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POTENCY AND DRUG STRENGTH
POTENCY
The products of potentisation are termed as potencies in different degrees.Potency denotes the power that is derived by the grades of medicinal power developed by the process of dynamization. They are a result of series of successive dilution, according to scale and friction through succussion or trituration.
Each stage of dynamization results in a medicine that is quantitatively reduced and qualitatively enhanced. The power generated is termed as 'potency' indicating the potentiality of the medicine.
Representation
The potency of the medicine is indicated by suffixing a numerical and an alphabet(s) to the indicated medicine.
* The numerical indicates the number of times the original drug is subjected to the process of dilution and friction.
* The alphabet indicates the scale under which the dilution is carried out - decimal, centesimal or fifty millesimal
Decimal scale
Decimal scale is denoted by 'X' or 'D' suffixed to the numerical.Hence, when the original drug is potentised once on the decimal scale, it will be represented as 1X or 1D.
If 'Cinchona' is potentised six times on the decimal scale, the power attained by 'Cinchona' will be denoted by 'Cinchona 6X', where 6 means the number of times 'Cinchona' is serially diluted and potentised and 'X' denotes that this potentisation is done according to the decimal scale.
Centesimal scale
Centesimal scale is denoted by 'C' or 'CH' suffixed to the numerical.Hence, when the original drug is potentised once on the centesimal scale, it will be represented as 1C or 1CH.
If 'Cinchona' is potentised six times on the centesimal scale, the power attained by 'Cinchona' will be denoted by 'Cinchona 6C', where 6 means the number of times 'Cinchona' is serially diluted and potentised and 'C' denotes that this potentisation is done according to the centesimal scale.
The potency of medicines prepared according to centesimal scale may also be represented by suffixing only the numerical and omitting the alphabet. Thus, Cinchona, serially diluted and potentised six times on the centesimal scale may be represented also as 'Cinchona 6'.
Fifty Millesimal Scale
* In India and Bangladesh - 0/1, 0/2, 0/3
* Western world - 1/0, 2/0, 3/0
* Hahnemann - 0/1, 0/20/3
* LM1, LM2, LM3
The '0' represents symbolically the poppy sized globule.'L' stands for Fifty and 'M' stands for Millesimal
DRUG STRENGTH
Drug strength signifies the strength of the drug in the given potency.In short, it is the concentration or the amount of the actual drug present in the given potency.
OLD METHOD
Class I = 1/2
Class II = 1/2
Class III = 1/6
Class IV = 1/10
NEW METHOD
Uniform drug strength is 1/10
EXCEPTIONS:
Sulphur = 1/5000
Phosphorus = 1/667
Cactus, Moschus = 1/20
Croton tig, Glonoine = 1/100
CALCULATION OF DRUG STRENGTH
Decimal scale
Potency - 1X
This is prepared by mixing 1 part of the original drug with 9 parts of vehicle. On potentisation, it gives 10 parts of 1X potency of the drug. Hence, 1 part of the original drug is present in 10 parts of 1X potency. Hence the drug strength of 1X potency is 1/10 or 10-1.
Potency - 2X
This is prepared by mixing 1 part of 1X with 9 parts of vehicle. On potentisation, it gives 10 parts of 2X potency of the drug. Hence, 1 part of 1X is present in 10 parts of 2X potency. Hence the drug strength of 2X potency is one-tenth of the strength of 1X potency, that is 1/10 X 1/10 = 1/100 or 10-2.
This can be tabulated as follows
POTENCY STRENGTH
1PX 1/10 = 1/101
2PX 1/100 = 1/102
3PX 1/1000 = 1/103
30PX 1/1030
nth potency - decimal scale 1/10n
Centesimal scale
Potency - 1C
This is prepared by mixing 1 part of the original drug with 99 parts of vehicle. On potentisation, it gives 100 parts of 1C potency of the drug. Hence, 1 part of the original drug is present in 100 parts of 1C potency. Hence the drug strength of 1C potency is 1/100 or 10-2.
Potency - 2C
This is prepared by mixing 1 part of 1C with 99 parts of vehicle. On potentisation, it gives 100 parts of 2C potency of the drug. Hence, 1 part of 1C is present in 100 parts of 2C potency. Hence the drug strength of 2C potency is one-hundredth of the strength of 1C potency, that is 1/100 X 1/100 = 1/10000 = 10-4. ???
This can be tabulated as follows
POTENCY STRENGTH
1PC 1/100 = 1/102 = 1/1001
2PC 1/10000 = 1/104 = 1/1002
3PC 1/1000000 = 1/106 = 1/1003
30PC 1/1060 = 1/10030
nth potency - centesimal scale 1/102n = 1/100n
Potentization Details
DEFINITION OF ORGANON BY:
HAHNEMANN
Homeopathic Dynamizations are processes by which the medicinal properties that are latent in natural substances while in their crude state, become aroused, and then become enabled to act in an almost spiritual manner on our life, i.e. on our sensible and irritable fiber.
STUART CLOSE
Homeopathic potentisation is a mathematico-mechanical process for the reduction, according to scale, of crude, inert or poisonous medical substances to a state of physical solubility, physiological assimilability and therapeutic activity and harmlessness, for use as Homeopathic healing remedies.
DYNAMIS OR DYNAMIC POWER
Dynamic action or power is the action of one substance on another substance without being able to recognize a sensible connection between cause and effect.
Hahnemann calls such effects dynamic, virtual, that is, such as result from absolute, specific, pure energy and action of the one substance upon the other substance.
*** The earth carries the moon around her in an orbit, in twenty-eight days and several hours, and the moon alternately, in definite fixed hours raises the seas to high tide and again correspondingly lowers them to ebb. This takes place not through material agencies, not through mechanical device, as are used for products of human labour.
*** Similarly, the energy of a magnet attracting a piece of iron or steel needle is not material, not mechanical. One sees that the piece of iron is attracted by one pole of the magnet, but how it is done is not seen. The steel needle becomes itself magnetic, even at a distance when the magnet does not touch it, and magnetises other steel needles with the same magnetic property (dynamically) with which it had been endowed previously by the magnetic rod.
In the same way, the dynamic effect of the sick-making influences upon healthy man, as well as the dynamic energy of the medicines upon the principle of life in the restoration of health is not in any way material or mechanical.
This is effected by mechanical action upon their smallest particles by means of rubbing and shaking and through the addition of an indifferent substance, dry or fluid. This process is called dynamizing; potentising (development of medicinal power) and the products are dynamizations or potencies in different degrees. [Aphorism 269, 6th edition, Organon of Medicine]
Potentisation is not merely the process of dilution that liberates the dynamic property of a drug, but the friction with an inert vehicle, by the process of succussion or trituration. So it is dilution plus friction that liberates the pharmacodynamic properties of the drug.
OBJECTS / ADVANTAGES OF POTENTISATION
1. By a continued process of reducing the material quantity of a drug, unnecessary medicinal aggravation and side effects of crude substances are avoided
2. Medicinal properties that are latent in crude state become aroused and awakened into activity.
3. Substances that are poisonous or toxic in their crude state like corrosive acids, poisons, heavy metals, venoms, etc. become important beneficial remedies after potentisation
4. Substances that are medicinally inert in their crude state may be rendered active after potentisation.
5. The concept of life, health and disease is not material, but dynamic in nature. Hence the concept of cure is also dynamic - and these properties are revealed by potentisation and provings.
6. Potentisation helps reveal peculiar 'individualistic' properties of a drug aiding in selection of the similimum on the basis of similarity of these peculiar individualistic symptoms.
EFFECTS / RESULT OF POTENTISATION
* Quantitative reduction of the drug material
* Qualitative increase in the disease curing properties
* Elimination of toxicity of poisonous drugs
PHENOMENON OF POTENTISATION
Successive dilution and friction
MATHEMATICS / SCALES OF POTENTISATION
* Centesimal scale
* Decimal scale
* Fifty Millesimal scale
MECHANICS / PROCESS OF POTENTISATION
* Trituration
* Succussion
HISTORY OF POTENTISATION
The principle of drug dynamization succeeded the proving of drugs and the enunciation of the law of similars and it was the third step in the evolution of Homeopathic principles.
Hahnemann began experiments of the application of proven drugs for the cure of the sick upon the basis of the law of similars, by using drugs in their full strength. He found that many times the patient became greatly aggravated. Hahnemann reasoned that the dose was too large, and he experimented by diluting the drug on a definite scale. To his surprise he found that he secured better results. He continued this process until he discovered that the curative power of drugs bore no proportionate relationship to the crude quantity, but that under the peculiar and systematic reduction by a regular scale, and the proper manipulation, many drugs in common use, and many substances supposed to be inert in their crude states, became endowed with new and hitherto unsuspected activities and powers.
Two closely related discoveries brought Hahnemann closer to the principle of dynamization -
1.
One was the improved curative effect of reducing the dosage of previously used medicines.
2.
The other finding was that substances such as salt or lycopodium, not previously identified as medicines became therapeutically active on undergoing this process.
* 1790 - 1796: Essay in Hufeland's journal
* 1798 - 1811: Prescribed medicines in usual doses, but slightly reducing doses. Upto this period, decrease of the dose was advised for the sake of preventing the violent action of the remedy. No mention in Medicine of Experience (1805) and 1st volume of Organon of Medicine (1810).
* Hahnemann gradually increased the dilution of medicines. Around 1825, Hahnemann began viewing these preparations as "dynamizations" or "potentisations" rather than as mere dilutions.
* It was this phase, when he understood the idea of friction as bringing about the remarkable change in the activity of the drug. This is represented in his article "How can Small Doses of such very Attenuated Medicine as Homeopathy employs still possess great power" in 1827.
* Hahnemann felt in 1829, the necessity of a limit in potentising and declared the ultimate degree of dilution to be the 30th centesimal potency.
* In the 5th edition of the Organon, Hahnemann clearly described the concept of potentisation in ?269. He provided the first specific instructions on dynamization in ?270-271.
* He then developed the Fifty Millesimal scale and described it in the 6th edition of the Organon (?270).
FIFTY MILLESIMAL SCALE
This scale was introduced by Hahnemann in Aphorism 270 of the 6th edition of Organon of Medicine, published in 1921. Hahnemann termed it - "Renewed Dynamisation".
Dr. Pierre Scmidt and Dr. Charles Pahud popularized this method. Since the publication of French translation of the 6th edition of Organon by Pierre Schmidt of Geneva and his articles in British Homoeoapthic Journal, July - October 1954: ''The Hidden Treasures Of The Last Organon'', attention of homoeopaths was drawn to these changes. These potencies were termed by Pierre Schmidt as "Fifty Millesimal Potencies".
DESIGNATION
The potencies prepared according to this method are denoted by prefixing '0', representing symbolically - 'medicamens au globule' or by the letters 'LM', representing 'fifty millesimal'.
* 0/1, 0/2, 0/3, ... 0/30 [in India and Bangladesh]
* LM 1, LM 2, LM 3, ... LM 30
* LM I, LM II, LM III, ... LM XXX
* 0/I, 0/II, 0/III, ... 0/XXX
* 1/0, 2/0, 3/0,... [in Western world]
PREPARATION OF LM POTENCIES
APHORISM 270, 6th EDITION, ORGANON OF MEDICINE
1. 1 grain of the drug substance is triturated for three hours with sugar of milk up to 3C in powder form.
2. 1 grain of 3C is dissolved in 500 drops of a mixture of one part of alcohol and four parts of distilled water.
3. 1 drop of this solution is put in a vial. To this are added 100 drops of pure alcohol and given one hundred strong succussions with the hand against a hard but elastic body. This is the medicine in the first degree of dynamization in the liquid form.
4. Small sugar globules are moistened and kept in a well-corked vial with the sign of (I) degree of potency. These globules are such that 100 weigh 1 grain and 500 of which absorb one drop.
5. Only one globule of this is taken for further dynamization, put in a second new vial (with a drop of water in order to dissolve it) and then with 100 drops of good alcohol and dynamized in the same way with 100 powerful succussions. With this fluid, globules are again moistened and put into a well-stoppered vial and protected from heat and sunlight and given the sign (II) of the second potency.
HOMOEOPATHIC PHARMACOPOEIA OF INDIA
1. Triturate the crude drug substance with sugar of milk in the proportion of 100 mg of dry substance or 0.1 ml of liquid substances with 10 g of milk sugar, up to 3C.
2. Prepare solution of 3C potency by adding in the proportion of 100 mg of the third potency to 50 ml of a mixture of Purified Water and dispensing alcohol prepared by taking 4 parts of Purified Water and 1 part dispensing alcohol. This is termed ''mother solution''.
3. Mix one drop or part of this mother solution with 100 drops or part of dispensing alcohol and give 100 strong succussions. This makes the first Fifty Millesimal potency, expressed as ''0/1''.
4. Soak globules of nearly uniform size, 100 globules of which weigh 65 mg, in a drop of the preceding potency, dry them. Take one globule and dissolve it in a drop of Purified Water in new phial. Add 100 drops of dispensing alcohol to it and give 100 strong succussions.
COMPARISION BETWEEN LM POTENCIES AND CENTESIMAL POTENCIES
1. For preparation of further potencies in centesimal scale, 1 part of previous potency is potentised with 99 or 100 parts of vehicle - MEDICAMENS A LA GOUTTE. In LM scale, globules are saturated and used to further potencies - MEDICAMENS AU GLOBULE.
2. The mother tincture or substance in the centesimal scale is a drop of the drug or one grain in weight. In LM, the starting solution is the solution of 1 grain of 3C in 500 drops of diluent containing water and alcohol in the ratio 4:1.
3. No. of strokes is ten in the centesimal scale and 100 in the LM scale.
PREPARATION OF THE DOSE FOR LM POTENCIES
In the 6th edition of Organon of Medicine, Hahnemann mentions making an aqueous solution of the LM potency. A fundamental reason for using the medicinal solution is to make it easier to adjust the dose of the remedy to fit the sensitivity of the constitution.
The preparation of the medicinal solution for administration is as follows
1. Take 1 globule of the desired potency and place it into a clean bottle. Take 4 oz. of distilled water. Add a small amount of pure alcohol, as a preservative and stabilizer. This medicinal solution is now ready for use.
2. Succuss the bottle just prior to ingestion 8, 10 or 12 times, depending on the sensitivity of the patient. This raises slightly the potency and activates the remedy.
3. Take 1 or 2 teaspoons of the medicinal solution and place it in 4 oz. of water and stir. Most cases are begun with 1 teaspoon and the amount is increased only if necessary. This is the first dose. Throw away the rest.
4. Each dose from the medicinal solution of each potency is to be applied in the same manner. In case of any aggravation to this dose, further administration is halted and the aggravation is allowed to settle down. If the same remedy is indicated, then it is now administered by diluting the medicine in 2nd, 3rd or 4th glass of distilled water, to make the dose as safe and harmless as possible.
POINTS TO CONSIDER
1. The remedy is always succussed just prior to ingestion for slightly raising the potency. The number of succussions is directly linked to the dynamic effect of the remedy at the time of ingestion. In aphorism 248 Hahnemann mentions 8 (hypersensitive), 10 or 12 (hyposensitive) as the number of succussion given to the solution prior to ingestion.
2. The dosage of the medicinal solution can be carefully adjusted to suit the sensitivity of the individual's constitution.
3. The average size of the dose is 1 teaspoon of the medicinal solution stirred into the water in the dosage glass. From this glass the patient takes 1, rarely 2, teaspoons of the mixture. Normally, start with 1 teaspoon and only increase the amount when necessary.
4. This two-fold process of succussing and diluting causes a considerable change in the dynamization of the remedy. As the succussing raises the potency, the dilution reduces the amount, thus allowing the remedy to work rapidly, gently and permanently.
ADVANTAGES OF LM POTENCIES
1. It becomes easy to select from a limited range of potencies.
2. No fear of aggravation of disease or patient's condition by administering it in high or low potency and in repeated doses.
3. Can be repeated any time when there is need for medicine according to Law of Similars.
4. Action is quick and rapid.
5. Accurate judgment of the nature of cure.
ADVANTAGES OF LM POTENCIES
1. Hahnemann wrote the preface to the 6th edition of Organon in February 1842. After a gap of 77 years, Dr. Haehl of Germany managed to get hold of the original manuscript in the early part of 1920 with the financial assistance of Dr. Boericke. In 1922 Dr. Boericke published the English translation of this edition. This long delay is one reason for the unpopularity of this scale.
2. Some of Hahnemann's followers started using these high potencies, even before Hahnemann had laid down instructions about this new method. Hering, Kent, Dunham and Nash advocated the practice of using high potencies like 200, 1M, 10M, 50M, CM, MM and claimed better therapeutic results in many cases that did not respond satisfactorily with thirtieth and lower potencies. With the absence of the new directions and the popularity of the high potencies for about ninety years, sufficient experience was gained with the high potencies. When the 6th edition of Organon was available for the profession, it found some reluctance amongst the profession also due its authenticity.
3. The intricacy of the mode of preparation of medicines and its administration and regulation has led to a lack of usage amongst the profession.
