Dr Sayeed Ahmad
The selection of potency has all along been a burning problem in homoeopathy. To fulfil the highest ideal of cure, not only the selection of the medicine must be correct, its potency and dose must also be accurate. It has been observed that a medicine may fail to produce any beneficial effect in a patient in low potencies but shows unexpected good result in high potencies. It does not mean that the lower potencies do not act at all in such cases. They do act, but their beneficial effects are not perceptible to us. Of course, if the medicine is repeated several times in lower potencies, its effect may be perceptible but even then very slowly and less distinctly than if applied in high potencies. Similarly, the reverse is also true when high potencies may fail to produce any appreciable change but low potencies act curatively. This is only because of the variation of susceptibility in different patients. We all know that selection of potency depends on the susceptibility of the patient. The higher the susceptibility, the higher should be the potency and vice versa.
But the great difficulty is that there is no instrument to measure the susceptibility of an individual. Various factors contribute to assume the susceptibility of a patient. His age, sex, mode of living, nature and depth of the disease, structural changes, various suppressions, vitality, mental and physical reactions to environmental stimuli etc., all contribute to understand the susceptibility. But very often we find difficulty when some factors indicate high susceptibility but some others the reverse, e. g. a tumour being an organic change indicates low susceptibility but the susceptibility of the patient as a whole may be high requring high potency. On the other hand “idiosyncrasy”, though indicates high susceptibility, requires low potency and so on. No doubt our knowledge of pathology helps us to a great extent in this respect but final conclusion depends on careful observation of the effect of medicine. For this reason it is better to start with medium potencies in all doubtful cases and then to go high or low observing the effect of the first dose. Routine use of exclusively high or low potencies is not desirable in homoeopathy. This is why we see Hahnemann changing his views about potency from time to time till before his death.
He was fully aware of the problem and tried to solve the same all through his life the ultimate outcome of which is the “fifty millesimal potency”. I believe the problem of potency may no longer bother us if we all start using 50-millesimal potency in all cases or at least in doubtful, incurable and acute cases. The problem of long gap in the centesimal potency from 30 to 200, 200 to 1M or 1M to 10M etc. may very well be solved by the use of successive higher potencies of 50-millesimal scale. I request my colleagues, especially the beginners in homoeopathy, to try fifty millesimal potency to see if this may be of any help to solve their potency problem. In India it is our usual practice to prescribe low potencies in acute and high potencies in chronic diseases. This practice is just the reverse of what it should be. In acute disease there is seldom any structural change to start with.
Naturally the susceptibility of the patient remains high in such cases. Moreover, the violence of the case, rapidity of progress and acute inflammatory condition suggest high susceptibility of the patient requiring high potency. This is true in case of influenza, dipththeria, measles, pox, whooping cough, typhoid (1st and 2nd week), meningitis, encephalitis etc. Here repeated doses of high potencies are necessary to arrest the progress of the disease and ensure early cure. But we generally prescribe low potencies in such cases resulting in failure or too late recovery which is contrary to the highest ideal of cure. But in acute diseases with lowered vitality, e. g., in severe dehydration, shock, collapse, extreme prostration, severe haemorrhage, typhoid state etc. the patient requires low potencies in repeated doses to gradually overcome the inhibitory state of the vital dynamis. Indiscriminate use of high potencies in such cases may lead to sudden death. Acute manifestations of chronic diseases with gross organic changes require low or medium potencies but require high potencies if the disease still remains in the functional plane or at the beginning of organic changes.
In chronic disease on the other hand susceptibility becomes gradually low because of long continued suffering and organic changes – hence they require low or medium potencies. Carelessness in selecting correct potency in such cases may lead to Dr. Kent’s 1st or 2nd observation which is undoubtedly not at all desirable to any homoeopathic physician. But in chronic diseases without gross organic changes, e. g. migraine, neuralgias, most of the paralysis, neurosis etc., high potencies act curatively if given in single or repeated doses as the case may be. Too low potencies in repeated doses even in organic chronic disease may lead to observation No. 10 while too high potencies in comparison to patient’s susceptibility leads to observation No.3 and the patient may have to pass through grievous suffering before amelioration or cure takes place. Difficult and incurable cases require medium and low potencies to start with. In my opinion 50-millesimal potency is best for this purpose. Even an incurable case may turn to curable stage after the use of few successive potencies in this scale.
In children and young adults there is generally no wear and tear of organs and tissues. As such they require high potencies for an early cure. But in old age the susceptibility becomes generally low because of wear and tear and senile degeneration, hence they generally require low or medium potencies.
Females in villages of our country are generally less exposed to worries, anxieties and complications of life. Hence their nervouse system generally is of quiet nature having a moderate degree of susceptibility requiring medium potencies. But irritable, highly strung males possess a high degree of susceptibility requiring generally high potencies. Persons engged in highly intellectual and mental work, e. g. doctors, lawyers, ministers etc. generally require high potencies because of their high profile and high susceptibility. On the other hand, persons engaged in physical labour without much of mental exertion generally require low or medium potencies because of their low susceptibility.
Disease begins in the dynamic plane and ultimately settles in organs or tissues. As such in all diseases we get functional symptoms to start with followed by secondary organic or pathological symptoms. Hence the more the disease is in the dynamic plane, the higher should be the potency and the more it is in the organic plane the lower should be the potency. This is why we may be able to abort many violent acute diseases in their beginning stage with repeated doses of high potencies. But the problem arises when we come across to types of susceptibility in a patient at the same time – the susceptibility of the patient as a whole being high while the susceptibility of his affected tissue is low, e. g. in tumour or chronic eczema etc. In such cases it is better to start with medium or low potencies and the moment reaction sets in, the potency should be changed to higher one. The growths or organic changes may not be reversible with the help of these high potencies but the disease processs will be cured. The end product of the disease may require surgical interference for their removal so as to avoid mechanical effects of the same.
Primary manifestation of psora, sycosis and syphilis require high potencies in repeated and large doses for an early and permanent cure but the secondary effects of these conditions require medium or low potencies to start with.
In mental diseases the susceptibility is generally very high, but high potencies are contra-indicated in such cases to start with because of the possibility of too violent an aggravation. I have seen a single dose of 30th potency to act curatively in such cases for months together. In diseases like bronchial asthma, organic heart diseases, diabetes mellitus, hypertension, cirrhosis of the liver, pre-tubercular and pre-cancerous states, piles, brain tumour, peptic ulcer etc. 50-millesimal potency give wonderful result.
From what has been stated so far, it is probably clear that no hard and fast rule is possible for the selection of potency. Susceptibility is the only guide in this respect. But to gauge the susceptibility of a patient, it requires thorough knowledge of the allied subjects of medicine including hygience, unbiased expeprience, attention in observing, freedom from prejudice and clear conception of the basic principles of homoeopathy including remedy response and second prescription.
Before I conclude I would like to cite few cured cases to substantiate my view that it is not only the selection of medicine but the accuracy of potency and doses that are the prerequisites in arriving at the highest ideal of cure.
- A case of acute headache with all the symptoms of Belladonna did not respond at all to 30th or 200th potency, but magically cured with a single dose of Belladonna 10M.
- A case of abdominal colic in a girl of 13/14 years of age, persisting for about 2 weeks with all symptoms of Colocynth did not respond to Colocynth 6 and 30 but cured completely with Colocynth 50M – four doses given at an interval of about half an hour.
- Case of whooping cough with all symptoms of Drosera did not respond well to Drosera 30 but cured within 3 or 4 days by repeated doses of Drosera 1M and 10M.
- Several obstinate skin diseases were cured within few weeks or months with repeated doses of 6th or 12th potency or with 50-millesimal potency when 200th or 1M potency produced only prolonged aggravation without being followed by amelioration or there was no remedy response at all.
- Cases of Bell’s Palsy or hemiplegia with all symptoms of Causticum did not respond at all to Causticum 30 but cured within a very short time with repeated (deviated) doses of 1M or 10M potency.
- Cases of piles with all symptoms of Acid Nitric or Thuja did not respond satisfactorily to the 200th or 1M but responded nicely to 50-millesimal potency of these drugs.
- A case of ascites due to cirrhosis of the liver responded unexpectedly to China in 50-millesimal potency when no satisfactory result had been obtained by prescribing centesimal potency.
- A case of neuralgic headache with symptoms of Chelidonium did not respond to 30th or 200th potency, but cured within 24 hours with 3 or 4 doses of Chelidonium CM given at intervals of 3/4 hours.
Reference: Editorial: The Homoeopathic Heritage, May, 1994