Part 1: The Aphorisms of the 4th, 5th and 6th Organon

The 4th, 5th, and 6th editions of Organon represent the development of Homoeopathy over a critical fourteen-year period in which Hahnemann perfected his healing art. It is very important to study the historical progression of Homoeopathy to understand the methods of the 6th Organon.

Some of the most important passages deal with administering the first dose and following the case to cure. The 4th Organon (1829) and the 1st Chronic Diseases (1828) established the method that most contemporary homoeopaths still use.

This was a decisive moment in homoeopathic history as Hahnemann introduced the vital force, chronic miasms, very small doses and the 30C potency.

In these works, the Founder suggests the use of a single unit dose of one poppy seed size pill, olfaction and the early liquid solution of the 30C potency. This method is called the single dose, wait and watch philosophy.

"As long, therefore, as the progressive improvement continues from the medicine last administered, so long we can take for granted does the duration of the action of the helpful medicine, in this case at least, continue, and hence all repetition of any dose of medicine is forbidden."

Organon of Medicine, 5th & 6th Edition
S. Hahnemann (Dudgeon & Boericke Editions), Appendix,
4th Organon, Aphorism 242, page 212

The first single unit dose of a homoeopathic remedy is a test to see if the remedy, dose and potency are appropriate for the patient. If there is a strikingly progressive improvement from the single test dose the remedy should not be repeated.

Sometimes the single dose performs a complete cure. More commonly there will come a time when the action of the remedy slows down and a relapse of symptoms appears. At this time, a second dose of the remedy is indicated.

The repetition of the dry dose is only allowed when there is a definite relapse of the symptoms. This warning was introduced to prevent the relapse of the symptoms that often accompanies the premature repetition of the dry pellets.

In the 5th Organon (1833) Samuel Hahnemann completely revises his system of administering the C potency remedies. In aphorisms 286, 287 and 288, he introduces a new delivery system, the medicinal solution. He also emphasized the effectiveness of olfaction for similar purposes. With these improved delivery systems comes a new case management procedure.

In aphorism 245 of the 5th edition Hahnemann reviews the ideas raised in aphorism 242 of the 4th edition.

"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 now 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."

Organon of Medicine, 5th & 6th Edition
S. Hahnemann (Dudgeon & Boericke Editions)
5th Organon, Aphorism 245.

Whenever there is a dramatic increasing response to the first dose of a homoeopathic remedy it is best to leave well enough alone! Unfortunately, many cases only demonstrate a slow progressive amelioration over a period of weeks to months and then there is a relapse.

In the 1820s Hahnemann had no special strategy to speed the cure in these slow or moderately improving cases. For this reason, the Founder started to experiment with the medicinal solution and olfaction and repeating the dose to reduce the time it takes to cure.

"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 effected, as recent and oft-repeated observations have shown, under three conditions."

Organon of Medicine, 5th & 6th Edition
S. Hahnemann (Dudgeon & Boericke Editions)
5th Organon, Aphorism 246.

A strikingly progressive increasing amelioration is the best possible response to a homoeopathic remedy. What do we do with slow moving cases?

In the footnote to this aphorism the Founder suggested that one could repeat the dose at suitable intervals in slow moving cases rather than waiting for a complete relapse of symptoms. Hahnemann called his new posology the "middle path" because it stands half way between the single doses wait and watch method and the mechanical repetition of the medicines.

In the footnote to aphorism 246 he suggested that a 30c should not be repeated more often than every seven days in robust patients and every nine, twelve to fourteen days in those more weak and excitable. This shows that Hahnemann was already using the medicinal solution of the C potency and developing his new posology system long before he discovered the LM potency.

Aphorism 246 of the 6th Organon

Aphorism 246 of the 6th edition is based on a synthesis of the ideas introduced in aphorisms 245 and 246 of the 5th edition with the addition of five new conditions to speeding the cure. It represents the entire 6th Organon method in a nutshell.

The first topic taken up is when a single dose of the LM potency produces a strikingly progressive improvement in the patient's symptoms.

"During treatment, every noticeably progressing and conspicuously increasing improvement is a state which, as long as it persists, generally excludes any repetition of the medicine being used because all the good being produced by the medicine is still hastening towards completion. This is not seldom the case in acute diseases."

Organon of the Medical Art
S. Hahnemann (O'Reilly 6th Edition)
Aphorism 246.

When a single dose of the LM potency produces an obvious progressively increasing amelioration the remedy should not be repeated. This is because the simillimum is already hastening toward cure at the fastest possible rate.

A strikingly increasing amelioration is one in which the patient feels better day by day as the symptoms are rapidly reduced and the vitality increases. The repetition of the LM potency under this condition can cause aggravations and relapse of the symptoms or just slow down the cure.

Single dose cures are more common in acute diseases but there are also chronic patients that only need a single dose or very infrequent repetitions. For the above reasons, I usually give my patients a single test dose of the chosen remedy at the start of the treatment.

On rare occasions, I may give a patient a series of three test doses with the instructions to stop the remedy immediately if there is any aggravation or striking amelioration. I only use this triple-split dose on those patients that appear hyposensitive when they cannot return for a quick follow up assessment.

"On the other hand, with somewhat chronic diseases, there are, to be sure, some cases that have slow, continuous improvement based on one dose of an aptly selected homeopathic medicine (taking 40, 50, 60, 100 days to complete the cure, depending on the nature of the medicine) but this is very seldom the case.

Also, it must be a matter of great importance, to the physician as well as to the patient, to foreshorten this period, if possible, by half, three-quarters, indeed even more, in order that a far more rapid cure might be attained.

The most recent and frequently repeated experiences have taught me that such rapid cures can be favorably carried out under the following conditions:"

Organon of the Medical Art
Hahnemann (O'Reilly 6th Edition)
Aphorism 246.

Many individuals read the above paragraph but fail to note that Hahnemann makes a grand differentiation between two fundamental types of remedy reactions. In the first part of aphorism 246 the Founder describes the reaction as a "noticeably progressing and conspicuously increasing improvement".

This is a strikingly progressive increasing amelioration is a reaction that is enhanced day by day. Under such conditions the repetition of the LM potency is normally "excluded" because the first single dose is already moving the patient toward cure at the fasted possible rate. In the second section of aphorism 246 the Founder uses the words "slow, continuous improvement".

There is a vast difference between a rapid improvement where the patient feels much better every day and a slow improvement where the patient barely notices any changes! It is only in these slow moving cases that aphorism 246 permits the repetition the LM potency at suitable intervals to speed the cure.

Next: When Necessary!