Principles of Homeopathy

 

 

Similia Similibus Curanter

This is the law of similars. It states that 'that which can cause can cure'. The onion, which produces tears in the eye and irritation (similar to a cold), can be used as a homeopathic medicine to cure colds which have irritating tears. The early Indians recognised this principle and states that Vishasya Vishamevam Aushadam and Samaha Samena Shantihi, but it was Dr.Samuel Hahnemann, who through his studies and experiments on the various medicines available in nature, practically proved the law.                        

 

Simplex Similimum Minimum

This principle consists of three words.
The first is Simplex i.e : simple medicines not compound should be prescribed. This is the doctrine of single remedy. Mixture of medicines or polypharmacy is not allowed. Only one medicine must be given at a time.
Similimum - As discussed previously the totality of symptoms of the patient must be taken. This will yield a picture which corresponds to one medicine, the similimum, which must be given. That medicine which has been tested on various provers and has produced similar symptoms as that of the patient is the similar remedy.
Minimum - A low dosage of medicine is recommended. In homeopathy less is more, so medicines of low potency and given at long intervals have a better impact. Hahnemann, in fact used to give just one dose of the medicine and wait to see the reaction over a period of time.            

 

Principle of Individualization

Treat the patient, not the disease. This is the most important doctrine of homeopathy. Not two human beings are alike and so the medicines used for their treatment need not be alike. Homeopathic medicines are prescribed based on the totality of symptoms of that individual. So, the name of the disease is not important to the doctor who tries to get a complete picture of the patient - his symptoms, the modalities of symptoms, his likes and disliked, his environment, etc. to arrive at the individualized remedy - which is the similimum.       

 

Principle of Potentisation

Homeopathic medicines are diluted in alcohol or milk-sugar(lactose) to make them more palatable and also to reduce the harmful effects. It has been found that the more the medicine is diluted, the more effective and powerful it becomes. So, the process of the dilution is called as potentisation and the medicines are referred to as potencies. The crude homeopathic medicine(eg : Cinchona/Lachesis) is triturated in alcohol to yield the mother tincture. The mother tincture is denoted by the symbol ø.
Potency :
1x potency of the medicine signifies 1 part of mother tincture diluted with 9 parts of alcohol / milk sugar.
2x potency is 1x of medicine diluted with 9 parts of sugar milk / alcohol.
1C potency is mother tincture diluted with 99 parts.
1M potency is mother tincture diluted with 999 parts.
Low potency    :    1x, 3x , 6x (3c), 12x (6c)
Medium potency : 12x, 30x, 30c
High potency : 200c, 1M, 20 M , CM, LM, etc.               

 

 

Law of Direction

 

The law of direction of cure proposed by Dr.Constantine Hering states that - "As a patient recovers from a disease, the symptoms move from within outwards, from above downwards, from center to circumference and disappear in the reverse order of their appearance"
A patient suffering from a skin disease may use various medicines which suppress this disorder and send it into the body and it may manifest as asthma. So, when this patient takes homeopathic medicine, the asthma is replaced with the skin infection and then finally the skin infection leaves to yield a cure.           

 

 

 

Three-legged stool

 

This principle attributed to the elder Lippe(Dr.Adolph Lippe) states that while prescribing a medicine, three leading symptoms of that medicine should match the symptoms of the patient. Just as a stool with three legs is more stable than a stool with one leg, medicine given on the basis of atleast three key symptoms is more reliable than that treated with one symptom. Thus, a careful study is required to apply this law

 

 

Use of Materia Medica

 

The Materia Medica is a dictionary of homeopathic medicines and their symptoms. It is a book which is the final authority on homeopathy. The materia medica contains the list of symptoms experienced by provers of the medicine. The symptoms are arranged in a systematic order - Mind (symptoms related to mind/mental), Head, Eyes, etc..
It is not required for a doctor to memorize or remember all the contents of the Materia Medica. What is required is to understand the nature / keynotes of each remedy. A number of materia medicas have been authored. Prominent among them are Kent's Lectures, Hering's Guiding Symptoms, Allen's Keynotes, etc. 

 

Repertorisation

 

The repertory is an index to the Materia Medica. It is a book containing all possible symptoms arranged in alphabetical order for each of the organs of the body. The physican has to regularly refer this book to find out the medicines which have produced in a prover, the symptoms of the patient. Only, through correct usage of the repertory, can the job of prescription be made easier.               

 

 

What is Homeopathy?

Homeopathy is the system of medicine which works on the principle of 'like cures like' (Similia Similibus curanter). This system of holistic healing was founded by Dr.Samuel Hahnemann, a German physician. Hahnemann, who was translating the a book on the medicinal properties of drugs, was reading the properties of the medicine Cinchona, when he read that Cinchona cures malaria, because of its bitter taste. Hahnemann was surprised by this statement and when he read on, he found a footnote which said that cinchona poisoning leads to malaria-like symptoms. This set him thinking and he decided to test the medicine of himself. He experienced the symptoms of malaria, by repeatedly taking the Cinchona medicine and after continuing his experiments found that those medicines which cause disease-like symptoms in healthy individuals are capable of curing the diseased individuals. So, homeopathy relies on the Materia Medica - a book containing the properties of medicines, properties which have been proved on healthy individuals. Homeopathic doctors rely on the materia medica as the authority for it contains not empty theories, but details of symptoms which were experienced by hundreds of provers. It is thus a system based on sound principles and as a result of solid experiments.               

 

How does Homeopathy work ?

The theory behind the working of homeopathy is that the body of every human being contains a vital force within the body which regulates the functioning of the body. Due to reasons such as heredity, environmental conditions, stress etc, this vital force weaken causing disease. So, disease is nothing but a complex of certain symptoms observed in the human body. The homeopathic physician make a study of not only the symptoms the patient is complaining of, but of the entire patient himself. This leads to a picture of the patient. The physician then prescribes homeopathic medicine, which matches this picture. Now, the medicine so prescribed would have caused the same symptoms in healthy person during 'drug provings'. This medicine is given in a highly diluted dose, so as to prevent side effects. This minute dose, creates a similar disorder in the vital force and provokes the vital force to react to the symptoms and overcome. (The same system is used in vaccines, where vaccination against small-pox is done by injecting the small-pox disease-causing organism, so that the body can build up its natural immunity 

Does Homeopathy rely on placebo treatment?

Now, all homeopathy medicines are given in a very low dosage. This is called as 'potentisation'. Hahnemann discovered that the more the medicine was diluted (with alcohol or lactose), the more potent it became. So, homeopathy makes use of medicines in a very low form. For eg: a doctor may prescribe a medicine with potency C. What it means is that the medicine has been diluted to C (100 times), i.e: for every ninty-nine parts of the diluent, there is one part of the medicine. The question is how does such a small dose work ? The medicines contain an internal energy which is transferred to the vital force leading to cure. Generally, there is a canard against homeopathy, that it relies on placebo treatment, which is totally false. While the medicines may contain so less of the substance that it cannot be detected in a lab, it has been proved that these medicines are highly effective. While, it is easy to say that men who take the medicine may feel that they are getting better due to auto-suggestion, homeopathy has just as effective in curing animals. Can anyone say that animals can be cured by placebo treatment 

Is Homeopathy of use in treatment of all types of diseases?

Homeopathy is the best way to cure both acute and chronic diseases. Right from fever, cough, cold to asthma, skin diseases, cancer and diabetes. All these are not only just curable but the cure is mild(without side effects) and permanent. While allopathy makes use of strong medicines to cure, which cause severe side effects, homeopathic medicines are not only sweet and east to take, they work highly effectively without any side effect. The danger of allopathic medicines is that they do not cure but suppress. For eg : a cough and throat infection is not cured by allopathic drugs, but is suppressed and the disorder may move to the lungs causing asthma and other severe problem. Homeopathy works on the principle of 'Cure the person, not the disease'. It takes into account the totality of symptoms of the individual and treats each individual separately.For eg: there may be two patients suffering from fever. While an allopath would prescribe the same medicine for both, the homeopath observes the overall symptoms. The first patient may be suffering from fever caused due to exposure to cold wind, also the patient is full of anxiety and fearful of death. This corresponds to a homeopathic medicine Aconite, which when given results in immediate cure. The other patient suffering from fever, has his conditions worse after midnight. Despite the high fever and thirst, he wants to drink just little quantities of water. This corresponds to a homeopathic medicine Arsenic. So, the same medicine may not cure two cases of the same disease. Homeopathy thus, treats the individual and not the disease. The name of the disease is not important to the homeopathic physician.               

 

Isn't Homeopathy too slow as a system of treatment?

Cases of acute diseases/disorders like headache, fever, cold, cough, etc can be cured within minutes through the proper selection of the homeopathic remedy. However chronic diseases like asthma, heart problems, cancer etc need time to cure. There is a belief that allopathic medicines give immediate relief, but at what cost ? The use of strong medicines and steriods weaken the body's natural immune system. Homeopathy restores the body to it's original state of health. If a disease is chronic in nature it means that it would have been in the human body for a long time, so it requires some time to be cured. This can vary depending on the problem and the patient. Generally, a strict diet is required while taking homeopathic medicines. Homeopathic medicines must always be taken on an empty stomach and stimulants like coffee, strong tea, nicotine, alcohol, etc must be avoided as they interfere with the working of the medicine. If the patient does not follow the diet prescribed, the healing process is slowed down. There are numerous cases of diseases of long-standing and of serious nature like kidney failure, heart failure, severe asthma which has been cured within a few days.               

 

If Homeopathy is so effective, why has it not overtaken allopathic?

Whatever criteria you may use, there is no doubt that homeopathy is much more effective than allopathy, but the sad fact is that homeopathy has lagged behind in popularity. The failure is not of the system, but of the physician. Homeopathy is a science and has its principles which have to properly applied to find the right remedy (the similimum). Homeopathy has more than 2000 remedies to choose from. Even if you filter out the not-so-used ones, you get more than 200 remedies. Choosing one among them is not so easy and requires the application of great skills on the part of the physician. Also, the homeopathic colleges have totally failed in teaching homeopathy as per the principles laid down by Hahnemann. This has resulted in doctors prescribing compound drugs (which is prohibited by Hahnemann, who calls for only one remedy to be prescribed at a time). Thus, their treatment is a hit and run affair. A number of homeopaths who neither understand nor are able to apply this treatment, prescribe allopathic medicines and thus discredit homeopathy. In fact the number of doctors who properly apply the scientific principles of homeopathy are but a few. This is the only reason why homeopathy has not overtaken allopathy. To quote Mahatma Gandhi - "Just like my principle of ahimsa(non violence) homeopathy can never failure. Failure if any is of the person who practices it".    

Can Homeopathy be practiced by anyone?

The answer to this is YES !! Anyone who has truly understood the principle of Simplex, Similimum,Minimum and anyone who is committed to the system of holistic healing, can practice homeopathy, even if they are not certified doctors.What is required is a knowledge of biology, knowledge of the human anatomy and physiology and most importantly the knowledge of symptomatology,i.e : diseases and their symptoms. This knowledge coupled with the mastery over the principles and a thorough understanding of the materia medica, will help in the practice of homeopathy. However, the fallacy that homeopathy can be practiced by reading books is totally FALSE. It is not reading books, but by understanding and applying principles that homeopathy can be practiced.                            

What are the different types of medicines used in Homeopathy?

Homeopathy uses an array of medicines whose source ranges from animals to plants and chemicals. Plants like Onion (Allium),Capsicum,Belladonna, Cactus, etc are used for preparation of homeopathic medicines. A large number of chemicals like Nitric acid, Arsenious acid, Iron, Phosphorous are popular homeopathic remedies. There are also a large number of animal sourced medicines like Naja & Lachesis which are snake poisons. Medicines are also prepared from substance like milk (Lac def) and sand (Silica). The products of diseases are used to prepare homeopathic medicines called as nosodes.These nosodes include Carcinosin (prepared from the cancer cells), Tuberculinum (prepared from the cells of the lungs of cow infected by tuberculosis), etc. While there may be a few people who are apprehensive of taking such medicines, they need not fear, because the process of preparing homeopathic medicines ensures that they are diluted such that they lose their original form and are rendered harmless.       

 

 

 

 

 

© Will Taylor, MD 1997

The Development of Dose and Potency
in the History of Homeopathy

 

It is important to recognize that Hahnemann spent his life systematically exploring the ramifications of similia similibus. Homeopathy did not spring fully-formed from the proving of Peruvian bark. If we are to understand our art, and particularly if we are to presume to further its development, we need to be familiar with the path of exploration followed by its founder.

It seems reasonable to date the birth of homeopathy at the 1796 publication of Hahnemann's Essay on a New Principal for Ascertaining the Curative Powers of Drugs. If I may presume to anchor a chronology on the date of this Essay, we find ourselves today in year 202 "AE". The completion of the 6th edition of the Organon, and Hahnemann's death, occured in 1843, "year 47". I'd like to use this framework to examine the development of homeopathy over those first 47 years, and in this essay to look specifically at the concepts of dose and dynamization as they developed over that time. In future essays I will address the related issues of repetition of dose and mode of administration, from this same perspective.

During the first 30-some years of the development of homeopathy; from 1796 to somewhere around 1828-1832, Hahnemann's focus in the preparation of medicines was on finding an appropriately small material dose.

Prior to his recognition of cure by similars, Hahnemann practiced in the manner of his allopathic brethren. A largely botanical pharmocopoea were prescribed in doses intended to impose specific actions on the body. Kohler's Medizinal Pflanzen, published posthumously in 1887, detailed 300 medicinal plants employed in this period. Mineral remedies such as arsenic, mercurial compounds, antimony, etc. were similarly employed in quantity sufficient to produce an observable allopathic effect. Hahnemann was quite familiar with the prevailing use of these medicaments, and in fact was responsible for the translation of Monroe's Materia Medica, Haller's Materia Medica of German Plants, the London College of Physicians' Thesaurus Medicaminum, and of Cullen's A Treatise on Materia Medica, which lauched this wonderful journey we continue today. In his pre-homoeopathic medical career, Hahnemann's dosing of medicines corresponded to that of his colleagues; in Directions for the Cure of Old Sores and Ulcers (1784; 12 years "BE") we see him prescribing (allopathically) antimony in doses of 5-50 grains, and jalap root in doses of 20-70 grains. Writings from 1787 see him prescribing conium at 4 grains to several quarter onces daily; belladonna at 12-15 grains every other day; aconite at 1/2-several grains several times per day; digitalis at 1/2-1 spoonful of the juice of freshly crushed leaves twice daily; and hyoscyamus extract, 1 grain several times/d up to 30 grains in 24 hours. In 1790 (6 years "BE") we see him prescribing cinchona according to the allopathic standards of the day, at 1-1/2 to 2-1/2 ounces (45-75 grams) per 24 hours. If these substances sound familiar to the homoeopathist of today, it is only because Hahnemann's allopathic experience with them paved the way for his recognition of their potential to be used as similia in the homoeopathic treatment of disease.

Following the 1790 proving of Peruvian bark, with the pivotal audacious footnote to Cullen's Materia Medica alluding to cure by similars; and prior to the publication of Essay on a New Principal ... in 1796 (year 1 "AE"); Hahneman began experimenting with treating with similia. These early experiments revealed many of the fundamental correlaries of similia similibus that went on to shape later homoeopathic practice, one of which was that a well-chosen similimum can act in a rather small dose. In this 1796 essay he makes reference to the use of "small doses", but does not clarify this further.

By 1798, 2 years "AE", we see Hahnemann using small crude doses homoeopathically. In his Hufeland's Journal article Some Kinds of Continued and Remittent Fevers he notes using Ignatia in "large doses" of 1/2 to 3 grains, dependent on age; Opium in 1/5-1/2 grain doses; and Camphor at 15-30 grains/day. In Some Periodical and Hebdomadal diseases he notes using Ignatia at 8 grains and China at 1/2-1 grain doses. Although these are still "crude" doses, and rather large by later homoeopathic standards, they represent dramatic reductions from the allopathic doses of his contemporaries.

Hahnemann's experiments during this time led him to the use of even smaller (tho still crude) doses, particularly with those remedies he used commonly; we see his doses smallest with those remedies that we today recognize as our polychrests, perhaps because he was developing greater experience with these even-then frequently-used medicines. In his Apothecaries Lexicon (1798; year 2) he refers to using Sabina "in very small doses", Hyoscyamus at 1/60-1/30 grain (.001-.002 gram), Stramonium at 1/100th or 1/1000th part of a grain, and Veratrum album at "one thousand times smaller doses than those used by the ancients".

Serial dilution in the preparation of remedies appears to have been introduced in 1799 (year 3). In his booklet Cure and Prevention of Scarlet Fever (published in 1801, describing his treatment of an epidemic in 1799), he offers the first detailed statements regarding dilution. Opium tincture was used undiluted externally on the abdomen, but for internal use was prepared with two 1/500 dilutions (creating a solution of 1/5millionth part of a grain/drop), with a dose of one to 2 drops. Ipecacuanha was used variably in a dose of 1/10 to 1/2 grain, or 1 to 10 drops of a 1/100 dilution. A dose of Belladonna used early-on of 1/432,000th part of a grain was described as "too large a dose"; in preparing a dose he made a dilution from the tincture in two dilutional steps, of 1/300 and 1/200, resulting in a solution in containing 1/24 millionth grain of dry belladonna juice per drop, and used 2 or more drops/dose, depending on age (up to 40 drops for an adult). Chamomilla was prepared by dissolving 1 grain in 1000 drops, and then diluted 1/800; this final dilution contained 1/800,000th grain of inspissated juice/drop, and 1 or more drops constituted a dose, depending on age.

At this point, trituration and succussion were not recognized for the role in which they are now seen the process of preparation. He offers descriptions of mixing such as "shaking the whole well" and "intimately mixed ... by shaking it for a minute" that suggest an interest in dispersing the substance well throughout the dilution medium. And he describes these preparations in terms that clearly speak of his understanding of them as dilutions, attenuations or reduced doses, such as "weak solution of belladonna".

Reference to Hahnemann's casenotes at this point reveals that he continued to use some medications in small crude doses. These tend to be those that might be considered "smaller remedies" today, which suggests that he was moving to "infinitisimal" doses particularly with those medicines which he employed frequently, and had established enough hands-on experience with to begin to appreciate their ability to act well in such extreme dilution.

Hahnemann's assertions on the efficacy of such "infinitisimal" doses naturally brought out some critcism from his materialistically-oriented contemporaries. He responded with his 1801 (year 5) article On the Power of Small Doses of Medicine in General, and of Belladonna in Particular, in Hufeland's Journal. It is clear that he still understood these infinitisimal preparations to be dilutions or small doses. But there is also an inkling of an appreciation of the release of medicinal power by dispersal of a substance in a quantity of solute, which begins to shadow his 32-years-later appreciation of the dynamization of remedies.

Hahnemann's first homoeopathic materia medica, the 2-volume Fragmenta de veribus medicamentorum positivis, came and went in 1805 (year 9) with no mention of dose, as did part 1 of his Materia Medica Pura in 1811 (year 15). The 1st edition of the Organon was published in 1810, and refered only to "small doses", individually determined for each medicine. In 1819 (year 23), the 2nd edition of the Organon devoted §s300-308 to the issue of dose. §300 stated: "The suitability of a medicine for any given case of illness depends not only on a relevant homoeopathic selection, but just as much on the correct quantity necessary or rather the smallness of the dose." He went on to suggest that dose determination requires "clear experiments, careful observation and accurate experience."

Writings from this time reveal some of the results of Hahnemann's "clear experiments, careful observation and accurate experience" in this first half of the second decade of homoeopathic practice. In an 1812 (year 16) epidemic of intermittent fever, he employed Arnica in the 18th centisimal delution, and Nux-v in the 9th. In his 1814 (year 18) article Treatment of the Typhus or Hospital Fever at Present Prevailing, he used Bryonia & Rhus tox in dilutions prepared by serially diluting 1 drop to 6 drams twelve times, shaken for 3 minutes at each step, and used a dose of 1 drop of the 12th dilution.

In the subsequent volumes of his Materia Medica Pura, published between 1816 and 1819 (years 20-23), we see a good deal of variation in dose and dilution, suggesting experimentation to discover an optimal dose for each remedy and condition under treatment. In part 2 (1816), doses range from 1 drop of the original preparation for Causticum, to the 30th centisimal dilution for Arsenicum. Ferrum is given in doses described as 1/100, 1/1000th, or 1/50,000th of a grain. For Pulsatilla, Rhus-tox and Bryonia, he makes recommendations contingent on the condition of the patient: 1 drop of the pure tincture if the patient is strong & the illness protracted, and higher dilutions (Puls in the 12th centisimal dilution, Rhus-t in the 12th-15th, Bry in the 18th) in acute illness & delicate patients.

In 1821 (year 25), in volume 6 of his Materia Medica Pura , Hahnemann refers constantly to treating with "the smallest part of a drop". In the 1822 2nd edition of volume 1 of the Materia Medica Pura, dosing recommendations ranged from the crude tincture for Cannabis, to the 9th to 30th centisimal dilutions or triturations, with the dose consistently specified as the "smallest part of a drop". By "year 26", Hahnemann had evidently begun giving remedies in fraction-of-a-drop doses on medicinally-moistened globules, and had apparently settled on a centisimal standard for his serial dilutions.

Although Hahnemann briefly alluded to an accentuation of medicinal influence from dispersing a medicine in fluid solution in his 1801 (year 5) article On the Power of Small Doses of Medicine in General, and of Belladonna in Particular, there is as yet no real mention of the notion of potentization or dynamization of remedies. These preparations arrived at through serial dilution were still viewed as attentuated doses, and the process of shaking the dilutional solutions or triturating the solid dilutions was viewed as essential merely to disperse the medicine thoughout the diluting medium.

In 1825 (year 29) Hahnemann's "infinitisimal" dilutions were attacked in an article in Allg. Anz. d. Deutschen, with the assertion that the dilution of a medicine to a decillionth of a grain would require "a mass of water of about 52 quintillion globes, each of the size of our earth".

Around this time (1825, year 29), Hahnemann began viewing these preparations as "dynamizations" (dynamische, dynamisation) or "potentizations" (potenz, potenzirung) rather than as mere dilutions or attenuations of dose. In his article Information for the Truth Seeker (1825, in Allg. Ans. der Deutschen), he states "For hundreds of years nothing was known of the power of many crude medicinal substances. These, if made into a solution, can, by repeated shakings or by long-continued trituration with non-medicinal powder, be worked up to very intensive medicines with marvelous effects. ... By trituration (shaking) the latent medicinal power is wonderfully liberated and vitalised, as if, once freed from the fetters of matter, it could act upon the human organism more insistently and fully. In reality dilution is potentizing, not merely a material splitting up and lessening, in which every part must be smaller than the whole, but a spiritualising of the inner medicinal powers by removing the covering of nature's forces, and the palpable substance which can be weighed, no longer enters into consideration."

A detailed description of the process of trituration, principally for the first 3 centisimal dilutions of insoluble medicinal substances, was given in part 2 of the 1st edition of Chronic Diseases (1835, year 39).

Hahnemann used the terms verdünnung (dilution), verkleinern (diminish), gabe (a giving; dose), dosis (a giving; dose), dynamisation/dynamische/dynamisirt (dynamization/dynamic/dynamized), and potenzirung/potenz (potentizaton/potency) to describe these various concepts. The term "too-strong dose" refered to prescriptions making a too-strong impression on the life force (see the Organon, §s275-276) either by to being too large (in a material sense) or of too great a potency.

Some of Hahnemann's followers were at this point "leap-frogging" their mentor in preparing even greater potentizations of remedies by serial dilution and trituration/succussion. Notable among these were Dr. Gross in Jüterbogk; Dr. Schreter in Lemberg; General Korsakoff in Russia; and later, Jenichen in Wismar. In 1829 (year 33) Hahnemann wrote to Schreter & Korsakoff, urging them to adopt a limit at 30C, and even to adopt this as a "standard" potency. Seemingly undaunted, they went on to develop still higher potencies; Korsakoff to the 1,500th centisimal, Jenichen to the 2,500th, 8,000th, and 16,000th. Wahle, in Rome, worked with 6C preparations prepared with 1,000 succussions at each dilutional stage. In the 5th edition of the Organon, published in 1833 (year 37), Hahnemann falls only a little bit short of recommending the 30C potency (decillionth dilution) as a standard.

This suggestion of a 30C "standard" for potentization represented more than just an attempt to set a standard in practice. It represented a striking break from Hahnemann's previous search for the optimal attenuated dosages for each medicinal substance. The notion of a pharmacological dose - even a highly-attenutated pharmacological dose - went out the window with his recognition of the dynamic nature of the potentized remedy, so that "the palpable substance which can be weighed, no longer enters into consideration".

In the 5th edition of the Organon, Hahnemann clearly spells out the concept of dynamization/potentization in §269. He provides the first specific instructions on dynamization in §s270-271; 30 successive serial dilutions of 1/100 dilution, with 2 succussions at each dilutional step to produce the decillionth dilution, (reduced from prev. 10 succussions - note to §270). He also advocates that Provings be carried out with the 30C potency (§128).

In 1833 (year 37), Constantine Hering, returning to Germany from Surinam, was shipwrecked off Martha's Vineyard & induced to settle in Philadelphia. With his 4th & 5th editions of the Organon, his first edition of Chronic Diseases, his 30Cs & some high potencies from Jenichen, the seed of homeopathy was planted on new soil and grew in its own directions. The homeopathy of the American Institute of Homeopathy (AIH) and later, the International Hahnemannian Association (IHA) was very much the child of the 4th & 5th editions of the Organon, developed along the lines of increasing centisimal potency.

In 1832 (year 36), Hahnemann began experimenting with olfaction of remedies, having the patient smell a moistened pellet as a dose. He described this in his preface to Boenninghausen's List of Symptoms of the Antipsoric Medicines , and again in detail in the 5th edition of the Organon (in the note to §288;). He evidently experimented extensively with olfaction in 1832-1833, but although he continued to use it as a dosing option into his later years, it did not catch on well among his colleagues.

Also about this time, Hahnemann began experimenting with giving the dose in solution, rather than as a dry pellet on the tongue. In the Organon, 5th edition, §s286-287 he describes an increase in the medicinal action of a dose when it is fully dispersed in medicinal solution.

In 1835 (year 39) Hahnemann wrote to Hering, describing the further diminution of dose by giving portions ("split doses") of a medicinal solution produced by dissolving a medicated centisimal pellet in a volume of water. This reduced dose allowed for more frequent repetition during the gradual amelioration of chronic disease, with gradual ascent of potency by stirring or succussion of the solution prior to each repeated dose. He wrote more detailed instructions on this approach in 1837 (year 41), which can be read in the preface to part 3 (2nd ed.) of Chronic Diseases.

When using remedies in the centisimal scale in split doses in medicinal solution, Hahnemann found it beneficial to increase the number of succussions at each dilutional step back to 10 (from the 2 succussions recommended in the 5th edition of the Organon). He apparently experimented with even greater numbers of succussions over the following year; see the preface to volume 5 of Chronic Diseases, published in 1838, where he makes reference to using "10, 20, 50 and more" succussions in the preparation of centisimals.

The LM (Q, fifty-millesimal) potency scale, which Hahnemann referred to only as his "medicaments au globule" as distinct from the centisimal "medicaments a la goutte", was developed in 1838 (year 42, 5 years before his death), with the intention of preparing remedies even better adapted for use in split dose in medicinal solution. These were prepared with even greater dilution at each step (~1/50,000, but using medicated pellets for the dilutions), and with far greater succussion at each dilutional step (100 succussions). Hahnemann shared this method during its experimental period only with Boenninghausen. He first described it in the 6th edition of the Organon (§270), which was prepared for the publisher in the year prior to his death (1842, year 46), but first saw light only in 1921 when William Boericke purchased the manuscript from the Boenninghausen family.

Intimately related to these new preparations (centisimals in medicinal solution, and shortly later the fifty-millessimals as described in the 6th edition of the Organon) were new approaches to the repitition of dose, a topic I'll cover in a subsequent essay.

Hahnemann's remedy chests at the time of his death (1843; year 47) contained 888 vials of centisimal remedies, in the 6th, 18th, 24th & 30th centisimal potencies (designated respectively II, VI, VII & X); a few vials of the 200th centisimal potency; and 1716 vials of LM potencies, most stocked in LM1 - LM10 range, with a few of the major polychrests stocked up to LM30 (designated 0/1, etc.). A letter from Melanie to Dr. Breyfogle of Louisville in 1876, shortly before her death, read: "Your enquiry as to whether Hahnemann altered his views about potencies in the last period of his life and whether he made us only of high potencies, I can answer in this way; Hahnemann used all degrees of dilution, low as well as high, as the individual case required. I saw him give the third trituration, but I also know that he used the 200th or even the 1,000th potency whenever he considered it necessary".