Choosing the Potency.- Now is there any teaching which will help us to choose the best potency for a given case? There is little teaching but many opinions. Practitioners who publicly boast of their liberality on this subject will too often be found on more intimate acquaintance, to practice and obstinate exclusivism in the use of some particular potency, generally a very low or a very high one; and to harshly criticize those who differ with them. This is unfortunate because such practitioners undoubtedly deprive themselves and their patients of many agents of cure which are easily within their reach.
The series of potencies has been compared to the gamut in music, “A skilful artist may indeed construct a harmony with the various vibrations of the same chord; but what a more beautiful and perfect harmony might he construct a by proper combination of all the sounds that can be elicited from his instruments.” (Guernsey.)
In general it may be stated that any curable diseases may be cured by any potency, when the indicated remedy is administered: but hat the cure may be much accelerated by selecting the potency or dose appropriate to the individual case.
Five considerations influence us in the choice of the dose:
1. The susceptibility of the patient.
2. The seat of the disease.
3. The nature and intensity of the disease.
4. The stage and duration of the disease.
5. The previous treatment of the disease.
Susceptibility of the Patient.- This is generally and rightly regarded as the most important guide in the selection of the dose. It is important to have some means of gauging, at least approximately, the susceptibility of a patient.
Susceptibility to medicinal action is only a part or phrase of the general susceptibility of the organism to all stimuli. By analogy, as well as by experience, we are led to a consideration of the main factors which modify and express susceptibility in general.
Susceptibility varies in different individuals according to age, temperament, constitution, habits, character of diseases and environment.
The susceptibility of an individual to a remedy at different times also varies. Idiosyncrasy may exist as a modifying factor. Homoeopathicity must always be considered.
*The more similar the remedy, the more clearly and positively the symptoms of the patient take on the peculiar and characteristic form of the remedy, the greater the susceptibility to that remedy and the higher the potency required.
The “indefatigable Jahr” has very lucidly and beautifully illustrated this point. He remarks an essential difference between the action of the low and high potencies, which consists, not in their strength or weakness, but in the *development of the peculiarities of the remedy, as we rise in the scale of potencies. This is based on the well known fact that provings of the tincture and lowest potencies of a drug as a rule produce only the more common and general symptoms of the drug, not very sharply differentiated from other drugs of its class. It is in the provings of the medium and higher potencies that the special and peculiar character of the drug is revealed by its finer and most characteristic symptoms. Jahr illustrates this by a geometrical figure, consisting of a number of concentric circles, with radii drawn to represent remedies in different stages of potentiation.
In the first to the third potency, as shown in the innermost circle where the radii lie close together, similar or related remedies like Arsenicum, Rhus., Bryonia, and Sulph., have a great many symptoms in common; but the higher they progress in the scale of potentiation the more radii recede from each other, so that each appears more and more distinctly in its peculiar and characteristic features.
All narcotics, like Belladonna, Stramonium, or Opium., for example in crude and massive doses act in a manner equally stupefying, causing death by apoplexy or paralysis; all drastics produce vomiting and purging, etc. It is only in small or potentiated doses that their most characteristic differences of action become apparent.
“By continual diluting and succussing,” says Jahr, “remedies get neither stronger nor weaker, but their individual peculiarities become more and more developed;” in other words, *their sphere of action is enlarged as represented by the concentric circles.
The practical bearing of this on the selecting of the potency or dose, according to Jahr, is as follows:- In a given case, where the symptoms are not clearly developed and there is and absence or scarcity of characteristics features; or where two or three remedies seem about equally indicated, susceptibility and reaction may be regarded as low. (third to twelfth) potency. But when the symptoms of a case clearly indicate one remedy, whose characteristic symptoms correspond closely to the characteristic symptoms of the case, we give the high potencies- thirtieth two hundredth, thousandth, or higher, according to the prescriber’s degree of confidence and the contents of his medicine case.
We may slightly modify Jahr’s advice by suggesting; the clearer and more positively *the finer, more peculiar and more characteristic symptoms of the remedy appear in a case, the higher the degree of susceptibility and the higher th potency.
This rule covers more points of the requirements to be stated later than appears at first glance. The class of cases (to be described later ) which require low potencies for their cure, do not as a rule present the finest and most characteristic shadings of symptoms which characterize the cases requiring high potencies; so that we may pretty safely judge the degree of susceptibility of the patient by the character and completeness of the symptoms.
Allowance should be made, however, for the varying ability of examiners. One man, keen of perception, accurate, painstaking. Conscientious and well trained, will see many things in a case which another not so endowed will fail to see.
Susceptibility is Modified by Age.- Generally speaking, susceptibility is greatest in children and young, vigorous persons, and diminishes with age. Children are particularly sensitive during development, and the most sensitive organs are those which are being developed. Therefore the medicines which have a peculiar affinity for those organs should be given in the medium or higher potencies.
Susceptibility is Modified by Constitution and Temperament.- The higher potencies are best adapted to sensitive person of the nervous, sanguine or choleric temperament; to intelligent, intellectual persons, quick to act and react; to zealous and impulsive persons.
Lower potencies and larger and more frequent doses correspond better to torpid and phlegmatic individuals, dull of comprehension and slow to act; to coarse fibered, sluggish individuals of gross habits; to those who possess great muscular power but who require a powerful stimulus to excite them. Such persons can take with seeming impunity large amounts of stimulants like whiskey, and show little effect from it. When ill they often require low potencies or even, sometimes, material doses.
Susceptibility is Modified by Habit and Environment.- It is increased by intellectual occupation by excitement of the imagination and emotions, by sedentary occupations, by long sleep, by and effeminate life. Such person require high potencies.
Susceptibility is Modified by Pathological Conditions.- In certain terminal conditions the power of the organism to react even to the indicated homoeopathic remedy, may become so low that only material doses can arouse it. A common example of this is seen in certain terminal conditions of valvular heart disease, where Digitalis is the indicated remedy, but no effect is produced by any potency. The patient will respond, however, to tangible doses of the pure tincture or a fresh infusion of Digitalis and sometimes make a good recovery from a condition that seems hopeless. Although such doses, judged only be their amount, might be regarded as “physiological” or pathogenetic doses, the nature of the reaction in such cases is clearly not pathogenetic but dynamic and curative, as many have witnessed. The form of the reaction compiles perfectly with the requirements of cure as to order and direction of the disappearance of the symptoms and nature of the result.
Quantity alone does not constitute a pathogenetic dose. Quality, proportionality and the susceptibility of the patient are also factors. What would be a large, injurious or perhaps dangerous dose for a highly susceptible patient, would have no effect whatever upon one whose power to react was very low by reason of the existence of gross pathological lesions, or of long existent, exhausting chronic disease and much previous treatment. *It is solely a question of approximating the quality and quantity of the dose to the grade or plane of the disease, according to the law of similars.
If the grade of the disease is low, and the power of the reaction low, the remedy must be given low. Thus we find, in such cases that the symptoms of the patient are usually of a low order; common, pathological symptoms; organon symptoms; gross terminal symptoms; symptoms; symptoms that correspond to the effects of crude drugs in massive toxic doses. The finer shadings of symptoms belonging to acute conditions, vigorous sensitive patients, do not appear. Potentiated medicines will not act. The case has passed beyond that stage, and the finer symptoms with it. Yet the symptoms remain and the almost hopeless conditions they represent, are still within the scope of the homoeopathic law; and they sometimes yield to its power, when the related law of posology is rightly understood and applied.
Dr. Close was born November 24, 1860 and came to study homeopathy after the death of his father in 1879. His mother remarried a homoeopathic physician who turned Close's interests from law to medicine.
His stepfather helped him study the Organon and he attended medical school in California for two years. Finishing his studies at New York Homeopathic College he graduated in 1885. Completing his homeopathic education. Close preceptored with B. Fincke and P. P. Wells.
Setting up practice in Brooklyn, Dr. Close went on to found the Brooklyn Homoeopathic Union in 1897. This group devoted itself to the study of pure Hahnemannian homeopathy.
In 1905 Dr. Close was elected president of the International Hahnemannian Association. He was also the editor of the Department of Homeopathic Philosophy for the Homeopathic Recorder. Dr. Close taught homeopathic philosophy at New York Homeopathic Medical College from 1909-1913.
Dr. Close's lectures at New York Homeopathic were first published in the Homeopathic Recorder and later formed the basis for his masterpiece on homeopathic philosophy, The Genius of Homeopathy.
Dr. Close passed away on June 26, 1929 after a full and productive career in homeopathy.