Part 1: Hahnemannian Homeopathy
Hahnemann's Advanced Methods is an introduction to the revolutionary works of Samuel Hahnemann's last 10 years (1833-1843). This text supplies all the essential information for using the techniques of the medicinal solutions for the C and LM potencies. This treatise is directed at homoeopaths who wish to deepen their study of Homoeopathy.
Hahnemann's Advanced Methods is a premier article on the methods of the 4th, 5th and 6th Organon, the medicinal solutions, and the C and LM potency. After reviewing the Principles of Hahnemannian Homoeopathy it is time to study Hahnemann's advanced posology methods.
This work introduces the fundamental philosophy of the new methods and provides a basis for clinical trials. Such an undertaking, of course, can only be carried out by those trained in Homoeopathy.
A working knowledge of this article is very important for putting the medicinal solutions and the methods of speeding the cure into practice. Take your time, print out and read this document well.
Homoeopathy is based on the teachings of Samuel Hahnemann as presented in The Organon of the Healing Art. This masterpiece expounds the four cardinal maxims of Homoeopathy: Likes Cure Likes, the Single Remedy, the Minimal Dose and the Potentized Remedy.
These principles form a system of checks and balances which makes the Doctrine of Similars a safe and effective modus operandi. Even in the first comprehensive work on the new method, The Medicine of Experience (1805), these four golden rules were present. This is the essence of Homoeopathy.
The first edition of The Organon of the Healing Art appeared in 1810, and in order to update this material, Hahnemann published subsequent editions in 1818, 1824, 1829 and 1833. The 6th and final edition was completed shortly before Hahnemann's death in 1843, but unfortunately, it remained unpublished until the German edition of 1920 and the English version of 1921.
These documents record the evolution of Homoeopathy through 7 levels of development. This is one of the reasons why so many conflicting statements are attributed to Samuel Hahnemann. It is only through a careful study of the historical development of Homoeopathy that these apparent contradictions can be resolved.
The 4th Organon and the 1st Chronic Diseases
Homoeopathy as commonly practiced was established in the late 1820s. These were watershed years for Homoeopathy as they represent the beginning of the most productive period of Hahnemann's career.
The Chronic Diseases, Their Peculiar Nature and Their Homoeopathic Cure. was published in 1828. This work contained new material on the pathogenesis of chronic diseases, the materia medica and case management. The Chronic Diseases was quickly followed by the publication of the 4th Organon (1829) which further elucidated homoeopathic philosophy, case taking and methodology.
In these foundation works Hahnemann introduced the theory of the vital force, the doctrine of the chronic miasms, and the immaterial 30c potency. The Hofrath lectured on our spiritual nature and the dynamics of the vital force, while at the same time, refuting the tolle causum (one-sided causation) and materia peccans (materialistic basis of disease) of the orthodox schools.
In his new healing system psychological and constitutional factors, the complete aetiological constellation, and the signs and symptoms are used as a guide to the choice of curative remedies.
The Single Unit Dose
Over the following fifteen years Homoeopathy went through a tremendous transformation as Hahnemann sought to consummate his system. During these years four new editions of The Chronic Disease (1830, 1835, 1837 and 1839) and the 5th (1833) and 6th (c. 1842) editions of the Organon were written.
During this period the Master Homoeopath introduced several new innovations that brought Homoeopathy closer to perfection. The 1st Chronic Diseases and the 4th Organon are companion volumes in which Hahnemann taught the administration of a single unit dose of one or two poppy seed size pellets.
Vide the aphorism 242 of the 4th Organon.
"As long, therefore, as the progressive improvement continues from the medicine administered, so long we can take for granted that the duration of the action of the helpful medicine, in this case at least, continues, and hence all repetition of any dose of medicine is forbidden [DL]."
The same point is also stressed in Aphorism 245.
"Even one dose of the same medicine which has up to now proved beneficial, if repeated before the improvement has begun to stand still in every direction, [DL] will, like an untimely interference, only aggravate the state..."
Hahnemann again reminds us at the end of this paragraph:
"In one word, we disturb the amelioration affected, and still to be expected from the first dose, if we give a second dose of the same originally well chosen remedy before the expiry of the period of action of the first; at all events, we thereby delay the recovery [DL]."
The Single Dose Wait and Watch Method
These aphorisms introduce the "wait and watch" philosophy which is a manifestation of the principle of minimal intervention, another important aspect of the maxim of the minimal dose.
If the sufferer is improving after the administration of the first dose of a remedy, all repetitions of the dose are completely counter indicated. It is only when there is a clear relapse of the symptoms that a second dose of a remedy may be administered. This injunction was introduced to prevent disruption of the healing process by the premature repetition of the remedy.
Hahnemann noticed that premature repetition of a dose often caused a relapse of symptoms as well as accessory symptoms (side-actions) of the remedy to appear. This mixture of natural and remedial symptoms confuses the picture and slows down the cure. This is why classical homoeopaths are very conservative about the repetition of the remedy before there is a definite relapse of the symptoms.
This demands great patience because even during a slow amelioration the sufferer must wait for a relapse of symptoms before they may take another dose. The 30c potency had shortened the time of cure but the entire process was still taking too long.
Some of Hahnemann's more enthusiastic disciples took it on themselves to begin experimenting with potencies well above the level he introduced. The advocates of the new higher potencies included Dr. Schreter, General Korsakoff of Russia, and Jenichen of Wismar.
The Father of Homoeopathy was concerned that their unorthodox methods of remedy preparation would destroy the pharmaceutical standards he introduced in 1828. For this reason he wrote letters to Schreter and Korsakoff recommending that all homoeopathic remedies be made by the methods introduced in the Organon and called for a limit on potency at 30c.
Two of his closest disciples, Dr. Stapf and Gross, were supporters of the new high potency movement and they quietly lobbied the Old Doctor to perform his own experiments. The era of the 4th Organon may be called "The Limit Maker" because Hahnemann sought to control the rapidly expanding power of his homoeopathic system.
As he raised the potencies he simultaneously reduced the size of the dose from 1 drop of the stock bottle to only 1 or 2 poppy seed sized pellets. After reducing the size of the dose he also limited the posology to the single unit dose and cautioned against any premature repetition of the remedy.
Finally, he suggested a limit on the potency at 30c level made by his pharmaceutical methods. All of these rules were safety measures Hahnemann introduced while he sought to overcome the difficulties that still remained in his system.
The New Posology
Hahnemann was not completely satisfied with the posology methods and case management he developed in the late 1820s. He wanted to improve the single unit dose "wait and watch" method, especially in resistant chronic diseases. The old master felt there must be a more efficient way of administering his remedies so he began a new set of posology experiments.
As early as the First Provers Union he used aqueous solutions to dilute remedies to control their powers during provings. With this in mind he decided to run trials on the action of the remedies in aqueous solution and compare the results with the single unit dry dose.
Samuel Hahnemann published the 5th edition of the Organon in the year 1833. This was followed by the publication of the 3rd, 4th and 5th editions of The Chronic Diseases in 1835, 1837 and 1839 respectively.
In these twin manuscripts he developed the sixth level of the homoeopathic system. In aphorisms 285, 286, 287 and 288 he clearly states his view that the aqueous solution is far superior in every way to the use of dry pellets. This is the final outcome of many years of experimentation with both methods.
Vide aphorism 286.
"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 [DL] 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 theorist may imagine there should be a weakening of the action of the 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."
At the same time, Hahnemann offered one more critical detail in the note to aphorism 287 which is essential to the new methods. This is the importance of succussing the remedy solution immediately before administration in the same manner as one succussed the homoeopathic dynamization when preparing the stock potencies.
In the note to this aphorism Hahnemann points out that anywhere from 1, 2, 3, to 10 or more succussions will progressively increase the potency of the aqueous remedy solution.
From this solution one or more teaspoons are given to the patient as a dose whenever necessary. In this way the homoeopath makes a more powerful solution that penetrates deeper than the dry dose, yet at the same time, the remedy acts more gently on the vital force. this is one of the major methods of adjusting the dose to suit the sensitivity of the constitution.
Hahnemann pointed the way forward in aphorism 287 when he asks homoeopaths to use their own experience to guide them in adjusting the dose to suit the patient.
"...everyone will be able to judge for himself how to proceed with regulation of the homoeopathic medicinal doses when desiring to diminish their medicinal action as much as possible, in order to make them suitable for the most sensitive patients."
The remedy solution must be succussed an appropriate number of times just before ingestion to make it harmonic to the sensitivity of the patient. The most sensitive constitutions may only need 1 or 2 succussions, whereas in the less sensitive types, 10 or more may be necessary to get a response.
The average number of succussions suggested in Hahnemann's The Chronic Diseases is 5 or 6. In this way the dose and potency may be tuned to suit the sensitivity of the constitution. This method is called adjusting the dose and is one of the greatest gifts of the 5th Organon.
Hahnemann Revises his Views
Hahnemann's experiments with the medicinal solution led to a review of the 30c limit he set on potency in his letters of 1829 and 1832. He knew through his own experiments that the high potency remedies were very powerful, but at the same time, he worried about the aggravations they could cause.
He was also concerned about a loss of homoeopathic pharmaceutical standards making uniform results difficult. Some of Hahnemann's closest disciples were disappointed and spoke to him about their experiences with the higher potencies. They discussed the pros and cons of the potency question and its potential effects on the future of homoeopathic practice and pharmacy.
After deep consideration Dr. Hahnemann decided to publicly support the high potency movement, but with certain cautions concerning their usage. In the 5th edition of The Organon Hahnemann publicly supported the high potency movement. In the footnote to aphorism 287 he recorded his own experiences of the use of the 60th, 150th and 300th centesimal potencies.
The fact that the medicinal solution and the use of high potencies are introduced together in the Organon shows that Hahnemann was working hard to perfect the homoeopathic system. With the medicinal solution he felt he now had the means to control the power of the ultra high potencies.
The Middle Path
Another important feature of the 5th Organon is Hahnemann's revision of his views on the repetition of the dose. In the 4th edition he outlined the single unit dose and the philosophy of the "wait and watch" method which was also in the first edition of The Chronic Diseases. In the aphorisms 245, 246 and 247 of the 5th Organon Hahnemann introduces what he calls the middle path concerning the methods of repeating the remedies.
Hahnemann begins his discourse on posology by clarifying the proper view of the single unit dose and when it is applicable in treatment.
He begins his new review in aphorism 245.
"Every perceptibly progressive and strikingly increasing amelioration [DL] 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 of the medicine taken continues to effect, is now hastening toward 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."
Notice the words strikingly increasing amelioration. Anytime there is a dramatic reaction to the first dose of a homoeopathic remedy there is no need for repetition as long as this dynamic affect is progressing. If the dose is repeated under these circumstances it will interfere with the dynamic reaction of the vital force and disrupt the cure.
Unfortunately, such marvelous cures are not that common, especially in chronic complex diseases. Many chronic patients only slowly improve over a period of months to years under the influence of a constitutional remedy. What should we do to speed the cure? Hahnemann sheds light on the situation in aphorism 246.
"On the other hand, the slowly progressive amelioration [DL] consequent on a very minute dose, whose selection has been accurately homoeopathic, when it meets with no hindrance to the duration of its action, sometimes accomplishes all the good the remedy in question is capable of performing by its nature in a given case, in a period of forty, fifty or a hundred days.
This is however, rarely the case, and besides, it must be a matter of great importance to the physician as well as the patient that were it possible, this period be diminished to one-half, one quarter, and even still less, which many often repeated observations have shown under three conditions.
- Firstly, the correct homoeopathic remedy must be chosen by the totality of the symptoms.
- Secondly, the remedy is to be given in the minimal dose so as not to overexcite the vital force. [The remedy is to be prepared with one, rarely two pills in an aqueous solution. Vide aphorisms 285, 286, 287 and 288. DL]
- Thirdly, the remedy may be repeated at suitable intervals to speed the cure, if necessary, without producing aggravations."
Hahnemann was frustrated by cases which demonstrated only a slow improvement, as by the rules of the 4th Organon, there was no way to speed the cure. He was not happy with having to wait for the relapse of symptoms before repeating the remedy in a slow moving case. This was making the cure take too long. This led the good doctor to perform countless experiments as he knew there must be a better way.
The Master Homoeopath began a set of experiments with the aim of overcoming the obstacles in the way of a rapid, gentle and permanent cure. In the note to aphorism 246 Hahnemann calls his method the "middle path" because it represents the balance point between the exclusive single dose and the routine repetition of the remedies.
The new posology maxim states that anytime the first dose produces a striking amelioration no more medicine is needed for the time being.
If, on the other hand, the first dose only produces a slow amelioration the remedy may be repeated at suitable intervals to speed the cure.
This new methodology can only be carried out if the remedy is prepared in a medicinal solution and given in a "split-dose". If the homoeopath is still using the dry pellet dose then they must follow the rules as given in the 4th Organon. This means the homoeopath can only repeat a remedy when there is a definite relapse of the symptoms even if the person is only slowly improving.
With the medicinal solution, however, the remedy may be repeated at suitable intervals as long as the patient is improving without any aggravations. This is how the cure can be reduced to one half or less the time it takes with the ordinary dry dose method.
These are some of the directions contained in the 5th Organon on the advanced methods of using the centesimal potencies. This methodology led the way to the methods of the 6th Organon and the LM potency.
A review of Hahnemann's writings shows that it is important to understand three factors to safely repeat the dose. These are the nature of the remedy, the nature of the constitution, and the nature of the disease.
1. The nature of the remedy.
The homoeopath should study the patterns of remedy activity, duration, and depth of action. In general, non-toxic plant remedies have shorter duration and a more gentle action. Mineral remedies tend to act more deeply and possess a longer duration of activity.
The nutritional minerals tend to be relatively more gentle than the toxic mineral elements. Toxic plants, minerals, and nosodes tend to need more care in their usage and the homoeopath should be more conservative in both potency and repetition.
2. The nature of the constitution.
The homoeopath must study the physical constitution and psychological temperament of the patient and their susceptibility factors.
The quick moving, nervous, allergenic and emotionally unstable types are usually more sensitive then those of a slower moving, calm, and generally more tolerant nature. The state of the constitutional sensitivity should be analyzed if the homoeopath is to prevent aggravations and complications.
3. The nature of the disease.
The homoeopath must perceive the nature of the acute and chronic diseases and their cycles. In general, disorders that involve rapid development, hyperactive tendencies, allergenic responses, and nervous irritability are more reactive than those of a slow, progressive, and insidious nature.
Those with advanced pathology and weakened vitality are often more sensitive to remedies than those with functional disorders and average general health.
If the homoeopath understands these three areas it becomes easier to safely repeat the homoeopathic remedies if and when needed.
Therefore, Hahnemann introduced three new revelations in the 5th edition; the introduction of the higher potencies, the use of the medicinal solution and the repetition of remedies at suitable intervals when needed.
In this way the 5th Organon can be truly called "The Limit Breaker" as Hahnemann removed the 30c ceiling on potency, overcame the obstacles associated with the dry dose, and removed the restriction on the repetition of the remedy when it was necessary to speed the cure.
Next: The Medicinal Solution