Dr N Hari hara Iyer MD(Hom)
Homoeopathic aggravation aph 280,281, 282,157
a) Acute disease
It usually happens that Homoeopathic aggravation will occur during the first hour or first few hours in the treatment of acute disease or disease of recent origin. Here we can observe that the dose of medicine is not sufficiently small (aphorism 157). But this aggravation will subside by itself and a recovery will follow after it.
b) Chronic disease
A Homoeopathic aggravation will usually occur at the end of treatment in chronic and long standing cases where a cure has almost reached or finished. It occurs only at the saturation point of medicine when it is administered in very small dose and is repeated by modifying the degree of potency each time before administration. This is a favorable stage of cure. Here medicine can be stopped or repeated at longer intervals. After adequate waiting the intensified original symptoms will disappear leaving a lasting and permanent cure.
Homoeopathic aggravation due to large dose.
In the case of 50 millesimal scale intensification of symptoms after a favorable medicine follow at the end of treatment. That is at the stage when the cure is almost finished or certain. But in acute or chronic case, if it is occurring initially it indicates that the dose of the medicine is large and more than needed.
Schein symptoms (aph 248)
Apparent symptoms used by the excess of homoeopathic medicine due to repetition in modified potency. These symptoms will subside by it self.
Cure with 50 millesimal scale of potency
To attain this goal, medicine selected should be suitable as far as possible, highly dynamised, it should be administered in water, repeated at definite intervals and in small dose are the parameters prescribed by Dr. Hahnemann. But the most important one to mention with particular stress is that the every repetition will be marked by change in the degree potency. It is made by 8, 10, 12 successions to the medicinal solution in between every administration.
Dr. Hahnenann made several experiments on repetition with unmodified potency. In all these occasion Hahnemann found either a neutralization of the action of the former dose or a cumulative effect of the medicine due to frequent repetition. So he concludes that the vital force will not accept the repetition of same unchanged potency without resistance. A cure can accomplished only if the medicine is applied in several different forms. The modification in degree of potency will capable of extracting the disease force from the grip of life principle leading to a permanent and lasting cure.
After administration of suitable medicine in small dose and following the law of repetition exclusively to 50 millesimal scale a cure can be witnessed by producing a homoeopathic aggravation at the end of treatment. When a reappearance of the old original symptoms is seen the medicine should be repeated at longer intervals or stopped for a while. Meantime convalescence occurs and the intensified symptoms will subside by it leaving the sick patient nothing but health.
Significance of new altered but perfected method.
50 millesimal form of dynamisation is the most perfected method. Most perfected because the drug prepared according to this scale is the most powerful but mildest in action. The material quantity of drug substance is reduced to infinitesimal as dynamisation proceeds further. The power is due to the true inner medicinal essence of drug substance is dissolved into spirit like conceptual essence by the more number of successions. In the crude state of the drug the conceptual essence is undeveloped. Through the peculiar process of potentisation crude drug substance is raised to the level of spirit like power similar to that of life principle. Because of the development of spirit like essence, the drug reaches its full capacity for penetration deep into the diseased life principle. Due to the development of full capacity and high penetrating power, the drug can forcefully influence the suffering parts of the organism. Now the medicine is capable of touching the suffering parts curatively. So naturally the influence of natural disease on life principle is neutralized. This can be experienced to a sick person very easily by the permanent and speedy disappearance of his morbid symptoms.
Nutshell is a speedy, gentle and permanent cure especially in chronic disease is the result and highlight of this highly dynamised suitable medicine applied in modified degree of potency.
Comments and observations on Dr. Hahnemann’s new altered but perfected method of dynamisation.
In this section of dissertation, the valuable opinion and views of eminent personalities who meditated on the 50 millesimal scale of potency are included. These suggestions will definitely work as an eye opener to those who are keeping their eyes tightly closed deliberately towards this scale. It will be a path finder to those who are ignorant of the hidden treasures of this scale of potency yet showed a diligence to study it.
The first part of this section includes the common ideas shared by all eminent homoeopaths who made an in-depth study on LM scale of potency.
- Name and Designation
- Why the new scale of potency is designated as 50 millesimal scale of potency.
- The cause of low popularity.
- The first promoters.
- The first pharmacy in India.
Difference between 6th edition and earlier editions of Organon with an emphasis to 50 millesimal scale of potency.
Special features with advantages and disadvantages of LM scale.
The second part is an abstract of the ideas and vision of those who fathomed in LM scale of potency. They carved and chiseled their immense practical experience and translated it into paper as valuable articles. The extract from the same are taken and excerpted it where ever necessary. To avoid the arrogance of duplication, the same ideas of Dr. Hahnemann from the writings of others are deliberately avoided. So the points referred to in this note are the one which are strongly said or vehemently objected in relation to the writings of Dr. Hahnemann. The personal views of these erudite with a strong perusal of arguments among themselves are also remarked in this section of study. In short, the facts which pave way for the smooth promotion and propagation of LM scale of potency are pasted in this part.
List of Scholars are:-
- Dr. Pierre Schmidt
- Dr. Ramanlal P.Patel.
- Dr. Harimohan Choudhary.
- Dr. Boenninghausen.
- Dr. Elizebeth Wright.
- Dr. Rima Handley.
- Dr. Raj Kumar Mukarji.
- Dr. Luc De Schepper.
- Dr. S.P. Dey.
- Dr. Fernando Flores Villalva
- Dr. Richard Haehl
- Dr. Charles Pahud.
- Dr. J.N. Kanjilal.
- Dr. Wenda Brewster O’Reilly
- Dr. A Voegeli.
- Dr. S.M. Bhattacharya.
- Dr. Sunil Setia.
- Dr. P. Sankaran.
Name and Designation
The new method of dynamisation proposed in the sixth edition of Organon is called as Millesimal scale, 50 millesimal scale, LM potency, Q potency etc. Q is the abbreviation of ‘Quinquagesimillesimal’ derived from latin word quinquagesimus – 50th and millesimus means thousand. In LM- L stands for 50 in roman numerals and M for 1000.
It is designated and represented in different ways. They are 1/0, 2/0, 3/0 etc; LM/1, LM/2, LM/3 etc; m/1, m/2, m/3 etc; Q/1, Q/2, Q/3 etc. But the usual method followed in India is 0/1, 0/2, 0/3 etc.
Here, the zero is prefixed. The numerator ‘0’ represents symbolically the poppy seed sized globule.
Dr. Richard Haehl in his works says “In centesimal scale of potencies Dr. Hahnemann always expressed in Roman figures. The new preparation from globules he described with Arabic figures surmounted by a circle 0/1, 0/2, 0/3 etc. Potencies obtained by the new ways were described by Dr. Hahnemann as ‘Medicaments au globule’ (medicine in globules) as distinct from medicament ‘a la goutte’ (medicine in drops).
But Dr. Rima Handley’s note shows that Dr Hahnemann was writing in his case records, with reference to the case of M Rousselot to whom Sulphur LM was given, as sulphur ./10/0 meaning one poppy seed sized globules of LM 10 potency of one dose of sulphur .
50 millesimal designated.
It is designated as 50 millesimal because the drug strength is reduced to 50,000 part to every successive potency. The process of potentisation starts in the globule form and ends in globule form.
Cause of low popularity
Dr. Hahnemann completed the manuscript of sixth edition of Organon by 1841 but was unable to publish in his life time. But later, due to various reasons, the manuscript was made available in 1920. Dr. Richard Haehl published the German edition in the same year and the English translation made by Dr Boericke was come to light in the year 1921. By this time, Homoeopathic practice was well established by the wait and watch policy based on the 4th edition of Organon.
Dr. J.T.Kent was an authority on Homoeopathic practice and he established the practice and 12 prognostic observations on the basis of centesimal potencies ranging from low to high. He died in 1916 before the publication of 6th edition and was totally unaware of new scale of potency.
Another strong criticism was that pharmaceutical companies and physicians started comparing this scale of potency with centesimal scale of potency. They made a false conception on the mind of physicians through an erroneous mathematical calculation. The allegation reads like this “Hahnemannans thirtieth potency of globule method of dynamisation of drugs (0/30) corresponds to seventy third potency of drop method on centesimal scale (73c)”.
Another cause of low popularity according to Dr. Choudhary is none of the pharmacopoeia has included the preparation of 50 millesimal. This reduced its authenticity as well as availability for use. Even thought Boericke translated the 6th edition, the pharmaceutical company, Boericke and Tafel never prepared medicine according to new scale.
Then the other difficulties such as poor patient compliance and lack of adequate knowledge about the principles of LM scale worked as a real hindrance to the propagation of this scale.
Dr. Charles Pahud of Lozen, France, through his article “My experience about Hahnemann’s fifty millesimal scale of potency’, published in the ‘British Homoeopathic Journal’ 1950 April issue drew the attention of Homoeopathic fraternity to the new method.
Another significant name to mention is Dr. Pierre Schmidt. He translated Organon to French. His famous lectures given in the faculty of Homoeopathy at Royal London Homoeopathic Hospital in 1954 awakened the idea of LM potency among audience. Apart from this, his article on LM scale published from 1954 to 1956 in British Homoeopathic Journal and Journal of American Institute of Homoeopathy ignited the idea of perfect cure through LM potency to Homoeopaths all over the world.
In India, Drs. Debendra Kumar Roy, Khagendra Nath Bose and Bejoy Kumar Bose introduced this scale of potency around 1957.
First Pharmacy to prepare LM Scale potency was Hahnemann publishing Co. Ltd. Calcutta (HAPCO).
Differences between the 6th and earlier editions of Organon with special emphasis on LM scale.
In the earlier edition, the dosage, potency, repetition was a great cause of concern and controversial point. Due to these fallacies, the cure was much prolonged, so also the patient sufferings. The sensitive patients and patients who harbor a deep seated pathologically degenerated state suffer from furious aggravations even from well selected medicine. The repetition rule was vague and was not able to ascertain the exact time of repetition of medicine. The preparation of medicine, number of succession to prepare new potency, single phial method or multiple phial method, the gap between each potency and a lot more raised a number of skepticism on the mind of Dr. Hahnemann himself.
All these lacunae are rectified in the new preparation where the power of medicine is increased but capable of acting in a milder way thereby preparing the vital principle of patient to face the Homoeopathic aggravations only at the end of treatment. The difficulties in aforesaid editions of Organon with reference to preparation, dosage, repetition, potency selection, administration, the gap between the potencies, unnecessary reactions of Life principle are solved to extend of a pinnacle of perfect cure.
Advantages of 50 millesimalscale
The drug strength is reduced to 50,000 times to previous potency. But the number of succession rose to 100 times. So the penetrating power is high and touches all suffering parts curatively. Being highly dynamised the spiritual conceptual essence of drug substance is intensely developed. Fuller power of drug is capable of extracting the disease force from Life principle in a complete and permanent manner.
So due to these special features of LM scale, it has real advantage over centesimal scale.
- Useful in both acute and chronic disease.
- No violent reaction is produced by Life force against or following the action of medicine.
- Action is immediate. Time span for cure is reduced to minimum.
- A permanent gentle restoration is the result.
- Medicine can be repeated ‘if necessary’.
- The gap between the two consecutive potencies is very meager. So the change of potency creates no problem to the patient.
- Convenient to use in hyper sensitive persons.
- Useful in conditions produced after suppression or repeated palliation.
- No worry of over dosing.
- As the action is quick, a wrong selection of medicine can be quickly identified.
- No antidot is required if the medicine is wrongly administered.
- Nothing will antidote the effect of medicine as the plane of dynamisation is very high.
- Can be safely administered with medicines of other therapeutic system in unavoidable circumstances.
- 0/1 to 0/30 is a limited range. So easy to choose.
- Toxic medicines can be used safely and can be repeated frequently.
- Can be used for palliative cases also.
- Same medicine can be used both as a curative and palliative remedy.
- Patient’s co-operation is more and he himself can adjust the dose if a Homoeopathic aggravation is produced.
- In primary stages of three chronic miasmatic states, Hahnemann advised frequent repetition.(F.N aph282)
- Deep acting medicines can be repeated if necessary.
- Patients’ compliance is poor.
- Administration and repeated succession in between dose is a real obstacle of trust.
- Illiterate patients must be educated properly.
- If the patients do not properly co-operate, administration and change in degree of potency before every administration is difficult.
- Illiterate patients cannot properly judge Homoeopathic aggravation. So they will continue medicine even after required dose.
- Limited potency is available.
- All medicines in this scale are not available.
- No clear mentioning on the amount of water to be dissolved with medicine.
- Second prescription restricted only to the new remedy.
- No mentioning of complementary remedy, multi miasmatic case treatment.
Observations of Dr. Pierre Schmidt
Dr. Pierre Schmidt is making a meticulously careful observation on the pharmacopallxy(repetition) pharmacopraxy (Preparation), Homoeopathic aggravations etc. on an innovative essay published in the British Homoeopathic Journal in 1954, in the title ‘Innovations and Last Advice of Hahnemann’. It was later published as a book ‘The hidden treasures of the last Organon’.
He says that in acute cases one dose may be necessary to initiate a cure. But in chronic cases the repetition of same unchanged potency will produce a therapeutic saturation and a blunt reaction will be the result. So potency has to be modified before every administration and can be repeated daily in one or two doses.
He is reiterating that medicine should be administered only in liquid form. “The absorption of any homoeopathic remedy to be repeated shall hence forth be exclusively in liquid form”. His strong objection to the dry form of administration can be seen in the following words. “Even today, I occasionally read in homoeopathic journals about cures affected by 50 millesimal in globules. This is positive proof that the prescribers of such doses have not understood the new method at all, as the remedies ought to be administered in liquid form only”. Dr. Pierre Schmidt finds reason for liquid administration; on the fact that the spiritual energy of medicine is liberated to the non-medicamental substratum only if it is used in water media. More than that the energy liberated will be absorbed by diseased vital force when there is more contact of sentient nerves. This hidden meaning of fallowing note reveals the above idea that “There was a time when succession was considered all important. Then dilution was brought to play the leading part. In the sixth edition, Dr. Hahnemann ascribes the real efficiency of homoeopathic remedies to the combination of these two pharmaco- practical factors, but he also lays stress on the non-medicamental substratum which enables the active substance to be dispersed and provides, as it were by contact a new influence of energy”.
In the preparation medicinal solution, he says a single poppy seed sized globule is crushed in a little sugar of milk which is to be dissolved in 100 grams of clean slightly alcoholised water and is to be vigorously shaken 10 times before each administration. He also favors low potency to high dynamisation when a change of potency is required in a case.
He contemplates the homoeopathic aggravation with rebound phenomena of modern medicine and in the case of 50 millesimal scale the “belated aggravation” as he coined is due to the saturation point of medicine.
In the process of dynamisation of new method, the chemist should follow the Hahnemannian way of multiple phial system in contrast to the single phial system of korsakoff.
In be-all note, Dr. Pierre Schmidt reiterates that the flaws of centesimal scale potency and dosage are redressed in the new altered method and an ardent follower of new scale can retrieve what he deprived earlier.
Observations of Dr. R.P.Patel.
Dr. R.P.Patel is considered as first among the authorities in 50 millesimal scale of potencies. Dr. R.P. Patel conducted many experiments on the new dynamisation though not keeping him much away from the rut prescribed in the 6th edition of Organon by Dr Hahnemann. Dr. Patel has shown the audacity to spill out the results of these experiments in “My Experiments with 50 millesial scale of potencies”, in spite of having some difference of opinions with the trustworthy followers. The main among them are about dry potency, jumping potency, rule of repetition, starting of medicine with 0/3, preparation beyond 0/30, opinion on plussing method etc.
In the opening pages, Dr. R.P.Patel makes a remark on the idea of Hahnemann to find out the new scale. Hahnemann meditated on the reduction of the material quantity of drug substance so as to reduce medicinal aggravations. So he made the ratio of dilutents to medicine as 50,000: 1. The number of succession was raised to 100 to increase the power on the other hand.
On the administration of medicine, Dr.R.P. Patel keeps the view that it can be administered in globules or in liquid form. He quotes Dr. Hahnemann that Hahnemann himself administered medicine in dry form as reported “one globule in milk sugar for seven days”. Dr. R.P. Patel finds merit in globules and emphatically asks us to follow him. The merit obtained is “The dose is vastly diminished by laying one such globule alone upon the tongue and giving nothing to drink”. This will touch less number of nerves and reduce the chance of aggravation. It will work as a uniform dose, in all persons and we can make a perusal of it for a further study. Still then he admits that liquid potencies have given him better results than dry globules.
On the preparation of medicinal solution also he differs. He says usually one or two No. 10 pills of indicated medicine are dissolved in 30 ml of water. This is in contrast to cherished notions 100 grams of Pierre Schmidt and 120ml of Harimohan Chowdhary and at least 8 table spoon of Hahnemann. The quantity to be taken at a time according to Dr. R.P. Patel also varies from 10 drops to ½ ounce at a time, to the standard one tea spoonful dose of Hahnemann.
One observation in the rule of repetition in acute disease is that when the patient is feeling improvement, medicine should not be stopped on all a sudden. The same medicine or the higher dynamisation of same medicine should be repeated at longer intervals and withdraw slowly. Only fewer repetitions are required to medicine belonging to mineral and nosode sources. On the repetition in chronic disease he says the repetition can be done after the observing the nature of patient. “In one famous case only one dose of Nux Vomica 0/30 improved the so called dangerous disease diabetes (Bronz type). Only two doses were given with in 4 months after first prescription”.
As only up to 0/30 are available, Dr. Patel himself prepared up to 0/50. In the preparation of the same he was using the multiple phial system of Hahnemann. Nux Vomica, Sulphur, Sepia etc were prepared up to 0/50.
He made proving with 50,000 scales. Drug Bryonia was used and few new symptoms obtained.
Certain potencies are suitable to certain patients. The change of potency produced no favorable responses in certain patients. Likewise certain drugs produced favorable responses in fixed potencies like Blatta in 0/1, Aconite in 0/1, Luffa in 0/3 Bacillinum and Sepia in 0/30 etc. In chronic pathological cases it is better always to begin with 0/3 and it produces a favorable responses. In stubborn cases millesimal scale of potency as especially in Bronchial asthma, Diabetes etc. are more effective. When 50 millesimal is given after centesimal it produces severe aggravations. Dr. R P Patel strongly supports the jumping method of administration of medicine. That is the medicine is given in the order 0/3 to 0/6 then to 0/12 etc instead of a true successive potency. Jumping produced not much harm to the patients. He noticed that in most of the cases the homoeopathic aggravation are revealed as ‘itching’.
Another strong justification which does not stands close to the argument of Dr. Pierre Schmidt and Elizabeth Wright is that plus method is exclusively for 50 millesimal.
To sum up Dr. R P Patel enriches even a casual reader through his magic of experiences and observations. He concludes that 50 millesimal is ‘the master piece by the master hand from the master mind’.
Observations of Dr. Harimohan Choudhary.
Dr. Choudhary is a well known Homoeopath with realistic outlook. He has immense experience of clinical practice with 50 millesimal scale of potency for more than 30 years. He narrates the well established dictums through his famous book “50 millesimal potency in theory and practice.”
Dr. Choudhary sympathizes that the new concept was not properly studied and utilized by the Homoeopathic fraternity. Physicians with rational outlook should welcome Masters latest innovations and findings which is claimed that it is a nearly perfect one. “As Homoeopathy is a revolution in the field of medicine, so is the Organon 6th edition in Homoeopathy”.
He links the dynamisation with dialectical materialism. When a matter (medicinal substance) comes into unity and contradiction with its opposite matter (e.g.: Vehicle) it creates a new thing and forms into a wholly new matter (unity and contradiction of opposites) and it changes qualitatively. These are the fundamentals of dialectical materialism. During succession of 100 times in every potency it imparts a kinetic energy to the molecules of drug and vehicle resulting in qualitative change. That is the reason why medicines become more dynamic and also gentle in their action in LM scale.
In the LM scale of potency, medicine has to be started from low to high in ascending order. That is if medicine started with LM1 it has to be followed by LM2, LM3 etc. It is better in any case to start from LM1. This rule is applicable in the administration new remedy after the previous remedy has produced the desired effect and a new group of symptoms emerged demanding a new remedy. It is contradictory to the opinion of Dr. R.P. Patel that he had tried 0/3 then 0/6 then 0/12 of suitable medicine with success.
He considers the medicinal solution once prepared in water with ¾ of the 4oz bottle should be used for 7 days or 14 days. The former is for daily repetition and the latter for alternate day’s repetition. Then the patient must raise his potency to the next higher one.
His logic behind the descending scale can be heard from his own words. “It is a fact that after application of similimum, disease state become weaker, the patient feels improvement both mentally and physically. Usually at the weaker state of disease, stronger and higher scale of medicine is applied. Naturally dis-similarity between diseases state and medicinal state arise as a matter of consequence. This is not at all desirable in Homoeopathy, being a science of similarity. So the application of medicine in descending scale is more logical and scientific”. For that he advice medicines should be started from LM5, LM8 or LM3 and descend. Dr. Choudhary shares his view with Dr. Pierre Schmidt that medicine must be applied only in water.
He is saying that for over sensitive patients olfaction is the best method. This is better effected by dissolving 1 no. 10 pill in 1 drop of water and ¾ part alcohol in a 1 oz vial.
Hahnemann advised 8, 10, 12 successions to the medicinal solution to change the degree of potency. Dr. Harimohan Choudhari gives interpretation to it that 8 succession to very sensitive patients, 10 to less sensitive ones and 12 to least sensitive persons.
This is the word that we have to consider seriously on repetition in 50 millesimal scales also, according to Dr. Harimohan Choudhary. He is referring to the foot note to Aph. 246 of Hahnemann in this context. His vast experience in the treatment of chronic disease shows that the patient cannot endure daily repetition in all diseases. So the repetition should be made cautiously. After the action of first potency the patient cannot endure the next potency even in two days repetition. So the time gap has to be even prolonged to 3rd or 4th day before repetition. He frankly admits that some of his sensitive patients left him because of incautious repetitions that lead to severe aggravations.
He observed that potencies from LM 1 to LM 4 are well tolerated by patients of normal vitality on repeating daily or alternate days. But in sensitive patients 3rd or 4th glass preparation may be necessary. Potencies from LM 5 to LM 8 are tolerated by patients of normal vitality if repeated once in 3 days intervals. LM 9 and LM 10 should be applied only 2 dose a week and higher potencies even at longer intervals.
His experience in acute disease confirms that only 2 or 3 doses may be necessary to complete a cure. Some cases complementary medicine may be required to restore completely.
Medicinal aggravation can be seen in LM scale of potency also. The causes are potency may be high or the dose may be large. If the medicine is not administered in liquid media there is a chance of aggravation. Aggravation can easily be produced in patients who are highly sensitive. This can be regulated by following strictly the norms of repetitions and dosage especially in patients with weak vitality, degenerated diseases and over sensitivity. Whenever an aggravation is noticed, the medicine should be stopped immediately or repeated at longer intervals.
A case report
A ten year old eczematous girl, probably of hereditary origin, was prescribed Bacillinum LM/1 in two consecutive doses, from first glass. It kept her well for 120 days. Then again LM/1 two doses after 25 jerks were applied. No further medicine was needed. Eczema disappeared, the patient improved mentally and physically.
Observations of Dr. Boenninghausen.
As a close friend and perfect disciple of Dr. Hahnemann, Boenninghausen kept a close relationship with Hahnemann to the extend that they communicated through letters till two months before the death of his master. So the homoeopathic community heard the words of Dr Boenhinghausen with full reverence and trust.
With reference to the article ‘Aluminium metallicum’ published in Allg.hom Zeit Vol 54, Boenninghausen remarked in the context of reliable preparation of drugs that “In the new edition of the Organon, which will probably appear yet in the course of this year, improved and completed by Dr. Hahnemann himself, a new simplified procedure for the potentising of medicines will be taught, which has considerable advantage over the former and yield a preparation as to the efficiency of which I can, from my own experience, give full praise. I know this procedure, but according; to my pledged word of honor, am not, as yet, permitted to communicate it to any one”.
Again the same idea is seen in the article ‘The use of High Attenuations in Homoeopathic Practice” which is now available in ‘lesser writings of Boenninghausen’. “The immortal Hahnemann, whose talent really looks sometimes like an inspiration from above, had in the last years of his life, arrived at a profound conviction of the efficiency of high attenuations, and had accordingly for sometime followed, in the preparation of his remedies and in his doses, a method different from that which he had recommended to the public in former works, the modifications then introduced he intended to publish to the world in the last edition of his “Organon”.
This perfect statements abrogates, even an iota of doubts in the mind of those skeptics who deny genuine Hahnemann touch in the 50 millesimal scale of potency.
Observations of Dr. Elizebeth Wright
A discussion on the rules of repetition according to Dr. Elizebath Wright is significant to narrate the point of ‘plussing method’. In the book ‘A brief study course of Homoeopathy’ and in the chapter ‘Prescribing – Potency selection’, Dr. Wright pin point about plussing method. The words read like this “Another method of multiple dosages which almost amounts to divided single dose is that of plussing. “Plussing” means dissolving your doses in a third of a glass of water, taking two spoonful, throwing away most of the rest adding water up to the original quantity, stirring and successing and again taking two teaspoonfuls as the second dose and so on. This raises the potency very slightly between each of the doses given some what wider range of plane and is particularly indicated in stubborn and refractory cases”.
Dr. Elizebeth Wright is who coined the term ‘plussing’ for this peculiar method. A careful study shows that it is a vague preparation procedure. No where here Dr. Wright is mentioning about 50 millesimal scale of potencies. It was used for centesimal scale though it mimics the preparation of medicinal solution of 50 millesimal for sensitive patients. In the introductory remark itself, Wright is mentioning it as a procedure of division of single dose. Dr. Pierre Schmidt is making a comment on plus method. “I had, in fact, already read years ago in BJH an article on ‘plus method’. I had even applied it and it had been a dead failure. Since then, none of our papers have ever mentioned it. It showed, however, how important it was to have Organon (6th edition) translated, as no one had ever applied the method in a proper way”. From this observation, it is clear that the plus method was not one properly related with LM scale.
Dr Rima, after making through study on the case records of Hahnemann, supposes, it can be a method which was prior to the preparation of medicinal solution for sensitive patients prescribed in the 6th edition. It was used in centesimal scale also “when he (Hahnemann) prescribed Cinnabar 30c to Mme Bournichon in May 1838, he wrote that it was to be diluted in 15 table spoonfuls. One teaspoonful was to be taken and then the liquid was to be successed five or six times between each subsequent taking of a tea spoonful. This technique appears to be the same as that used by some present day Homoeopaths and referred to as ‘plussing’. It should be noted, however, that Hahnemann himself not use this term. Subsequently he developed a further method of varying the dose, especially for sensitive patients”.
But Dr.R.P. Patel, in an uncompromising word argues that the ‘‘plus method is only for the 50,000 scale potencies in the 6th edition of Organon and not for centesimal scale”. Here Dr. Patel is referring to the plus method as the method used to change the degree of dynamisation before every administration. He gives justification to his argument that Dr. John Weir also rightly opined against the use of plus method with centesimal scale. The nut shell is that never use plus method with centesimal scale nor mix the ideas of 5th and 6th edition of Organon in repetition.
The ‘plussing’ method and the indications for plus according to Luc De Shepper is quite interesting. “For sensitive patients, in order to dull the possibility of aggravating the step from LM1 to LM 2, I would tell them that when the LM 1 bottle has only one teaspoon remaining, to fill it with purified water half way and then continue with the same number of succession (this is the plussing method) Since the last teaspoon LM 1 contains all the added successions it is the strongest teaspoon of LM 1 and therefore the ideal one to be diluted. This way, when the patient finishes this plussing bottle, and take the first teaspoon of LM 2 (if still needed), any aggravation will be minimal or non-existent.”
A careful analysis based on the observations of Dr. Elizebeth Wright is warranted as number of doctors made remarks in favour and against the plus methods. The study should revolve and rotate on the observations of Wright just because she coined the term ‘plussing’ and put the procedure in paper, interpreting Hahnemann’s observations. The remarks starts with the idea that “dissolve your dose in a third of glass of water; taking two spoonful, throwing away most of the rest.” This clearly indicates that a medicinal solution is not prepared for further use instead it is thrown away. Second one is that the mother solution is not successed instead it is dissolved in another glass of water of original quantity in the initial stage itself. These two procedures are apparently contradictory to the customary practice followed in fifty millesimal scale where the original medicinal solution prepared in eight table spoonful is successed 8,10,12 time not only during the first dose but throughout the entire period of administration of the dose. In the second dose this procedure is repeated. In the case of sensitive patients also the successed powerful dose is diluted.
The pith and substance of the intention of preparation of medicinal solution of 50 millesimal scale to be dispensed to the patients is that the powerful energy dissolved in original medicinal solution is first successed then diluted just before administration. The paramount point is that energy is liberated to vehicle. Life principle will accept it without resistance only if it is modified through succession. It is diluted in water to confirm that medicinal energy reaches the sentient nerve as far as possible. Where as in plus method the procedure is dissolving, diluting and stirring which is absolutely intended to reduce the material quantity of drug substance in centesimal scale. This is not absolutely necessary in the case of LM potency as it has been achieved in the primary level itself by moistening one drop of mother tincture of LM potency with 500 globules.
So to conclude in one word ‘they are not one and the same’.
Observations of Dr. Rima Handley.
Dr. Rima Handley made a delve into the manuscript of case records of Hahnemann. He referred fifty four volumes of case books of Hahnemann which are preserved in Institute for the History of Medicine in Stuttgart. He is more particular in narrating the historical aspects and the preliminary researches made by Hahnemann to arrive at the dictums of LM scale of potency in the sixth edition of Organon of medicine. So naturally a number of contradictory remarks and obsolete notations can be visualized in the case records used by Hahnemann in that transition period to LM scale of potency. The facts of experiments with his comments are delivered in the chapter ‘Ultimate attenuation’ of his work ‘In Search of Later Hahnemann’ with ample support of cases reports of Hahnemann.
The case records verify that Hahnemann was using high centesimal scale in the years of 1838, 39, 40.M. Barre received 100 centesimal in 1839 September 29th and M. Collmann received 181C round about the late 1839. In 1840 also he was using high centesimal scale but with slight modifications. This note is supported by Dr. Breyfogle of Louis Ella. This is reported by Dr. Richard Haehl in his work ‘Life and letters of Samuel Hahnemann’.
But due to various reasons he shifted to new scale and Rima notes that Hahnemann called it as LM potency . Towards the end of 1840 one patient M. Rousselot received Sulphur in LM potency (./10/o) for his vertigo. ‘He was the first person to receive LM potency’
From the case books, Rima noted that the remedies like Sulphur, Cal.Carb. Graphites, Silicea, Lycopodium, Nat.mur, Nux.vomica, Phosphorus, Hep.sulph, Belladona, Bryonia, Opium were frequently used and on repetition. Out of which almost all remedies were used below LM 7, except Sulphur which was used below 24. Experiments were done in leap potency (jumping) and descending scale especially with Sulphur. Medicines were not always started from primary level. Referring to the case of Mlle de Baunad, she received the first remedy Sulphur in LM 4 potency for her chronic headache. But whenever she was suffering from acute ailments in between was treated with centesimal scale. For her sore throat Phosphorus 30c and ear pain Chamomilla 30c was the potency of choice. Later she was continued her chronic treatment with Sulphur LM 8. So the conclusion of case of Mr. Baunad that Hahnemann used LM for chronic condition and C for acute condition.
One point of criticism was that Hahnemann continued his practice with centesimal scale even after invented LM scale. Being highly dynamised and highly attenuated, advice of olfaction was less made with LM scale. In the case records no mention of the number of successions to be made in between to change the degree of potency. Perhaps there may be a routine way that is why he has not mentioned it in case records.
Hahnemann made all these experiments on patients, though it now seems pitiable, to arrive at a final conclusion and goal of reaching an unlamentable cure. Thus Rima Handley concludes that “Hahnemann had finally released spirit from matter, energy from mass, as we would now say, achieved the transmutation which had been the goal of alchemist and chemist for thousands of years”.
Observations of Dr. Rajkumar Mukerji.
One interesting and controversial observation was made by Dr. M Evritt. Dr.M Evritt compared the value of 50 millesimal scale with that of centesimal scale of Dr. Hahnemann. On the basis of this argument some critised that the difference between the 50 millesimal and centesimal scale in strength is very meager.
The comparison is as follows:-
- LM I 16x 8c
- II between 20x & 21x 10c
- III between 24x & 26x 13c
- VIII between 44x & 51x 25c
- X between 52x & 61x 30c
Therefore, it can be the 30LM is less than 100c.
In this connection to refute and challenge the mere argument that 50 millesimal scale is not a high potency compared to centesimal, the difference between Dr.Hahnemann’s centesimal preparation and Korsakovian preparation has to be referred to. We can collect the details regarding the same from the book ‘Homoeopathic Dose and dilutions of Dr. Rajkumar Mukerji’.
Dr. Hahnemann was using multiple phial system for the preparation of his centesimal scale where as all the others including Korsakov and Jenichen etc. were following single phial system preparation. So the drug strength of both these systems of preparation is entirely different. Dr. Mukerji is making a comparison of centesimal Hahnemann (CH) with centesimal Korsakovian(K).
- 4 CH is equal to 6 K
- 5 CH is equal to 30 K
- 7 CH is equal to 200 K
- 9 CH is equal to 1,000 K
- 10 CH is equal to 10,000 K
- 18 CH is equal to CM K
Any potency above 18 C of Hahnemann will be of the power and strength much higher than CM of Korsakovian potency, the 30th potency of Hahnemann will be much much higher than CM available today. So the 30 LM is equal to 72 C of Hahnemann means it is very powerful and the drug strength is very very high.
To conclude the comparisons of different scales of potency in relation to strength and power of drug is insignificant, because the preparation and dilution methods are entirely different in different methods.
Here, the comments of Dr. R.P.Patel are significant to mention. He says the power and pharmaco dynamical properties depend upon the number of succession along with the dilution and attenuation of medicinal substance.
It requires only 730 successions to reach the 73rd centesimal scale where as to reach 0/30 more than 3000 successions are necessary. So also these potencies are beyond comparison as the process of attenuation and number of friction are entirely different.
Observations of Dr. Luc De Schepper.
Dr. Luc De Schepper, in his book ‘Hahnemann Revisited’ makes a number of valuable comments both associating and dissociating with the views of Dr. Hahnemann.
He says medicine should be always started in LM 1 then changed only in ascending order. It should be ended with LM 30 if that particular case demands it. It should never be administered in dry form. On repetition he shares the view of Dr. Choudhary that medicine should not be given automatically and repeated daily. It should be repeated whenever and wherever necessary.
Never administer medicines in dropper bottles. He restricts the use of eye dropper saying that wave form of succession will be altered and thereby the power of energic imprint of the remedy also. The size of the remedy bottle has an impact on the drug energy of the remedy, shown by the studies conducted by Dr. David Little. So he insists four ounce Rx bottle for persons of normal constitution and eight ounce bottle for sensitive patients to prepare the medicinal solution. He adds some practical tips to the use of LM scale. Main among them is about the number of succession. He says in sensitive patients along with the dilution of medicine, the number of succession can be reduced to two or four etc. The number of succession can be changed based on sensitivity. Infants, pathologically advances case, old age patients require two in between succession where as patients dull constitution requires 10-12 successions. In the case of repetition with higher potency, the number of succession can be reduced. That is in the way the eight successions is used for LM 1, six successions can be used for LM 2.
He makes some contra indication for the use of LM potency. In hyper- sensitive idiosyncratic patients, the highest potency will produce aggravations. Nosode drug is not fit for LM potency. In depressive patients or patients suffering from mental ailments, he usually set aside LM scale. In frank cases of psora with eruption, fresh syphilis with chancre and sycotic complaints where manifestations and changes are visible, it is better to avoid LM potency. But the conditions which seem contradictory to the LM potency according to Schepper are well managed by LM potency by other Indian doctors.
He advises a test dose for sensitive patient and wait for 48 hours for a reaction. The main reaction after the first dose may be like ‘Driving miss Daisy’. This reaction is normal. Here the patient getting good response. This is an ideal situation and the remedy can be repeated.
One important variation, which was opposed by many, of which, Luc believes that, he will end the case with 200 C or 1M of the suitable medicine. He explains and justifies it by a conclusion. By repeated administration of LM scale, the natural disease will become weaker and artificial disease will become stronger. So this may create accessory symptoms. 1M potency has less penetrating power than LM and it will suit with the diminished natural disease state. This will avoid accessory symptoms and the patient will be settled with a speedy cure at the end.
Observations of Dr. S.P.Day.
Dr. S.P. Dey, the most celebrated teacher and a pioneer in the faculty of Homoeopaths in India, through his essay 50 millesimal potency (LM Potency) affirms that “If we study the different stages of evolution of strength and potency of medicine, it can be clearly appreciated that the 50 millesimal potency is the only weapon for fulfilling the ever-cherished ideal of rapid yet gentle process of cure”.
One criticism was the LM potency and the rule of repetition in LM potency is not the off-spring of Dr. Hahnemann. But refuting the charges, Dr. S.P. Day believes “None of the alterations and amendments made in the sixth edition is contradictory to the principles of Homoeopathy, rather it is quite in concordance with them. It is especially attributable to 50 millesimal potency also”.
He observed many advantages to 50 millesimal potency from his vast experience. He says in skin diseases and especially diseases which have a suppressed history it is very useful and cures completely without producing severe aggravations. In long standing cases cure can be achieved in a shorter duration of time. Contradictory to the statement of Dr. Luc de Shepper, and associating with Dr. Hahnemann, Dr. S.P.Day has an opinion that in the primary stages of miasmatic disease where rapid repetition is absolutely necessary, 50 millesimal is the ideal choice of potency. It is a good scale of potency to tackle mental diseases. His experience shows that even the repetition of deep acting medicines produced no marked aggravations in these cases. One important precaution by Dr. S.P. Day is that in 50 millesimal scale, repetition of medicine is done very frequently. So that if a medicine is not properly selected on symptoms similarity, it will work as a palliative in incurable case and will be a disaster to the patient, physician as well to Homoeopathy.
Observations of Dr. Fernando Flores Villalva.
Dr. Villalva, native of Quito, carefully browses the works of Dr. Hahnemann and others in LM scale and made a number of observations on LM scale.
Apart from the narration of LM Scale of potency, he is more specific in the quantity of medicinal solution to be used in LM, stating that a table spoon contains 15 cc of water. So a homoeopathic medicinal solution for LM potency must contain at least 120 cc in a vial. Adding to this, he makes a comment that a tea spoonful dose must contain 5 cc of medicinal solution. Another important observation which makes him distinct from others is in the way he interpreted aph 248 of Dr. Hahnemann. Here Hahnemann advises one or (increasingly) several tea spoonful doses. The interpretation is based on the letter communication between Dr. Croserio and Dr. Boennighhausen. “To this Hahnemann makes reference when from a micro globule dilution in a glass containing eight tablespoonfuls take one tablespoon to another glass of water from which this patient is given one teaspoonful for the first day, two for the second day, three for the third, and so forth until a reaction is observed”. So increasing the dose accordingly until a reaction is set in.
On dry administration of medicine, he says it is more suitable in mild and moderate cases which have originated recently. He observed that dry dose produce an aggravation immediately after its ingestion but the health restoration is slow compared to water potency. He says if there is an aggravation immediately after ingestion it is better to explain in terms of 12 observations of Kent and a make an easy second prescription.
He shares the view that diseases like diabetis, asthma, blood pressure are more amenable to LM treatment. But in these cases physician should be able to judge properly and distinguish between the final aggravation due to suitable medicine and a natural evolution of disease.
Observations of Dr. Richard Haehl.
In the chapter ‘XXIV’ supplement 224, under the heading ‘Hahnemann’s medicine chests’, Dr. Richard Haehl is giving a detailed profile of the medicines and potencies used by Hahnemann in his last days in Paris. It is seen in the book, life and letters of Hahnemann Vol. II.
“These are placed in two polished wooden boxes. The larger one is 48 cm long and 30 cm wide; and contains altogether 600 small glass bottles filled with globules. The smaller box is 26 cm long and 22 cm wide and contains 288 small bottles. The degree of potencies is indicated in Hahnemann’s own way.
- II means one billionth part – 6 cent
- VI means one sextillionth part – 18 cent
- VIII means one octillionth part - 24 cent
- X means one decillionth part – 30 cent
(B) Medicaments aux globules.
A large polished wooden case in laid with ivory 63 cm long and 34 ½ cm wide affords room for 1716 glass tubes. The remedies contained therein are prepared by the new method of potentising and designated as medicaments aux globules with 0/1, 0/2, 0/3 etc. Most medicines are kept in stock in different degree of potency (1 to 10). Only a few as far instances Mercsol, Sulphur and few others are potentised upto 30th degree”. Also Dr.Richard Haehl noted that 73 medicines in the chest were intact. He noted down the list of medicines also. Dr. Richard Haehl also noticed that some of the medicines are lost partly or wholly This shows that in the last years of practice, Dr. Hahnemann was using LM scale in an elaborate manner.
Observations of Dr. Charles Pahud.
One pioneer in Homoeopathy, who rediscovered the merit of LM scale, published his views in ‘Experience with Hahnemann’s 50,000th dilution’, “with these marvelous dilutions one can obtain marvelous cures too, and shorter time than with usual centesimal potencies”. He makes a number of observations in the years 1849 and 1850 by treating more than 250 cases with LM potency.
Observations of Dr. Kanjilal.
Dr. Kanjilal is a homoeopath of international repute and illustrious teacher, keeps the opinion that the LM scale will remarkably reduce the aggravations and the same produced at the end of treatment make us to control the dose and repetition and thereby enabling the homoeopathic physicians to make a rapid, gentle and permanent cure.
Observations of Dr. Wenda Brewster O’Reilly.
Dr. O’Reilly has made the translation of Organon last edition into English in an excellent way. The style of writing with the concluding notes in the sides of aphorisms has inspired a lot many to turn into philosophical aspects Homoeopathy. Dr. Luc de Shepper hails Dr. O’Reilly for the translation especially of the aphorisms of50 millesimal scale of potency and it inspired him to make an in-depth study on it.
Observations of Dr. A.Voegeli of France
Dr. A.Voegeli has done many experiments on 50 millesimal scale. He treated more than 1,000 cases with LM and published the results in an article “The dose in Homoeopathy and the influence of dosologic experience on the knowledge of the disease phenomena”. published in the journal “Homoeopathic Francaise”. Voegeli”s main observations are:- Remedy should be used in solution and the medicinal solution should be prepared in 25% alcohol. The number of succession should be fixed as ten in each time and whenever the reaction starts the medicine has to be stopped for 3-5 days.
Observations of Dr. S.M Bhattacharya.
Dr. S.M. Bhattacharya wrote an article in the March 1957 issue of Hahnemannian gleanings titled ‘Hahnemann’s 50 millesimal scale of potency”. The high light of the article according to Dr. R.P. Patel are that he tried to expose the fallacy of Dr. Dudley W. Everritt on conversion table of centesimal with 50 millesimal on account of the difference in preparation. (The point is discussed elaborately in the observations of Dr. R.K. Mukerji) He finds merit both centesimal and 50 millesimal and asks the common homoeopaths that shall we discard Kent, Nash and all emirates in lieu to embrace the power of 50 millesimal?
Observations of Dr. Sunil Setia.
An article was written by Dr. Sunil Setia in Homoeo Buzz March 2009 issue Vol. 4 No. 3 under the title ‘LM Potency, the discovery un-noticed by many’. Apart from the usual dictums and paragons of LM scale, Dr. Setia introduces the arguments of Mr. Everest. Mr. Everest was a close confident of Hahnemann. He was the person who prepared globules and medicinal accessories to Dr. Hahnemann. Quoting the letter of Mr. Everest to ‘The Times’, Dr. Setia argues that Hahnemann was not at all satisfied with the way of tackling degenerative and stubborn chronic disease even after publication of 5th edition of Organon. Hahnemann was industrious to dig out the fathomed truth of a more handy dose and potency in dealing the same. So at last he arrived at the LM scale with the peculiar style of repetition. According to Dr. Setia, Mr. Everest stood as an eye witness to these great and fruitful transitions of Hahnemann.
Observations of Dr. P. Sankaran.
Dr. P. Sankaran, a converted Homoeopath hails the effects of LM scale especially in chronic cases. He illustrates the effectiveness of the same in a case of Neurosis, to a query in Indian Journal of Homoeopathic Medicines Vol. II.
Dr.N.Hari hara Iyer.MD(Hom)
Dept. of Organon.
Dr.Padiar memorial Homoeopathic Medical College. Ernakulam.