UNDERSTANDING CLINICAL ASPECTS OF FIFTY MILLESIMAL

SCALE OF POTENCIES IN HOMOEOPATHIC PRACTISE

PRESENTATION BY: DR. BIPIN JETHANI

Assistant Professor/ Reader,Department of Organon of Medicine

Nehru Homoeopathic Medical College & Hospital,

New Delhi.

E-mail: drbipin.jethani@gmail.com

FIFTY MILLESIMAL SCALE OF POTENCIES:

HAHNEMANN’S FINAL REFORMATION IN POSOLOGY

  

‘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. …..

Footnote to §246 of sixth edition 

  

‘…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).Footnote to §246 of sixth edition 

EVOLUTION OF FIFTY MILLESIMAL SCALE OF POTENCIES

WITH ANY PROBLEM THESE QUESTION NEED TO BE ANSWERED

TRANSFORMATION FROM CENTISIMALS

TO FIFTY MILLESIMALS

In light of his experience, Hahnemann suggested two modifications in the mode of administration of centesimal scale of potencies :

• ADMINISTRATION of similimum IN LIQUID FORM

• CHANGING DEGREE OF DYNAMISATION WITH EACH DOSE ADMINISTERED TO THE PATIENT

need to administer medicine in liquid form

‘Such a globule, 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 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.’

§ 272 (Sixth Edition)

need to change degree of dynamisation with each dose

‘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………...

§ 247 (Sixth Edition) 

§ 247 (Sixth Edition) of organon of medicine

……….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 homœopathic 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.

Change affected in centisemal scale of

potencies

Hahnemann consequently incorporated these two principles of posology (administration of similimum in liquid form and changing degree of dynamisation with each dose) in the centesimal scale of potencies.

ADMINISTRATION IN LIQUID FORM

“Experience has shown me that it is most useful in disease of any magnitude to give to the patients the powerful homoeopathic pellet or pellets only in solution and this solution in divided doses……….

Preface to the 3rd volume of ‘The Chronic Diseases - Their Peculiar Nature and Their Homoeopathic Cure’

Preface to the 3rd volume of ‘The Chronic Diseases - Their Peculiar Nature and Their

Homoeopathic Cure’

………In this way, we give the medicine, dissolved in seven to twenty tablespoonfuls of water in acute and  very  acute  diseases  every  six,  four  or  two hours;  where  the  danger  is  urgent,  even  every hour  or  every  half-hour,  a  tablespoonful  at  a time; with weak persons or children, only a small part of a  tablespoonful may be given as a dose. In chronic diseases I have found it best to give a dose  of  a  solution  of  the  suitable  medicine  at least every two days, more usually every day”.

CHANGING DEGREE OF DYNAMISATION WITH EACH DOSE

‘Our  vital  principle  cannot  well  bear  that  the  same unchanged  dose  of  medicine  be  given  even  twice  in succession,  much  less  more  frequently  to  a  patient…….. But  in  taking  one  and  the  same  medicine  repeatedly;  if the dose is in every case varied and modified only a little in  its degree of dynamisation,  then  the vital  force of  the patient  will  calmly,  and  as  it  were,  willingly  receive  the same medicine even at brief intervals very many times in succession with the best results….

Preface to the 3rd volume of ‘The Chronic Diseases - Their Peculiar Nature and Their Homoeopathic Cure

Preface to the 3rd volume of ‘The Chronic Diseases - Their Peculiar Nature and Their

Homoeopathic Cure’

…….This  slight  change  in  the degree of dynamisation is effected; if the bottle which contains the solution of one or more  pellets  is  merely  well  shaken five  or  six  times,  every  time  before taking it”.

HAHNEMANN OBSERVED FURIOUS AGGRAVATION IN SENSITIVE PATIENTS.

‘But  with  so  small  a  diluting  medium  as  100  to  1  of  the medicine,  if  many  succussions  by  means  of  a  powerful machine are forced into it, medicines are then developed which, especially  in  the higher degrees of dynamization, act almost immediately, but with furious, even dangerous violence, especially  in weakly patients, without having a lasting, mild reaction of the vital principle.’ 

Footnote to § 270 (sixth edition)

SOLUTION TO THE PROBLEM:INCREASING THE RATION OF

DILUTION

‘With this disproportionate higher ratio between medicine and diluting medium many successive strokes of the vial filled two-thirds with alcohol can  produce  a  much  greater  development  of power…..…The  method  described  by  me,  on the  contrary,  produces medicines of highest development of power and mildest action, which,  however,  if  well  chosen,  touches  all suffering parts curatively.’

Birth of fifty millesimal scale of potencies

• Increased diluent ratio.

• Administration in liquid form.

• Changing degree of dynamisation with each dose.

MODE OF ADMINISTRATIONMade 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…….

§ 248 FOOTNOTE – 6TH EDITION OF ORGANON OF MEDICINE

MODIFICATION OF DOSE IN LM POTENCIES

…………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.

§ 248 FOOTNOTE – 6TH EDITION OF ORGANON OF

MEDICINE

HAHNEMANN REVEALED HIS NEW DISCOVERY TO BARON VON

BOENNINGHAUSEN.

Hahnemann shared the methods of the LM potency with him

before he passed away. Thus other than Melanie Hahnemann,

Boenninghausen seems to be the only person who was privy

to this information.

HAHNEMANN’S CORRESPONDENCE

WITH BOENNINGHAUSEN

Hahnemann  sent  Baron  von  Boenninghausen two LM case histories  in 1843,  shortly before he  left  for  his  Heavenly  Abode.   The  Baron shared  these  cases with his  colleagues  in  the Stapf's Archives, Volume  1  number  1 published in 1844, page 69. 

BOENNINGHAUSEN’S SILENCE ON 6TH EDITION OF ORGANON

After  Samuel's  death  Melanie  Hahnemann  told the  Baron  von  Boenninghausen  that  the  6th Organon would  soon  be  published. When  he announced  this  event  to  his  colleagues, Melanie  asked  him  to  remain  quiet  on  the subject until after she published the work. Out of respect for Hahnemann's widow the Baron did  not  disclose  all  the  information  in  his possession. 

"In the new edition of the Organon which will probably appear yet in the course of this year, improved and completed by Hahnemann himself, a new simplified procedure for the potentizing of medicines will be taught, which has considerable advantages over the former and yields a preparation as to the efficacy 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 anyone."

The Lesser Writings; C. M. F. Boenninghausen, Aluminium Metallicum, footnote, page 74.

BOENNINGHAUSEN’S KNOWLEDGE OF LM SCALE OF POTENCIES

ADVANTAGES OF LM POTENCIES

LM  potencies  give  freedom  from  the  bondage  of medicinal aggravation on account of their mild action and enable the physician to achieve gentle cure. It is for  this  reason  that  these  potencies  are  of  greatest utility  for  highly  sensitive  individuals  and  are excellent  in  palliating  incurable  diseases  (where there  is  extensive  pathological  damage)  with  least danger of aggravation.

HIPPOCRATIC NOTION OF ‘PRIMUM NON NOCERE’ 

ADVANTAGES OF LM POTENCIES

• The  administration  of  medicine  (in  Fifty Millesimal  scale)  in  frequently  repeated modified  doses  hastens  the  process  of  cure and paves the way for rapid return to state of health.

• However;  in  case  of  centesimal  scale;  the physician  and  the  patient  remain  arrested  in the hands of medicine for a long time and this unneccessarily  prolongs  the  suffering  of  sick individuals

• The selection of potency is much less ambiguous since LM’s are always started with the lowest degree of dynamisation (ie LM/1).

• The more frequent repitition of the dose in LM potencies minimizes the danger of accidental antidoting of the remedy.

• Moreover; in case the remedy action needs to be antidoted (due to incorrectly chosen medicine); this can be achieved much more easily since the involved doses are much smaller. (Aph. 283).

• In case of administration of LM potency; the patients are taught to observe their own symptoms and adjust their own dosage. Consequently; active involvement of patient is possible which allows for better patient management and compliance.