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Opening the Home Medicine Chest - What potency should I use? Choosing the right dose and strength of a remedy

Todd Hoover, MDOne of the longest running and perplexing questions in homeopathy has always been "what potency does one use in a given situation?" The shortest answer to that has not changed much over the past 200 years—"use the lowest potency that will lead to a curative effect, without significant adverse effects." This is a wonderful, albeit impractical answer for both the beginner and the experienced practitioner.

A bit of background

The longer answer requires a bit of background. When homeopathic remedies are prepared, the plant, mineral or animal substance undergoes a successive dilution and shaking (or succussion) process. The volume of solution into which the original substance is diluted represents the type of potency of the final remedy. Three different potency scales are in common use in modern homeopathy: X, C, and LM. The X potencies are diluted 1 portion of substance to 9 portions of solution. The C potencies are diluted 1 to 99, and the LM potencies are diluted 1 to 50,000. #Additionally, the number of times the original solution is diluted along a given scale is represented by a numeric symbol to further describe the potency. For example, if the element Sulphur was diluted 1 part to 10 progressively, 5 times, the resulting "potency" would be described as 5X. And if the plant substance Cyclamen were diluted 1 to 100, thirty times, the potency would be 30C.

The second aspect of preparing homeopathic remedies involves a shaking or "succussing" process. After the original substance is diluted according to the chosen scale, the mixture is forcibly shaken and then struck into the palm or onto a firm object approximately 20 times. The theory behind succussing is proposed to be an excitation of the solution to provide it with a dynamic property. Modern physics shows that another model may be more precise. The formation of certain water based "shells" of the molecules of the original substance can persist in the solution after a succussion process. Current researchers in homeopathy are investigating whether the formation of these shell structures can actually account for the clinical effects of the remedies.

The various scales of remedies were chosen arbitrarily. The use of these potency scales over the last 200 years, however, has created a body of knowledge that is quite useful to practicing homeopaths today. Beginning practitioners and acute prescribers will generally have access to the C and X potencies. Generally, in the US, over-the-counter single remedies like Sulphur or Chamomilla will be found in the C potencies of 6C, 12C or 30C. Combination remedies where several remedies are placed into one pill for a given ailment, such as ear infections or teething, will usually contain X or C potencies like 2X or 3X. Lower numbers are called the low potencies. When a remedy is prepared to 30C or greater dilutions, it is considered a high potency. LM potencies are most frequently used for individuals with a high degree of sensitivity to any medicine and are best used by experienced practitioners.

Guidelines

Several guidelines will help you choose a good potency for a given situation. In general, low potencies have a less intense and shorter duration effect over a greater percentage of people. Higher potencies will tend to affect only those individuals who need that particular medicine and #will act more deeply upon their system for a greater period of time. In my experience, for an acute illness such as a cold or ear infection, a 6C or 12C remedy can be used 2 to 5 times per day for several days with good results. If a 30C is used, the dosage may only be required once or twice to achieve a curative effect. Chronic conditions such as asthma require treatment by an experienced homeopathic practitioner who may use potencies like 200C or 1000C to achieve the desired effect.

Several factors specific to the individual being treated can strongly influence the choice of potency. In my experience, the younger and more robust the patient, the higher the potency they will be able to tolerate before displaying any adverse effects. Older patients and those with fragile health or high levels of sensitivities will frequently show negative effects when given too high a potency or an incorrectly chosen remedy. Sensitive patients include those with eczema and sensitive skin, allergies, asthma, mental-emotional disorders and autoimmune diseases such as multiple sclerosis. When in doubt, it is always better to use a lower potency even though this may act more slowly and require more frequent doses.

Choices and lessons

The correct choice of remedy is always of greater importance than the correct choice of potency. However, I have learned the hard way that an incorrect potency can create a lot of confusion in a case. Early on in my practice I had the opportunity of treating a delightful child with the most severe eczema. She had been treated with numerous remedies by other practitioners with partial success, but the eczema had remained. Her skin was red, raw, and scarred from the waist down. The mother would wrap all #four limbs in gauze at night to prevent the girl from tearing her skin. She was much worse from bathing and from heat. From these and the remainder of her symptoms, I decided that Sulphur was the clear choice of remedy for her.

Sulphur was prescribed in a 30C potency. All symptoms became much worse. At no time did the rash improve, yet I was convinced Sulphur was the correct choice. Sulphur 6C was given and a similar result occurred. Later a Sulphur 200C was given, and again the eczema was worse. My confidence was shaken. Perhaps Sulphur was not such a good choice. Maybe a close relative of Sulphur might work. I tried Calcarea sulphurica and Sulphur iodatum with no benefit. Eventually, after several more incorrect remedies, I went back to my original choice of Sulphur in the very low potency of LM2. I heard from the mother six months later, when she called about the child suffering with a toothache. When I asked about the eczema, she said it had completely cleared shortly after the remedy was given. The child has been very healthy for the past five years and I continue to reflect on the value of that experience. Now when I am entering into doubt and confusion, this case reminds me that patience may reveal the health and vitality that lies hidden around the next bend.

The choice of remedy potency can be as simple or complex as you choose to make it. Fortunately, being close to the right choice is frequently all that is required. The most important aspect of using homeopathic medicines is to remember to evaluate the response of the patient. If the individual is improving, there is nothing to do but wait. If the symptoms were improving, but then relapsed, the remedy should be repeated. And if the symptoms are worsening despite the remedy that was given, either the potency is too low or the chosen remedy is incorrect. Always remember that the correct treatment for any person is the one that helps them achieve the greatest level of health or "the lowest potency that will lead to a curative effect, without significant adverse effects."

About the author:


Todd A. Hoover, MD, is a board certified family physician and homeopath practicing in Narberth, Pennsylvania. He is a graduate of Jefferson Medical College and studied homeopathy at the New England School of Homeopathy, as well as with Ananda Zaren, Vassilis Ghegas, and others. He has been practicing homeopathy for nine years. He is also a yoga teacher, father, avid cyclist, and "full-time explorer of things unknown."