dear JW,
I am curious to know whether hahnemann ever experimented by giving a LM dose, as a single dose. it is there in the paris case books ?
(by single dose I mean - one or two globules given as a single dose. it may be given dry or in water as one dose. by single dose I do not mean one dose from the dilution glass)
from a post sent by david little, it appears that hahnemann never gave a single dose of the LMs.
may I request you, as a renowned homeo historian, to confirm whether H ever gave a LM - as single dose.
is it there in the paris case books or any other writing of H or any other source ?

dear hans weitbrecht,
it appears from your posts that you have access to the paris case books (which I don't have) and have studied them in detail.
did you find any case where H gives a LM as a single dose ?
have you ever tried it yourself ?
I am particularly interested to know if someone has given the higher LMs, as a single dose (like dr ramanlal patel and dr risquez).
please let me know, if possible.

thank you JW and hans for your kind co-operation.

regards,
dr manish agarwala

I do not have the casebooks, so I cannot tell you.
I thought that David Little answered this in detail.

JW

Dear Colleagues,

The subject of posology and case management is vast. First of all, lets look at what is in the Organon. Hahnemann wrote in aphorism 246 that any strikingly progressive improvement is a sign to let the single dose act without repetition. Then is says in cases where there is only slow improvement over 30, 60 or 100 days we may need to repeat the remedy to speed the cure. This offers two scenarios. Those cases in which there is a strikingly progressive improvement that continues day to day, and those cases in which there is little, slow or no improvement over a longer period of time. It is these slow moving cases that Hahnemann says his "new methods" can speed the time of cure to 1/2, 1/3 or even less the time it takes with the single dry dose. To do this, he says, on must met the following 5 conditions.

1. The remedy must be a good simillimum. There is no way to fulfill condition number one in advance. How do not know if the remedy is good or bad before we give it? Perhaps, the first dose, or the second, third, four, five, sixth or seven dose caused a serious aggravation or new symptoms to appear showing it was the wrong remedy. This can not be told in advance. The first testing phase of giving a remedy must be carried out carefully. Giving the daily dose to everyone automatically is a grand mistake.

2. It should be highly potentized and dissolved in water. To speed the cure one should use dynamic potency in the medicinal solution for oral, nasal and dermal applications. This is a very important requirement in speeding the cure.

3. Use the remedy in small doses. The small divided doses used in the medicinal solution are central to the new posology. Too many dry pills accumulate until they produce prolonged aggravations and antagonistic secondary reactions of the vital force.

4. The remedy should be given at suitable intervals according to "experience". Then one must decided what the suitable intervals are for the individual patient according to the time and circumstances.

5. The remedy should be succussed prior to administration of the remedy so that the patient never receive the exact same potency twice in succession. This makes the remedy act much more gentle on the vital force.


First of all, one must understand the difference between a "strikingly progressive" improvement and a "slow" improvement. The instructions for repeating the dose to speed the cure relate only to those cases are not cured with single or infrequent doses. All of the statements that follow about the daily and alternate day dose relate to slow moving and "protracted cases". The daily dose may be given only, as Hahnemann, "when necessary".

These are the baseline instructions given by Hahnemann in the 1840s. How did Samuel practice this in the clinic? My review of the microfiches of Hahnemann's Paris Casebooks from RBI has revealed a few interesting observations in the areas of posology and case management. The Paris casebooks and eyewitness accounts allows one to put together the following picture.

It appears that Hahnemann liked to give his single doses by olfaction followed by placebo for at least one week. There are some patients that are given most, if not all, their remedies by olfaction accompanied by placebos. These persons are receiving relatively infrequent doses. Some of his liquid doses may also have been single doses. The second method was to give a short series 3 to 7 oral liquid doses and have the patient return in one week. The single dose and short test series were Hahnemann's baseline method at the start of the case. He did such things quite often with both the C and LM potency in medicinal solution.

On this basis the Founder would individualize his case management according to the reaction of the remedy. At the beginning of treatment he gave either a single dose followed by placebo or short series of 3 to 7 divided doses interpolated with or followed by placebo. He rarely repeated a remedy for very long without giving placebo and waiting and watching for some time. Hahnemann used almost as much placebo as medicine in most his cases. Anytime there was a strikingly progressive amelioration, aggravations or a confusion in the symptoms he stopped the remedy, gave placebos and waited and watched.

There is not one case in the Paris journals in which Hahnemann uses the daily dose for weeks, months and years on end. The idea that Hahnemann always gave the daily dose is a complete myth. His method uses the single dose followed by placebo or an "on again - off again" approach in which a series of divided doses and placebo are alternated. Hahnemann's remedy and posology were individualized according to the symptoms, the reaction and the circumstances. His final methods are a perfect balance of waiting and watching and acting and observing as needed. This is the middle path that avoids the extremes of always giving a single dose or using the daily dose on all patients!

There is no one method of giving or repeating a remedy that is suitable for all patients all the time. This is a mechanistic idea in which all individuals are reduced to a panacea-like single formula for the masses. This does not work as well as the method of individualization taught by Hahnemann in the aphorism 246 and elsewhere. The most prudent thing to do is give a single dose or a short series of doses and see the patient in 7 days and then decided what the next step should be. This next step could be using placebo and waiting, giving another single dose, or perhaps, giving short of doses at suitable intervals depending on circumstances. In cases where there is a strikingly progressive response to a single dose or short series of doses the remedy should not be repeated as long as this state lasts.

Giving the daily dose to everyone for days, weeks or months before testing the remedy leaves too much to chance and delay to say nothing of complications. The first rule of healing is, "Do no harm". It is one's responsibility to test the remedy before repeating it too many times. To start slow in the beginning and test the remedy means to reach the goal of cure quickly in the end. To start off to fast with too many doses means delaying, and sometimes, even spoiling the cure. This is because we have not properly tested the remedy in the beginning to find out how often the patient really needs the remedy. Once in a lifetime? Once a month? Once a week? Every other day? Once a day? Once a ???????

How do we know if the patient would respond to a single dose olfaction in strikingly progressive manner if we give them the daily dose for one week to one month? At this time, we do not know if our remedy causes a good or bad reaction? How do we know how the patient will react *before* we give the remedy? Maybe the remedy will make them feel better, maybe it will cause an aggravation, maybe it will make them sicker! How do we know if the remedy meets the first condition of aphorism 246. We are not fortune tellers.

The only way to know who will have a striking response, who will have a slow response, and who will have no response is to test the remedy first with a single dose or a short series of divided doses. This tells one whether to let the single dose or short series act and wait and watch or to repeat the remedy at suitable intervals to speed the cure. There are no magic formula like "do this then do that" that is good for all patients! Some patients need single doses at very infrequent periods. Others might need a dose once a week, or a series of 2 or 3 doses over a week. Some might need the remedy on every day or alternate days until they begin to improve. There are as many possibilities and there are people in this world.

I would never give a patient a homeopathic remedy for 7 days straight at the start of treatment unless I had a very special reason for do so! That would spoil my single dose cures and infrequent repetitions! These are one's most dramatic cures. If you repeat the remedy for a week on such people at the beginning of treatment may cause aggravations, accessory symptoms and antagonistic counter actions of the vital force. This interferes with testing a series of 3 doses over a 3 to 7 day period and other often used intervals. To give the daily dose mechanically to most patient is not in harmony with the golden Homoeopathic principle of INDIVIDUALIZATION. Hahnemann's case management methods are open, individualized, responsive and flexible according to the circumstances - not generalized, fixed, mechanistic and predetermined.

Similia Minimus
Sincerely, David Little

I have read and heard cases where a single dose of LM was all that was needed (ever, for an acute; or for months or years for chronic). I don't know whether the prescriber had *planned* to give one dose only, or whether they simply realized that after that one dose nothing more was needed.

Hahnemann does say that whenever you see a striking and progressive improvement after a single dose, you must repeat no more, but wait and see how long the effect lasts. I assume this is what happened in the cases I read, and I assume that Hahnemann must have seen that effect here and here -- but that's only my assumption.

Best,
Shannon

David asked me for a case study of a single LM dose cure, and I wanted to find a really good one - and here it is:

10 year old intact female Australian Shepherd with an unremarkable history. Had been treated by me for an injury a few years before, arnica followed by ruta grav for a bad sprain. Recovery had been fast and complete. Her heat cycles had always been basically normal, and she'd never had anything but a slight drop in energy for a week or two afterwards, and some clinginess during. Had not had any other homeopathic treatment, had one course of antibiotics in puppyhood, had two puppy vaccines but none since. Athletic, happy, healthy dog. Had two litters of healthy puppies, last one at age 7.

Had come in season about two months before and it seemed normal, but after it was over, she seemed "off"... low energy, low appetite with some signs of nausea on smelling food (turned her head away and licked lips), some weight loss, droopy, not interested in her usual favorite activities, not normally affectionate to her owner, not acting toward other dogs in the house as she usually did - the ones she normally liked best she ignored, and she was very irritable toward the younger dogs.

She seemed very chilly and was constantly looking for the warmest spots to lie in.

She seemed anxious in the evenings.

Although she did not have diarrhea, she had a moist looking exudate in her anal area.

Although she didn't seem interested in exercise, walks, or her normal activities, she seemed to be calmer and more herself after exertion. She also seemed at her best right after a nap.

Ruled out pyometritis by ultrasound. Blood work entirely normal.

I gave one dose sepia LM 1 in water. The next morning her owner called and said she had, for the first time since being in season, bounded over in the morning and woken her up demaning to go out and play. She had kissed and cuddled with her after the morning walk, also a favorite routine that had not been in evidence since the last estrus. She also ate her breakfast with gusto. All the symptoms resolved in the next ten days, including the anal exudate.

Three years later she has never needed another remedy for any reason, and has had normal heat cycles since that time.

The lifespan of this breed is about 12-14 years.

Christie Keith
Caber Feidh Scottish Deerhounds
Holistic Husbandry since 1986
http://www.caberfeidh.com