Potency and Its Implications
NATIONAL JOURNAL OF HOMOEOPATHY 2000 Nov / Dec VOL II NO 6.
Dr Anita Lobo
'Sul / Nat-m

(Editor: The general discussion on potency has been omitted from the article as it is covered in Dr RD Jain's article and some repetitive portions have also been cut) Potency is the power of a medicinal substance to produce a desired effect. The process involved is called potentisation. The two methods are trituration and succussion. By repeated experiments and close observations, it has been discovered that mother tinctures are oftentimes quite inactive or inert to produce curative effects on natural diseases which are dynamic in origin and nature. So, in order to cure these dynamic diseases, it is essential to rouse the latent power of drugs which lie hidden in them by a process devised by Master Samuel Hahnemann.

Selection Of Potency: Different Views
This depends on the susceptibility of the patient together with the acuteness and chronicity of the disease. The question of what is the best potency for a given case and what is best for habitual use is a broad subject and an almost endless field for speculation and observation, ranging from tinctures to the highest potencies. The various potencies are all more or less related to individuals and it is the individual that we should study. While undertaking the study of Materia Medica Pura, we find that in its early editions, Master Hahnemann recommended a particular dose (potency) for a particular remedy.

As time passed, the Master conducted vast experiments and analyzed his experience and in the subsequent editions of Materia Medica Pura and Chronic Diseases, he suggested to give every remedy in the 30th potency, though in the later ripe years of his life, he observed remarkable cures by administering different remedies in various potencies, more particularly LM potencies which he elaborated in his 6th Edition of Organon.

This left the field wide open to physicians to decide on the appropriate potencies in cases following the experience of different Homoeopaths as guides. Carrol Dunham first started using 3rd, 12th, and 15th in acute diseases, and later on 200th in all forms of the disease. He believed that 'minimum the dose, better the result'. He elucidated the presumption of every case being in favour of high potency to be begun with, but if no favourable results are achieved, then give the lower potencies to stimulate the high potencies.

Stuart Close: the remedy may be given in the form of mother tincture or low trituration, first in moderate, then in increasing strength until the dosage is found to which the patient will react. In general practice, he advises to use lower potencies in acute diseases and where pathology is far progressed. Use higher and highest in chronic cases and when mental symptoms are prominent.

W I Pierce: when well-selected remedy fails to act, if we have been using low potency, jump to a higher one; or if high potency, drop suddenly to a very low one for a few doses and then back to the original. D M Borland says, 'All ranges of potencies have their uses; but in certain instances, one potency is to be preferred to another.

N Puddephat says 'Low potencies as 1X, 3X, 6X, or 3rd are given in gross pathological; medium potencies 6th and 12th in functional disorders, in mental disorders higher and highest potencies from 200th upwards; when all the symptoms of the patient are perfectly matched by a given drug (the similimum), then the highest potencies 10M, 50M, CM, MM, will work miracles.

Garth Boerike: used 3x to 6x potencies in the beginning and higher potencies when the drug has less physiological action and when a case has improved and then gone back.

Constantine Hering: `If symptoms of a case have more resemblance to the primary symptoms of the drug then lower potencies on the contrary have more resemblance with the latter effects (secondary symptoms), hence advocate higher potencies'.

Elizabeth W Hubbard Says: `In order to truly wipe out the cause of a so-called disease, one must administer the remedy on or near the plane of the cause'. For mental and acute cases, the high potencies (10M and upward) would be employed, in marked organic and pathological changes, and chronic cases, lower or medium potencies should be selected; certain acute crisis such as cardiac asthma, would have to be treated with medium or low potencies.

The Degree Of Susceptibility: also influences potency selection. Certain persons who are oversensitive require medicines in low potencies. The sluggish require low potencies every few hours or a very high potency to get any action. Feeble patients are those where the vital force can be overwhelmed easily. Hence repetition is to be avoided. Acutely sick, robust patients will stand repetition of high potencies, although ideal is the single dose.

Children usually need high potency, the elderly individuals require medium potencies except for euthanasia. In idiosyncratic patients, medium potencies are to be given. When patients are habitually poisoned by a crude substance, it is not advisable to give that substance in very high potency but instead an antidotal substance given in high potency helps, with certain exceptions.

Case
Mr MF, aged 31yrs, a Muslim, consulted for the following complaints:

Chief Complaints

Associated Complaints

Past History
The patient took Allopathic Treatment for chief complaints with only temporary relief. No H/o Asthma, TB, Hypertension, Diabetes Mellitus or any other disease.

Family History
Father had H/o Pulmonary tuberculosis, expired due to heart attack at 47 years of age.

Patient As A Person
Diet : Mixed.
Appetite : Good.
Cravings : Mutton3, chicken3, fish3.
Aversion : Vegetables3.
Thirst : For cold water -> 2-3 glasses/day.
Perspiration: Partial increased: Face++, Scalp++.
Bowels : Regular - once/day.
Micturition : D/N - 3-4/1-2.
Reactions-Physical
Meteriological: Likes winter.
Thermal Reaction: Bath - warm water.
Covering - thin bedsheet.
Uses A/c always.
Hot patient.

Life Space Investigation
The patient, from upper middle class family, is the only son. He was working abroad earlier and returned with a plan to settle in his home town. He invested his money in real estate business but then the work stalled due to crash in share market. This led to a lot of financial stress and much anxiety. He takes all problems very seriously but does not share them with others and keeps thinking of them. As a result he gets very much irritated but he controls himself. He is married and has two male children. He has no problems with his family life.

Mentals
Intellectual State: Memory - good.
Judgement - good.

Emotional State
Anxiety- About job due to financial crunch.
Brooding -Takes problems very seriously.
Doesn't share with others.
Irritable- Gets irritated when anyone talks to him when not in mood but controls.

Sleep And Dreams:
Duration - 10 PM to 7 AM
Sleep - Sound.
Dreams - Occasional, unremembered.

General Physical Examination
Appearance - Lean, Weight - 56 Kg.
Pallor - Absent, Oedema - Absent.
Glands - Not palpable.
Vital Signs: Temp - 99°F.
PR- 74/min, regular, good volume.
BP- 130/80 mm of Hg.
RR- 18/min.Abdomino-thoracic.

Systemic Examination:
Respiratory System: Vesicular breath sounds heard, no added sounds.
CVS: S1, S2 heard; no murmurs.

Local Examination:
Face- No eruptions.
(Eruption seen only on sun exposure).

Diagnosis
Photosensitive Dermatitis: White skinned face (exposed part) Lateral side of nose, erythema, pappule, < sun exposure to.

Chronic Constitutional Totality
Mental Generals: Irritable.
Brooding++.
Anticipatory anxiety.
Physical Generals: Appearance - lean.
Cravings - Fish3, mutton3, chicken3.
Aversion - Veg3.
Perspiration-increased partially;
Face++, Scalp++.
Hot patient.
Characteristic Particulars:
Lateral side of nose, AF Sun³.
Pimply eruption, greasy secretion.
Burning and redness of eyes.

Rx: Natrum-mur.
Acute Totality
Lateral nose: Pimple - like eruption A/F: Sun³. Burning. Greasy, oily secretion. < heat, Redness of eyes
Scalp: Itching. Hair-fall Powder-like scales.
Rx: Sulphur.

Miasmatic Background
Fundamental Miasm: Tubercular.
Dominant Miasm: Psoric.
General Management:
Ancillary Measures: Reduce exposure to sun. Use covering like a cap. Regularly wash the face with cold water.
Specific Treatment:
On the basis of Chronic Constitutional Totality, Nat-mur 200 was given on 3/11/98, 4 pills once in 3 days at bed time.

Criteria For Follow-Up

1. Appetite.
2. Bowels.
3. Perspiration.
4. Sleep.
5. Redness of face.
6. Pimples at side of nose.
7. Greasy secretion.
8. Burning of eyes.
9. Watering of eyes.
10. Dandruff.

Follow-Ups (With Dates And Prescription)

After 2 months, the patient reported saying that all his complaints were better; and now he didn't have any trouble going out in the sun. Therefore placebo was administered for 1 month.

Conclusion:
In the above case, on the basis of Chronic Constitutional Totality, the well-indicated remedy was administered. There was improvement in the patient's complaints. Remedy regulation was followed. Once improvement stopped, even after repetition, then the potency was raised higher and it worked effectively.

References:

1. Dr ML Dhawale-Principles and Practice of Homoeopathy - part I - reprint edition 1994 - ICR, Bombay.
2. Dr Herbert Roberts- principles and art of cure by homoeopathy- reprint edition 1999- B Jain Publishers Pvt Ltd, New Delhi
3. Dr Richard Hughes: The Principles and Practice of Homoeopathy - reprint edition 1994 - B Jain Publishers Pvt Ltd, New Delhi.
4. Dr Stuart Chose: The Genius of Homoeopathy - reprint edition 1999 - B Jain Publishers Pvt Ltd, New Delhi.
5. Dr Samuel Hahnemann: Organon of Medicine - 6th Edition B Jain Publishers Pvt Ltd, New Delhi.
6. Dr NK Banerjee and Dr N Sinha - A Treatise on Homoeopathic Pharmacy - reprint edition 1992 - B. Jain
7. Dr RE Dudgeon: Lectures on Theory and Practice of Homoeopathy - reprint edition 1994 - B. Jain
8. Dr J T Kent: Repertory of the Homoeopathic Materia Medica and a word index - reprint edition 1995 - B. Jain
9. Davidson- Principles and Practice of medicine - 17th ed.
10. Dr James Tyler Kent. Lectures on Materia Medica - reprint edition 1996 - B.Jain Sankaran P - Potency problem -3rdedition. the Hom. Medical Publishers, Mumbai.