Part 4: Administering the Remedy

A homoeopathic medicine must be prepared correctly, and administered properly at the right time, to produce a rapid, gentle and permanent cure.

In the second part of aphorism 248, Hahnemann offers some examples of how to apply the medicinal solution in slow moving protracted cases.

"2. In protracted diseases, give the medicine daily or every second day.

In acute diseases, give the medicine every six, four, three or two hours. In the most urgent cases, give the medicine every hour or even more frequently.

In chronic diseases, every correctly chosen homeopathic medicine, even one whose action is of long duration, may be repeated daily for months with ever-increasing success [when fifty-millesimal potencies are used]."

Organon of the Medical Art
S. Hahnemann (O'Reilly 6th Edition)
Aphorism 248.

In paragraph 248 Hahnemann says in protracted diseases (those that improve very slowly on a single dose) the patient "may" receive the remedy daily. He does not say that the LM potency must be repeated daily in every case.

Some read this sentence without acknowledging that the first part of aphorism 246 says whenever there is strikingly progressive amelioration on a single dose, or anytime during the treatment, the remedy should not be repeated.

They also ignore the fine print in the footnote to aphorism 246 that emphasizes that the daily repetition is only used when necessary.

In the beginning of aphorism 246 Hahnemann says that LM single dose cures of acute diseases were not uncommon. If one ignores all these conditioning factors, and only follows the above suggestions, they will over medicate many of their patients.

All the statements concerning the rapid repetitions in aphorism 248 relate only to those patients that slowly improve on a single dose or infrequent repetitions. In any case, the remedy must be stopped as soon as there is any aggravation, new symptoms, or a marked increasing amelioration.

I have not found one case in the Paris casebooks where Hahnemann gave a daily dose for months on end without stopping the remedy and interspersing placebos with equally long periods of observation.

Changes of Symptoms and the Second Prescription

One of the most satisfying experiences for a homoeopath is when one remedy completes the cure of a chronic patient. If a chronic remedy is a true simillimum it will be beneficial in a number of potencies without unnatural changes of the symptoms.

When a remedy is a distant partial simillimum it will remove a few symptoms but then produce new medicinal signs in other areas changing the natural symptom pattern. Many who are inexperienced in this area think that these changes are new diseases or deeper layers coming to the surface.

If one is not careful one may continue to give more partial simillimums until the natural symptom pattern is totally disrupted. One must be very careful when new symptoms appear to give a better remedy that is a more perfect simillimum.

I can always tell how well I understand a case by how many remedies I have given over a period of 1 or 2 years. If I have to give more than 1, 2, or 3 remedies for the chronic symptoms something is usually wrong with my approach.

There are exceptions to this rule, but in general a good remedy should act over long periods of time in higher and higher potencies without major changes of symptoms.

Every homoeopath must learn to recognize when it is time for a change of prescription. When the patient experiences new ailments and the rest of the symptoms take on an altered pattern, the time has come to retake the case and give a better remedy.

Hahnemann offers an example of a change of symptoms in point 4 of aphorism 248.

"4. If the patient undergoes one or another important ailment that he never had before in his life, and the rest of the disease appears in a group of altered symptoms, then another medicine, more homeopathically appropriate, must now be selected in place of the one that was used.

The new medicine should be administered in just such repeated doses. Again, each dose of the solution should be modified with the proper vigorous succussions in order to somewhat alter and heighten its degree of potency."

Organon of the Medical Art
S. Hahnemann (O'Reilly 6th Edition)
Aphorism 248.

A definite change in symptoms is an indication to retake the case and give a new remedy. The new prescription should be started in the lowest degrees (LM 0/1-0/7) and the potency is raised in a serial fashion to the higher degrees.

It does not matter if the previous remedy reached an ultra high potency like the 0/20. One always starts a new remedy with the lower potencies and works upward through the scale stage by stage.

In aphorism 171 Hahnemann notes that a new remedy is often chosen by the remaining symptoms after the previous remedy has accomplished all it can.

"In chronic diseases that are not venereal (therefore those most usually arising from psora) one often needs to employ several antipsoric remedies in succession to bring about a cure, each to be homeopathically selected in accordance with the result of an examination of the group of symptoms that remain after the pervious means has completed its action."

Organon of the Medical Art
S. Hahnemann (O'Reilly 6th Edition)
Aphorism 171.

Sometimes certain symptoms remain or old symptoms appear that are not well suited to the present remedy. This is a different situation than the appearance of new symptoms caused by new factors affecting the case or the use of partial simillimums.

As long a remedy causes the old symptoms to reduce in number and decline in strength, one can rest assured that the case is progressing in the right direction.

Sometimes one remedy is not sufficient to cure a protracted degenerative disorder, especially those based on layers and complex miasms. Under these circumstances one must determine the proper time to change the remedy.

James Kent wrote:

When the demonstration is clear that the present remedy has done all it is capable of doing - and this demonstration can not be made until much higher potencies than usually made have been tried - then the time is present for the next prescription.

To change to the next remedy becomes a ponderous problem, and what shall it be?"

Kent's Lesser Writings
J. T. Kent, The Second Prescription
page 418-419.

What should we do when there is a change of symptoms not affected by a previous remedy? At this time, the homoeopath should ask themselves the following questions.

  • What is the cause of the change in symptoms?
  • Are they produced by a new exciting or fundamental causes?
  • Is the patient doing anything different that could be causing these new symptoms?
  • Is this a dissimilar layer of symptoms coming to the surface after the removal of a previous layer?
  • How do we know the difference?

There are three major reasons for a change in symptoms, i.e., an artificial change caused by an inappropriate medicine, the appearance of new exciting and fundamental causes, and the arousal of deeper dissimilar layers of illness during the process of cure.

A wrong remedy or a partial simillimum may artificially change the nature of the symptom pattern. At this time, the symptoms produced by the remedy and the remaining natural symptoms must be combined and a better medicine prescribed. This should regularize the vital force and move the case toward cure.

If the patient receives two, three or four inappropriate remedies in a row the natural symptom pattern may be seriously altered. Such a muddled case can only be restored to health by an experienced homoeopath.

For this reason, the greatest care must be applied to each and every prescription.

Sometimes, the patient comes in contact with new causes that may change the symptom pattern. Perhaps, the patient suffers from a virulent acute disease that produces a sequel. Maybe the patient becomes infected with a chronic miasm (psora, sycosis, etc.) that they previously did not suffer. There may be a new befallment like a physical or mental trauma that changes the nature of the symptoms.

The nature of the new phenomena must be investigated, the case retaken, and a new remedy chosen. These unhappy situations are conditions where the disease state has actually become more complex.

The third reason for a change in the symptom pattern is the appearance of old dissimilar disease layers as the reversal of symptoms takes place under a curative treatment. These deeper layers may represent old unresolved disorders, suppressions, and the activation of latent states.

Deeper layers also appear when one sided disease states begin to resolve. If the new symptoms are found in the materia medica under the same remedy, there is no need to change the prescription.

When these symptoms are not similar to the remedy under employment, the case must be retaken and a new simillimum administered. In order to comprehend this process one must have some understanding of how layers and complex disorders develop.

Next: How to Complete a Cure