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Guidelines in 6th Edition of Organon of Medicine (1842)
All emphasis (bold/italic/underline) and notes by Dr. Manish Bhatia
§ 245 Sixth Edition
Having thus seen what attention should, in the homoeopathic treatment, be paid to the chief varieties of diseases and to the peculiar circumstances connected with them, we now pass on to what we have to say respecting the remedies and the mode of employing them, together with the diet and regimen to be observed during their use.
Every perceptibly progressive and strikingly increasing amelioration in a transient (acute) or persistent (chronic) disease, is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever, because all the good the medicine taken continues to effect is new hastening towards its completion. Every new dose of any medicine whatsoever, even of the one last administered, that has hitherto shown itself to be salutary, would in this case disturb the work of amelioration.
- Whenever there is a striking or marked amelioration, DO NOT repeat the medicine, as long as the amelioration lasts.
§ 246 Sixth Edition
Every perceptibly progressive and strikingly increasing amelioration during treatment is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever, because all the good the medicine taken continues to effect is now hastening towards its completion. This is not infrequently the case in acute diseases, but in more chronic diseases, on the other hand, a single dose of an appropriately selected homoeopathic remedy will at times complete even with but slowly progressive improvement and give the help which such a remedy in such a case can accomplish naturally within 40, 50, 60, 100 days. This is, however, but rarely the case; and besides, it must be a matter of great importance to the physician as well as to the patient that were it possible, this period should be diminished to one-half, one-quarter, and even still less, so that a much more rapid cure might be obtained. And this may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions: firstly, if the medicine selected with the utmost care was perfectly homoeopathic; secondly, if it is highly potentized, dissolved in water and given in proper small dose that experience has taught as the most suitable in definite intervals for the quickest accomplishment of the cure but with the precaution, that the degree of every dose deviate somewhat from the preceding and following in order that the vital principle which is to be altered to a similar medicinal disease be not aroused to untoward reactions and revolt as is always the case1 with unmodified and especially rapidly repeated doses.
1 What I said in the fifth edition of the organon, in a long note to this paragraph in order to prevent these undesirable reactions of the vital energy, was all the experience I then had justified. But during the last four or five years, however, all these difficulties are wholly solved by my new altered but perfected method. The same carefully selected medicine may now be given daily and for months, if necessary in this way, namely, after the lower degree of potency has been used for one or two weeks in the treatment of chronic disease, advance is made in the same way to higher degrees, (beginning according to the new dynamization method, taught herewith with the use of the lowest degrees).
- A single dose may often bring about striking improvement in acute cases.
- But in chronic cases, it is often not enough to prescribe a single dose.
- The most rapid cure can be attained in chronic cases if -
- The medicine selected is perfectly similar
- The medicine is dissolved in water to prepare the dose.
- The medicine is repeated at suitable intervals
- The dose should be altered every time. No two doses should be alike. Slight difference should be made by succussing the medicine every time.
- This alteration of dose can be done with LM scale. After using one potency for a week or two, advance should be made to subsequent potency in LM scale.
§ 247 Sixth Edition
It is impractical to repeat the same unchanged dose of a remedy once, not to mention its frequent repetition (and at short intervals in order not to delay the cure). The vital principle does not accept such unchanged doses without resistance, that is, without other symptoms of the medicine to manifest themselves than those similar to the disease to be cured, because the former dose has already accomplished the expected change in the vital principle and a second dynamically wholly similar, unchanged dose of the same medicine no longer finds, therefore, the same conditions of the vital force. The patient may indeed be made sick in another way by receiving other such unchanged doses, even sicker than he was, for now only those symptoms of the given remedy remain active which were not homoeopathic to the original disease, hence no step towards cure can follow, only a true aggravation of the condition of the patient. But if the succeeding dose is changed slightly every time, namely potentized somewhat higher (§§ 269-270) then the vital principle may be altered without difficulty by the same medicine (the sensation of natural disease diminishing) and thus the cure brought nearer.1
1 We ought not even with the best chosen homoeopathic medicine, for instance one pellet of the same potency that was beneficial at first, to let the patient have a second or third dose, taken dry. In the same way, if the medicine was dissolved in water and the first dose proved beneficial, a second or third and even smaller dose from the bottle standing undisturbed, even in intervals of a few days, would prove no longer beneficial, even though the original preparation had been potentized with ten succussions or as I suggested later with but two succussions in order to obviate this disadvantage and this according to above reasons. But through modification of every dose in its dynamiztion degree, as I herewith teach, there exists no offence, even if the doses be repeated more frequently, even if the medicine be ever so highly potentized with ever so many succussions. It almost seems as if the best selected homoeopathic remedy could best extract the morbid disorder from the vital force and in chronic disease to extinguish the same only if applied in several different forms.
- If a medicine is repeated in same potency and dose then medicinal symptoms will appear.
- Medicines, even highly potentized, can be repeated frequently if the dose is varied each time.
§ 248 Sixth Edition
For this purpose, we potentize anew the medicinal solution1 (with perhaps 8, 10, 12 succussions) from which we give the patient one or (increasingly) several teaspoonful doses, in long lasting diseases daily or every second day, in acute diseases every two to six hours and in very urgent cases every hour or oftener. Thus in chronic diseases, every correctly chosen homoeopathic medicine, even those whose action is of long duration, may be repeated daily for months with ever increasing success. If the solution is used up (in seven to fifteen days) it is necessary to add to the next solution of the same medicine if still indicated one or (though rarely) several pellets of a higher potency with which we continue so long as the patient experiences continued improvement without encountering one or another complaint that he never had before in his life. For if this happens, if the balance of the disease appears in a group of altered symptoms then another, one more homoeopathically related medicine must be chosen in place of the last and administered in the same repeated doses, mindful, however, of modifying the solution of every dose with thorough vigorous succussions, thus changing its degree of potency and increasing it somewhat. On the other hand, should there appear during almost daily repetition of the well indicated homoeopathic remedy, towards the end of the treatment of a chronic disease, so-called (§ 161) homoeopathic aggravations by which the balance of the morbid symptoms seem to again increase somewhat (the medicinal disease, similar to the original, now alone persistently manifests itself). The doses in that case must then be reduced still further and repeated in longer intervals and possibly stopped several days, in order to see if the convalescence need no further medicinal aid. The apparent symptoms (Schein - Symptome) caused by the excess of the homoeopathic medicine will soon disappear and leave undisturbed health in its wake. If only a small vial say a dram of dilute alcohol is used in the treatment, in which is contained and dissolved through succussion one globule of the medicine which is to be used by olfaction every two, three or four days, this also must be thoroughly succussed eight to ten times before each olfaction.
1 Made in 40, 30, 20, 15 or 8 tablespoons of water with the addition of some alcohol or a piece of charcoal in order to preserve it. If charcoal is used, it is suspended by means of a thread in the vial and is taken out when the vial is succussed. The solution of the medicinal globule (and it is rarely necessary to use more than one globule) of a thoroughly potentized medicine in a large quantity of water can be obviated by making a solution in only 7-8 tablespoons of water and after thorough succussion of the vial take from it one tablespoon and put it in a glass of water (containing about 7 to 8 spoonfuls), this stirred thoroughly and then given a dose to the patient. If he is unusually excited and sensitive, a teaspoon of this solution may be put in a second glass of water, thoroughly stirred and teaspoonful doses or more be given. There are patients of so great sensitiveness that a third or fourth glass, similarly prepared, may be necessary. Each such prepared glass must be made fresh daily. The globule of the high potency is best crushed in a few grains of sugar of milk which the patient can put in the vial and be dissolved in the requisite quantity of water.
- Method 1 to prepare & give medicinal solution.
- Take one (or more, if required) globule of the indicated remedy, crush it in few grains of sugar of milk.
- Put it in a glass vial and add 120 ml (8 tablespoons) to 600 ml (40 tablespoons) water depending upon the amount and strength of solution required.
- Add to it some alcohol as a preservative.
- Succuss the bottle vigorously.
- Give 1 to 2 teaspoons from this bottle as one dose.
- Succuss the bottle twice before each dose.
- Method 2 to prepare medicinal solution.
- This method removes the need for large bottles and lot of liquid solution.
- Take one (or more, if required) globule of the indicated remedy, crush it in few grains of sugar of milk.
- Put it in a glass vial with approx.100 ml (7-8 tablespoons) water.
- Add to it some alcohol as a preservative.
- Succuss the bottle vigorously.
- Take a glass with 100 ml water and Put 1 spoon (15 ml) solution from the bottle in it.
- Stir and give 1 to 2 teaspoons from this glass as one dose.
- Succuss the bottle twice before each dose.
- If the patient is very sensitive, put 1 spoonful from the first glass in a second glass of 100 ml water. Stir and give the dose from the second glass. Dilute further for more sensitive patients.
- In chronic cases, repeat in such fashion daily or on alternate days; in acute diseases, every 2 to 6 hours; in emergency or very acute cases, every hour or even every few minutes.
- Once one bottle of medicinal solution is finished, prepare the next bottle with a globule of higher potency.
- Repeat the same medicine in increasing dynamization as long as the patient continues to improve.
- If new symptoms (medicinal) are experienced, medicine should be stopped and case reassessed.
- If after a considerable period of improvement, the patient experiences a homeopathic aggravation, stop the medicine. Most likely the aggravation will subside in a few days and the patient will be cured.
- Method for olfaction
- Take a 1 dram glass vial and fill it with dilute alcohol.
- Put 1 crushed globule in it and sucuss vigorously.
- Smell the bottle every 2 to 4 days. Sucuss 10 times before each olfaction.
Every medicine prescribed for a case of disease which, in the course of its action, produces new and troublesome symptoms not appertaining to the disease to be cured, is not capable of effecting real improvement,1 and cannot be considered as homoeopathically selected; it must, therefore, either, if the aggravation be considerable, be first partially neutralized as soon as possible by an antidote before giving the next remedy chosen more accurately according to similarity of action; or if the troublesome symptoms be not very violent, the next remedy must be given immediately, in order to take the place of the improperly selected one.2
1 As all experience shows that the dose of the specially suited homoeopathic medicine can scarcely be prepared too small to effect perceptible amelioration in the disease for which it is appropriate (§§ 275-278), we should act injudiciously and hurtfully were we when no improvement, or some, though it be even slight, aggravation ensues, to repeat or even increase the dose of the same medicine, as is done in the old system, under the delusion that it was not efficacious on account of its small quantity (its too small dose). Every aggravation by the production of new symptoms - when nothing untoward has occurred in the mental or physical regimen - invariably proves unsuitableness on the part of the medicine formerly given in the case of disease before us, but never indicates that the dose has been too weak.
2 The well informed and conscientiously careful physician will never be in a position to require an antidote in his practice if he will begin, as he should, to give the selected medicine in the smallest possible dose. Like minute doses of a better chosen remedy will re-establish order throughout.
- If a medicine produces medicinal symptoms, then it is not the simillimum
- In such case, if the medicinal symptoms are severe, an antidote should be given.
- If medicinal symptoms are not severe, another remedy should be given.
§ 272 Sixth Edition
Such a globule,1 placed dry upon the tongue, is one of the smallest doses for a moderate recent case of illness. Here but few nerves are touched by the medicine. A similar globule, crushed with some sugar of milk and dissolved in a good deal of water (§ 247) and stirred well before every administration will produce a far more powerful medicine for the use of several days. Every dose, no matter how minute, touches, on the contrary, many nerves.
1 These globules (§ 270) retain their medicinal virtue for many years, if protected against sunlight and heat.
The suitableness of a medicine for any given case of disease does not depend on its accurate homoeopathic selection alone, but likewise on the proper size, or rather smallness, of the dose. If we give too strong a dose of a medicine which may have been even quite homoeopathically chosen for the morbid state before us, it must, notwithstanding the inherent beneficial character of its nature, prove injurious by its mere magnitude, and by the unnecessary, too strong impression which, by virtue of its homoeopathic similarity of action, it makes upon the vital force which it attacks and, through the vital force, upon those parts of the organism which are the most sensitive, and are already most affected by the natural disease.
§ 276 Sixth Edition
For this reason, a medicine, even though it may be homoeopathically suited to the case of disease, does harm in every dose that is too large, the more harm the larger the dose, and by the magnitude of the dose and in strong doses’ it does more harm the greater its homoeopathicity and the higher the potency1 selected, and it does much more injury than any equally large dose of a medicine that is unhomoeopathic, and in no respect adapted to the morbid state (allopathic).
Too large doses of an accurately chosen homoeopathic medicine, and especially when frequently repeated, bring about much trouble as a rule. They put the patient not seldom in danger of life or make this disease almost incurable. They do indeed extinguish the natural disease so far as the sensation of the life principle is concerned and the patient no longer suffers from the original disease from the moment the too strong dose of the homoeopathic medicine acted upon him but he is in consequence more ill with the similar but more violent medicinal disease which is most difficult to destroy.2
1 The praise bestowed of late years by some homoeopathists on the larger doses is owing to this, either that they chose low dynamizations of the medicine to be administered (as I myself used to do twenty years ago, from nor knowing any better), or that the medicines selected were not homoeopathic and imperfectly prepared by their manufacturers.
2 Thus, the continuous use of aggressive allopathic large doses of mercurials against syphilis develops almost incurable maladies, when yet one or several doses of a mild but active mercurial preparation would certainly have radically cured in a few days the whole venereal disease, together with the chancre, provided it had not been destroyed by external measures (as is always done by allopathy). In the same way, the allopath gives Peruvian bark and quinine in intermittent fever daily in very large doses, where they are correctly indicated and where one very small dose of a highly potentized China would unfailingly help (in marsh intermittents and even in persons who were not affected by any evident psoric disease). A chronic China malady (coupled at the same time with the development of psora) is produced, which, if it dose not gradually kill the patient by damaging the internal important vital organs, especially spleen and liver, will put him, nevertheless suffering for years in a sad state of health. A homoeopathic antidote for such a misfortune produced by abuse of large doses of homoeopathic remedies is hardly conceivable.
- A similar drug in large, often repeated doses can do more harm to the patient than an allopathic drug.
- The more similar a medicine, the greater are the adverse effects of its frequent repetition.
- Large doses of medicine (allopathic or homeopathic) often make the case incurable.
- Hahnemann calls large doses of even the 'similar' remedies - allopathic and unhomeopathic!
For the same reason, and because a medicine, provided the dose of it was sufficiently small, is all the more salutary and almost marvellously efficacious the more accurately homoeopathic its selection has been, a medicine whose selection has been accurately homoeopathic must be all the more salutary the more its dose is reduced to the degree of minuteness appropriate for a gentle remedial effect.
- The more similar a remedy, higher the potency, lesser the dose.
§ 278 Sixth Edition
Here the question arises, what is this most suitable degree of minuteness for sure and gentle remedial effect; how small, in other words, must be the dose of each individual medicine, homoeopathically selected for a case of disease, to effect the best cure? To solve this problem, and to determine for every particular medicine, what dose of it will suffice for homoeopathic therapeutic purposes and yet be so minute that the gentlest and most rapid cure may be thereby obtained - to solve this problem is, as may easily be conceived, not the work off theoretical speculation; not by fine-spun reasoning, not by specious sophistry can we expect to obtain the solution of this problem. It is just as impossible as to tabulate in advance all imaginable cases. Pure experiment, careful observation of the sensitiveness of each patient, and accurate experience can alone determine this; and it were absurd to adduce the large doses of unsuitable (allopathic) medicines of the old system, which do not touch the diseased side of the organism homoeopathically, but only attack the parts unaffected by the disease, in opposition to what pure experience pronounces respecting the smallness of the doses required for homoeopathic cures.
§ 280 Sixth Edition
The dose of the medicine that continues serviceable without producing new troublesome symptoms is to be continued while gradually ascending, so long as the patient with general improvement, begins to feel in a mild degree the return of one or several old original complaints. This indicates an approaching cure through a gradual ascending of the moderate doses modified each time by succussion (§ 247). It indicates that the vital principal no longer needs to be affected by the similar medicinal disease in order to lose the sensation of the natural disease (§ 148). It indicates that the life principle now free from the natural disease begins to suffer only something of the medicinal disease hitherto known as homoeopathic aggravation.
- A suitably selected medicine should be given in increasing dose (succussion) till their is continued amelioration.
- If the original symptoms appear to aggravate after a long period of amelioration, then the medicine should be discontinued as this is a sign of cure.
§ 281 Sixth Edition
In order to be convinced of this, the patient is left without any medicine for eight, ten of fifteen days, meanwhile giving him only some powders of sugar of milk. If the few last complaints are due to the medicine simulating the former original disease symptoms, then these complaints will disappear in a few days or hours. If during these days without medicine, while continuing good hygienic regulations nothing more of the original disease is seen, he is probably cured. But if in the later days traces of the former morbid symptoms should show themselves, they are remnants of the original disease not wholly extinguished, which must be treated with renewed higher potencies of the remedy as directed before. If a cure is to follow, the first small doses must likewise be again gradually raised higher, but less and more slowly in patients where considerable irritability is evident than in those of less susceptibility, where the advance to higher dosage may be more rapid. There are patients whose impressionability compared to that of the insusceptible ones is like the ratio as 1000 to 1.
1 The rule to commence the homoeopathic treatment of chronic diseases with the smallest possible doses and only gradually to augment them is subject to a notable exception in the treatment of the three great miasms while they still effloresce on the skin, i.e., recently erupted itch, the untouched chancre (on the sexual organs, labia, mouth or lips, and so forth), and the figwarts. These not only tolerate, but indeed require, from the very beginning large doses of their specific remedies of ever higher and higher degrees of dynamization daily (possibly also several times daily). If this course be pursued, there is no danger to be feared as is the case in the treatment of diseases hidden within, that the excessive dose while it extinguishes the disease, initiates and by continued usage possible produces a chronic medicinal disease. During external manifestations of these three miasms this is not the case; for from the daily progress of their treatment it can be observed and judged to what degree the large dose withdraws the sensation of the disease from the vital principle day by day; for none of these three can be cured without giving the physician the conviction through their disappearance that there is no longer any further need of these medicines.
Since diseases in general are but dynamic attacks upon the life principle and nothing material - no materia peccans - as their basis (as the old school in its delusion has fabulated for a thousand years and treated the sick accordingly to their ruin) there is also in these cases nothing material to take away, nothing to smear away, to burn or tie or cut away, without making the patient endlessly sicker and more incurable (Chron. Dis. Part 1), than he was before local treatment of these three miasms was instituted. The dynamic, inimical principle exerting its influence upon the vital energy is the essence of these external signs of the inner malignant miasms that can be extinguished solely by the action of a homoeopathic medicine upon the vital principle which affects it in a similar but stronger manner and thus extracts the sensation of internal and external spirit-like (conceptual) disease enemy in such a way that it no longer exists for the life principle (for the organism) and thus releases the patient of his illness and he is cured.
Experience, however, teaches that the itch, plus its external manifestations, as well as the chancre, together with the inner venereal miasm, can and must be cured only by means of specific medicines taken internally. But the figwarts, if they have existed for some time without treatment, have need for their perfect cure, the external application of their specific medicines as well as their internal use at the same time.
- To confirm that the patient is cured, keep the patient on placebo for a few weeks.
- If all the symptoms disappear, the case is cured.
- If some symptoms continue to linger, raise the potency.
- The general rule for treatment of chronic disease is - Start the treatment with low (lowest?) potency and then gradually ascend to higher potencies using the medicinal solution.
- But if an infectious chronic disease - say scabies, syphilis or gonorrhea - is present in its active form, then it may be necessary to begin the treatment with higher potencies and the medicine may be repeated daily. What this means is that if one is suffering from any deep, chronic disease - infectious in nature - in its acute, active state - then the medicine may be repeated daily in high potencies. This will not apply if the patient has a history of any such disease or if the disease has been treated/suppressed allopathically.
- Warts may require external application of the suitable medicine along with the internal administration.
§ 284 Sixth Edition
Besides the tongue, mouth and stomach, which are most commonly affected by the administration of medicine, the nose and respiratory organs are receptive of the action of medicines in fluid form by means of olfaction and inhalation through the mouth. But the whole remaining skin of the body clothed with epidermis, is adapted to the action of medicinal solutions, especially if the inunction is connected with simultaneous internal administration.1
1 The power of medicines acting upon the infant through the milk of the mother or wet nurse is wonderfully helpful. Every disease in a child yields to the rightly chosen homoeopathic medicines given in moderate doses to the nursing mother and so administered, is more easily and certainly utilized by these new world-citizens than is possible in later years. Since most infants usually have imparted to them psora through the milk of the nurse, if they do not already possess it through heredity from the mother, they may be at the same time protected antipsorically by means of the milk of the nurse rendered medicinally in this manner. But the case of mothers in their (first) pregnancy by means of a mild antipsoric treatment, especially with sulphur dynamizations prepared according to the directions in this edition (§ 270), is indispensable in order to destroy the psora - that producer of most chronic diseases - which is given them hereditarily; destroy it both within themselves and in the foetus, thereby protecting posterity in advance. This is true of pregnant women thus treated; they have given birth to children usually more healthy and stronger, to the astonishment of everybody. A new confirmation of the great truth of the psora theory discovered by me.
- Medicine can be given through mouth, tongue, nose, or intact skin.
- Medicines can be applied on intact skin and given internally at the same time.
- For an infant, medicines can be given to the mother if the baby is breast-feeding.
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