroyed by external measures (as is always done by allopathy). In the same way, the allopath gives Peruvian bark and quinine in intermittent fever daily in very large doses, where they are correctly indicated and where one very small dose of a highly potentized China would unfailingly help (in marsh intermittents and even in persons who were not affected by any evident psoric disease). A chronic China malady (coupled at the same time with the development of psora) is produced, which, if it does not gradually kill the patient by damaging the internal important vital organs, especially spleen and liver, will put him, nevertheless suffering for years in a sad state of health. A homoeopathic antidote for such a misfortune produced by abuse of large doses of homoeopathic remedies is hardly conceivable.


Summary Notes

  • A similar drug in large, often repeated doses can do more harm to the patient than an allopathic drug.
  • The more similar a medicine, the greater are the adverse effects of its frequent repetition.
  • Large doses of medicine (allopathic or homeopathic) often make the case incurable.
  • Hahnemann calls large doses of even the ‘similar’ remedies – allopathic and unhomeopathic!

§ 277 Sixth Edition

For the same reason, and because a medicine, provided the dose of it was sufficiently small, is all the more salutary and almost marvellously efficacious the more accurately homoeopathic its selection has been, a medicine whose selection has been accurately homoeopathic must be all the more salutary the more its dose is reduced to the degree of minuteness appropriate for a gentle remedial effect.


Summary Notes

  • The more similar a remedy, higher the potency, lesser the dose.


§ 278 Sixth Edition

Here the question arises, what is this most suitable degree of minuteness for sure and gentle remedial effect; how small, in other words, must be the dose of each individual medicine, homoeopathically selected for a case of disease, to effect the best cure? To solve this problem, and to determine for every particular medicine, what dose of it will suffice for homoeopathic therapeutic purposes and yet be so minute that the gentlest and most rapid cure may be thereby obtained – to solve this problem is, as may easily be conceived, not the work off theoretical speculation; not by fine-spun reasoning, not by specious sophistry can we expect to obtain the solution of this problem. It is just as impossible as to tabulate in advance all imaginable cases. Pure experiment, careful observation of the sensitiveness of each patient, and accurate experience can alone determine this; and it were absurd to adduce the large doses of unsuitable (allopathic) medicines of the old system, which do not touch the diseased side of the organism homoeopathically, but only attack the parts unaffected by the disease, in opposition to what pure experience pronounces respecting the smallness of the doses required for homoeopathic cures.

§ 280 Sixth Edition
The dose of the medicine that continues serviceable without producing new troublesome symptoms is to be continued while gradually ascending, so long as the patient with general improvement, begins to feel in a mild degree the return of one or several old original complaints. This indicates an approaching cure through a gradual ascending of the moderate doses modified each time by succussion (§ 247). It indicates that the vital principal no longer needs to be affected by the similar medicinal disease in order to lose the sensation of the natural disease (§ 148). It indicates that the life principle now free from the natural disease begins to suffer only something of the medicinal disease hitherto known as homoeopathic aggravation.


Summary Notes

  • A suitably selected medicine should be given in increasing dose (succussion) till there is continued amelioration.
  • If the original symptoms appear to aggravate after a long period of amelioration, then the medicine should be discontinued as this is a sign of cure.

§ 281 Sixth Edition
In order to be convinced of this, the patient is left without any medicine for eight, ten of fifteen days, meanwhile giving him only some powders of sugar of milk. If the few last complaints are due to the medicine simulating the former original disease symptoms, then these complaints will disappear in a few days or hours. If during these days without medicine, while continuing good hygienic regulations nothing more of the original disease is seen, he is probably cured. But if in the later days traces of the former morbid symptoms should show themselves, they are remnants of the original disease not wholly extinguished, which must be treated with renewed higher potencies of the remedy as directed before. If a cure is to follow, the first small doses must likewise be again gradually raised higher, but less and more slowly in patients where considerable irritability is evident than in those of less susceptibility, where the advance to higher dosage may be more rapid. There are patients whose impressionability compared to that of the insusceptible ones is like the ratio as 1000 to 1.
1 The rule to commence the homoeopathic treatment of chronic diseases with the smallest possible doses and only gradually to augment them is subject to a notable exception in the treatment of the three great miasms while they still effloresce on the skin, i.e., recently erupted itch, the untouched chancre (on the sexual organs, labia, mouth or lips, and so forth), and the figwarts. These not only tolerate, but indeed require, from the very beginning large doses of their specific remedies of ever higher and higher degrees of dynamization daily (possibly also several times daily). If this course be pursued, there is no danger to be feared as is the case in the treatment of diseases hidden within, that the excessive dose while it extinguishes the disease, initiates and by continued usage possible produces a chronic medicinal disease. During external manifestations of these three miasms this is not the case; for from the daily progress of their treatment it can be observed and judged to what degree the large dose withdraws the sensation of the disease from the vital principle day by day; for none of these three can be cured without giving the physician the conviction through their disappearance that there is no longer any further need of these medicines.

Since diseases in general are but dynamic attacks upon the life principle and nothing material – no materia peccans – as their basis (as the old school in its delusion has fabulated for a thousand years and treated the sick accordingly to their ruin) there is also in these cases nothing material to take away, nothing to smear away, to burn or tie or cut away, without making the patient endlessly sicker and more incurable (Chron. Dis. Part 1), than he was before local treatment of these three miasms was instituted. The dynamic, inimical principle exerting its influence upon the vital energy is the essence of these external signs of the inner malignant miasms that can be extinguished solely by the action of a homoeopathic medicine upon the vital principle which affects it in a similar but stronger manner and thus extracts the sensation of internal and external spirit-like (conceptual) disease enemy in such a way that it no longer exists for the life principle (for the organism) and thus releases the patient of his illness and he is cured.

Experience, however, teaches that the itch, plus its external manifestations, as well as the chancre, together with the inner venereal miasm, can and must be cured only by means of specific medicines taken internally. But the figwarts, if they have existed for some time without treatment, have need for their perfect cure, the external application of their specific medicines as well as their internal use at the same time.


Summary Notes

  • To confirm that the patient is cured, keep the patient on placebo for a few weeks.
  • If all the symptoms disappear, the case is cured.
  • If some symptoms continue to linger, raise the potency.
  • The general rule for treatment of chronic disease is – Start the treatment with low (lowest?) potency and then gradually ascend to higher potencies using the medicinal solution.
  • But if an infectious chronic disease – say scabies, syphilis or gonorrhea – is present in its active form, then it may be necessary to begin the treatment with higher potencies and the medicine may be repeated daily. What this means is that if one is suffering from any deep, chronic disease – infectious in nature – in its acute, active state – then the medicine may be repeated daily in high potencies. This will not apply if the patient has a history of any such disease or if the disease has been treated/suppressed allopathically.
  • Warts may require external application of the suitable medicine along with the internal administration.

§ 284 Sixth Edition

Besides the tongue, mouth and stomach, which are most commonly affected by the administration of medicine, the nose and respiratory organs are receptive of the action of medicines in fluid form by means of olfaction and inhalation through the mouth. But the whole remaining skin of the body clothed with epidermis, is adapted to the action of medicinal solutions, especially if the inunction is connected with simultaneous internal administration.1

1 The power of medicines acting upon the infant through the milk of the mother or wet nurse is wonderfully helpful. Every disease in a child yields to the rightly chosen homoeopathic medicines given in moderate doses to the nursing mother and so administered, is more easily and certainly utilized by these new world-citizens than is possible in later years. Since most infants usually have imparted to them psora through the milk of the nurse, if they do not already possess it through heredity from the mother, they may be at the same time protected antipsorically by means of the milk of the nurse rendered medicinally in this manner. But the case of mothers in their (first) pregnancy by means of a mild antipsoric treatment, especially with sulphur dynamizations prepared according to the directions in this edition (§ 270), is indispensable in order to destroy the psora – that producer of most chronic diseases – which is given them hereditarily; destroy it both within themselves and in the foetus, thereby protecting posterity in advance. This is true of pregnant women thus treated; they have given birth to children usually more healthy and stronger, to the astonishment of everybody. A new confirmation of the great truth of the psora theory discovered by me.

Summary Notes

  • Medicine can be given through mouth, tongue, nose, or intact skin.
  • Medicines can be applied on intact skin and given internally at the same time.
  • For an infant, medicines can be given to the mother if the baby is breast-feeding.

Guidelines in Chronic Diseases (1828-1830)

All emphasis (bold/italic/underline) and notes by Dr. Manish Bhatia


Summary Notes

  • By 1830, Hahnemann was already using the liquid medicinal solution extensively. He was still experimenting with it, therefore Chronic Diseases has guidelines for the dry dose similar to the 4th edition and guidelines for the medicinal solution similar to the 5th edition.
  • It might be necessary to repeat medicines frequently in acute disease or chronic disease or acute nature/aggravation.
  • In chronic cases we have to wait before repetition, till the first dose exhausts its action.
  • The medicine should be repeated in another potency preferably.
  • At this time Hahnemann was repeating potencies without any fixed criteria – either ascending or descending the scale (giving 12 c after 30c or 24c after 18c etc).
  • A similar medicine may need some intercurrents to get the best result. For e.g.., a patient on Sulphur may need Hepar-sulph, Nux-vomica or Mercury in between.
  • If the physician is sure of his prescription, the first potency should be dissolved in 4 ounce (110 ml) water. One third of it should be taken immediately as one dose and the rest should be repeated for the subsequent two days to finish the 4 ounce prepared. The medicine should be stirred each time before it is taken, to raise the potency. This appears to be the the first experiment of Hahnemann with the liquid solutions.
  • In a chronic case, the energy levels (vitality) of the patient should start increasing right from the start of the treatment.
  • The best time to take an antipsoric medicine is in the morning in fasting state.
  • If you need a feeble effect, take a dry globule on your tongue. For better effect, dissolve the globule in 2-3 teaspoon of water and drink it.
  • Do not take anything for half an hour (at least) after taking the medicine.
  • The patient should avoid undue mental or physical excitement during the course of treatment.
  • After taking the medicine, the patient should not involve himself in any mental or emotional activity (like reading, talking, computers, electronic games etc) for at least one hour.
  • In chronic cases, the medicine may be repeated every other day or even daily in medicinal solution in ascending potency.
  • In acute cases, dissolve 1 to 2 pills in 100 to 200 ml water and give the patient half to one teaspoon every hour to every 6 hours depending upon the case. If the symptoms start aggravating with frequent repetition, increase the interval between two doses.
  • For chronic cases, medicinal solution should be prepared using half water and half alcohol.
  • Dissolve 1 or more pills in 10 to 20 ml solution of water and alcohol. Shake well till pills dissolve. From this solution put one or more drops of water in a cup with 15 ml water and stir well. Give patient this solution as one dose or give half internally and apply half on skin. Before each dose, give the bottle of medicinal solution 6 to 10 strokes.

—– Page – 125 —–

But if these appropriately selected antipsoric medicines are not allowed to act their full time, when they are acting well, the whole treatment will amount to nothing. Another antipsoric remedy which may be ever so useful, but is prescribed too early and before the cessation of the action of the present remedy, or a new dose of the same remedy which is still usefully acting, can in no case replace the good effect which has been lost through the interruption of the complete action of the preceding remedy, which was acting usefully, and which can hardly be again replaced.

It is a fundamental rule in the treatment of chronic diseases: To let the action of the remedy, selected in a mode homoeopathically appropriate to the case of disease which has been carefully investigated as to its symptoms, come to an undisturbed conclusion, so long as it visibly advances the care and the while improvement still perceptibly progresses. This method forbids any new prescription, any interruption by another medicine and forbids as well the immediate repetition of the same remedy. Nor can there be anything more desirable for the physician than to see the improvement of the patient proceed to its completion unhindered and perceptibly. There are not a few cases, where the practiced careful Homoeopath sees a single dose of his remedy, selected so as to be perfectly homoeopathic, even in a very severe chronic disease, continue uninterruptedly to diminish the ailment for several weeks, yea, months, up to recovery; a thing which could not have been expected better in any other way, and could not have been effected by treating with several doses or with several medicines. To make the possibility of this process in some way intelligible, we may assume, what is not very unlikely, that an antipsoric remedy selected most accurately according to homoeopathic principles, even in the smallest dose of a high or the highest potency can manifest so long-continued a curative force, and at last cure, probably, only by means of a certain infection with a very similar medicinal disease which overpowers the original disease, by the process of nature itself, according to which (Organon, § 5, Fifth Edition,) two diseases which are different, indeed, in their kind but very similar in their manifestations and effects, as also in the ailments and symptoms caused by it, when they meet together in the organism, the stronger disease (which is always the one caused by the medicine, §33, ibid.) destroys the weaker (the natural one). In this case every new medicine and also a new dose of the same medicine, would interrupt the work of improvement and cause new ailments, an interference which often cannot be repaired for a long time.
—– Page – 127 —–
The only allowable exception for an immediate repetition of the same medicine is when the dose of a well-selected and in every way suitable and beneficial remedy has made some beginning toward an improvement, but its action ceases too quickly, its power is too soon exhausted, and the cure does not proceed any further. This is rare in chronic diseases, but in acute diseases and in chronic diseases that rise into an acute state it is frequently the case. It is only then, as a practiced observer may recognize – when the peculiar symptoms of the disease to be treated, after fourteen, ten, seven, and even fewer days, visibly cease to diminish, so that the improvement manifestly has come to a stop, without any disturbance of the mind and without the appearance of any new troublesome symptoms, so that the former medicine would still be perfectly homeopathic suitable, only then, if say, is it useful, and probably necessary to give a dose of the same medicine of a similarly small amount, but most safely in a different degree of dynamic potency.* When the remedy is thus modified, the vital force of the patient will allow itself more easily to be further affected by the same medicine, so as to effect by it everything that may be expected of this medicine and in this ailment.

To adduce an example: a freshly arisen eruption of itch belongs to those diseases which might soonest permit the repetition of the dose (sulphur), and which does permit it the more frequently, the sooner after the infection the itch is received for treatment, as it then approaches the nature of an acute disorder, and demands its remedies in more frequent doses than when it has been standing on the skin for some time. But this repetition should be permitted only when the preceding dose has largely exhausted its action (after six, eight or ten days), and the dose should be just as small as the preceding one, and be given in a different potency. Nevertheless it is in such a case often serviceable, in answer to a slight change of symptoms, to interpose between the doses of pure sulphur, a small dose of Hepar sulphuris calcareum. This also should be given in various potencies, if several doses should be needed from time to time. Often also, according to circumstances, a dose of Nux vomica (x) or one of mercury (x)** may be used between.

—–

(* If it, has first been given in the 30th potency it will now be given in perhaps the 18th, and if a repetition should, be again found serviceable and necessary, it might afterwards be given in the 24th. and later perhaps also in the 12th and 6th, etc., if, the chronic disease should have taken on itself an acute character. A dose of medicine may also have been suddenly counteracted and annihilated by a grave error in the regimen of the patient, when perhaps a dose of the former serviceable medicine might again be given with the modification mentioned above.)

(In cases where the physician is certain as to the homeopathic specific to be used, the first attenuated dose may also be dissolved in about four ounces of water by stirring it, and one-third may be drunk at once, and the second and third portions on the following days; but it should each time be again stirred so as to increase the potency and thus to change it. Thereby the remedy seeing to take a deeper hold on the organism and hasten the restoration in patients who are vigorous and not too sensitive.)

(** That the itch-patient during such a treatment must avoid every external application, however harmless it may appear, e.g., the washing with black soap, is not necessary to emphasize.)

—– Page – 128 —–

If I except sulphur, Hepar sulphuris and in some cases Sepia, the other antipsoric remedies can seldom be usefully given in immediately repeated doses. Indeed it is hardly ever needed in chronic diseases, as we have a goodly supply of antipsoric remedies at our disposal, so that as soon as one well selected remedy has completed its action, and a change of symptoms, i.e., a change in the total image of the disease, appears, another antipsoric remedy homeopathic appropriate to the altered case may be chosen to greater advantage and with a more sure prospect of hastening the cure, than if we take the risk of prescribing the former medicine which now is no longer altogether adequate. Nevertheless in very tedious and complex cases, which are mostly such as have been mismanaged by allopathic treatment, it is nearly always necessary to give again from time to time during the treatment, a dose of Sulphur or of Hepar (according to the symptoms), even to the patients who have been before dosed with large allopathic doses of Sulphur and with sulphur-baths; but then only after a previous dose of Mercury (x).
Where, as is usually the case in chronic diseases, various antipsoric remedies are necessary, the more frequent sudden change of them is a sign that the physician has selected neither the one nor the other in an appropriately homeopathic manner, and had not properly investigated the leading symptoms of the case before prescribing a new remedy. This is a frequent fault into which the homeopathic physician falls in urgent cases of chronic diseases, but oftener still in acute diseases from over haste, especially when the patient is a person very dear to his heart. I cannot too urgently warn against this fault.

Then the patient naturally falls into such an irritated state that, as we say, no medicine acts, or shows its effect,* yea, so that the power of response in the patient is in danger of flaring up and expiring at the least further dose of medicine. In such a case no further benefit can be had through medicine, but there may be in use a calming mesmeric stroke made from the crown of the head (on which both the extended hands should rest for about a minute) slowly down over the body, passing over the throat, shoulders, arms, hands, knees and legs down over the feet and toes. This may be repeated if necessary.
A dose of homeopathic medicine may also be moderated and softened by allowing the patient to smell a small pellet moistened with the selected remedy in a high potency, and placed in a vial the mouth of which is held to the nostril of the patient, who draws in only a momentary little whiff of it. By such an inhalation the powers of any potentized medicine may be communicated to the patient in any degree of strength. One or more such medicated pellets, and even those of a larger size may be in the smelling-bottle, and by allowing the patient to take longer or stronger whiffs, the dose may be increased a hundred fold as compared with the smallest first mentioned. The period of action of the power of a potentized medicine taken in by such inhalation and spread over so large a surface (as that of the nostrils and of the lungs) last as long as that of a small massive dose taken through the mouth and the fauces.
—–

(* That a homeopathic potentized dose of medicine should ever fail of having an effect in a treatment conducted with care, I think impossible; I have never experienced it.)

(Even persons born without the sense of smell or who have lost it through disease, may expect equally efficient help from drawing in the imperceptible vapor (proceeding from the medicine and contained in the vial) through one nostril or the other, as those do who are gifted with the sense of smell. From this it follows that the nerves possessing merely the sense of touch receive the salutary impression and communicate it unfailingly to the whole nervous system.)

—– Page – 137 —–
The strength of a patient under an antipsoric treatment, even if it should be continued ever so long, ought continually to increase from the very commencement of the correct treatment even to the restoration of health and of the normal state. The strength increases during the whole of the cure without the use of the so-called tonics, and the patients joyously rise up again of themselves in proportion as their life is delivered from its corroding enemy.*

The best time for taking a dose of antipsoric medicine seems to be, not an hour before going to bed but, rather, early in the morning while fasting. The medicine in the numbered paper (as also all that succeed) if it is desired that it should act but feebly, should be taken dry and allowed to dissolve on the tongue, or be moistened with two or three drops of water on a spoon, and by itself, without in either case drinking anything after it or eating anything within half an hour or a whole hour.**4
After taking the medicine the patient should keep perfectly quiet at least a full hour, but without going to sleep (sleep delays the beginning of the action of the medicine). He must avoid during this hour, as indeed throughout the treatment, all disagreeable excitement, nor should he strain his mind immediately after taking the dose, in any way, either by reading or computing, by writing, or by conversations requiring meditation.

—–

(* It is inconceivable how allopathic physicians could think of curing chronic diseases through a continuance of exhausting and debilitating treatments, without being restrained by their lack of success from repeating continually their perverse treatment. The amara which they give between, together with the quinine, without being able to supply the strength lost, only add new evils.)
(Numbering the powders continuously has the convenience that the physician when the patients render their daily report (especially those living at a distance) putting first the date and the number of the powder taken that day, can recognize the day when the patient took his medicine, and can judge of the progress of its action according to the report of the following day.)

(** If the medicine is to act more strongly it must be stirred in a little more water until dissolved before taking it, and in still more water if it is to act still more strongly, and the physician should order the solution taken a portion at a time. If he orders the solution taken in one or three days it must be stirred up not only the first time, but also the other two times, by which every part thus stirred acquires another somewhat higher degree of potency, and so is received more willingly by the vital force. To direct the use of the same solution for a greater number of days is not advisable, as the water, kept longer, would begin to putrefy. How a dose for smelling may be adapted to all degrees of strength, I have mentioned above.)

—– Page – 156 —–

In chronic diseases I have found it best to give a dose (e.g., a spoonful) of a solution of the suitable medicine at least every two days, more usually every day.

But since water (even distilled water) commences after a few days to be spoil, whereby the power of the small quantity of medicine contained is destroyed, the addition of a little alcohol is necessary, or where this is not practicable, or if the patient cannot bear it, I add a few small pieces of hard charcoal to the watery solution. This answers the purpose, except that in the latter case the fluid in a few days receives a blackish tint. This is caused by shaking the liquid, as is necessary every time before giving a dose of medicine, as may be seen below.

Before proceeding, it is important to observe, that our vital principle cannot well bear that the same unchanged dose of medicine be given even twice in succession, much less more frequently to a patient. For by this the good effect of the former dose of medicine is either neutralized in part, or new symptoms proper to the medicine, symptoms which have not before been present in the disease, appear, impeding the cure. Thus even a well selected homeopathic medicine produces ill effects and attains its purpose imperfectly or not at all. Thence come the many contradictions of homeopathic physicians with respect to the repetition of doses.

But in taking one and the same medicine repeatedly (which is indispensable to secure the cure of a serious, chronic disease), if the dose is in every case varied and modified only a little in its degree of dynamization, then the vital force of the patient will calmly, and as it were willingly receive the same medicine even at brief intervals very many times in succession with the best results, every time increasing the well-being of the patient.

This slight change in the degree of dynamization is even effected, if the bottle which contains the solution of one or more pellets is merely well shaken five or six times, every time before taking it.

—– Page – 157 —–
Now when the physician has in this way used up the solution of the medicine that had been prepared, if the medicine continues useful, he will take one or two pellets of the same medicine in a lower potency (e.g. if before he had used the thirtieth dilution, he will now take one or two pellets of the twenty-fourth), and will make a solution in about as many spoonfuls of water, shaking up the bottle, and adding a little alcohol or a few pieces of charcoal. This last solution may then be taken in the same manner, or at longer intervals, perhaps also less of the solution at a time; but every time the solution must be shaken up five or six times. This will be continued so long as the remedy still produces improvement and until new ailments (such as have never yet occurred with other patients in this disease), appear; for in such a case a new remedy will have to be used. On any day when the remedy has produced too strong an action, the dose should be omitted for a day. If the symptoms of the disease alone appear, but are considerably aggravated even during the more moderate use of the medicine, then the time has come to break off in the use of the medicine for one or two weeks, and to await a considerable improvement.*
When the medicine has been consumed and it is found necessary to continue the same remedy, if the physician should desire to prepare a new portion of medicine from the same degree of potency, it will be necessary to give to the new solution as many shakes, as the number of shakes given to the last portion amount to when summed up together, and then a few more, before the patient is given the first dose; but after that, with the subsequent doses, the solution is to be shaken up only five or six times.
—–
(*In treating acute cases of disease the homeopathic physician will proceed in a similar manner. He will dissolve one (two) pellet of the highly potentized, well selected medicine in seven, ten or fifteen tablespoonfuls of water (without addition) by shaking the bottle. He will then, according as the disease is more or less acute, and more or less dangerous, give the patient every half hour, or every hour, every two, three, four, six hours (after again well shaking the bottle) a whole or a half tablespoonful of the solution, or, in the case of a child, even less. If the physician sees no new symptoms develop, he will continue at these intervals, until the symptoms present at first begin to be aggravated; then he will give it at longer intervals and less at a time.
As is well known, in cholera the suitable medicine has often to be given at far shorter intervals.
Children are always given these solutions from their usual drinking vessels; a teaspoon for drinking is to them unusual and suspicious, and they will refuse the tasteless liquid at once on that account. A little sugar may be added for their sake.
—– Page – 159 —–
I have, therefore, lately found the following mode of administration preferable with careful patients. From a mixture of about five tablespoonfuls of pure water and five tablespoonfuls of French brandy – which is kept on hand in a bottle, 200, 300 or 400 drops (according as the solution is to be weaker or stronger) are dropped into a little vial, which may be half-filled with it, and in which the medicinal powder or the pellet or pellets of the medicine have been placed. This vial is stoppered and shaken until the medicine is dissolved. From this solution one, two, three or several drops, according to the irritability and the vital force of the patient, are dropped into a cup, containing a spoonful of water; this is then well stirred and given to the patient, and where more especial care is necessary, only the half of it may be given; half a spoonful of this mixture may also well be used for the above mentioned external rubbing.

On days, when only the latter is administered, as also when it is taken internally, the little vial containing the drops must every time be briskly shaken five or six times; so also the drop or drops of medicine with the tablespoonful of water must be well stirred in the cup.

It would be still better if instead of the cup a vial should be used, into which a tablespoonful of water is put, which can then be shaken five or six times and their wholly or half emptied for a dose.

Frequently it is useful in treating chronic diseases to take the medicine, or to rub it in in the evening, shortly before going to sleep, because we have then less disturbance to fear from without, than when it is done earlier.

When I was still giving the medicines in undivided portions, each with some water at a time, I often found that the potentizing in the attenuating glasses effected by ten shakes was too strong (i.e., the medicinal action too strongly developed) and I, therefore, advised only two succussions. But during the last years, since I have been giving every dose of medicine in an incorruptible solution, divided over fifteen, twenty or thirty days and even more, no potentizing in an attenuating vial is found too strong, and I again use ten strokes with each. So I herewith take back what I wrote on this subject three years ago in the first volume of this book on page 149.

In cases where a great irritability of the patient is combined with extreme debility, and the medicine can only be administered by allowing the patient to smell a few small pellets contained in a vial, when the medicine is to be used for several days, I allow the patient to smell daily of a different vial, containing the same medicine, indeed, but every time of a lower potency, once or twice with each nostril according as I wish him to be affected more or less.

About the author

Dr. Manish Bhatia

Dr. Manish Bhatia

- BHMS, BCA, M.Sc Homeopathy (UK), CICH (Greece)
- Asociate Professor, Organon & Homeopathic Philosophy, SKH Medical College, Jaipur
- Founder Director of Hpathy.com
- Editor, Homeopathy 4 Everyone
- Member, Advisory Board, Homeopathic Links
- Co-author - Homeopathy and Mental Health Care: Integrative Practice, Principles and Research
- Author - Lectures on Organon of Medicine vol 1 & 2. CCH Approved. (English, German, Bulgarian)
- Awardee - Raja Pajwan Dev Award for Excellence in the Field of Medicine; APJ Abdul Kalam Award for Excellence in Homeopathy Education
- Visit Dr. Bhatia's website https://www.doctorbhatia.com/

3 Comments

  • Dear doctor, your work is much exhaustive but is appreciable. It would be better to conclude the work pointwise(regarding hom.posology) of Dr. Hahnemann. Each point must be examplified from Hahneman’s case record.This will ccertainly guide us for further research. As I think, a further clinical research is required regarding the potency-selection & repetition of dose.For this we should work.
    Thanks a lot.

  • I have suffered greatly at the hands of so called homoeopaths who did not understand Hahnemann. HE said that patients differ in sensitivity as from 1 to a 1000 , note he did not say from 1 to 10. so you must not bulldoze patients with too much repetition or too soon a repetition. also if given in water the volume is most important to match the sensitivity of the patient. I have had viscious provings by numpty headed practioners. who will not learn from their mistakes

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