Small dose and potencies

Importance of Small dose and potencies in Homeopathic prescription and science behind it along with views of various stalwarts have been written by Gibson Miller in Elements of Medicine….

HOMOEOPATHY is founded on the observation that like cures like, that a drug which can cause symptoms in certain dosage can also cure sick states characterised by similar symptoms. This curative effect is usually brought about by quite small or, even, by infinitesimal doses.

Material doses may sometimes be used by the homoeopath; on the other hand, doses measured in microgrammes are often nowadays prescribed by non-homoeopaths.

Homoeopathicity is not a matter of size of dose but of similarity between the known symptoms of a drug-induced deviation from health and the observed symptoms of a sick person.

It had been known from ancient times that large doses of a poison might be countered by the previous ingestion of small quantities of the same substance. Hahnemann wisely reasoned that if large or continued doses of a drug could cause disease symptoms, the best way to stimulate the body to counter a similar state of sickness would be to employ quite small doses of the same drug.

It is now known in connection with experimental physiology, both as regards plants and animals, that “very small doses may evoke reactions which are the very opposite of those following large doses”.

It is, therefore, of great interest to note such sayings of Hahnemann as the following :

“The reasonable physician will choose only the most suitable dose of the indicated remedy, so that hardly a sign of aggravation of the disease will be aroused”. (Symptoms are evidence of the body’s reaction to the disease-producing agency; aggravation of the symptoms may result from over-stimulation or from inefficient eliminatory function).

“That is to say, he will choose a dose which as a counter-force only just exceeds the disease-force against which it is directed”.

“The counter-force chosen as exactly as possible for the removal of a natural disease force” (able to assist the body in its effort to cure) “should be so calculated that it will only just attain its object and will do the body no harm in any way through unnecessary strength”. (Hence the dual advantage of the small dose; first, no over-stimulation and, second, no toxic side- effects).

When Dr. Samuel Hahnemann started to put into practice the idea that likes could be cured by likes he used material doses, but the results were not satisfactory and he devised the plan of using quite small doses prepared by diluting the solid drug or fluid tincture progressively by tenths or by hundredths.

In the case of solids such as ambergris (AMBRA GRISEA), charcoal (CARBO VEGETABILIS), quartz (SILICEA) this was done by adding nine parts of lactose to one part of drug substance and then triturating with pestle and mortar very thoroughly for about an hour. This gave the 1x (decimal) potency; or the 1c (centesimal), if 99 parts of diluent were used. Potencies in the centesimal scale are in practice written without the letter “c”, this being understood.

One part of the resulting mixture was then diluted with a further 9, or 99, parts and the procedure repeated. It was found that after three triturations the resulting product became soluble. Further dilutions could then be carried out as with fluid tinctures in successive phials.

The thorough trituration did more than just dilute the drug substance, it resulted in subdivision. This was also achieved in the successive fluid dilutions by succession, that is by giving the phial containing the fluid a series of sharp bumps. In this way and working by hand these dilutions, or subdivisions, were carried up to the 30th centesimal degree, namely 1 x 10 60.

These amazingly small doses were more effective than the material doses.

It had become not a matter of size of quantity of dose but of quality and strength. By the process of dilution and subdivision the crude substance had apparently been, as it were, dematerialised and a power to stimulate the body’s curative resources had been generated or released.

Whatever the explanation, these excessively small doses were found to be therapeutically active. Hahnemann, therefore, quite appropriately called them “potencies”. The lower dilutions whether in the decimal or the centesimal scale are known as “low potencies”. Those of 30 and higher are spoken of as “high potencies”.

The pills, tablets or powders used are medicated by being moistened with a few drops of fluid potency, and retain their effectiveness indefinitely provided they are kept properly stoppered, and protected from contamination by exposure to strong odours such as camphor or moth balls and the like.

Small sugar granules medicated in this way can be conveniently added to unmedicated powders, to be taken dry on the tongue. Pills or tablets should be allowed to dissolve in he mouth, which should be free from other contaminants such as tobacco smoke, peppermint or toothpaste.

For some purposes low potencies, e.g., 1x, 2x, 3x, 6x, 12x, are thought most suitable. Centesimal potencies in frequent use are 6, 12, 30, 200, 1m, 10m. Higher potencies also are often employed, but special skill and care are needed in their use.

In extremely weak or in highly sensitive subjects the higher potencies may be contra-indicated as being liable to cause an adversely violent reaction. But usually the action of the homoeopathic potencies is gentle and persuasive, stimulating and enhancing natural physiological responses and doing so with an absence or almost negligible degree of risk.

It became popular to confuse homoeopathy with “giving medicines in small doses, so small that they could not possibly have any effect”. This is entirely a misconception, the small dose having nothing to do with the principle of like curing like. It was simply that in practice this method of cure was found to be more effective with the small dose than with material doses.

This misconception has persisted to the present day. To quote from The Doctor’s Dilemmas by Louis Lasagna M.D., 1962 : “Today, the word homoeopathic is generally used in medicine to connote the use of doses so minute as to be devoid of effect”.

Minute the doses may be but not without effect. Indeed sometimes the aggravation which follows the administration of, say, a dose of SULPHUR 200 or LYCOPODIUM 200 could be such as to convince even the most sceptical. Not that such an aggravation would have any deleterious effect or prove of lasting duration.

It is now well known that exceedingly small amounts of drugs or other substances such as trace elements in plants, enzymes, allergens, elementary atomic particles, are capable of producing far-reaching effects.

The small dose which acts with such well-proven therapeutic effect should no longer be ignored but its merits should be recognised and widely employed.

An interesting example of the efficacy of the infinitesimally small is afforded by an experiment with pheromones, the sexual attractants of insects. “On a fine summer evening a reared female moth is placed in a wire cage, through which air can pass, in a garden or on a balcony”.

“Reared males are marked and released at various points at distances of up to two miles. It will often be found that the males are swarming round the cage before the observer gets home”. At a distance of two miles the concentration of pheromone in the air must be infinitesimal.

Dr. Sidney Cohen in Drugs of Hallucination writes : “One of the astonishing properties of LSD is its intense and lasting action in infinitesimal amounts…. Two pounds equitably distributed would mentally dissociate every man, woman and child in Greater New York for an eight-hour period”.

In such a contingency the actual concentration of the drug in the New York atmosphere would obviously be exceedingly dilute, but still effective.

Further examples could be cited from many aspects of present-day scientific research, but such knowledge was not available to Samuel Hahnemann. The more remarkable, therefore, that he was able to express his conviction of the value of the small or potentiated dose in such words as the following :

Organon, paragraph 2rr : “Experience has shown that the very smallest doses of drugs chosen for their homoeopathicity to disease are a match each for the corresponding disorder. For if the disease does not manifestly arise from a serious morbid change in some important organ hardly any dose of the homoeopathically selected remedy can be so small as not to be stronger than the natural disease.”

Hahnemann, of course, recognised the possibility of the presence of advanced irreversible pathological tissue damage.

“The ordinary observer has no conception how extraordinarily sensitive the body becomes to drugs when it is diseased, and especially to drugs chosen homoeopathically.”

This is a further reason for employing the small dose. It is a guiding rule in homoeopathic prescribing to stop the medicine when there is definite improvement and not to repeat as long as improvement is maintained.

Over-dosing with too large or too many doses might defeat the aim of aiding the resources of the body by over-stimulation. In other words the objective should be to obtain the maximum of benefit with the minimum of medication.

Robert Gibson-Miller
He was born in 1862, and was educated at Blair Lodge and the University of Glasgow, where he graduated in medicine in 1884. Early in his career he was attracted to the study of Homoeopathy, and with the object of testing the claims made for this system of medicine he undertook a visit to America. As a result of his investigations there Dr. Miller was convinced of the soundness of the homoeopathic theory. Dr. Miller did not write much, but we owe him also his Synopsis of Homoeopathic Philosophy and his small book, always at hand for reference, on Relation ship of Remedies.