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Dosing, Repetition, Frequency of Repetition of the Dose, etc.....

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  • Dosing, Repetition, Frequency of Repetition of the Dose, etc.....

    Hi All,
    I was reading the thread on Chronic Sinus problems and posted much the same question there...but to keep it more general for further discussion and not clutter up nyripon's thread - I'm opening this new thread. I really want to understand this method of dosing - whether it is okay, or not (I'm thinking not from my level of knowledge thus far...but stand open for discussion).

    Regarding telling a patient to take a remedy in 30c - in water (succussed between doses) taken three times per day for a few days...and then back off if improvement comes on... my question/s/thoughts/comments posted there are as follows:

    Why not just one dose and wait - have him report back in a few days time to see what has happened -if anything?

    How do we know - if he doses three times per day for a few days - and is only told 'back off if you improve'- that he will truly understand when it is necessary to stop dosing AND that he isn't actually proving the remedy by then? (no offence to you Rip)

    This has been niggling me to no end - because it appears to me to be routine prescribing and I don't understand how individuality is played when you tell patients to take something three times per day to see what happens rather than trying one dose - waiting for a response - THEN assessing where the case stands.

    Don't we take multiple doses of 30c when we prove remedies?? It seems to me, that if you dose a patient with many doses, without carefully monitoring any and all reactions to each dose, that it would be all too easy for them to start proving the remedy making it very difficult to tell if it is indeed curative or proving.

    Just pondering here and I hope that you [Snoopy] will explain your reasoning behind this type of dosing, because I definitely want to understand the thinking behind it.

    All the best,
    "The significance of a fact is measured by the capacity of the observer."
    Carroll Dunham

  • #2
    Thanks Lisa, some of the same questions I had. How about those that prescribe several doses (4-5)of 200c to kick start a case? And would this be more advisable as diluted in water doses, succussed between each dose?


    • #3
      Dear Lisa,

      It all depends on the severity or urgency; for instance (I'm taking my information here from Robin Murphy's ORGANON PHILOSOPHY WORKBOOK, the chapter, "Hahnemann's Water Potencies"), in an emergency, like a heart attack, the remedy may need to be given initially every 5 minutes, and then less often according to the response. In an acute disorder, "Dose may be 1-3 times daily of 30C, 200C or LM/1. Most effective in a water solution with succussions between each dose. Adjust as needed."

      By giving the remedy in water and telling them to succuss before each dose, you protect the over-enthusiastic patient who might not be willing to stop when improvement sets in, thinking, "One more dose just for good luck!", which could be the dose that antidotes the whole thing if it weren't a slightly higher potency because of succussion.

      You do have to tell them to stop if they get worse--something they'll be happy to do if they know they have your permission.

      The sinusitis case seems very painful, and he had taken a number of doses of Hepar before with some small improvement, which is why I thought once a day probably wouldn't do it.

      If there's a dramatic improvement with one dose of a 30C--and there often is--there's no need to repeat it.

      When you really need to worry about repeating the dose is when you're repeating without succussing, in which case, you risk an antidote or a proving.

      When I took my daughter to Dr. Karl Robinson a year ago for a bad cough, he said: Caust. 30C 4 times a day. By day 2 I knew it was the right remedy and decreased the dosing as improvement was made.

      By the way, congratulations on curing your daughter with Apis 12C!!!!


      [ 29 December 2001: Message edited by: Snoopy ]</p>


      • #4
        Hi jayj,

        Yes, I understand that changing the potency between doses is important (and agree that potency should be changed from my understanding)..but I'm more wondering about dosing a new case with repeated doses of 30c to kick start a case...rather than just taking one dose, reporting back and seeing if anything is happening. Or just going straight for LM's if they are called for (okay, how to tell if LM's are called for is another subject, so I won't go off on that tangent but rather try to keep this to the subject at hand).

        Just wondering [img]redface.gif[/img] ....

        "The significance of a fact is measured by the capacity of the observer."
        Carroll Dunham


        • #5
          Ahh, just saw your posts Snoopy , thanks for you reply .

          Right, some of what you say - makes total sense - in theory....if one has taken a complete case and knows the sensitivity of the patient they are working with, and if the ailment is an acute, etc, etc..

          Your first example...heart attack...well, yes, only repeat a remedy (and change the potency) according to the response of the patient. Pretty clear cut.

          This is just my point, though... only repeat a remedy according to the response of the patient.

          It seems to me that a single dry dose would tell us something in a shortish time (acutes) - and leaves less room for confusion when giving a prescription to patients (instructions of prepartation in water along with when to repeat and when to stop!!!). Then one could proceed with more explicit instructions on repetition (water doses) if the first dry/test dose yielded favourable results....or, GASP , give them a 200c .

          You said:
          <blockquote>quote:</font><hr>The sinusitis case seems very painful, and he had taken a number of doses of Hepar before with some small improvement, which is why I thought once a day probably wouldn't do it.<hr></blockquote>

          You know what Snoopy - you may just be right, BUT isn't it safer and less risk of mucking the case, if he just tried one dry dose to start and waited to see (for a few hours or less, even if he can't wait for longer....I do have sympathy for pain hey!) before starting off repeating (water) doses several times a day?

          Another thought:
          Are you saying that if you succuss each time - to raise the potency from previous doses..that you never run the risk of proving a remedy?? What if it ain't the right remedy...are you of the opinion it 'goes through you with no problems'? I heard Karl say something like this to me last summer, but Snoopy from my experience that isn't so and I bet we'll discuss it next summer when I go home again (okay okay..I know you'll say with higher potencies this is more risky....but lower potencies can have lasting effects too!! And Karl said he hadn't seen any cases that were mucked up - or confused...hmm, I must ask him more about this on my next visit!! Maybe I misunderstood him ).

          I dunno...It just all seems to simplistic to me, at the moment...but maybe I'm wrong in this particular case.

          I just know that in other cases, I've wondered why remedies have been suggested for people to try....but perhaps that should've been my topic instead of this one?

          Man, I need to go to bed's late here and I'm not as bright as I was earlier . I'll check again tomorrow..when I'm rested and fresh and can keep my thoughts in better order .

          Night night,
          "The significance of a fact is measured by the capacity of the observer."
          Carroll Dunham


          • #6
   daugher really did well on that one dose of Apis 12c...and I really thought we were going to have to go up to a 30...even my Homeopath asked me why I started so darn low..and only when she heard my daughter's response to it did she sorta say, "Okay...then stick with that in water if it needs repeating but in future it is quite all right to go with a 30c to start in acutes like this".

            I live-n-learn, hey .
            "The significance of a fact is measured by the capacity of the observer."
            Carroll Dunham


            • #7
              Dear Lisa,

              you are absolutely right - there is no reason not to give a single dose of 30c and wait and see what happens, repeating only if improvement is partial or slips back to what it was before. The same can be said for 12c, which is still a powerful potency when the remedy is correct.

              Many people (myself sometimes included) give a number of doses based on what we were taught. This comes, I think, from an underlying feeling that the remedies aren't really strong enough, despite our experience. The idea that you need to kick start a case....I understand the desire, but why do we need to do this? The goal is gentle cure, not a shove.

              Although, I believe many patients WANT to really feel the remedy has done something dramatic. It can be hard convincing someone that the remedy they took 3 weeks ago has alleviated their migraines or eczema etc. But if they get an nice big aggravation, then they can pinpoint the moment the remedy started working, and they will more readily accept that homoeopathy does something after all. Perhaps practitioners feel this way too?
              David Kempson.<br />Dip.Homoeopathic Medicine.<br />Lecturer Australian College of Natural Therapies (Brisbane Campus)<br />Member AHA, AROH, HMA<br />Member Australian Homoeopathic Association. Member#0442.


              • #8
                Dear Lisa,

                I didn't notice my daughter was improving from her cough until at least 2 doses of the 30C were given. Imagine that you tell the average person suffering with an unpleasant acute that they can't repeat the medicine for 24 hours, so that you can see what one dose will do. Imgagine their dismay at having to suffer needlessly and for so long. So then the next day you say, OK, now try it twice a day. The acute drags on when it could have been alleviated in 24 hours.

                First of all, yes, it's an approximation and has to be adjusted to fit the person and the situation. The 3 times a day won't be apt for a bad car accident and yet might be too much for a simple indigestion which will surely resolve with one dose of a 30C.

                So, you really have to tell your patient, "If you get significantly better, stop the remedy, wait, repeat if you relapse or the case stalls." You may have noticed that I usually say that. And I say, Stop if you get worse and wait; improvement may follow.

                Talk to ya later,


                • #9
                  Dear Jayj,

                  4 or 5 doses of 200C to kick start a case? That sounds abusive, and unnecessary.



                  • #10
                    Great results with the Apis!

                    I have been prescribing lately with a "one dose & wait", explaining to patients that each remedy has a different duration, and can be used quicker if the body's vitality so requires.
                    I explain that a remedy may work for up to several weeks and look up the table at the back of Boericke or Kent's Repertorys and let them know how long.
                    I then give them my cell phone number and ask them to call me if they need to - either an aggravation or if they have felt the remedy wear off.
                    I also make a repeat appointment for them for when the remedy's duration is likely to finish.(about a month for Lyc.
                    Unless I know that they are familiar with the "less is more" principle of homeopathy & are unlikely to take a remedy "just in case", they won't get a sachet of pillules to take home.

                    So far, I have had good results doing this & patients have come back, saying that the changes in some cases have been gradual, but they know when the remedy has worn off & the duration between repeats is extended each time.
                    Perhaps the placebo effect?...

                    Some come in for acute prescribing.(where I DO give pillules to take home, at no extra charge)

                    Anyway, this is the path I have decided to take regarding my prescribing & I hope it helps you in your studies.


                    • #11
                      Thanks again, Snoopy. I wasn't suggesting to tell a patient they had to wait 24 hours between doses, but rather I think I'd tell them to call me when their symptoms worsened again.....kind of along the lines of what Ozzie posted after you.

                      I get the feeling it is partly about finding a way to give instructions that are in line with the Principles of prescribing, but that are somewhat convenient to the practitioner and the patient....can't be easy since all situations are different!

                      Thanks for your input, Ozzie ...much appreciated!! I like that you tell your patients to ring you when they feel something is happening (or not!) me this sounds like a better way to individualise, though I'm not sure how easy it is to manage, but then you seem to be doing well in this that is encouraging.

                      I know that my own Homeopath takes calls daily - during two one-hour-periods; once in the morning and once in the I know I can ring her during those times if anything is happening. And in the case of an emergency, I can leave a message and she'll get back to me asap...

                      Thanks again everyone for all the input.

                      "The significance of a fact is measured by the capacity of the observer."
                      Carroll Dunham


                      • #12
                        In my experience,(I admit being puzzled more often than not), dosing and potency is just as individual as the patient and case is and perhaps an individualistic approach is needed when choosing potencies and dosage frequency.

                        However, at this point, I could use you all's help in this little case:
                        I have given a friend Sulph 30C for treatment of her hemorrhoids. She reported immediate improvement of part of the sx and reappearance of older sx in reverse order, however after 4 days of taking 2 - 3 doses a day it hasn't cleared up yet and the condition is kind of getting a little worse before the next dose is taken. It looks like Sulph is the right remedy, but doesn't quite clear up the condition. Is this the time to go higher in potency (200C?) The hemorrhoids have come on about 3 months ago.
                        (BTW, she fits the Sulph traits beautifully on the mental/emotional planes)
                        I appreciate your help.


                        • #13
                          You could try putting the remedy in water and succussing before each dose before going up to a 200C.



                          • #14
                            Hi Claudia,
                            Just from a physiological point of view, I wouldn't expect haemorrhoids to disappear within a couple of days. How about a wait-and-see period?



                            • #15

                              The whole issue of repetition of the dose is totally dependent on the practitioner's ability to read secondary reactions clearly. First of all, there has to be a recognition that there is a primary action caused by the remedy and then a secondary reaction of the patient's Vital Force to the action of the remedy. This is why the wait and watch principle needs to be applied.

                              I've just read up an acute case of cerebro-spinal meningitis in a 1 year old child using LM's. The case belongs to David Little and his advice on the correct and uncomplicated use of LM's can be found at his website

                              This case is interesting because of the clinical tips he offers. This child had been hospitalized, lumbar punctured and blood tested to confirm the diagnosis. Penicillin had been used for 7 days which reduced the fever and made the case asymptomatic. 48 hours after finishing antibiotic therapy the fever 104 degrees returned with vengeance.

                              Belladonna, a well-noted remedy in these types of meningitis, was given in water, 200C and repeated. This held the fever for a while but it soon relapsed to 104 degrees. The question of going to 1M was considered, but rejected on the basis that an aggravation in these types of cases could leave this child dead. At this point David realized that although the fever had returned at the same hour and had all the same signs and symptoms as the original onset the previous week, this was in fact no ordinary simple onset fitting the Belladonna picture, but was a complicated suppressed case.

                              Based on signs and symptoms and its relationship to Belladonna, Sulphur LM1 was given for 6 doses then there was a relapse. LM 2 was given for several doses every 3 hours which reduced the temperature by a couple of degrees but then the meningitis haemorrhagic rash became visible under the skin on the child's legs. When this rash appears it is generally a sign that death is immiment, but he was encouraged by the way that the child's face showed less pain and anxiety than previously, LM 3, 3 doses, was given after which the rash symptoms disappeared. After 2 and half days from commencement of homeopathic treatment, the child was up and running about and continuing to improve, so LM 4 was given, twice daily for the next four days as meningitis is known for its tendency to return.

                              This case shows that in acute prescribing it's not only repetition of the dose that is important. It's also knowledge of relationship of remedies and knowledge of the disease itself that can determine success or failure.