Do you want to know what it means by posology and what its practical use and when it is used in homoeopathy, does it helps in selecting the medicine and establishing the cure in the patient? Let’s find out in our today’s post.
The word “Posology” means the doctrine of the science of doses. It is the science that teaches us about selection, administration and repetition of doses. The meaning of the word Posology came from the Greek word “posos” which means “how much” and “logos” which means “science”. Health is a state of equilibrium, where the vital force is balancing the harmonious functioning of different parts of the body in a perfect manner.
The disease is the disturbance of this harmonious functioning of the organism, caused by an inimical dynamic force called miasm. This is because the vital force on its own is unable to restore the disturbed state of the organism as the miasmatic force is more powerful than the vital force. Hence, in diseased conditions, the medicinal force has to be employed in such a way that the medicinal force is not only similar but also stronger than the miasmatic force.
This alone can remove the miasmatic force and health is restored as per nature’s law of cure. The knowledge of susceptibility and remedy reaction is very important to understand the posological principles of homoeopathy. The idea about the site of the disease, the intensity of the disease, the duration of the treatment and the previous treatment taken by the patient has to be kept in view while selecting a dose and potency for the patient.
Hahnemann in his “Chronic diseases” says that any physician can make three mistakes while practising. The first one is in the selection of the similimum, the second one is the selection of proper potency and dose and the third one and the most important one is the repetition of the dose and potency selected. Hence, posology has become an important artistic aspect of the homoeopathic practice.
The knowledge of susceptibility and remedy reaction is very important to understand the posological principles of homoeopathy. The idea about the site of the disease, the intensity of the disease, the duration of treatment and the previous treatment taken by the patient has to be kept in view while selecting a dose and potency for the patient. “In practice, the whole scale of potencies from lowest to the highest is open to the homoeopathic physician.
He defines his power and sphere of influence over health and disease largely by the number of differing potencies he possesses and the skill with which he uses them”-says Stuart Close.
Hahnemann, in § 278 questions, “What is the most suitable degree of minuteness for sure and gentle remedial effect; how small, in the other words, must be the dose of each individual medicine, homeopathically selected for the case of disease, to effect the best cure?” He answers this question immediately, “Not the work of theoretical speculation, not by fine-spun reasoning, not by specious sophistry, can we expect to obtain the solution of this problem. Pure experiment, careful observation of the sensitiveness of each patient, and accurate experience can alone determine this in each individual case.”
For the selection of potency and the repetition of doses, there are no hard-core rules in the homoeopathic system. H. A. Roberts says regarding the selection of the potency, “It is pure experiments and precise observations only that this object can be obtained”. The existing posological principles are derived from the past clinical experiences of the pioneers.
- Guidelines for the Selection of Potency
- Higher Potencies
- Lower Potencies
- Time of Administration
- Repetition of the Remedy
- Time of Administration
- Posology and Second Prescription
Guidelines for the Selection of Potency
1. The potency must always be selected based on the susceptibility of the patient. The general rule is, “greater the susceptibility of the patient, the higher will be the potency”. Finckle says, “The dose is appropriate which will be proportionate to the degree of susceptibility of the patient.” He also explains the law of least action, “The quality of the action of a homoeopathic remedy is determined by its quantity”. This law is also called the posological principle of homoeopathy.
2. According to Stuart Close, the following five indications help in choosing the potency:
- i. Susceptibility of the patient
- ii. Seat of the disease
- iii. Nature and intensity of symptoms
- iv. Stage and duration of the disease
- v. Previous treatment of the patient
3. Susceptibility of the patient: Susceptibility of the patient varies from age, temperament, constitution, habits, the character of the disease, and environment. “The more similar the remedy, the more clearly and positively the symptoms of the patient take on the peculiar and characteristic form of the remedy, the greater the susceptibility to the remedy and higher the potency required”.
4. Susceptibility and age: Susceptibility is greater in children and young and gradually decreases with the age.
5. Susceptibility, constitution and temperament: Sensitive, nervous, sanguine and chlorotic temperaments are more susceptible. Intelligent, impulsive, zealous persons, have increased susceptibility. Torpid, phlegmatic, dull, sluggish individuals are less susceptible, hence they need low potencies.
6. Susceptibility, habits and environment: Patients of highly intellectual characters, emotional people and patients with long sleeping hours need high potencies.
7. Susceptibility and the pathological status of the disease: Diseased with increased pathological conditions show decreased susceptibility, so invariably require low potencies. “So in terminal conditions, when the patient does not react well to the selected remedies nor intercurrent remedies, given in the potentised form and small doses, resort to crude drug and increase the dose to the point of reaction,” says Stuart Close.
8. The disease characterized by diminished vital reaction requires low potencies, while disease characterized by increased vital reaction responds better to higher potencies.”
9. Closer the similarity of the symptoms in the case and the selected remedy, the higher the potency must be given, provided no contraindications for the usage of higher potencies.
10. The more similarity in the case for mental symptoms, the higher will be the potency.
11. If the selected medicine is an inert, crude substance in its natural form, it works curatively in the highly dynamized form. Example: Carbo-veg, Natrium mur, Silicea etc.
12. If the prescription is based on poor indications, the remedy should not be given in higher potency, but lower potencies like 30th will be safer.
13. Dr M. L. Dhawale has an idea that if one potency has worked better in one case previously and the symptoms have recurred in the same picture, the potency should not be changed. But Hahnemann says, “Every consecutive potency that we repeat must be slightly higher than the previous potency”.
14. In chronic cases, if the higher potencies do not work or cease to work, change the potency to 30th and repeat it.
“By continual diluting and succussing, remedies neither get stronger or weaker, but their individual, peculiarities become more and more developed, the sphere of action is enlarged” — Jahr
Potencies of 1M or Above are Considered Higher Potencies
Indications of the High Potencies
1. Closer the similarity of the symptoms, especially with the characteristic symptoms of the case, the higher will be the potency.
2. The more mental symptoms, the remedy covers the higher the potency.
3. In acute diseases, despite the similarity, if smaller potencies fail to produce the wanted reaction, switch over to the higher potencies and can be repeated if the case agrees.
4. After a long relief of symptoms by the smaller potencies, despite repetition, if symptoms recur in the same fashion, the same remedy in higher potencies can be repeated.
5. Nosodes as a rule usually are prescribed in higher potencies, especially when indicated remedy fails to bring out the response i.e. as an intercurrent remedy.
6. Those substances which are inert or poisonous in crude form can be administered in higher potencies. Example: Silicea, Arsenicum album etc.
7. If a patient is allergic to certain chemical substances, the same crude drug in higher potencies can cure the allergy. But this concept is not acceptable universally by all homoeopathic physicians. Kent explains a similar condition while discussing idiosyncrasies.
Not only an indication of the high-end potencies, but an ideal homoeopath should also be very much aware of its contradiction and when to avoid such higher potencies.
Contraindications of higher potencies
1. In advanced pathological conditions, no scope for the curative remedy to bring out the curative response, hence the usage of the higher potencies is contra-indicated. This is because the constitutional deep acting, curative remedy may cause unwanted, fatal results like “killer aggravations”, as there is no vitality left out in such patients. Such cases have to be considered fatal cases and have to be palliated.
2. Hypersensitive and idiosyncratic patients should not be given too high potencies. This is because they keep on proving every remedy they get.
After understanding the higher potencies it is necessary to learn how to use Lower potencies. Dr Kent recommends the usage of potencies like the 30th and 200th will be ideal. Low Potencies Potencies at 30th and below 30th are considered low potencies generally.
Indications of lower potencies:
1. Cases with more common and particular symptoms of Kent and less general symptoms require low potencies. This is because the selection of the medicine is done based on poor indications.
2. Those remedies not properly proven are best prescribed in low potency to avoid unwanted reactions. Organopathic remedies are prescribed in low potencies, though it is not the proper way of selecting the remedies.
3. Almost all bio-chemic remedies are used in small doses and with low potency.
4. When the similarity between the selected remedy and the totality of the patient is poor and the perfectly indicated symptoms are less, it is always better to administer the remedy in lower potencies.
5. If the physical symptoms of the case are more prominent and the mental symptoms are not properly found or visible, it is advisable to prescribe the remedy in low potencies.
6. In idiosyncratic and hypersensitive patients, usually lower potencies are safer. If the expected result is not observed the potency can be adjusted to suitable higher potencies.
Contraindications of lower potency
1. Remedies that are active and violent in action in their crude forms like Phosphorus and Lachesis are indicated in higher potencies than in lower.
2. In Those cases where mental symptoms are prominent and suitable to the remedy picture, lower potencies may not bring out a good response, hence higher potencies are indicated.
3. Nosodes are better administered in higher potencies without frequent repetitions.
Time of Administration
1. The best time for the administration of the indicated anti-psoric remedy is early in the morning on empty stomach. The patient is asked to keep himself away from taking food at least one hour or half an hour after taking the medicine says Hahnemann in his chronic diseases.
2. The indicated curative remedy should not be given before the time of its aggravation, but the best time for its administration is after the aggravation is over. Example: Natrum mur should not be given early in the morning, but after 11 A.M., Sulphur acts best if given on an empty stomach.
3. Nosodes or intercurrent remedies like Tuberculinum etc are indicated after the acute episode has subsided. This should not be given during the attack as this may aggravate the condition and make the case more complicated.
4. In treating chronic cases, the constitutional remedy should not be given during the acute attack or acute phase, but after the acute attack is over. The physician must differentiate the acute totality from the chronic one.
5. In case of menstrual complaints, the best time for the administration of the indicated curative remedy is immediately after the periods are over and not before or during the flow. Acute remedies can be prescribed to control the most annoying complaints during the period.
6. In the case of menorrhagia, Hahnemann in his “Chronic diseases” advises the use of Nux vomica in high dilutions. This medicine has to be administered after the menstrual flow has stopped and not during or before the flow.
7. In asthmatic attacks, the constitutional remedy is best indicated after the acute attack is over and should not be administered during or before the expected attack. The acute state can be controlled with the usage of the indicated remedy for the acute totality.
Repetition of the Remedy
1. As soon as the curative response has been noticed, any sort of repetition in the case of chronic diseases is not indicated. This can be noticed by the appearance of the slightest homoeopathic aggravation.
2. Status quo indicates no remedy and wait and the watch is the indication. This can be done for a considerable period and if no progress is seen in the case, the case can be re-taken and the medicine indicated for the present totality can be given to the patient.
3. The only indication of the further repetition of the remedy is the reappearance of the symptoms. In chronic cases, unnecessary repetition of the remedy will spoil a good case rather than hasten the cure. “Repeat the dose only when the improvement ceases,” says Stuart Close.
“Every perceptibly progressive and strikingly increasing amelioration during treatment is a condition which as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever,” says Master Hahnemann in § 246.
4. In acute cases the indicated remedy can be repeated frequently even every half an hour once. Once the patient starts improving, the medicine can be withdrawn abruptly or in a tapering manner, gradually increasing the time interval of repetition.
5. In chronic cases, a single dose is still in practice. Multiple doses are indicated only when the single dose fails to bring out the desired response. It is understood by the master by the publication of the 6th edition, that the single dose may bring about a cure in a slow, continuous manner of improvement. This may take up to a period of 50, 60 or 100 days. Hence splitting up the dose into medicinal solutions can speed up the cure by ½, ¼ or less time. But each dose has to be succussed before its administration as the vital force does not accept or respond to the same unaltered dose of similimum.
6. Frequent change of the potencies and remedies is not good in chronic cases, which may end the prescriber in a confused state of the symptoms. “Too large doses of an accurately chosen homoeopathic medicine, and especially when frequently repeated, bring about much trouble as a rule. They put the patient seldom in danger of life or make his disease almost incurable” says master in § 276.
7. In the footnote to § 282, while adding his recent views on treating the recent cases of miasmatic conditions of recent origin Hahnemann writes, “These not only tolerate, but indeed require, from the very beginning large doses of specific remedies of ever higher and higher degrees of dynamization daily”. This treatment is applied to the three miasmatic diseases while their symptoms are still effloresced on the skin.
8. In the recent 6th edition of Organon, Hahnemann explains the new ascending method of repetition of the remedies. In § 280, “the dose of the medicine that continues serviceable without producing new symptoms is to be continued while gradually ascending, so long as the patient with general improvement, begins to feel in a mild degree the return of one or several old original complaints”.
9. The frequent repetition of the remedy by the new ascending method of administration i.e. “every repeated dose however modified somewhat by shaking before its administration” has to be done till the homoeopathic aggravation has been noticed in the case.
10. Gordon’s theory of double doses: Dr Gordon of Edinburgh, came out with a theory of double doses. He advises giving the indicated remedy in two different doses 8 hours apart. The first dose will be of a lower potency to be administered at bedtime and the second dose will be of a higher potency to be administered the following morning. Dr Wright in her work “A brief study course in homoeopathy” explained this in brief. This method was not tried by many homoeopaths because of various reasons.
11. Wright also introduces us to the plussing potency. “Plussing means dissolving your dose in a third glass of water, taking two spoonfuls, throwing away most of the rest, adding water up to the original quantity, stirring and succussing and again taking two spoonfuls as the second dose and so on. This raises the potency very slightly between each of the doses, gives a somewhat wider range of plane and is particularly indicated in stubborn and refractory cases”.
12. Garth. W. Boericke on the repetition of the doses comments, do not change your drugs often, allow at least overnight in most acute diseases, the medicine to act. Remember children react promptly to medicine; do not expect the same rapid effect in adults. Coffee, tea, tobacco, alcohol, cathartics, sedatives, etc also interfere in homoeopathic drug action. The following general rules apply to homoeopathic remedies until and unless generally indicated. The remedies may be taken dry on the tongue or if preferred, with water or dissolved in water.
13. Dosage: Globules of 30 size: Adult 3 to 5 pills Children 2 pills Infants 1 pill
Time of Administration
1. In acute cases, the indicated remedy may be given every half an hour or even frequently depending upon the severity of the case.
2. In chronic cases, a single dose is the law. But according to the new scale of dynamization (50 millesimal potencies), the remedy may be repeated 3 to 4 times a day, by spacing the repetition of doses at 8, 12, 4, and 8 time hours of the day.
3. As soon as the patient’s condition improves, lengthen the intervals between the repetitions of doses and discontinue when the patient improves.
Posology and Second Prescription
(Also Refer to Second Prescription)
1. If the symptoms recur in the same intensity the same remedy can be repeated in the same potency and the same dose provided the symptomatology is still indicating the same remedy.
2. In case the first potency has not proven beneficial and incapable of achieving any good to the patient despite the symptom similarity and despite waiting for a relatively long period, the change of the potency of the same remedy is indicated
3. Before changing the potency, every remedy has to be repeated in the same potency several times.
4. In the case of Nosodes if the lower potencies aggravate the condition, switch over to higher potencies instead of repeating the same.
5. In case the symptoms picture changes after the first prescription, remedies that follow well the first prescribed remedy, or complementary, should be tried as the second prescription. The antidotes or inimical are best avoided as much as possible.
6. After showing a fine improvement for some time some cases do not progress further and come to a standstill. This condition is called blockage, for example, miasmatic blockage. The usage of a nosode or a miasmatic remedy as an intercurrent remedy based on the symptom picture can solve this problem. Examples: Sulphur, Tuberculinum, Psorinum etc.
7. The French schools of homoeopaths recommend the administration of deep acting indicated remedy along with the drainage remedy in low potency. This drainage remedy is expected to remove the bad effects developed by the disease. But such practice is condemned by the kentian or spiritual school.
8. Kentian school does not recommend the usage of the intercurrent remedy but the administration of the remedy in the series of potencies. And to change the remedy again when the symptom picture changes.
9. Severe aggravation indicates and requires an antidote.
10. Reverse order of Hering’s law requires an antidote.
11. Alternating two remedies at short intervals is not a classical way of repeating the remedies.
In conclusion of today’s topic, WWE would like to say posology is an important aspect of pharmacology that deals with the proper dosing and administration of medications. It takes into account various factors such as age, weight, disease state, and the pharmacokinetics of the drug. Therefore, healthcare professionals must have a thorough understanding of posology and apply it judiciously in their clinical practice. Thank you for visiting our site, you can also read our other articles