Editor's Note: The potency selction guidelines
in this article are a collection of personal views of various
authors and are based on individual experiences. These are
not definite indications for the use of any potency
and some of the guidlines might not get approval from many
modern homeopaths. These guidelines can add to our understanding
of the complex issue of homeopathic posology but should not
be followed blindly in any case.
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HIGH POTENCIES
In acute diseases 1M and 10M are the most useful. From 10M to
the MM are all useful for all ordinary chronic diseases in persons
not so sensitive.
In persons suffering from chronic sickness and not so sensitive,
the 10M may first be used, and continued without change so long
as improvement lasts; then the 50M will act precisely in the same
manner, and should be used so long as the patient makes progress
toward health; them the CM may be used in the same manner, and the
DM and MM in succession. By this use of the series of potencies
in a given case, the patient can be held under the influence of
the similimum, or a given remedy, until cured. …… (Kent)
The more similar the remedy, the more clearly and positively the
symptoms of a patient take on the peculiar and characteristic form
of the remedy, the greater the susceptibility to that remedy, and
the higher the potency required.
Generally speaking, susceptibility is greatest in children and
young, vigorous persons, and diminishes with age. Children are particularly
sensitive during development, and the most sensitive organs are
those which are being developed. Therefore the medicines which have
a peculiar affinity for those organs should be given in the medium
or higher potencies.
The higher potencies are best adopted to sensitive persons of the
nervous, sanguine or choleric temperament; to intelligent, intellectual
persons, quick to act and react; to zealous and impulsive persons.
If the potency is too high its action may be too deep and far
reaching, and the reaction too great for the weakened vital power
to carry on. Such remedies as Sulphur, Calc-c, Mercurius, Arsenic
and Phosphorus, given in the 50M or CM potencies, have sometimes
hastened tubercular or tertiary syphilis cases into the grave. In
beginning treatment of such suspicious or possibly incurable cases
it is better to use medium potencies, like the 30th or 200th and
go higher gradually, if necessary, as treatment progresses and the
patient improves… (S. Close)
When the symptoms of a case clearly indicate one remedy, whose
characteristic symptoms correspond closely to the characteristic
symptoms of the case, we give high potencies—thirtieth, two
hundredth, thousandth, or higher according to the prescriber’s
degree of confidence and the contents of his medicine case. ………………….
(Jahr)
If a case seems relatively curable and free of physical pathology,
higher initial potencies may be tried, ranging from 30 to CM. The
primary guiding principle here is the degree of certainty which
the homoeopath has about the remedy. If the medicine seems very
obvious and covers the case very well, a very high potency may be
given in a person with a curable system. If the remedy is not so
clear, it is better to begin with a potency closer to 30. ……………………………………
(George Vithoulkas)
In children with acute ailments (because their defensive mechanisms
are quite strong), it is best not to give potencies lower than 200;
thus 200 to CM potencies can be given, depending upon certainty
of the medicine for acute ailments.
An M.D with a few years’ experience in homoeopathy attempted
to treat a child suffering from severe mental disorders. The patient
had received approximately fifteen remedies, some of which had partial
actions and others of which had no action. The case was sent to
me and the case taken during the initial interview showed clearly
Veratrum Album, which had been given only as the tenth prescription
amidst a variety of others. Based upon this initial interview, Veratrum
Album 50M (it is best to with go high potencies if possible in such
cases) was given again with instructions to wait after that for
a full three months in order to fully evaluate the direction of
the remedy.………………………………(George
Vithoulkas)
MEDIUM POTENCIES
From 30th to 10M will be found those curative powers most useful
in very sensitive women and children.
In sensitive women and children, it is well to give the 30th or
200th at first, permitting the patient to improve in a general way,
after which the 1M may be used in similar manner. After improvement
with that ceases, the 10M may be required.
Some patients are very sensitive to the highest potencies and
are cured mildly and permanently by the use of 200th or 1000th.
There are other individuals who are torn to pieces by the use of
the highest potencies.
Patients who have heart disease, or who are suffering from phthisis
are apt to have their sufferings increased and the end hastened
by the higher potencies; they do better under 30th or 200th.
If you strike too high she is not sensitive, it is not sufficient.
Keep to the mild potency so long as it works. It is not well to
jump too many degrees. From the crude to 10M there is a range of
degrees in ordinary persons. . (Kent)
A single dose of the appropriate nosode (In a case, which is not
at all susceptible to the indicated remedy) in a moderately high
potency, will sometimes clear up a case by bringing symptoms into
view which will make it possible to select the remedy required to
carry on the case. ………………………………………
(Stuart Close)
A correctly chosen remedy given in too low or sometimes too high
a potency, or in too many doses, may cause an aggravation of the
existing symptoms as to endanger the life of the patient; especially
if the patient be a child or a sensitive person and if a vital organ,
like the brain or lung be affected. Belladonna in the third or sixth
potency, given in too frequent doses in a case of meningitis, for
example, may cause death from over-action; whereas the thirtieth
or two hundredth potency given in single dose or in doses repeated
only until some change of symptoms is noticed, will speedily cure.
Phosphorus 3rd or 6th in pneumonia under similar circumstances may
rapidly cause death. The low potencies of deeply acting medicines
are dangerous in such cases in proportion to their similarity to
the symptoms. …………………………….
(Stuart Close)
Oversensitive patients present a unique problem for potency selection.
There are patients who are excessively “nervous” reactive
to all physical and emotional stimuli, usually lean and quick in
their movements, restless, sensitive to odors and noise and light,
and frequently suffering strongly from exposure to chemicals in
the environment or food. Such people are very reactive both to low
potencies (on physical level) and high potencies (on electrodynamic
level). Consequently, it is better to restrict initial prescriptions
to 30 or 200 in such patients; depending upon their reaction, later
potencies might go higher or lower. But initially at least, 30 or
200 are the best selections for oversensitive patients. …(George
Vithoulkas)
On the other hand, another young person comes to you with a similar
complaint, but you cannot decide whether she needs Pulsatilla or
Sulphur. You finally decide upon Pulsatilla after many hours of
careful study; in this instance, you would tend to give only a 30
or 200 for the initial prescription because of the lack of clarity.
In still another case with a skin eruption, you may see clearly
that Pulsatilla is indicated. Yet the patient reports that she able
keep her skin eruption under control by using cortisone ointment
“only” twice a week. Further you observe that there
are other weaknesses of the organism—a weak vitality, the
patient is easily tired, easily affected by chemicals in the environment.
In this type of case you would not give a potency higher than 200;
otherwise you may witness an unnecessary prolonged aggravation.
If the patient is elderly, chronically weakened, or even if severely
weakened by the acute ailment (for example, if it has developed
into a severe pneumonia), a 200 potency would be preferable for
the initial prescription, even if the remedy is quite obvious. …(George
Vithoulkas)
LOW POTENCIES
Sometimes very sensitive patients will do well on a high potency
if they have been prepared for it by the use of a lower one. (connect
sentences) I have seen Sulphur and Phosphorus act so strongly that
I have regretted it. In lung cases, consider whether she has lung
space enough to make recovery probable. If she can bear it, give
it in low potency, but do not give it if there is not lung space
enough to warrant it. ……. (Kent)
Where the symptoms are not clearly developed and there is an absence
or scarcity of characteristic features; or where two or three remedies
seem about equally indicated, susceptibility and reaction may be
regarded as low. We give, therefore, the remedy which seems most
similar, in a low (third to twelfth) potency. ………………….
(Jahr)
Lower potencies and larger and frequent doses correspond better
to torpid and phlegmatic individuals, dull of comprehension and
slow to act; to coarse fibered, sluggish individuals of gross habits;
to those who possess great muscular power but who require a powerful
stimulus to excite them. Such persons can take with seeming impunity
large amounts of stimulants like whisky, and show little effect
from them. When ill they often require low potencies, or even sometimes
material doses. …………(Stuart Close)
If the grade of the disease is low, and the power of reaction low,
the remedy must be given low. Thus we find, in such cases, that
the symptoms of the patient are usually of a low order; common,
pathological symptoms; organ symptoms; gross terminal symptoms;
symptoms that correspond to the effects of crude drugs in massive
toxic doses. The finer shadings of symptoms belonging to acute conditions,
in vigorous sensitive patients, do not appear. Potentized medicines
will not act. The case has passed beyond that stage, and finer symptoms
with it. Yet the symptoms remain and the almost hopeless conditions
they represent, are still within the scope of the homoeopathic law;
and they sometimes yield to its power, when the related law of posology
is rightly understood and applied.
People who are accustomed to long and severe labour out-of-doors,
who sleep little and whose food is coarse, are less susceptible.
Persons exposed to continual influence of drugs, such as tobacco
workers and dealers; distillers and brewers and all connected with
the liquor and tobacco trade; druggists, perfumers, chemical workers,
etc. often possess little susceptibility to medicines and usually
require low potencies in the illnesses.
The seat, character and intensity of the disease has some bearing
upon the question of the dose. Certain malignant and rapidly fatal
diseases, like cholera, may require material doses or low potencies
of the indicated remedy.
Occasionally a case will be met which is not at all susceptible
to the indicated remedy. Hahnemann has recommended in such cases,
the administration of Opium, in one of the lowest potencies, every
eight or twelve hours until some signs of reaction are perceptible.
By this, he says, the susceptibility is increased and the new symptoms
of the diseases are brought to light. Carbo-veg, Laurocerasus, Sulphur
and Thuja are other remedies suited to such conditions. They sometimes
serve to arouse the organism to reaction so that indicated remedies
will act. ……….(S. Close)
There are certain types of cases in which relatively low potencies
should be used¯ at least initially. Patients who have weak
constitutions, old people, or very hypersensitive people should
initially be given potencies ranging, roughly, from 12x to (space)200.
The reason for this is that higher potencies can over stimulate
the weakened defense mechanism, resulting in unnecessary powerful
aggravations.
Children who are suffering from severe problems should generally
be given low potencies. An infant with severe eczema or psoriasis
is likely to have a severe aggravation if given a high potency.
Consequently, such cases might be given just a few doses (say daily)
of a 12x, or just one dose of a 30 or 200.
Generally, cases with known malignancy should not initially be
given potencies above200. If a case is merely suspected to have
a malignant or premalignant condition, the initial prescription
should not be higher than 1M. Again such potency restriction is
in order to avoid unnecessary powerful physical aggravations, which
require considerable experience to manage. ……………...
George Vithoulkas)
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Excerpted from : The Appropriate Potency by Dr. Mir Zahed
Dr. Zahed in an honorary lecturer at the Homoeopathic Academy of
Niagara- Canada. He has authored the following books:
1. How to Understand the Homoeopathic Materia Medica.
2. Case Taking in the Light of Organon.
3. The Appropriate Potency.
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