Part 6: The 7th Organon
Hahnemann only used the LM potency for 3 years before leaving for his Heavenly Abode. If he had lived another four or five years he would have written the 7th edition of the Organon.
I am not qualified to write the 7th Organon but over the last 18 years I have gathered a large volume of clinical experience. It would appear from my studies, and those of my colleagues, that today's patients are more sensitive than Hahnemann's patients in Germany in the 1840s. For this reason, I have made certain adjustments to the way in which I practice and teach the use of the LM potency.
First of all I would like to say that I, and my colleagues, have not found it necessary to give the daily dose very often, especially with well chosen remedies. The daily dose has proved itself useful only in those patients we were quite hyposensitive or on heavy allopathic medications that were reducing the effect the remedy.
Even the alternate day dose is not all that common, especially over a longer period of time. The most common rapid repetitions are those that are given every 3 or 4 days.
We have also noticed that the daily and alternative day dose must be reduced as soon as there a signs of improvement to prevent aggravations. The more sensitive the patient is the less often they will need a dose of the remedy.
I have many patients that only take the LM potency once every 4, 5, 6 or 7 days. Some only need the remedy every one or two weeks, while other only need it once a month, etc.
As Hahnemann said, it is most important to use your own experience to figure out what is best for each and every patient. All mechanistic schedules and mechanical repetitions should be avoided.
In part 1 of aphorism 248 Hahnemann spoke of using between 8 and 12 succussions of the medicinal solution prior to administration. We have found that a minimum of 8 succussions is far too many for today's hypersensitive patients.
Therefore, I have suggested that the potential range of succussions should be between 1 and 12 depending on the sensitivity of the patient. A modern hypersensitive patient can only tolerate between 1 to 3 succussions, and a moderately sensitive patient may only need 4 to 7.
We have found that succussions should not be overly hard or they may "shake up the vital force". I was once asked by an experienced homoeopath new to the LM method why he was seeing a strange pattern of accessory symptoms in some of his cases. I asked him how he was succussing his doses. He was giving the medicinal solution very hard slams on a book. I advised him not to use such hard succussions and the problem never reoccurred.
In part 1 of aphorism 248 Hahnemann suggests that the patient should be given 1, or ascendingly, several teaspoons of the medicinal solution from the remedy bottle. In his example in footnote 248 he speaks of stirring one tablespoon of the medicinal solution into a dilution glass containing 8 to 10 tablespoons of water.
This has caused some practitioners to always start out with a tablespoon instead of using 1, or increasing more teaspoons as needed, as suggested in the main aphorism.
Doctor Croserio's letter, however, points out that Hahnemann used both large and small spoons depending on the case. It has been our experience that 1 tablespoon is too large a dose from the remedy bottle for the very sensitive and moderately sensitive modern patient.
Therefore, we suggest that the instruction in the aphorism take precedent over the example in the footnote. We recommend 1 teaspoon as the average starting point for most patients, and that this amount is increased to 2, 3, or even more teaspoons, if and when needed.
In part 3 of aphorism 248 Hahnemann suggests changing the potency every 7-8 to 14-15 days. The Paris casebooks show that this suggestion was not a rigid rule because he often gave long periods of placebo and raised his potencies much more slowly.
It has been our experience that such rapid changes in potency are not necessary or even beneficial in many cases. Those who are very sensitive do not take to such rapid changes of potency without aggravations, and in some cases, relapses.
We have found that a certain percentage of individuals do better if they are left on the same potency for a longer period of time. This, however, is not always easy to tell in advance.
Sometimes a change to a higher potency does not suit the patient and one has to return to the previous potency to correct the case. It seems that certain patients need to stay on a particular potency for a longer period than Hahnemann suggested. Once again, trial and error is the greatest teacher.
Hering said in his preface to the American edition of the Chronic Diseases (1845) that it is important for all of us to go further in the practice of Homoeopathy than Hahnemann and correct the errors of the past while remaining true to our principles. In this spirit I have done my best to share my many years of experience with the LM potency.
For this reason, I have made certain modifications to some suggestions given by the Founder while staying true to the philosophy he introduced. I have repeated some statements several times in this discourse because I feel that certain essential ideas must be repeated from a number of different vantage points.
The most important maxims of homoeopathic posology and case management are individualization and the words "if and when necessary". For the sake of easy reference I will offer a brief review of my posology methods.
1. I begin my cases with a single test dose (C or LM) of a well chosen remedy, potency, and dose adjustments. Under rare circumstances I may give a short series of three test doses at the most suitable intervals (daily, alternate day, every three days, every four days, etc.).
In this case, I tell the patient to stop the medicine immediately if there is any aggravation, new symptoms or a strikingly progressive improvement. I only do this with relatively hyposensitive patients with stable vitality that live too far away for me to observe the case more closely in the beginning. In India most people do not have a phone.
2. When there is a strikingly progressive amelioration from a single test dose, or a short series of test doses, the remedy is not repeated. This is because there is no need to speed the cure. My colleagues and I have witnessed many cases cured by a single dose and infrequent repetitions.
A. Once the strikingly progressive amelioration slows down the remedy may be repeated at similar intervals to continue the rapid cure.
If the strikingly progressive amelioration last for 3, 4, 5, or 6 days, I repeat the remedy every 3, 4, 5, or 6 days. If the progressive improvement last for 1, 2, 3, or 4 weeks, I give the remedy every 1, 2, 3, or 4 weeks.
If the progressive improvement lasts for 1, 2, 3, 4 months, I give the remedy every 1, 2, 3, or 4 months, etc. If it lasts for 1, 2, 3 or 4 years I give the remedy every 1, 2, 3 or 4 years, etc.
3. When there is little or no amelioration or only a slow improvement in response to the single test dose, or short series of test doses, the remedy is repeated at more rapid intervals.
These suitable intervals are (as Hahnemann said) what "experience has shown to be the most suitably appropriate for the best possible acceleration of the cure".
A. I judge the appropriate intervals in accordance with the sensitivity of the patient, the nature and stage of the disease state, the age of the patient, and the state of their vitality. Those that seem hyposensitive yet have relatively stable vitality may receive the remedy daily.
Those that seem a little less hyposensitive may receive the remedy on alternate days. Those that are a little more sensitive may receive the remedy every three or four days, etc.
At this time the patient is given a series of three to seven doses to see if the sensitivity and disease condition has been judged correctly.
I tell the patient to stop the remedy immediately if there is any aggravation, new symptoms, or strikingly progressive amelioration.
B. If the chosen interval produces a satisfactory improvement the remedy is continued at this rhythm to speed the cure.
When the patient experiences a significant improvement these intervals are slowed because the patient no longer needs as much medicinal stimulation.
In this way aggravations in the middle of treatment can be avoided.
C. When the patient reaches the point where they no longer show any symptoms, and the vitality has completely returned, the medicine is stopped to test the cure.
If there is no relapse of symptoms after waiting and watching for a reasonable amount of time they are cured. If some of the symptoms return the remedy is again repeated at slightly longer intervals to complete the cure.
D. If there is an aggravation toward the end of treatment the medicine is stopped and a period of waiting and watching is begun.
If the symptoms pass off quickly, and the patient does not relapse, the cure is complete. When there is a return of symptoms the remedy is again administered but at slightly longer intervals in order to prevent any reoccurrence of the aggravation and complete the cure.
After carrying out this procedure the methods described in point 3C or point 3D are repeated if necessary.
There are many more adjustments of the medicinal solution and potency that may be needed during the process of cure but this offers the basic methodology in relationship to the single dose, infrequent repetitions and repeating the dose at more rapid intervals to speed the cure.
David Little is an American living in India with his family. He has done an in depth study of the original microfiches of the Hahnemann's Paris Casebooks, especially those from the years 1840-1843 when Hahnemann used both the higher potency C and LM potency.
David is publishing a two volume work called, The Homoeopathic Compendium, which contains around 2500 pages of ground breaking material on the clinical practice of homoeopathy.