Homeopathy Papers Organon & Philosophy

Questions Patients Ask-10

questions patients ask image

Elaine Lewis answers patients’ questions. Down to earth answers about clinical practice.

Elaine answers questions patients have about homeopathy.


 Questions in blue, answers in black.

How Long Does The Remedy Stay In Your Body?

Elaine, how long does it take for a homopathic remedy to get
out of my system? thank you– lb

If you are asking because you’re having an aggravation, then I suggest you read “The Aggravation Zapper”:

The Aggravation Zapper


Now, if you’re not having an aggravation and you’re just curious?  It depends on a lot of things.  If you’re having an acute illness of some sort or an emergency, the remedy will be “used up” fast!

If you have a chronic case and you took a high potency, like a 1M, that remedy could conceivably hang on for months!  And it might actually take weeks or months before you even feel any results from it, good or bad.  Or let’s say you were given the right remedy, right potency and it cured your symptoms.  It may last, again, possibly for months—you may be completely cured by it, and because you were cured, you may have no way of knowing when the remedy “wore off” or stopped being present.  

I know someone who had a bad reaction to a 10M potency which he took in over-dose and the aggravation lasted for years!  I also know someone who took a 1M of a remedy that seemed to do nothing and then, about a month later, after we had completely forgotten about it, he aggravated!!!!  

So, one should not be prescribing high potencies casually in chronic disease; acutes are a different story, because as I just said, the remedy gets used up fast!  What are high potencies for, mostly?  Acutes—like pneumonia, car accidents, animal bites, burns, head injuries, a fright, a case of the flu, food poisoning, etc.  What are they not for?  A chronic disease that’s been plodding along for many months or years. 

For these cases, try starting with a 6C in a bottle of water, three times a day with five succussions before each dose; or a 9C twice a day, or a 12C once a day, adjusting your dosing based on the reaction to the previous dose, raising the potency as needed, stopping the remedy if an acute or emergency occurs, giving the acute remedy in a 30 or 200C, and then going back to your low potency in water with 5 succussions before each dose when the acute has subsided.  That’s the way to do it!


Does The Constitutional Remedy Ever Change?

Hi Elaine,

Hope you are well.

More or less…

Few years ago, you prescribed Silica as a constitutional remedy for our son for allergies/asthma.

The question I have for you is:

– For a certain person, will the constitutional remedy change over a time?

That’s a very good question.  I would have to say yes.  When we say “constitution”, we simply mean the remedy that matches the whole person, including his mental/emotional state.  Now, if someone has an accident and you go to help him and he says, “Oh no, I don’t need any help, I’m fine, really, just fine!  I don’t need a doctor, no way; I’m fine, really.”  Those are the “mentals” of Arnica!!!!  This person is now “Arnica”, though he may have been Arsenicum yesterday.  Not anymore!!!  So, in that context, yes, a person’s constitution can change.  Give him Arnica and he will go back to being Arsenicum, more than likely.

– If symptoms have not disappeared, do you recommend taking the constitutional remedy as and when needed for years or take it regularly for extended periods?

If symptoms have not disappeared, it suggests that the remedy is wrong and the case needs to be retaken.  Now, are you asking, “Will the constitutional remedy cure any disease that comes along?”  If a person has a disease or condition, the whole case has to be retaken–local symptoms along with the generals, which include the mental/emotionals. 

You may discover that what seems like a “local” disease, in fact, has mental concomitants which are not the same as his usual mentals or what we sometimes call his “constitution”!  In such a case, his presumed constitutional remedy is not going to help him.  You have to go with the remedy that the “new” mentals match.  

If the case has no mentals, and the physicals are all common (like a hay fever case that just has sneezing and runny eyes and nothing else to hang your hat on) then you could give the “constitutional” remedy that the patient is known for, or, if there is a remedy that is very common for the diagnosis that the patient has, you can try that first.  For instance, a friend with hay fever once complained to me of burning discharge from the eyes and I gave her Euphrasia 30C without a moment’s hesitation and the burning stopped within minutes!

– Also, do you know if patients have been able to get rid of allergies with homeopathic remedies?

Well, sure, we ought to be able to treat allergies.  I just gave you an example.   


Patient Getting No Results After Taking Hundreds of Remedies?


Elaine, I have spent thousands of dollars on past homeopaths with no lasting results. 


I’ve experienced amazing temporary results but no permanent ones.  I’ve taken hundreds of remedies in the following strengths: 1M, 10M, 50M, CM, MM, 10MM.  Is there any reason to think that you could do better?

I can see now why you’ve had only temporary results, because you’ve taken only high potencies, which are very easily antidoted.  A slight breeze comes along and Poof! they’re gone!  Daily low potency prescribing in chronic disease is much more permanent, less easily antidoted, and even if your last dose is antidoted for some reason, you’re going to take another dose again anyway so it doesn’t matter! 

Here is a very common scenario:  Someone comes to me and says, “I was on Sepia 200C.  I was doing fine.  Then the remedy stopped working.  I went up to 1M and nothing happened.”  I then say, “Here, take Sepia 6C, in water, three times a day, with five succussions before each dose.”  Amazingly, the remedy works again!  Why?  I don’t know!!!!  I have to assume it’s more grounded because it’s a lower potency.

Now, understand:  6C is only the starting potency, it will surely have to be raised going forward (perhaps to 9C then to 12C, etc. and it may have to be raised often and you’re really going to have to stay on top of this and monitor the case in terms of how it’s changing!)  

How do you know when to raise the potency?  The patient will tell you!  “My hay fever is coming back!”  You might eventually get to 200C, who knows; but, you get there one step at a time, you’re much more grounded this way, much less susceptible to antidoting!  Of course, a lot depends on the patient.  Some can’t follow directions, some don’t have the discipline to manage their case or stay in touch with you or just don’t get the whole thing!  For these people, you have to give a 200C, one dose, and hope for the best!


What If Remedy Is Producing Positive Changes Everywhere Except The Chief Complaint?


Elaine, I have a question about the LM scale or any scale really — Say you are giving a small dose, not daily, and you are noticing consistent, steady improvement in some things, but not the chief complaint. Do you hold steady with that dosing schedule or consider increasing the dose or the frequency?  Do you only consider changing anything about the dosing when you see things lag, or is increasing the size of dose, or frequency of dose, gradually, a good way to gently nudge things forward without losing progress?  If on “any” level it is working, is it a mistake to mess with the dosing until/unless you see the improvements lag/stop?

Claire, you ask a lot of questions!  I was awake for most of it so I’ll try to answer you.  You’re saying certain things in the case are improving steadily, but not the thing you took the remedy for!  And you’re saying, “How big a deal is that, is that good news?  Should I keep dosing?  Should I raise the potency?  Take it more often?”

I don’t know, Claire; but I do know this.  You would have to consider it good news if you’re taking a remedy and you’re getting better in any way at all!  That can’t be bad news!  So, the question really is, what is getting better and what was the thing you wanted to get better?

When you give a remedy, your body decides what it’s going to do with it.  It says, “This insomnia is really the worst thing as far as I’m concerned!”  Meanwhile, you’re thinking, “No, no it’s not!  I wanted this awful rash to go away, I can’t stand it!  It’s so ugly and people are staring at me!”  In that case, I think you stick with the remedy; because, sleep actually is more important than a rash, and your body knows it!  So you would stay with that remedy, and probably at the same level of dosing as long as you keep seeing movement in the case.

Now, on the other hand, if you’ve got insomnia, and you’ve taken a remedy for it, like, say, Carcinosin, and instead of clearing up your insomnia it clears up your rash!  Is this good news?  Are we happy with this kind of “progress”?  Probably not; UNLESS, since ‘healing takes place in reverse order’ according to Hering’s Law, the rash was the most recent thing in the case!  So, you might expect the rash to go first!

What it all comes down to is, do you know and understand Hering’s Law?  Here it is.

Healing takes place:

From the inside out

From the most important organs to the least important organs

From the center to the periphery

From above downward

and in reverse order of occurrence

Maybe we’d be better off calling it “Hering’s Guidlines”.  But this is what you have to think about when evaluating remedy reactions.

In acute cases, it’s really clear.  We’re always looking for (ta-da!) the Signs Of Health!  Here they are:  

The Signs of Health:

1. Relaxation, possibly to the point of falling asleep

2. Sense of relief

3. Return to naturalness

4. Feeling of well-being

5. Return of appetite

6. Improvement in energy

7. Better sleep

8. Spirits are lifted

9. Patient stops dwelling on the negative


When we see the signs of health after a remedy, we rejoice, regardless of what’s going on in the physical realm!  We assume the body is going to straighten all that out in due time!

In chronic prescribing, we’re happy to see this too; but, in acute prescribing, it’s very striking!  Children almost always fall asleep after the right remedy!

So, the best possible scenario in a chronic case would be that despite the fact that you’ve given the remedy and the thing that you wanted to go away hasn’t gone away, you still see the signs of health!  That would be a REALLY good sign!  If that happened, you would rejoice and stick with the remedy and not ditch it because the chief complaint was still there.  Always ask your patient, when he tells you your remedy “didn’t work”, “How are you mentally/emotionally?”  Because they’re not trained to tell you that or think that way!  How they answer that question will tell you what you need to do next!

However, there may come a time that you realize that too much time has gone by and even though the patient’s spirits are lifted, the disease marches on!!!!  At this point you have to concede the possibility that you’ve treated the layer below the pathology and that the pathology needed a remedy all its own!  It can be as simple as this:  Your mother is a Calc-carb who sprained her ankle.  You take her to the homeopath, the homeopath takes a complete constitutional case and says, “Your mother loves sweets, she’s over-weight, she worries, she’s over-responsible… she’s a calc-carb!”  You take her home, give her the remedy, her energy comes up, her sleep improves, she stops worrying so much, but she’s still got a sprained ankle!  That’s because she needed Rhus tox!  She had a Rhus tox sprained ankle:  Stiff, better warmth, better for continued motion.

So, you might say that this example ignored the last part of Hering’s Law: “Healing takes place in reverse order”.  The most recent event in the case was the sprained ankle, so, that had to be treated first!

Your chief complaint might be due to outside influences and have nothing to do with your constitution at all!  It could come from your “diet”, your truly heroic consumption of sugar!  This is usually enough to kill anybody! 

Gum disease, as another example, has more to do with your mercury amalgams than your personality!

When elderly patients come to you, you have to consider first and foremost that their Rx drugs have caused whatever is wrong with them!  Look up the side effects of their drugs, the elderly are generally all on heart and blood pressure drugs which they probably never should have been put on in the first place because they are famously the victims of poor eating habits, heating up frozen dinners every night, some are getting institutional food full of sugar and white flour, and this, then, is basically what’s wrong with them and what has to be cured!  

No responsible doctor would ignore this and put them on drugs!  But guess what?  Doctors write prescriptions, that’s what they do, it’s pretty much all they do!  So, if you’re a homeopath and a patient comes to you with some “condition”, your first question should be, “What drugs are you on?”  Next question, “What are you eating and drinking?”

Have I answered your question, by the way?

You make a good point; someone looking at constitutional stuff might miss the boat on the main complaint.

This might be the biggest conundrum in homeopathy!  “Should I treat the disease?  Should I treat the person?  If I treat the person, will the disease go away?”  I think most homeopaths are erring nowadays on the side of “If I treat the person, the disease will go away!”  Sometimes it will!  Here’s how I decide this question:

Is the disease recent?  Did it come from “without”?  Is there a clear etiology? (“I was breathing in dust at the construction site and I got asthma.”)  Does that sound constitutional?  Not to me!  Of course, you have to ask, “Describe your asthma attack.  When does it come on?  What’s it like, what happens?  What’s the trigger?  What does it make you do?  What was the cause? etc.” 

However, if the most compelling information in the case is “constitutional”, then I would prescribe based on that, especially if the asthma is non-descript, there are no modalities, no aggravation time, nothing to hang your hat on, but you see a clear Phosphorus personality with the burning thirst for ice cold drinks?  I would go with Phosphorus.

Though, are there times when the emotionals/mentals, cravings etc. are addressed through a remedy that doesn’t necessarily correlate to a complaint and then that complaint gets healed anyway through the remedy choice?

So you’re saying, “Does Calc-carb ever heal the sprained ankle even though it’s a Rhus tox sprained ankle?”  Maybe so, maybe it can.  But if that were the case, it would have meant that someone came to see me with a sprained ankle, and instead of perceiving Rhus tox within 10 minutes, which is very easy to do, I took a 2 hour case, meaning I over-looked the obvious, over-charged him, wasted his afternoon, gave the wrong remedy, and got lucky!  That patient should have gotten Rhus tox and been sent out the door in 10 minutes!

Is the rule of thumb to not be too swayed by constitutional type stuff and lose sight of the nature of the complaints themselves?

I believe Hahnemann said, “You have to perceive what has to be cured.”  This is probably what he was referring to.  The alternative to “perceiving what has to be cured” is to have a “protocol” that “fits” every patient, e.g.: Every patient gets a miasm remedy, every patient gets his constitutional remedy, etc.

I think we should follow Hahnemann’s advice and perceive what has to be cured and then take the case according to that perception.  If I perceive, as I often do, that a patient’s “diet” is the cause of his problem, then his diet has to be changed.  Sometimes I google a client’s so-called “health bar” 

How to Choose the Best Health Bars – Cleveland Clinic

and show him on the ingredients list that it’s mostly sugar!  And of course, he’s shocked because he thought he was eating “health food”!  “It says ‘All Natural’!”


 What Am I Supposed To Order?  So Many Options!  So Many Brands!



I am sooooo confused to choose the remedies.

There are two brands; Ainsworths – very expensive but they have many options as you see on web site.  If you say it is the best i will go with it.

Boiron – inexpensive but they have three options (pellets or liquid dilutions and tinctures)

Boiron is fine.  Whatever is cheaper and gets there the fastest.  I use Boiron all the time.  But I also have Ainsworths remedies here too.

So, I do not know what they are.  Pellets or liquid dilutions and tinctures?

Tinctures means it’s an herb and not a homeopathic remedy!  So, just ignore “tinctures”.  As to liquid or pellets, either one, it doesn’t matter.

What are the difference between them?

Nothing!  Buy whatever’s cheaper.

Do they have the same efficiency?

Yes, the same.

Do I prepare them for a few days?  Can I carry them in my purse?

Yes, you can carry remedies in your purse and you probably should, as they do you no good at home when you’re out.  This is really very simple.  If you’re going to be taking a remedy daily for some reason, buy yourself a small spring water bottle, pour half of it out, drop a pellet or a drop of your liquid remedy into your spring water bottle.  Take a sip.  Label it.  Put it in the refrigerator.  When you need to take it again, succuss your bottle five times and take another sip.  No, you can’t just keep taking dry pellets over and over again, just ask Hahnemann, go to The Organon, Aph. 246-249.  BUT, you can certainly put your first aid remedies in your purse or pocket and carry them around with you in the event you have a fall, or cut yourself, etc. 

I’m worried about running out of my remedies.

Homeopathic remedies are “energies”, they are not physical substances!  Therefore, you can never “run out” of them!

Let’s take your liquid bottle for example.  When it gets low?  All you have to do is fill it back up with water, shake it, and the remedy is BACK!!!!!  Now, if you’ve got a bottle of pellets?  When your bottle gets down to two pellets, just dump them into a bottle of water or a disposable cup of water, shake or stir, and the remedy is BACK!!!!!  YOU CAN NEVER RUN OUT OF YOUR REMEDY!!!!  Whether you take a remedy as a pellet or as a sip, it’s the same thing!  As soon as you drop a pellet of Arnica into a bottle of water, you now have two sources of Arnica!  Yes, you can have ENDLESS sources of Arnica! 

People kill me when they say, “I ran out of my remedy!”  So sad.  I can remember being in this position many times in the early days, being at the bottom of my bottle and panicking!  It’s a sin that people don’t know that it’s impossible to run out of a remedy!

Now, here’s all I ask:  Whenever a remedy is to be repeated day after day, or even hour after hour, make a remedy solution bottle!  What that means is this: You get yourself a small spring water bottle, you pour half of it out, you drop one or two pellets of your remedy into the water bottle, succuss 5 to 10 times before each dose, and take a dose/sip as needed.  Always succuss before each sip.  Here’s a video that demonstrates that:


Stop Dosing!

Now, why do you have to do this?  Because Hahnemann says in The Organon #246 and 247 not to give the exact same potency repeatedly, over and over again, because that could result in a “proving” or aggravation!  The way to avoid this outcome is to succuss the bottle before each dose which changes the potency just enough to forestall a possible aggravation and keep the case moving!  Also, Hahnemann says in Aphorism 246, if a striking improvement has occurred in the case, stop dosing as long as the improvement lasts!  Also stop dosing if the remedy has made you worse!


Will Your Constitutional Remedy Cure Anything?


Dear Elaine,

I was researching more about remedies, and found that Phosphorus almost perfectly matches my personality

In what way?

It is used for freckles, which is one of my main symptoms, and also helps anxiety and fear.

Well, so do dozens of other remedies.  It would be better if it matched a specific fear you had. Phosphorus’ big fear/delusion is that they are alone on an isolated island.  This is why they try so hard and are so good at making friends, because of this fear that they will wind up alone.  They are always better for company and sympathy.  They love to be the center of attention.  As long as people are paying attention to them, they are not alone—their big fear.

My question is, if you find and use your correct constitutional remedy, and it raises your vibration, would it help all the health issues you have

It might.

Or just the types of ailments it is known to treat?

Clearly it is not going to treat every illness or injury you get.  If you get a Gelsemium flu, the most common kind of flu that’s out there (sleepy, dizzy, dull, chilly, thirstless and apathetic and worse for company), is Phosphorus going to cure that?  Is Phosphorus thirstless?  Just the opposite! 

Is Phosphorus going to treat a pounding headache from being out in the sun?  I’m going to give Belladonna for that.  You could say, “Yes but, it’s the person’s constitutional remedy!”  Not anymore!   Not if you’re sleepy, droopy, drowsy, dizzy, dull, thirstless, apathetic and worse for company, that’s not Phosphorus!  Worse for company?  Are you kidding?  That’s Gelsemium!  

If you’re Phosphorus and you get hit by a car (God forbid!) and you’re walking around saying, “Oh, I don’t need a doctor, I’m fine, really, I’m fine!”  That’s Arnica!  You’re Arnica now!  What if you’ve got a kind of pneumonia where your lungs are filled with mucus that’s rattling around but you can’t raise it, what’s the remedy for that?  Is that Phosphorus?  No, that’s Antimonium tart!  Are you going to give Phosphorus for that?  I hope not.

You know, it just really all depends on what’s compelling in the case.  As Hahnemann said, we have to perceive what has to be cured.  If there’s a local complaint of recent origin with clear symptoms, clear indications of a certain remedy, you can’t ignore that and take a 2 hour constitutional case!

Get over it! 

Now, on the other hand, it can also happen that the clearest image in the case is the constitution!  The “chief complaint” may be lacking in information–no sensation, no concomitants, no modalities, too far-gone, complex and confusing…but you see a clear Arsenicum in the patient’s nature–his fussiness, anxiety, his critical, judgmental, negative, argumentative demeanor and it’s the most striking, most characteristic thing in the case!  Then I would give Arsenicum!

I’ve read both that remedies only work on specific symptoms and also that they work on people, raising their entire energy vibration and therefore addressing all their health issues.

I hope I’ve explained how it can be both, depending on what’s most compelling in the case.  I know that this is one of the biggest disputes in homeopathy!




Don’t Go Higher Than 21C?


Hi Elaine Lewis,

I read your article on wet dosing vs dry dosing on Hpathy and I am most intrigued by your work!

I am currently being treated by a homeopath using the wet dose.

Make sure you succuss the bottle five or ten times before each dose.

All is going well.  I just had a question about your indication that if using the C potency don’t go higher than 21c.

I don’t recall ever saying that!!!!  You would have to show me where I said that!  That makes no sense at all!

Please see below were you state which potencies you use when you don’t use the LM scale:

“And now, a few more clarifications before we go: What happens when people can’t get the LM potencies?  They are more expensive than the C potencies, and they are often unavailable.  In these cases, I use a lower potency, like a 6C, 9C or a 12C, and I treat it as if it were an LM–putting it in a four-ounce bottle of water, succussing before each dose, adding a capful to a dosage cup filled with water, stirring, and then a sip from the cup is a dose.”

OK, first of all, I think you meant to say 12C, not 21C!  So the idea here is that if you’re treating a chronic case, you want to be able to dose daily.  Why do you want to dose daily?  Because you don’t want to be held hostage to a high potency that’s only given once!!!!!

Let’s say you have arthritis pain that is worse on first motion, better on continued motion and better for a hot shower.  That’s Rhus tox!  My choice is that I can give you Rhus tox 6C in water three times a day with five succussions before each dose, or I can give you 9C twice a day or I can give you 12C once a day, or, I can give you 30C — but it’s not always clear when to repeat a 30C in chronic cases…once every 2 weeks maybe?  Hard to say–or, I can give you Rhus tox 200C and tell you to come back in a month.  This is what most homeopaths do. 

But why don’t I like that?  For one thing, the case may start with an aggravation which will make the patient hate you and homeopathy both!  You may never see that person again ever!  Plus, in the middle of treatment, the patient may come down with an injury or an illness, and you won’t be able to treat it because you’re being held hostage to Rhus tox 200C!  Your hands are tied!  Why would we do this to ourselves?  If I’m giving the patient Rhus tox 12C once a day and the patient falls and injures himself, I can stop the Rhus tox, give Arnica 30C for the injury, and then go right back to Rhus tox 12C for the arthritis pain and I’ve taken care of two issues and the patient is happy!

My questions is:

If using anything greater than or equal to 30c can the remedy be taken everyday? (Wet dose of course)

If you’re going to give a daily dose, start low.  This gives you flexibility; plus, you don’t start the case off with an aggravation which is unlikely to endear the patient to you.  Now sure, 6C is most likely going to wear off soon, so you explain: “Potencies stop working and need to be raised.  This is normal.  It doesn’t mean homeopathy doesn’t work.  Tell me when the remedy seems to be wearing off and repeated doses don’t hold as long.  When that happens, we will ‘plus’ your bottle up to 9C, or you can buy the 9C, and your remedy will work again.”

Hahnemann says that:
“…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.”

BUT then he goes on and says–

“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”

I am confused by this because…he is basically saying chronic diseases can be cured by a single dose and then just waiting 40-100 days. At the same time he is saying that in a chronic case the medicine should be taken everyday.

Which one is right?

You know what?  I translated this aphorism in my “Case Management” article (“Case Management in a Hop, Skip and a Jump”):


Read it and see if your questions are answered, if not, let me know what you still don’t understand.

If not using the LM scale or a low potency C scale, can you still take the remedy daily?

You are on much safer ground if you start a chronic case with either 6C three times a day, 9C twice a day or 12C once a day, increasing the potency as needed.

My current homeopath is using 30c then 200c and then all the way to 1m with the wet dose.  Is this wrong?

That is typical for homeopaths to go from 30 to 200 to 1M, but normally they don’t use water, they use just the pellets; but, the question is, is your homeopath changing potencies only as-needed or as a “protocol” where, “If it’s June, it must be 200C!” because that would be insane. 

The potency is determined by how the patient is doing.  If he’s doing well, there’s no reason to change.  Always stay with what’s working!  Moreover, I think 200C is a bit too high of a jump from 30C.  I think going to 50C would be more appropriate.  But again, there would have to be evidence that you actually needed to go higher, and you would, of course, have to succuss before each dose, and redose only if you were starting to relapse from the previous dose.

Also, how much should be taken each time. Hahnemann indicates teaspoonfuls (Was a teaspoon smaller back in his day?  Because a teaspoon by today’s standards is actually quite a bit of remedy)

I always say “take a sip from the bottle” because people can’t carry teaspoons around with them!  Plus, you shouldn’t be using your good silverware for this.  Maybe saying “a capful” would be appropriate, as it approximates a teaspoon.

Thank you,
Pratin Shah


Aphorism 247


Dear Elaine,

It’s Daniel again.

I had a premonition you were going to be here!

For chronic disease, and when using a high potency (30c-200c) clearly redosing frequently is unnecessary and a bad idea. (for most, some may need it)

And for chronic disease, you shouldn’t be starting with a high potency, never mind redosing frequently!  This is from Aph. 161 from The Organon:

“…but where medicines of long action have to combat a malady of, considerable or of very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper small, gradually higher doses, each somewhat modified with renewed dynamization (§ 247).”

What is he saying?  Here’s my translation:  Where remedies have to be employed in chronic complaints, where no aggravation should be tolerated, you will not have this problem if you start the case in small doses, raising them gradually, always succussing before each dose.

He then sends us to Aph. 247, which says:

“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 dynamization degree, as I herewith teach, there exists no offence…”

Put The Remedy In Water and Succuss Before Each Dose!

This aphorism, #247, is the “You must put the remedy in water and succuss the bottle before each dose” clause of The Organon!  In other words, to sum up what he said:

1. Don’t start chronic cases off with high potencies.  Start low and go up gradually.

2. Don’t repeat dry doses (the pellets) and don’t repeat water doses that haven’t been succussed nor stirred first!

The idea being that giving the exact same dose over and over again, whether wet or dry, does not stimulate the body to keep on healing or reacting to the remedy.  At some point a “tolerance” is developed and the remedy is ignored!  Later, if the dosing continues in this way, the remedy starts to aggravate.

Is once a month ok?

There is no rule other than the patient’s response to the last dose!  Once the patient has responded, your job is easy!  If there’s a striking improvement, you do nothing.  If he starts sliding backwards, it’s time to start dosing again.

How do you know that you should redose,

You can assume that if you’re giving a 6C three times a day, at some point you’re going to see a reaction.  How much of a reaction tells you how aggressive you need to continue to be.  Sometimes being aggressive means you need to raise the potency.  I just recently had a hay fever patient who I started on Wyethia 6C.  The improvement was very minor.  I had her plus the bottle to 12C.  The improvement was still minor.  We ordered the 30C and got somewhat better results, but not great; so, we ordered the 200C.  To make a long story short, we really didn’t nail down the case until we got to Wyethia 1M!  So how did we get to the 1M potency?  One step at a time, trial and error!  That’s how we knew what potency she needed!  She finds that she needs to repeat the remedy about once a week because that’s when she starts to relapse.

Regardless of the potency you’ve chosen, always remember: A striking improvement precludes any further dosing, redose at the first sign of relapse; also, an aggravation precludes any further dosing.

If you don’t see physical improvement in a month?

If you’re giving a 6C three times a day, and it’s the right remedy, you will see a reaction before a month, and often in a few days.




Combination Remedies


Dear Elaine,

It’s Daniel again.

No!  Really?

I’m staying with the single remedy Phosphorus for a few months and I’ll see if that helps with my skin issue. (Which is the main reason I’m taking it.)

However, for my other main symptom, internal scar tissue, I was wondering about combining remedies and what you thought about it.

I went back and read your article on Using More Than One Remedy In A Case: What Would Hahnemann Say?


In that, you support alternating remedies in certain cases.  What about combining many remedies that address an issue, as long as they don’t conflict or antidote each other?

For example, for internal scar tissue I was thinking of combining Thuja, Silicea, Hypericum, Arnica, Calc Fluor, Graphites, Thiosinaminum and Phytolacca.

No.  Thios is enough.  It’s our main scarring remedy.  I would give Thios. 6X four times a day.

I’ve read that in combinations the body uses what it needs and leaves what it doesn’t.

But then what are provings if that’s true?  We could never conduct a proving because one’s body would just ignore the remedy since it doesn’t need it!  And imagine proving a combination remedy!  Which remedy is the body proving?   All of them?  One of them?  What if it were proving one of the non-essential remedies, you’d never know, you’d have to stop the whole thing, even the one that was working!

Also in the comments to your article many people state they have used combinations with great success instead of alternations.

Combination remedies are a “necessary evil”.  The reason is, how do you ever get Joe Six-Pack to try homeopathy if he’s got a sore throat and he walks into the health food store and all he sees are a bunch of bottles called “Arsenicum album”, “Rhus toxicodendron”, “Spongia tosta”….?  What does that mean to him?  Nothing!  

So, we have to have products called, “Sore Throat”, “Cough”, etc. because we can’t assume that people just automatically “know” to buy Spongia when they have a dry cough that sounds like a seal barking.  How would they know?  But YOU, you would know, right?  What a Spongia cough is?  Why would you say, “I know I’ve got a Spongia cough, but, I’m also going to take Antimonium tart, Pulsatilla, Ipecac….  Why?




Complex Disease


Oh.  Just one more thing….

Are you sure you’re not Columbo?


I don’t understand, if I alternate between the 30c main remedy (taken lets say once a month) and a low 6x remedy (taken a few times a day), how can the body respond to both?

Why won’t taking one cancel out the other?  I’ve read your articles, but they don’t seem to explain.

Is it a matter of high potency vs low?  How can the body hold both energy vibrations independently? Most classical homeopaths say that taking another remedy overrides the effects of the one before.

They do?  The Kentian prescribers give their 200C remedy that’s supposed to last a month and then if you tell them you have an acute illness they say, “Take an aspirin!”  Because they’re so afraid of your Belladonna or Arsenicum antidoting their Phosphorus 200C!  This is why high-potency/one-dose-and-wait prescribing is impractical and doesn’t match real-world living.  In the real world, people get sick and injured and shouldn’t be asked to take a drug to supposedly accommodate a 200C remedy that you took a week ago! 

The alternative is to have the patient on a low daily potency so that it can be stopped during an acute while the Arnica or whatever is given, then returned to when the acute is over.  So much more practical!

But back to your question, In Aph. 40, Hahnemann talks about complex disease.  He says in the footnote, regarding the presence of more than one disease in the patient, “…they are not a fusion [meaning they don’t combine into a ‘new’ disease] but instead, in such cases, the two dissimilar diseases exist only beside each other in the organism, … their cure is completely accomplished by the timely alternation of the best … remedies….”

What could be more clear than that?  The timely alternation of the remedies.  Certainly, your case of internal scarring, plus your constitutional picture, are not related to each other, they are beside each other.  We’re not going to expect a remedy for scarring, like Thios., to match your constitution!

Does this answer your question?

Yes, it does.

Right, so, two separate etiologies, meaning the two issues are unrelated to each other; so, you wouldn’t expect the remedy for one to cure the other.

So from tomorrow I’ll start using Thios. 6x 4 times a day in a liquid dose, following your guidelines of only adding pellets the first time, and then just adding more water if it runs low, sucussing then and also before each dose.


I’ll stop doses once I see improvement, and only redose if I feel improvement has stopped.

Or cut the dosing in half and see if the improvement continues.  If it doesn’t, go back to four times a day.

Same with the Phos, only redosing if I feel I need to, and just once a month or less since it’s a 30C potency.

That’s a contradiction in terms: “once a month” and “when I need to”.  I would stick with “when I need to”, as this isn’t allopathic medicine where everyone is given the same instructions.  “As needed” is more appropriate to homeopathy.

Thanks again for taking the time to explain all this.  I can’t say how much I appreciate it.

Just so I understand this correctly…..

Some patients may have multiple ailments in their energy body which can not be addressed with just one remedy.

Because there are different etiologies.  Look at it this way:  Imagine that there are problems emanating from your mental state, problems resulting from being bitten by mosquitoes and problems caused by physical trauma.  As you can imagine, all three might be going on at the same time.  This is called “complex disease”.  Hahnemann says you need to alternate the remedies in such cases and it makes perfect sense!

Taking a new remedy will not cancel the effects of the previous one UNLESS it is incompatible or inimical with it, the previous remedy will continue to have an effect. This makes sense in a way as we eat and drink other liquids all the time that have “substances” in them, and they don’t interfere with a remedy we have taken.  Both humans and animals who take homeopathy, eat and drink other stuff that doesn’t stop a remedy from working.

Is that right?

I’ll give you an example.  You’re suffering a loss, so you need Ignatia.  At the same time you’ve been bitten by numerous mosquitoes after doing yard work in over-grown weeds (which pretty much describes my lawn), and at the same time, while doing it, you slipped and fell and hurt your knee.  You took Ignatia but of course that’s not going to stop the mosquito bites from itching so you took Ledum for that, which, of course, didn’t help the swelling in your knee from the fall, so you took Arnica.

The area of need is going to reach out for, and benefit from, the appropriate remedy.  The mosquito bites aren’t going to resonate with Arnica, and the swollen knee will just ignore Ignatia.  But as soon as you give Arnica, the knee is going to stop hurting.  It won’t matter that you just took Ledum or previously took Ignatia, the knee will still respond to Arnica.  HOWEVER, if you’ve got multiple symptoms from a single cause, you don’t need multiple remedies for it, you need ONE remedy that covers the array of symptoms emanating from that cause!

For example, you’ve got a fever, muscle aches, diarrhea, sore throat, runny nose, prostration, anxiety, restlessness and fear of death.  That’s not 4 or 5 different remedies, that’s an Arsenicum flu!   One remedy, because there’s only one illness, one cause.  The muscle aches didn’t come from gardening, the runny nose didn’t come from allergies…they all came from the same thing—a flu bug; hence, one remedy despite multiple symptoms.

Do you have it now?  (Please say yes cuz I’m out of gas!)


Elaine Lewis, D.Hom., C.Hom.

Elaine takes online cases.  Write to her at [email protected]

Visit her website: elaineLewis.hpathy.com


About the author

Elaine Lewis

Elaine Lewis, D.Hom., C.Hom.
Elaine is a passionate homeopath, helping people offline as well as online. Contact her at [email protected]
Elaine is a graduate of Robin Murphy's Hahnemann Academy of North America and author of many articles on homeopathy including her monthly feature in the Hpathy ezine, "The Quiz". Visit her website at:
https://elainelewis.hpathy.com/ and TheSilhouettes.org


  • Hi Elaine,
    What a lovely Q and A series. As students of homeopathy, we have asked these questions and pestered our teachers to explain to us – in every seminar and class room session – till the teachers got sore throat from talking!!! You have brought all these questions together and answered in such a funny way. I loved reading through it and learned a lot. Thank you.

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