Frequent Repetition of High Potencies
NATIONAL JOURNAL OF HOMOEOPATHY 2000 Nov / Dec VOL II NO 6.
Compiled by:
T K Kasiviswanathan
'Calc-fl / Apis / Rhus-t / Anat-tart / Merc-cor / Cic / Aur-met / Op

Normally homoeopaths are careful in using high potencies ie 1M and above. They are repeated in a case only after a sufficient lapse of time and when the previous dose had accomplished all it can. There are/were however some Homoeopaths like Bellokossy, Dr Borland and Dr M B Desai who repeated high potencies in cases with good results. Dr Desai writes as under:

"We have been taught that the single dose infrequently repeated is the ideal. We have also been warned that high potencies can be very dangerous. But by using high potencies and repeating them more frequently, I have noticed that I am able to get better results without meeting any bad effects. I have experienced this to such an extent that I have now made it a practice to use high potencies in frequent repetition. This theory can be well understood only if the disease process, the meaning of cure and the mode of action of the medicine are fully comprehended."

He adds that the hereditary and acquired conditions of a disease are kept dormant in the background in the system, constantly straining against the natural resistance, to become manifest at any available opportunity. The prescription should not be content with relieving the apparent symptoms but to reach the background and eradicate the disease fully. It can be done by giving constant aid to the resistance with medical impetus.

So long as there is sufficient scope to affect the dormant disease condition, the impetus given by repetition in any amount, he says, will be absorbed by the vital force as required, so as to assist in the elimination of the background; there is therefore no chance of medicinal aggravation. He cites the views of Dr Borland of UK that high potencies can be repeated in acute conditions, CM every two hours. (Dr Borland's views are reproduced later in this article). As high potencies have a deeper action than low ones, they create a condition whereby the disease force is made to lose its influence and to retreat.

"The remedy linked potency in frequent repetition is essential to root out suppression, to avoid the development of Sequelae, to keep open the channel of elimination, to do away with overlapping of disease conditions, to avoid the creation of tendencies, to do away with complexes, to effect constitutional changes, to organize tissue building, to stop wasting and rejuvenate the system. This theory has helped me to deal with scores of obstinate cases of tuberculosis, paralysis, nephritis, epilepsy, insanity, diabetes and other dangerous diseases with ease and surety. If this theory is introduced into the practice of Homoeopathy with courage and proper guidance, it can positively enhance the progress of our science. This method does not allow any patchwork in the system; one by one the complexes and unhealthy impressions in the system are eliminated and the ultimate aim of overhauling of the system is achieved."

"I am aware that many orthodox homoeopaths will raise their eyebrows at this method of practice. It is true that in the later part of his life, Hahnemann was repeating remedies more frequently and advising such repetition. In the Sixth Edition of Organon, he wrote that in chronic diseases the remedy might be repeated every day till the patient is cured. I therefore suggest that my experiences should be viewed in the light of this background."
(Extracted from an article of Dr Desai published in Principles of Prescribing by Dr K N Mathur)

Unfortunately Dr Desai does not appear to have left behind any published record of his cures of various chronic conditions with frequent repetition of high potencies, though case records might still be available. However, Dr Desai dealt with treatment of different coma cases with Homoeopathy in a lecture, which was subsequently published as a booklet. In that lecture he said that "Different individuals showing the same pathological conditions will have different well-marked peculiarities manifested under different sets of backgrounds.

Secondly, however simple, complicated or grave the condition may be, we have to sort out the exact disease phenomenon from the cluster of symptoms assembled together from three different items, viz: 1) the symptoms produced under general resistance called corroborating symptoms. 2) The possible symptoms of elimination, and 3) the symptoms of actual disease process. Knowledge of these conditions will create an understanding of the exact disease condition and will thereby simplify the prescription.

After having properly understood the disease condition, which has developed on a particular background, it will be quite clear that our patient has to pass through a series of conditions or stages while eradicating the disease condition by way of elimination. This puts an end to the miracle one dose shot, which simply effects a palliation or a deviation of the condition to something else or a temporary surface management of the ailment. The proper understanding of the disease condition can enable us to predict the series of situations that may intervene during the cure".

Dr Desai in that booklet had illustrated his approach with several cases of coma treated with the use of frequent repetition of high potencies of the remedy. He has in that process given some clinical tips which are reproduced below before some of his illustrative cases are presented.

Dr Desai gave importance to the miasmatic background as one of the causative backgrounds for the disease and recommends specific remedies for eradicating that layer.

Syphilitic Background:
History of abortions in mother, a history of insanity in the family, personal history of dysentery, stomatitis, tonsillitis, ottorrhoea and mumps indicate this background and can be covered by Syphilinum, Aurum-met, Merc-sol and Zinc-met.

Dr Desai advocates that for the condition of coma under syphilitic background a few doses of Syphilinum very high ie CM at intervals of half an hour will show beneficial effect within a few hours. It should not be used where there are heart or lungs are involved with organic complications. It should be followed up till there is continuous improvement and thereafter by prescribing the indicated remedy.

Similarly Aurum-met and Merc-sol should be given when indicated in high potency at ½ hour intervals till reactions are manifest.

Sycotic Background: It is indicated by a history of rheumatism or gout, warts, neuralgias, vaccination, small pox, sinusitis, etc. In his experience Thuja is the only medicine to clear away this background in a case of coma and it can run well till complete recovery.

A few cases of his including coma cases where he adopted this practice are given below for information and understanding his approach.

Case 1: Of Osteomyelitis
A well-known surgeon advised immediate amputation of the affected leg of a girl, aged 7. The girl was chilly, had bad teeth, history of attack of small pox two months back. The osteomyelitis had affected the long bone. She could not take cold drinks and was better with warm/ hot drinks. She was brought to Dr MB Desai for treatment. It was a question of life and death. In all seriousness Dr Desai prescribed Calc-flour CM daily two doses. The inflammation, fever and the pain subsided gradually. The repairs to the bone were noticed through X-rays taken periodically and within three months of such a treatment total rejuvenation of the decayed bone was evident.

Case 2: Coma Case
A girl aged 8, used to get high temperature and became totally unconscious on the third day. The eyes were red. There were sudden cries and she used to toss her head involuntarily. The skin on the forehead became red with a raised band about two inches broad.

Dr Desai prescribed Apis 1M 8 doses per day and for two days there was no change. Taking the mother's history he noted that she had four abortions and that she also had paralysis of left leg with dementia and the girl patient was therefore given Merc-sol CM four doses daily. Within two days she got free urination and the restlessness became less. Apis-mel 1M 8 doses were then given daily. Restlessness disappeared on the next day and the red band on the forehead moved down and disappeared after 13 days. There was no temperature on the fifth day. She recovered.

Dr Desai observes "It is the toxemia of the brain which begins with delirium, passes into stupor with convulsions and affects the senses one by one and ends in coma. So only the total elimination of the toxins can assure the complete cure by bringing all the senses back to normal condition one by one in the reverse order of the affection. This condition, when not properly treated by steady repetition, leaves behind its sequele in proportion to the toxicity left over.

Case 3
A boy had acute cold with fever. Rhus-tox 1M four doses did not give relief. The next day the boy began to cough severely with pain in the chest. The tongue was coated white and he had little thirst. Antim-tart 1M every four hours did not help. There was extreme prostration and the patient became unconscious on the fifth day. He began to pass dysenteric stools involuntarily and in small quantities frequently. On this last symptom, Dr Desai prescribed Merc-cor 1M every two hours. The quantity of stools increased with free passage of flatus.

By 10th day the passing of such stools was checked but as the other conditions persisted, the prescription was again changed to Antim-tart 1M. This time the temperature came down to normal within 24 hours and there was considerable relief of pain in the chest. The mental condition came to normal within four days. It was observed that the boy had mumps six months earlier and it was treated with external application. The simple cold developed into pneumonia and subsequently to coma by the dominant background of mumps. Dr Deasi says that he has used Mercury for pneumonia several times with success on the strength of such background and mercurial tongue and history of dysentery or stomatitis.

Case 4: A Case of Severe Convulsions
A 12-year-old boy had high fever after severe vomiting in the school. Within next 3 hours he became unconscious with convulsions of a very severe type. The condition of opisthotonus with lock-jaw persisted and convulsions were continuous. It was a difficult task to feed the boy in such a situation. He was prescribed Cicuta 1M every hour. There was apparently no improvement for 3 days. He passed urine at intervals with severe convulsions; no stools. The medicine was continued for four more days without any relief. Dr Desai noticed on a visit to the patient that boy's grandmother was rubbing her gold ring with milk on a stone to give a gold concoction as tonic to the sick boy.

On that observation, he gave Aurum-met 1M every hour and the boy began to respond to his surroundings on the next day though his convulsions and fever remained the same. The medicine was continued for four more days and on the fourth day the comatose condition cleared without relief in fever and convulsions. Thereupon Dr Desai again prescribed Cicuta 1M and this time it worked favourably within 12 hours. He passed flatus frequently and later he passed a profuse stool containing two worms; there were no convulsions next day and fever also subsided. Here worms were the exciting factor that led the condition of fever to develop into coma on a serious background of Aurum.

Case 5: Cerebral Tumour
A boy aged 11 developed severe headache and his eyesight became weak. He went into coma very often and became stoop-shouldered and walked with unsteady gait. The X-ray revealed brain tumour for which surgery was suggested but only 1% chances of survival. His mother was against such surgery and tried Ayurveda treatment, which benefited for sometime. He developed burning all over the body, had voracious appetite; the headache with vomiting increased in intensity. The boy was therefore very depressed and began to lose interest in everything. He became unconscious while vomiting one day. At that stage it was decided to try Homoeopathy and Dr Desai was consulted.

The family history revealed that his father died of paralysis and mother had hypertension; father was fond of ayurvedic preparations and used to take a gold preparation as a tonic. The etiology was that the boy suffered from malaria, which led to jaundice two years ago, for which Ayurvedic medicines were given.

For the immediate complaint of unconsciousness, Dr Desai gave Opium CM every hour and the boy regained consciousness in 6 hours but complained of severe headache. Vomiting started and continuance of Opium for next 2 days did not help. Taking the family history and background of the disease, Syphilis and Tuberculosis inheritance were noted and this along with voracious appetite of the patient Desai selected Aurum- iodide as the constitutional remedy; it was prescribed in 1M potency every two hours. The patient slowly started improving in all areas with reduced headache and intensity of vomiting and in 6 months there was appreciable improvement. He got cured completely in 4 years. The X-ray taken at that time revealed no sign of brain tumour. Later the boy became a big businessman.

These cases, especially coma, were difficult to treat and Dr Desai has demonstrated how high potencies of the indicated remedies will cure such cases; note the very frequent and continued use of high potencies and astute selection of the remedies and his grasp of the miasmatic background of the cases.

Dr P Sankaran also conducted a number of experiments in the Government Homoeopathic Hospital, Mumbai by giving frequently high potencies of selected remedies. Many sub-acute and chronic cases treated with high potencies repeated frequently, were cases of chronic bronchitis, bronchial asthma, eczema, paralysis, pulmonary tuberculosis, nephritis, psoriasis, carbuncle etc. Only in three cases some aggravation was noticed which could be attributed to repetition. . He did not find any harmful effects in other cases; he also gives the details with two cases in his booklet "Repetition of Doses".

Dr Douglas M Borland advocates use of high potencies in frequent repetition in acute diseases. He writes in his lectures on Pneumonias "The second method of treating acute conditions is by the administration of higher potencies- something above a thirty. You will find that by the administration of these higher potencies you abort the disease. It does not run its normal course; the duration of the illness is very much shortened and you have an anticipated crisis. Instead of getting the crisis from the seventh to tenth day (by using low potencies) you get it from twelve to forty-eight hours of starting the treatment, irrespective of the day of the disease.

A crisis is always attended by a certain amount of stress, possibly a certain amount of risk, although this is not so likely when the crisis occurs early rather than when it occurs after seven to ten days of continued fever. The temperature crashes over a few hours but you do not get a collapse because you have a perfectly healthy patient to start with instead of one whose vitality is impaired by long toxaemia." At the same time he cautions that one has to be very careful in selecting the similar remedy while administering high potencies; while using low potencies one can produce a modifying effect without necessarily covering the whole case.

As regards repetition of higher potencies, he advises: "- -to continue the administration of the selected drug until the temperature has reached normal and has remained normal for at least 6 hours (in cases of Pneumonia). Otherwise you will find the patient tends to get a further rise of temperature and will require a second course of medicine, possibly same or another, say 24 hours later, whereas if you have kept up the administration for six hours after the temperature has become normal, you do not, as a rule, get a relapse at all.... It is wiser to give the drug in high potencies, every two hours for the reason that you want a number of stimuli on a comparatively short period of time in order to obtain a crisis within twelve to twenty-four hours. . In six hours you ought to find the temperature coming down; in 12 hours it will probably be down to normal and in twenty four hours it certainly ought to be."

Tips:
He then gives tips in different stages of pneumonia as to the use of and repetition of the drug.. ..In incipient stage of pneumonia , "if you are using potencies above 30, I think you are wise to repeat your medicine at not longer intervals than one hour for the first four hours and after that keep us your administration at two-hourly intervals over a period of twelve hours in all". In his experience this way of repetition will abort the whole thing.

In the next frankly developed pneumonia Dr Borland says "in my own practice, in the average case, I would prescribe 10M of the drug though where the indications are clear my preference would always be to go higher provided there is no contra-indications. I give CMs in preference to 10Ms if I am perfectly certain that I have the right drug. The average case of pneumonia, when it is frankly developed, will require at least six doses of medicine; it may require more. One finds that the average length of action of each dose is round about two hours ie it need repetition every two hours".

In a case of complicated pneumonia (either the patient has a mixed infection or he is unhealthy to start with or broncho-pneumonia) "I tend to give 1M rather than a 10M because it seems to produce less disturbance and yet produces a definite reaction. I repeat at about the same intervals as for an ordinary straight pneumonia. In an alcoholic patient I tend to give higher potencies, probably a 10M or CM".

Thus we have evidence that frequent repetition of high potencies both in acute cases and in difficult cases like coma are found to be effective. However, handling high potencies in such frequent repetition requires considerable skills and knowledge of the disease, miasmatic background etc. Dr Hahnemann had developed 50ML potencies and on the basis of his own practice for several years advocated frequent repetition of such potencies in ascending scale in chronic cases and also pointed out that the medicinal aggravation, if any, would always came very near the curative stage by which time the vital force is able to absorb it.

But his LM potencies are different from centesimal potencies referred to in this article.

Dr Sankaran observes "No doubt that the cases reported by these Homoepaths have been treated successfully with such rapid repetition of high potencies. But there is no comparative presentation and study of cases treated with infrequent repetition and similar ones treated by frequent repetition of high potencies to prove that the latter method is indeed infinitely superior and quicker in its action. It may not therefore be advisable for the large majority of less experienced Homoeopaths, who may not be able to assess the effects so carefully to adopt this method straightaway. It would be preferable to conduct carefully controlled trials and note the advantages or disadvantages of this method before adopting it universally." But how many cases of coma of the type treated by Dr Desai will a Homoeopath get nowadays when the preference is for allopathic treatment?

Sources:

1. Principles of prescribing - compilation by Dr K N Mathur
2. Coma - its Homoeopathic treatment by Dr Maganlal B Desai
3. Pneumonias- Lectures by Dr Douglas M Borland
4. The Repetition of Doses- by Dr P Sankaran