split dose

Well. The indications of a big storm brewing over. : )

Dear Jacob and Sajjad

Let us make this thread an example of how to discuss various view points, without loosing one's cool.

I will come back.

Murthy

Dear Joe

I was never the first one to start an unnecessary argument. However, if somebody tries to belittle me, I will retaliate.

The whole problem was that people stoop down to the levels of commenting on persons and personalities,when they can't discuss logically.

When they know, their lack of knowledge is thoroughly exposed, they resort to these gimmics.

Don't assume a 'better than thou' posture, and start preaching, as you yourself are no better.

All people are observing 'the congratulations to gavinimurthy' thread, where I kept silent, but you too joined the hooligans.

With what face, you want to come now, and start preaching? You lost your right long back.

Don't irritate me further.You had enough humiliation in the last few weeks, and I don't want you to suffer further.

Murthy

It is a question of one's own experience. There are no hard and fast rules.

Like Rajiv said, there are many practitoners who tested the split dose, as mentioned above, and found it to be very useful, for chronic cases.

I personally used this method on many patients, including myself, and it works.

Murthy

Dear Rajiv

David Little is one of the celebrities, promoting this method. You might have read them too.

Murthy

Hahnemann's Advanced Methods
Part 2: The Medicinal Solution
-- David Little


The Limitations of the Dry Dose

The next major renovations in the practice of Hahnemannian Homoeopathy appear in the second part of the 1837 edition of The Chronic Diseases in the article called Concerning the Technical Part of Homoeopathy. This is a very valuable article as it acts as the technical complement to the methods he introduced in the 1833 edition of the 5th Organon.

Hahnemann intended that the various editions of Organon and The Chronic Diseases should be read together as they form a complete picture of the latest developments in Homoeopathy.


These techniques not only brought the centesimal system of Homoeopathy closer to perfection, but also pointed out the direction it would be taking in the future. In the 1837 commentary Hahnemann begins by assessing his experience of the dosing procedures that he used during the late 1820s and shares the outcome of his latest research in Homoeopathy.

He says:

'Since I last addressed the public concerning our healing art I have had among other things also the opportunity to gain experience as to the best possible mode of administering the dose of the medicines to the patients, and I herewith communicate what I have found best in this respect.

A small pellet of one of the highest dynamizations of a medicine laid dry upon the tongue, or the moderate smelling of an open vial where one or more such pellets are contained proves itself the smallest and weakest dose with shortest period of duration of its effects.'

Due to the great diversity of age, predispositions, sensitivities, physical constitutions, mental temperaments, reserves of vital powers, and environmental factors, etc., a homoeopath needs a flexible dosage system that allows for the adjustment of the remedy for each individual case. This is something that the medicinal solution supplies.

Vide Concerning the Technical Part of Homoeopathy.

'Nevertheless the incredible variety among patients as to their sensitivity, their age, their spiritual and bodily development, their vital powers, and especially in the nature of their disease necessitates a great variety in their treatment, and also in the administration to them of the doses of medicine.'

The best way to adjust each individual dose of a remedy to the sensitivity of the individual constitution is to use the medicinal solution. This is because the aqueous solution is far more flexible than the dosage of the dry pills.

Also of great importance is the following revelation that tells us why the untimely repetition of an unadjusted dose causes complications and explains the reason homoeopaths disagree so much about the repetition of doses.

'Before proceeding, it is important to observe, that our vital principle cannot bear well that the same unchanged dose of medicine be given even twice in succession, much less more frequently to a patient. For by this the good effect of the former dose of medicine is either neutralized in part, or new symptoms proper to the medicine, symptoms which have never before been present in the disease appear, impeding the cure.

Thus even a well selected homoeopathic medicine produces ill effects and attains its purpose imperfectly or not at all. Thence come the many contradictions of homoeopathic physicians with respect to the repetition of doses.'

The fact that the vital force cannot adapt to the repetition of an unadjusted dose is the conclusion of around 40 years of experimentation and should not be taken lightly. In the 6th Organon, Hahnemann adds that even with the perfect remedy it is unwise 'to let the patient have a second or third dose taken dry.'

The production of these side-effects is the main reason why repeating remedies before the relapse of symptoms is contraindicated in the Homoeopathy of the 4th Organon. The use of the medicinal solution overcomes this problem because it can be adjusted with succussions so that the patient never receives the exact same potency twice.

Vide Concerning the Technical Part of Homoeopathy

'But in taking one and the same medicine repeatedly (which is indispensable to secure the cure of a serious chronic disease) if the dose in every case is varied and modified only a little in its degree of dynamization, then the vital force of the patient will calmly, and as it were willingly, receive the same medicine even at the briefest intervals, very many times in succession with the best results, every time increasing the well being of the patient.

This slight change in the degree of dynamization is even effected, if the bottle which contains the solutions of one or more pellets is merely well shaken five or six times.'

The single unit dose is considered by many to be the only pure form of Classical Homoeopathy as they are only familiar with the 4th Organon 'wait and watch' method.

By 1833 the founder of Homoeopathy was using the remedy solution in a split dose so he could repeat a homoeopathic medicine whenever he felt it was necessary. Homoeopathy as commonly practiced has not progressed past the techniques Hahnemann introduced between 1828 and 1829 although his more progressive techniques were published in the 5th Organon in 1833 and The Chronic Diseases in 1837.

The Use of the Medicinal Solution

Hahnemann often communicated his new techniques privately with some of his most respected students before he made them public. One year before the publication of the 1837 edition of The Chronic Diseases, Hahnemann wrote a letter to Constantine Hering in which he gave detailed instructions of the latest techniques relating to the medicinal solutions. He gave the following advice to his life long friend.

This is recorded in Bradford's Life and Letters of Hahnemann, page 367.

'I have made some improvements in the technicalities of our art, which I will now first communicate to you.....Now, as my medicines are very powerful, I seldom dissolve more than one globule in 7, 15, 20, 30, tablespoons of water [DL], and, because the patient has no distilled water (which, besides, after a few days becomes spoilt and ferments), I employ for this purpose spring or river water mixed with 1-15th or 1-20th part of spirits of wine or I put three or four small pieces of hard wood charcoal into the solution.

This mixture, (of which the patient affected with a chronic malady takes a tablespoon or 1, 2 or 3 teaspoons [DL] every day, or every other day, is to be shaken in the bottle five or six times every dose taken, in order to change the degree of dynamization each time. [DL]'

This is the first document we have that Hahnemann gives the full details of the split dose and medicinal solution. Hahnemann suggested that the medicinal solution be preserved with 1-15th or 1-20th parts of spirits of wine. Where alcohol was unsuitable Hahnemann used three of four small pieces of hard wood charcoal instead.

He was witnessed later in his career putting 1 teaspoon of alcohol into 4 oz. of water as a preservative. We find that in environments that tend toward easy spoilage, up to 1/3 of the solution must be preserved with brandy.

In Hahnemann's letter to Hering he mentions the proper amount of the solution to be given to the patient varies from 1, 2 or 3 teaspoons, depending on the sensitivity of the constitution, age, nature of the disease, etc.

In the following year of 1837 Hahnemann released to the public the conclusion of his experiments with the technical methods of giving the homoeopathic dose. In this article he also gives the advice about the repetition of the remedies in acute and chronic diseases.

Vide Concerning the Technical Part of Homoeopathy

'Experience has shown me, as it has no doubt also shown to most of my followers that it is most useful in diseases of any magnitude (not excepting even the most acute, and still more so in the half-acute, in the tedious and most tedious) to give to the patient the powerful homoeopathic pellet or pellets only in solution, and this solution in divided doses [DL].

In this way we give the medicine, dissolved in seven to twenty tablespoons of water without any addition, in acute and very acute diseases every hour or every half hour, a tablespoon at a time, with weak persons or children, only a small part of a tablespoon (one or two teaspoons or coffee spoonfuls) may be given as a dose.

In chronic diseases I have found it best to give a dose (e. g., a spoonful) of a solution of the suitable remedy at least every two days, more usually every day.'

Hahnemann had experimented with the use of the homoeopathic remedies in water ever since the early provings of homoeopathic remedies in 1813. He used the water dose as one of his techniques of controlling the toxicity and power of the remedies during the provings. The new split-dose is succussed just before each dose is ingested to raise the potency in an upward direction.

By replacing the single unit dose with the new split-dose it became possible to use one pill several times! This apparent contradiction is resolved by the fact that the remedy solution is made with only one #10 pill that is dissolved into several liquid portions that are used repeatedly.

For this reason Hahnemann called his new technique the 'split-dose' method instead of a 'multi-dose' method, as in this sense it is a still only one dose (i.e., one pill).

Hahnemann realized early on that too many doses of the dry pills accumulated until they produced troublesome aggravations. Even though the patient may be taking the solution more times they are still receiving a smaller amount than they would if they repeated a dry dose even once. This is a very subtle aspect of the theory of the minimal dose that took Hahnemann many years to fully understand.

Preparing and Administering the Medicinal Solution

The preparation of the remedy solution for the centesimal potencies can be summarized in 7 easy steps.

1. Take a 6 to 8 oz. bottle and drop in one, rarely two, # 10 pills of the chosen remedy. Hahnemann suggested that the size of the medicinal solution could vary from 3.5 to 4 oz. (7 to 8 tablespoons) up to 20 ounces (4O tablespoons) of water mixed with brandy. I usually use between 4 to 6 oz. of liquid in my medicinal solutions. I use slightly larger bottles because this leaves enough space to produce good succussions. When speaking of succussing to make potencies Hahnemann suggested leaving up to 1/3 of the vial empty. The larger medicinal solutions (8 oz., 12 oz., etc.) are only necessary when one is treating a hypersensitive, as the larger amount of water makes the dose act more gently.

2. Add enough water mixed with brandy to fill the bottle up to 2/3 to 3/4 full with liquid. A sufficient amount of brandy or pure alcohol, as a preservative, should be included in the solution. If the solution is to be used over a long period of time mix 30% to 50% brandy with the water used in the solution. A lesser amount of ever-clear would do the job.

3. The bottle is to be succussed just prior to ingestion in order to activate the remedy and slightly raise the potency. The number of succussions greatly affects the action of the remedy on the vital force. For those who are hypersensitive 1, 2, or 3 succussions is usually enough. Those of an average sensitivity more normally need 4, 5, 6 or 7 succussions. Those who have rather low sensitivity may need 8, 9, 10, 11, 12 or more succussions. It is best to start with a lower number of succussions and increase the amount if and when necessary. Succussions are one of the methods of adjusting the dose.

4. In this article Hahnemann suggests that 1, 2, or 3 teaspoons of the medicinal solution should be given to the client depending on their sensitivity. Children are given 1/2 teaspoon. Infants should receive 1/4 teaspoon or less depending on their age. Most adults do quite well starting out with 1 teaspoon. The size of the dose can be gradually increased if more reaction is needed. A constitution of a lower sensitivity might need 2 or 3 teaspoons before they will react sufficiently to the remedy.

Hahnemann's Paris casebooks demonstrate that the old master later preferred to use a medicinal solution and a dilution glass to further attenuate his dose. 1, 2, or 3 teaspoons of the medicinal solution are stirred into 4 oz. of water and 1, 2, or 3 teaspoons are given to the patient as a dose. Hahnemann gave his centesimal potencies for the most part in the exact same manner as his LM potencies. The dose can also be adjusted by the amount of the remedy given.

5. The dose should be adjusted through a series of dilution glasses when treating a hypersensitive, an elderly person, severe pathological tissue changes, allergies or any dangerous condition. Succuss the remedy bottle with a conservative number of succussions and take one teaspoon and stir it into the first dilution glass. From this glass take a teaspoon and stir it into a second dilution glass and from this a dose is given to the client.

An extreme hypersensitive may need the remedy diluted through 2 or 3 such dilution glasses. In this case a teaspoon or less is taken from the first glass and stirred into a second or third glass. These individuals are normally almost impossible to treat with Homoeopathy but adjusting the dose in this manner brings them great relief.

6. Give the client one test dose and wait and watch for a reasonable amount of time to see how the remedy reacts. This time period depends somewhat on the timeline of the disease you intend to treat. Acute and chronic diseases each have their own peculiar nature. If there is a striking response and a dramatic improvement let the single dose act without interference. If there is only a slow or moderate improvement the dose may be repeated at proper intervals to speed the cure.

7. If the remedy produces any aggravation it is best to wait and watch for the expected amelioration. If the remedy is going to be given again it must be adjusted in a downward direction. This means one could use a lower potency, less succussions, a smaller dose, one or more dilution glasses, or give only one dose or repeat the remedy at longer intervals. The homoeopath can use one or more of these techniques as needed. These are examples of how to adjust the dose in a downward direction.

Of course, all the normal precautions should be taken and the client asked not to eat or drink 1/2 hour before and after taking the remedy. These are the basic instructions on how to prepare and administer the liquid dose.

It may take some time to learn how to adjust the dose to fit the sensitivity of the individual as well as to match the nature of the disease to be treated. This comes with time and experience.

Some may ask why go through all the trouble to use the medicinal solutions? The answer is quite simple. Do you want to treat the most chronically ill and the most hypersensitive persons? Do you want to speed the time of cure to 1/2, 1/4 or less the time it takes with the dry dose? Do you want to use Hahnemann's most advanced methods and walk in his footsteps?

If you do, then a little more effort on your part is well worth while.

*************

Source: http://www.hpathy.com/philosophy/little-medicinal-solution.a....

Murthy

Dear Sajjad

One way out for the 'clinical' situation, perhaps is for the doctor, to make the water dose himself, and give it to the patient, telling him to take a tablespoon out of it daily, after succussing.

You can get special labels made,with your name, the name of the clinic,in multiple colors and make it look attractive.

Murthy

Dear Jacob

I will read sixth edition once again, and see whether Hahn. made any statement prohibiting the use of water dose, in 'c' potencies, and advised to depend on LM's alone.

I agree to some extant that we may not know, which potency we are using, at the end of a week,while using the water dose.

But, I was sure that we can never reach the next scale,by succussing the water dose,even say, after a month of the water dose.

Perhaps, this is where we differ fundamentally.

I feel both dilution and succussion are necessary to really increase the potency even by one. What I thought was that by succussing alone, we may be increasing the dynamisation/potency very very minutely, say a 30 may become, 30.0001, and next time 30.0002. So, to make it even 31 is impossible.

But, the way you are putting, is completely different.

When I say 'there are no hard and fast rules' I meant about the way we understand these phenomena.

Unless and until we know, how the homeopathic medicines become more potent, by dilution and succussion, this debate will continue.

it is an accepted observation that dilution alone is useless to increase the potency.

However, I am yet to here that succussion alone is also useless.

Having said that, I remember having read that, Hahn. advised not to ship liquid potencies over long distances, as he felt the jerks it undergoes during the many modes of travel, the medicine is subjected, may increase the potency.

Well.You may have a point here.If succuussion makes only a little difference,then why did he say, not to ship it in liquid form, over long distances?

I may be indirectly playing into your hands.(laughing) I know it.However, I would like to go to bottom of this.

I don't mind myself to be proved to be wrong. I want the concept to be clear.

He always felt safe to ship dry pellets only.

I have to dig that reference out. It may take time, as I didn't bookmark it, and have to search again.

Murthy

wow.

I got it without much effort. : )

*************

Hahnemann & Others On The Succussion of Medicinal Fluids, etc.
[Originally requested by Phyl Eyre of the South Downs School of Homeopathy, UK]
by Peter Morrell

‘His keen interest for chemistry and pharmacy, completely underestimated by so many of his colleagues, became of great service to Hahnemann in his later work.’ [Haehl, vol. 1, pp.268-9]

Homeopathic remedies are not only diluted but also succussed. As the physical nature of homeopathic remedies is still unknown, so the precise role which succussion plays in the process is a mystery. The origin of succussion as a process also remains obscure.

It has been mentioned before that the idea for first using succussion was based upon the jostling of medicinal liquids in bottles when riding on horseback. In the past this idea has been derided and dismissed. But it might in truth have some small basis in fact. Quite inadvertently, while looking for something else entirely, I chanced upon the following about succussion:

‘In the Organon, however, he stated that trituration and succussion release the ‘spirit-like power’ of the medicine - which is compatible with his assumption that medicines act through their spiritual (geistlich) or dynamic impact upon the organism [321, d].’ [Coulter, vol. 2, p.403]

d. For this reason Hahnemann warned against shipping the liquid remedies over long distances, since they receive ‘an enormous number of additional succussions during the transport, and they are so highly potentized during a long journey that on their arrival they are scarcely fit for use, at least not for susceptible patients, on account of their excessive strength, as many observations go to prove’ (Lesser Writings, 736 *) Fortunately for suffering humanity, the dry pills were not affected in this way (ibid., 766 **)

Note 321. Hahnemann, Organon, Sec. 269, 270.

* ‘It is only in this form [i.e. dry pills] that the homeopathic medicines can be sent to the most distant parts, without any alteration of their powers, which is impossible to be done in their fluid form; for in that case the medicinal fluid, which has already been sufficiently potentized during the preparation (by two succussions at each dilution), receives an enormous number of additional succussions during the transport, and they are so highly potentized during a long journey, that on their arrival they are scarcely fit for use...’ &c, as stated by Coulter above. [Lesser Writings, pp.735-6]

** ‘The supposition of our author that dry globules that have been impregnated with a certain degree of development of power can be further dynamized and their medicinal power increased in their bottles by shaking, or carrying in the pocket, like medicinal fluids further shaken, is not borne out by any fact and will appear to me incredible until it is supported by proper experimental proofs.’ [Hahnemann, Lesser Writings, p.766]

Stuart Close says this about potentisation:

‘Under certain conditions he found, perhaps to his surprise, that instead of weakening the drug he was actually increasing its curative power. In reducing the density of the mass he perceived that he was setting free powers previously latent, and that these powers were the greatest and most efficient for their therapeutic purposes...’ [Close, 1924, The Genius of Homeopathy, p.216]

Furthermore, in his last years in Paris, Hahnemann frequently instructed patients to shake their liquid doses in the bottle before their daily dose, thus enhancing or re-invigorating their medicinal power. Or to stir vigorously with a spoon in the glass.

‘He...[advised] ...that the liquid medicine, having been made up, should be slightly succussed between each dose...’ [Handley, 1997, In Search of the Later Hahnemann, p.131]

‘Only very occasionally is a succussion of the container of the liquid specified...this appears to be a succussion of the stock bottle, or main container, rather than of an intermediate glass.’ [ibid., p.131]

‘...it was stated that he should...shake the glass of water ten times and then put the contents into another glass, taking a teaspoonful from there mornings and evenings...one teaspoonful from this was to be put into a glass of water, this was to be shaken well...the glasses of water were to be thrown away each evening.’ [Handley, p.133]

In an essay titled ‘Hahnemann’s Doses of Medicines’, dated 1844, and published in his Lesser Writings, Boenninghausen gives us Dr. Croserio’s account:

‘Hahnemann at all times used only the well known small pellets...moistened with the 30th dilution...he would dissolve one or at most two in eight to fifteen tablespoons of water and a half or whole tablespoonful of French brandy in a bottle and thoroughly shake it up. Only one tablespoon of this solution was put in a tumblerful of water, and of this latter the patient would take only a coffeespoonful until he observed some action.’ [Boenninghausen, p.212]

‘From correspondence with Boenninghausen and conversations with Everest, it is clear that in the final years of his life, Hahnemann considerably diverged from his earlier methods of dilution.’ [Haehl, vol.1, p.325]

A similar account is given in Handley, 1997.

‘He never prescribed two different remedies, to be used in alternation or one after the other...’[ibid., p.213]

But Handley says he sometimes did, especially by olfaction.

‘Hahnemann in the last years of his practice seemed to devote his whole dexterity to continually diminish the doses of his medicines. On this account he in the last years frequently contented himself to allow his patients to smell of the medicine...in chronic diseases he would in no case allow the patient to smell at the medicine oftener than once a week, and would give nothing but sugar of milk besides...by your constant correspondence you have had abundant opportunity to appreciate his rare powers of observation...’ [ibid., p.213]

Most of this is already well known.

‘...he potentized in the last years all his medicines with many, at least with 25 strokes.’ [ibid., p.215]

‘But with time there emerges ever more clearly the view that, by shaking and trituration, a uniform mixing, dilution and weakening of the medicinal substance is not all that is achieved; on the contrary, the material part of the medicine is thereby more and more eradicated and as a consequence the spiritual part of the medicine (not perceptible to human faculties) is released and extraordinarily increased. This is dynamization...be possible to increase the power by succussion; the more the medicine is succussed when prepared, the stronger its effect...’ [Haehl, 1922, vol.1, p.324]

‘...in regard to the most appropriate number of succussions he altered his opinion repeatedly within a few years.’ [ibid., p.326]

As usual, Dudgeon makes some very informative, but also some very critical remarks about succussion:

‘By trituration and succussion, he says, the medicinal power of medicines may be increased almost to an infinite degree. Hence we are warned against succussing our succussive dilutions over-much.’ [Dudgeon, p.346]

‘So fearful is he of increasing the medicinal potency of a medicine by shaking it too much, that he earnestly deprecates the practice of carrying about medicines in the liquid state, as the mere shaking of walking or driving will, he alleges, increase their potency to a dangerous extent.’ [ibid., p.347]

‘Whilst in the earlier periods of the growth of his system he merely tells us to shake the bottle, to shake it strongly - to shake it for a minute or longer - he afterwards tells us that much shaking increases the power of the medicine to a dangerous extent, and therefore only two shakes must be used for each dilution. Latterly, however, he again loses his dread of shaking, and after once more appointing ten shakes for each dilution as the standard, he becomes more liberal and allows twenty, fifty, or more shakes, and half a dozen shakes to the bottle before each dose of the medicinal solution. Again, whereas in one place he says that the shaking is the only agent in the dynamization...in another he alleges that dilution is essential to the dynamizing effect of succussion, and that all the rubbing and shaking in the world will not dynamize an undiluted substance.’ [ibid., pp.349-50]’

All these quotations also illustrate the manner in which Hahnemann believed that succussion was more important in creating potency than mere dilution. He seemed to believe that by violent shaking some subtle medicinal power, derived from the kinetic energy of shaking, was imparted into the liquid. And it was this subtle force which he believed to be the true healing power of the remedy.

Sources:

Bradford, Thomas L, Boenninghaussen, The Lesser Writings, Jain
Close, 1924, The Genius of Homeopathy, Lectures and Essays on Homeopathic Philosophy
Coulter, Harris, L, Divided Legacy A History of the Schism in Medical Thought, Washington, 1975
Dudgeon, Robert Ellis, 1853, Lectures On the Theory and Practice of Homeopathy
Haehl, Richard, 1922, Samuel Hahnemann His Life and Works
Handley, Rima, In Search of The Later Hahnemann, Beaconsfield, UK, 1997

********

Murthy

I forgot to post the url for the above.

http://www.homeoint.org/morrell/articles/pm_succu.htm

Murthy