Hello,

I'm just inching my way into working with LM potencies and would appreciate some advice from my more experienced and learned colleagues

An older lady came with stomach pains, heartburn, headaches and backaches. The stomach pains are such that she can barely eat anything any more that has the slightest bit of fat in it.

Pulsatilla came up in the rep, and fits her personality, she needs a lot of reassurance. I gave an initial dose of a 12C in water, and she felt as if her blood circulation had increased for a while. Since she seems hypersensitive, I figured it would be a good case for LM potencies. After a couple of weeks on LM1 now, she feels generally more energetic, her back is better, stomach a little better, other symptoms weather sensitive... But now she tells me each time she takes the remedy (1 teaspoon of the medical solution in half a glass of water, stirring once), she feels some tightness in her chest for an hour or so, and then it goes away. It is not an old symptom.

Now, this being a new symptom, I would have to conclude that she is producing a remedy symptom (Puls is in grade 2 under chest, constriction), wouldn't I? And that there is a danger of suppression. However, on the other hand, it's not that local symptoms disappear and her energy goes down. On the contrary, she seems more energetic in general...

I'd appreciate any guidance or comment

Kind regards,
Karin

OK, her energy is still up and she's improving but getting "accessory symptoms" of the remedy, which only means you have to cut back. Maybe she only needs this remedy every other day, or every three days. If you're succussing the remedy bottle, which you should be, you could cut the succussions in half. Finally, you could go to a second dosage cup, which is to say, instead of taking that spoonful into her mouth, add it to another cup of water, stir and take a spoonful of that cup.

Keep adjusting until she's able to experience only improvement without symptoms of the remedy.

Snoopy

Dear Karin,

You don't say what size the remedy solution bottle is. Is it a 4oz bottle or a smaller sized dropper bottle?

You don't mention how many succussions of the remedy solution bottle you use. 3 is ample in hypersensitive cases.

Do you stir one teaspoon into a 4oz glass of water, and then give one teaspoon from that glass?

How often is the lady taking a dose?

It really sounds like you're on to a winner with this remedy choice, only that the dosage is too strong. This is the beauty of the LM potency, it can be adjusted to suit the individual precisely.

If the improvement overall is striking, but causing an initial aggravation with each dose you can modify the dosage by either:-

* Reducing the number of succussions. This will reduce the intensity (but not the strength) of the impact of the dose.

* Give the remedy in a second cup of water. That is, one teaspoon from the 1st cup stirred into a 2nd 4oz cup of water. Take one teaspoon of the 2nd cup as a dose. This also reduces the impact but not the strength.

* Give the dose less frequently. (Please note that Hahnemann almost NEVER gave a daily dose of any remedy.)

You need to discern that the improvement is capable of holding for longer periods of time in between doses. It is a mistake to think that you just keep on dosing until an aggravation occurs. This is not what Hahnemann intended or did in practice.

Hi Snoopy and Chris,

Thanks for your input.

I had already cut the dose, but I'll continue to do so.

With the dosage I have pretty much followed the instructions by David Little on www.simillimum.com.

The medical solution is in a 6 oz bottle, water and a bit of alcohol. After succussing once, she is putting one teaspoon of that in half a glass of water, then taking one teaspoon of that, every third day. Initially she took it every other day, with three succussions. She actually did say that the tightness is less since we cut down, it doesn't last as long but it's there. I guess she is indeed hypersensitive.

If we cut the dose down further, and she keeps having those symptoms, would it be on to the next LM? It seems that some homeopaths take jumps from LM 1 to LM 3 or higher. Is it more advisable to go one step at a time? 1, 2, 3, etc.?

Grateful fro any advice,
Karin

Grateful

PS

I was also wondering if it could be the alcohol in the solution that was doing it to her - she doesn't drink much otherwise.

hello karin, and other learned colleagues
organon paras 179 -184 are relevant to this situation as i understand it. notably para 181.

boenninghausen's concordances are a great help in selecting the remedy according to organon para 184, after the well-selected first remedy has done its work.

puls is not sensitive to weather changes which is a main modality here so i would think of changing remedies for this reason too. many remedies are sensitive to fats.

also you can ask yourself, according to hahnemann's list of psoric disease in Chronic Diseases, do i need to treat this as a psoric case, using primarily the antipsoric remedies? [low energy, needs reassurance, sensitive to weather give hints]

hans weitbrecht's method of giving lm's makes sense to me and an article can be found on www.boger-boenninghausen.com

Karin,

I would continue to modify the dose further before changing the remedy. I have to admit I used to think 2 succussions, 6 succussion, 10 succussions - what the heck difference could it possibly make??? Well, when you have made a good remedy choice, it makes all the difference. You never really understand the potential of our remedies until you see the simillimum act. That is, right remedy, right potency, right dosage.

If you overdose from the beginning you are continually on the back foot trying to figure out what this means, what happened there, if only I hadn't made that change here.....etc, etc.

If this lady is improving that means your remedy is working. If the dosage causes an initial aggravation which then goes away, and she continues to improve, that's a sign of the right remedy, wrong dosage.

I go up the scale step by step, I don't jump potencies anymore. You can move up quickly if you need to. It takes forever and a day to unravel a badly mismanaged case.

Boenninghausen and Hahnemann were expert zigzag prescribers. They had a limited materia medica to work with and found that a lot of their patients suffered from accessary symptoms. So they zigzagged their way through the treatment trying to avoid aggravations. We all choose partial simillimums a lot of the time through inexperience mostly. So it is important to know the Concordances and how to use remedy relationships effectively. In the 1840's Hahnemann was doing less and less of this zigzig prescribing because he had by this time developed the LM potency scale and could modify the dose to prevent aggravations rather than changing to a completely different, but related, remedy. Boenninghausen on the other hand continued to practise in the other way.

Dear Karin,

Yes, go up one step at a time. In fact, if she is improving so much on LM/1, you may even choose to fill the bottle back up when it gets down to the bottom and keep going with it. If the vital force is saying, "I like this potency"
why change it? We shouldn't follow rules for their own sake, we should follow the patient and take our cue from his response.

You can try going every 4 days with this patient or go to a 2nd cup as described earlier.

According to the Organon, you'll know you're finished with a remedy when an old symptom returns. This is what Hahnemann calls the true homeopathic aggravation; it comes at the end of treatment when the body has recovered so much vitality that it can now throw out a previously suppressed symptom. So, watch for this in your case and tell your patient that it will be a good sign when it happens.

Snoopy

Karin,

You wrote: If we cut the dose down further, and she keeps having those symptoms, would it be on to the next LM?

Which symptoms do you mean by "those symptoms"? If you mean the aggravation symptoms after taking the dose, I would modify the dosage in one or some of the ways listed above.

If she is overly hypersensitive she may not be 'ready' for the LM potency scale. A general rule is if the patient can tolerate up to 30C then they may be considered suitable for the LM scale especially in chronic cases of long-standing illnesses. Hahnemann often used olfaction in his hypersensitive cases where the 3rd, 4th, 5th dilution cup still did not prevent aggravations.

If you mean after modifying the dose to avoid those aggravating symptoms after taking the dose, the original complaints are progressing too slowly, or not at all, then yes, you need to step up to the next potency level. I have not found refilling the remedy solution bottle of the same potency to be as effective as moving up to the next potency level. When you have the correct remedy you should be able to move up the potency scale to promote rapid, gentle healing and cure.

I agree with Chirs's Analysis, KArin.

And I would suggest (if she's still hypersensitive to the LM's) using single doses of 30 instead. In water make them a little smoother to handle, but that does not matter.

Warmly,
doctorleela

[ 12 April 2002, 20:20: Message edited by: doctorleela ]

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