History and evolution of potentization

Dr Chandana Chandran 

POTENTIZATION

Similar word found in the dictionary:

• POTENTIA: means power; ability; to perform.
• POTENTIAL: (Latin:- potentialis) capable of coming in to action.
• POTENTIATE: make more powerful.

DEFINITION

It is a mathematico-mechanical process by virtue of which the inherited dormant dynamic curative power of drugs is aroused or increased by modifying drug strength/drug power to dynamic power through simultaneous and successive process of dilution & friction in definite order according to pharmacopoeia.

POTENTIZATION OR DRUG DYNAMISATION

Master Hahnemann in his preface to the 5th volume of chronic diseases defines:            “ Homoeopathic Dynamisation are processes by which the medicinal properties, which are latent in natural substances while in their crude state, become aroused and then become enabled to act in our life,i.e., in our sensible and irritable fibre. This development of properties of crude natural substances(dynamisation) takes place in the case of dry drug substances by means of trituration in mortar, but in case of fluid substances by means of shaking or succussion, which is also a trituration.

According to STUART CLOSE “he called it as potentiation instead of potentisation. according to him po-ten-she-a-shun  means: the synergistic action of two in which the total effects are greater than sum of the independent effects of the two substance. “he called it as potentiation instead of potentisation.

According to him “HOMOEOPATHIC DYNAMISATION” is a mathe- matico-mechanical process for the reduction, according to scale, of crude, inert or poisonous medicinal substances to a state of physical solubility, physiological assimilability, and therapeutic activity, and harmlessness, for use as homoeopathic healing remedies.

HISTORY OF POTENTIZATION

Two closely related discoveries brought Hahnemann closer to the principle of dynamization:

• One was the improved therapeutic effect of reducing the dosage of previously used medicines.
• The other finding was that substances such as salt or lycopodium, not previously identified as medicines became therapeutically active on undergoing this process.

So Hahnemann, setting out simply to reduce the quantity of his doses, discovered potentization, an entirely new principle in posology. This is the principle, which gives life and power to the system of medicine that Hahnemann developed and is the third great step in the evolution of the law of cure.

EVOLUTION OF THE CONCEPT OF PONTENTIZATION

Hahnemann’s approach to potency was modified in each phase of his medical career. A point worth emphasising is that he was an experimenter and innovator, motivated more by practice than by theory. These phases can be discussed in detail along with the published works that Hahnemann was involved with at each stage.

1784-1796 PRE-HOMOEOPATHIC MEDICAL CAREER

• Before discovering the law of similars, Hahnemann’s treatment of his patients differed very slightly from that of other physicians.
• His prescriptions corresponded in composition weight and quantities with those of his contemporaries.
• 1790- Hahnemann translated Cullen’s Materia Medica– historic discovery relating to Cinchona Bark.
• Hahnemann wrote- “Surely toxicity is nothing but the violent manifestation of an extremely powerful agent applied in too high dose and in the wrong place.”
• 1796- Hufland’s journal – “ESSAY ON A NEW PRINCIPLE FOR ASCERTAINING THE CURATIVE POWERS OF DRUGS.” In this essay he makes reference to the use of ‘small doses’, but does not clarify what he meant by “small”.
• The aggravation or the increase of disease symptoms following the administration of the homoeopathic remedy, induced him gradually to decrease the dose.
• But this diminution was not so swift and it was only by experiments and bedside experiences that the necessity was felt by him.

1797- 1800: FIRST HINT OF DILUTION

• 1798 (Hufland’s journal)- ‘SOME KINDS OF CONTINUED AND REMITTENT FEVERS’. Here, he noted using Ignatia in doses of 2 to 3 grains; Opium in 1/5 – ½ grain doses; Camphor 30- 40 grains/ day; Ledum 6- 7 grains.
• Although these are still ‘Crude’ doses, and rather large by later homoeopathic standards, they represent dramatic reductions from the allopathic doses of his contemporaries.
• The first hints of dilutions are found in his ‘Apothecaries Lexicon’(1798), where he recommends Sabina ‘in very small doses’; stramonium at 1/100^th or 1/1000^th part of grain.
• Hahnemann’s experiments during this time led him to the use of even smaller doses, with those remedies he used commonly. Serial dilution in the preparation of remedies appears to have been introduced in 1799.

1801- 1813: DISPERSING THE SUBSTANCE WELL THROUGHOUT DILUTION MEDIUM

• 1801- ‘CURE AND PREVENTION OF SCARLET FEVER’. He offered exact details of the preparation and administration of belladonna.
• He offers descriptions of mixing such as ‘shaking the whole well’ and ‘intimately mixed by shaking it for a minute’ that suggest as interest in dispensing the substance well throughout the dilution medium. He describes these preparations in terms as dilutions, attenuations or reduced doses.
• Hahnemann wrote an article ‘ON THE POWER OF SMALL DOSES OF MEDICINE IN GENERAL, AND OF BELLADONNA IN PARTICULAR’, in Hufland’s journal in 1801. He still understood the infinitesimal preparations to be dilutions or small doses.
• The 1st edition of the organon was published in 1810, referred only to “small doses”, Individually determined for each medicine. In 1811, The first part of “material medicapura” appeared without any mention of the size of dose. In 1813, Hahnemann published the dissertation “Sprit of the new Theory of Healing’’ where he wrote, ’The spiritual power of the medicine attains its purpose not by quantity but by quality’.
• Up to 1813, nothing definite was written by Hahnemann. There appeared general remarks about dilution and reduction of size of doses.

1813-1819: SEED OF DYNAMIZATION THEORY

• 1813- ‘Spirit of the Homoeopathic Doctrine of Medicine’ – Drugs, besides their physico-chemical properties, possess another property by which they alter the qualitative state of the organism. More the materiality of a drug is reduced, by processes of dilution or trituration, greater the specific therapeutic quality lying dormant in the drug seemed to be unveiled.
• This is the seed of dynamization theory. So it is dilution plus friction that liberates the pharmacodynamic properties of the drug.
• In 1814 article “treatment of the Typhus or Hospital Fever at present Prevailing” where he mentions Bryonia and Rhustox in dilutions prepared by serially diluting 1 drop to 6 drams twelve time, shaken for 3 minute at each step, and used a dose of 1 drop of the 12th dilution.
• Vol 2 of material medicapura (1816) has dilution on the Centesimal scale (1:100) as far as 30th potency under arsenicum. As for the method of agitation, he still says: well shaken or accurately shaken.
• His observations had demonstrated that certain substances, ineffective in their natural form, as common salt, charcoal, lycopodium, silica, lime, etc. become available as an efficacious medicine only after prolonged trituration with milk sugar.
• The fourth vol. of material medicapura appeared in 1818. Until then, Hahnemann had used gold only in solution. Here under Aurum, he discusses the first metal to be triturated. From that time onwards no longer designated the different degrees of his dosages as dilutions, but as ‘power developments’ or ‘potencies’.

1820- 1828: ‘DYNAMIZATIONS’- IMPORTANCE OF FRICTION

• 1821 – Sixth volume of Materia Medica Pura, Hahnemann referred constantly to treating with “the smallest part of a drop”.
• Hahnemann mentioned for the first time, in the preface: bring down ten times, using the full strength of the arm. Hahnemann was then adopting the use of globules, whereby a fraction of a drop could be administered easily.
• In 1822, 2nd edition of volume 1st of the material medica pura, dosing recommendation range from the crude tincture for cannabis, to the 9th to 30th centesimal dilution or trituration with the dose consistently specified as the “smallest part of a drop”.
• From the various volume of the second edition of the material medicapura. (1824 – 1827), he gradually increased the dilution of remedies. 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 Homoeopathy” employs still possess great power’in 1827. Hahnemann used the terms ‘dilution’, ‘diminish’, ‘dynamization’ / ‘dynamic’ / ‘dynamized’, and ‘potentization’ / ‘potency’ to describe these various concepts. The term ‘too-strong dose’ referred to prescriptions making a too-strong impression on the life force either by to being too large (in a material sense) or of too great a potency.

1829- 1837: ‘STANDARD POTENCY 30C; OLFACTION’

• Hahnemann felt in 1829, the urgent necessity of a limit in potentising and declared the ultimate degree of dilution to be the 30^th centesimal potency.
• In 1832, Hahnemann began experimenting with olfaction of remedies.
• 5^th edition of the Organon- Hahnemann described the concept of potentization in §269.
• A detailed description of the process of trituration, principally for the first 3 centesimal dilutions of insoluble medicinal substances, was given in part 2 of the 1st edition of chronic diseases (1835).
• Hahnemann also began experimenting with giving the dose in solution, rather than as a dry pellet on the tongue.
• In 1835 Hahnemann described ‘split doses’ of a medicinal solution produced by dissolving a medicated centesimal pellet in a volume of water. This reduced dose allowed for more frequent repetition.
• In the 2nd edition of vol. 3 of chronic diseases (1837) he changed his method again, going back to 10 succussion strokes. In 2nd volume of chronic diseases gives a further minor change of method. Hahnemann had found that metals triturated for a total of 3 hrs, exactly 1 hr. per stage, were soluble in water. All dry material – plant minrals metals were triturated upto 3c and then converted into a liquid and potentized.

1838: FINAL INSTRUCTIONS

• LM potency scale, which Hahnemann referred to as “medicaments au globule” as distinct from the centesimal ‘medicaments a la goutte’, was developed in 1838.
• 5 years before his death, with the intention of preparing remedies even better adapted for use in split dose in medicinal solution – 6th edition of the Organon (§270). Intimately related to these new preparations, were new approaches to the repetition of dose.
• Potentisation was a result of repeated experimentations by Hahnemann.
• Hahnemann took many years (aprox 30 -40 yrs) to come to the conclusion of higher dynamisation. Lot of assumptions, experiments, permutations & combinations were done by him. So the existing form of dynamic medicines today are an outcome of hard and extensive labour and is not as simple as it looks. It passed many hurdles & controversies and now it is in its refined form.

USE OF PILULES IN EVOLUTION OF THE PRINCIPLE OF POTENTIZATION

• After 1818 Hahnemann no longer gave the drops as they were, instead patients were given the smallest part of a drop. To divide a drop and obtain its smallest part, he used pilules made from sugar that were 100-300 to a grain. In the 3rd edition of Organon (1824), he said: ”… in so far as one drop of spirits of wine adequately wets about a hundred such pilules”.
• When Chronic Diseases appeared in 1828, he was using pilules weighing 200 to a grain, and had acquired sufficient skill to wet 300 of these with a single drop.
• At first Hahnemann gave drops produced by shaking for minutes at time, varying the number of drops according to the age of the patient. These proved fairly powerful, however, and he soon advanced as far as the 30C.
• He also felt that there had to be a limit somewhere. Reducing the dose by wetting pilules, i.e. dividing a drop into between 100 and 300 parts also did not get him nearer to his goal.
• Finally, in 1838 the LM potencies make their first appearance. In the sixth edition of Organon of Medicine, he mentions the use of pills, such that 100 of which one grain and 500 such globules can scarcely absorb one drop.
• One can therefore conclude that Hahnemann changed his views on potency mainly in the light of clinical experience rather than empty speculations and theories. It is also clear that he was moving higher and higher and that in his later phase he settled both on olfaction and the LM potencies as being especially gentle and effective methods of drug administration.
• He regarded them as superior for practical reasons, not out of any preconceived notions. Although Hahnemann spoke only of medicines that were attenuated to the 30th centesimal, he did question how far the subdivision of the substance could be carried before it failed to produce an effect.
• Within Hahnemann’s lifetime, the drugs became more attenuated. Boenninghausen and Lehrmann, a pupil of Hahnemann, produced preparations made by hand in the Hahnemannian manner up to the 200th attenuation.

POST-HAHNEMANN ERA

• DECIMAL SCALE- DR. C. HERING

Introduced in the 1830s by the American homeopath Constantine Hering. Denoted by (D or X), diluting the substance to ten times its original volume each stage. It has a dilution factor of 1:10 meaning that one part of the drug substance or potency is diluted in 9 parts of a Vehicle. The D or X scale dilution is therefore half that of the same value of the C scale; for example, “12X” is the same level of dilution as “6C”.Decimal potencies are easy to use and can be dispensed as pilules, tablets or liquids. Being “low potency” remedies, they can be repeated frequently with little risk of producing proving symptoms. For this reason they are commonly sold by retail outlets for self treatment of simple acute problems. The Schuessler Tissue Salts are one such example. They are less commonly prescribed by homeopathic practitioners as they have limited use in the treatment of deep-seated chronic conditions.

• VON KORSAKOFF

Von Korsakoff, a Russian, introduced the concept of using a single vial in the potentization process; the amount of liquid adhering to the emptied vial would be considered as one part of the next attenuation.

Ninety-nine parts of menstrua were then added to produce the 1:100 centesimal ratio. Hahnemann entered into correspondence with Korsakoff as early as 1829. He did not speak against the method or against the higher attenuations but only suggested that, for the sake of ‘uniform results’ it would be best to stay with the 30th attenuation. He is quoted, in a letter to Dr. Schreeter (1829) that ‘there must be a limit to the thing, it cannot go on to infinity.

Another early experimenter, Julius Caspar Jenichen, was introduced to homoeopathy by Gustav Wilhelm Gross, another of Hahnemann’s pupils, The methodology Jenichen used to produce his potencies is a topic for another time. Suffice to say that Jenichen believed that it was the succussion of the drug that gave its strength. He began with a vial of the 29th liquid dilution, which was allowed to evaporate completely. The empty vial was then filled with alcohol and succussed, every twelve shakes increasing the potency by one degree. It was Jenichen who introduced to homoeopathy the concept of potency rather than simply dilution. After Hahnemann’s death in 1843, further work began in an effort to explore the ‘edges of the envelope’ of potentization. W. W. Robinson describes the time as an era when the physical and chemical sciences were beginning to take a more definite form, the concept of high potency thrived in what might be termed an atmosphere of “gentle philosophy.

• CARROLL DUNHAM

Carroll Dunham One of the first people to attempt to mechanize the potentization process was Carroll Dunham. Upon returning from a visit with Boenninghausen, he decided to produce some 200th potencies. He was assisted in the task by his father. The job, using the single vial Korsakoff method, took one week.

• FRANCIS EDMUND BOERICKE

The Boericke machine is unknown, save one woodcut that appeared in The Organon. The tube on the top drew water into a pump. At the first revolution of the wheel, the pump drew 100 drops of water into the pump housing. The second revolution of the wheel pushed the water out into the potentizing vial on the left. The continued motion of the wheel converted the rotary movement into a reciprocating vertical motion that shook the vial. The potentizing vial had a narrow-necked opening at the bottom. After it had been given five full shakes, all the liquid in the vial had been shaken out of it. It was then ready to receive another per minute. hundred drops from the pump. It was calculated that the machine could make 100 potencies per minute. Dr. Skinner writes, in 1879, of having seen the machine in operation. He was critical of its operation in that it took a person to work the machine, and he believed that the inhalation of high potencies was injurious to the health. At the time of that writing, Skinner reports that the machine was not being used. The fate of the machine, and the possible potencies that were made by it, remains unknown.

• BERNHARDT FINCKE

In 1865, Fincke wrote a small volume titled On High Potencies, published by A.J. Tafel in Philadelphia. This book presents cases that were cured with high potencies, some made by hand, some dry-grafted in the Korsakovian manner. Fincke had experimented with several methods of making the higher potencies. His original potencies (up to a 30c) were made by hand with alcohol in the Korsakovian manner. He succussed each potency 180 times in a ‘dactylus rhythm’ (ONE, two, three). In 1869, Dr. Fincke was granted a patent for a new potentizing process, that of ‘fluxion. ‘In this process, a one dram vial filled with a hand- made 30c potency is subjected to a continuous water flow. Using a long glass tube called a ‘regulator’ the water flows from the bottom of the vial, displacing the water above it. When one dram of water has flowed through the vial the potency was considered to have been raised by one degree.

• THOMAS SKINNER

In 1878, Dr. Skinner had developed the ‘Skinner Fluxion Centesimal Attenuator‘. This device was designed to mount above a small sink in the office or home. The motive power was water pressure. The device consisted of a water wheel which turned a shaft to which was attached two small cradles. These cradles each held a small glass vial. The main shaft had a counter attached which measured how many times the machine cycled. Over each cradle was a small diameter down-spout. All of the water lines were fitted with stop-cocks, so the flow of water could be easily regulated. Skinner believed that his preparations, made in the 1:100 ratio of the Hahnemann centesimal, were the equivalent of a true centesimal potency. It was his desire to place all the potencies on the same scale of attenuation and notation ‘without cavil or doubt’ and that notation should be the centesimal or Hahnemannian scale. About his machine, he said: It makes 50 centesimal potencies per minute, 3,000 per hour, 72,000 per day, 100,000 in about thirty-three hours, and the MM, or millionth, in three hundred and thirty hours, or about fourteen days and a half, running night and day and there is no doubt whatever that it is the millionth centesimal potency of Hahnemann.

• P. BURDICK

This machine was discussed in an article that appeared in the May 1879 edition of the North American Journal of Homaeopathy. Martin Deschere, MD, concerning the exact calibration of the fluxion potencies on the centesimal scale. He describes this potentizer as ‘the first correct and truly centesimal potentizer. James Tyler Kent Some time after 1903, when he wrote the letter praising the Skinner potencies, Dr. Kent developed his own potentizing machine. It is not known who built it, or the extent of Kent’s involvement in its construction. It was used by Ehrhardt and Karl to make high potencies above 1M, and was mentioned in their 1915 catalogue.

NEW CLASSICAL METHODS OF POTENTISATION

LMs: A UNIQUE POTENCY, A UNIQUE METHOD

• The LM potencies are made by diluting the remedy in a ratio of 1 to 50,000 at each step instead of 1 in 100, while still keeping the succussions at 100. (A detailed explanation is provided below under How to Make the Remedies.) The high number of dilutions raises the power of the remedy very high, while the relatively low number of succussions keeps the aggravations low. The result is that the remedy action quickly penetrates very deep, to the mental-emotional level and far back in the patient’s timeline. This allows a cure in much less time than Hahnemann’s previous centesimal method, which is exactly what he was looking for the rapid, gentle and permanent cure. At the same time, any aggravation wears off quickly. Usually in 24 hours or less, thereby allowing immediate adjustment. By reducing the intensity and duration of action through a high degree of dilution, we can now regulate the homeopathic aggravation, something that was impossible before the invention of this potency.
• LMs are also called Q potencies, both of which refer to the 1 in 50,000 dilution. (1. And M are the Roman numerals for 50 and 1000 respectively, while Q is an abbreviation for “quinquagesimillesimal,” derived from the Latin quinquagesimus [50th] and millesimus [thousandth]). The specific potencies are notated 0/1, 0/2 or 1/0, 2/0, or Q1, Q2, etc. in which the 0 stands for the tiny poppy seed granules on which they are prepared.

HOW LMS ARE MADE

• To fully understand the differences between centesimals and LMs, it is helpful to compare how they are made. Most centesimals are made by diluting one part of the remedy mother tincture in 99 parts of alcohol (such as Ever clear or vodka) and succussing it 10 times to make a le repeat for each successive potency.
• Remedies which begin as solids (such as most minerals) go through the process of tribing to which Hahnemann developed. (Liquids like snake venoms are dropped onto lactose and triturated A milliliter of liquid is equal to a gram of solid in this case, so I ml of a liquid remedy would be poured over 99 grams of lactose and then triturated) The goal is to grind one part of the remedy substance with 99 parts of lactose in a mortar and pestle, but Hahnemann found it onwieldy to grind the whole batch at once, so he would divide the 99 parts of lactose into three batches. He would grind and scrape the remedy with the first batch for 20 minutes, then add the second batch and grind and scrape another 20 minutes, finishing with the last batch for a total of 60 minutes grinding and scraping. When Hahnemann first developed this method he declared it equivalent to diluting and succussing in a 1 in 99 ratio; i.e., he said it was an alternative way to make 1c. By the time a solid remedy substance has been triturated up to 3c, it is soluble and can then be diluted and succussed like a liquid remedy.
• LM potencies begin the same way as centesimals, except that they are made by tritura tion up to 3e no matter what the original substance. Plants are crushed with lactose instead of being made into a tincture. Remedies which begin as a liquid (like sepia ink, snake venoms. and Petroleum) are dropped onto lactose pellets in a 1 to 99 ratio. Apparently as Hahnemann worked with triturated remedies he found that this process released the dynamic or energetic properties of the remedy better than dilution and succussion.
• To understand the vast difference between LMs and centesimals it helps to understand Hahnemann’s line of reasoning and why he began experimenting with the LMs. His students and homeopathic colleagues around him were experimenting with very high potencies (up to 16M) and skipping many steps between potencies administered to patients, thus jumping thousands of succussions between doses. The result was what Hahnemann called the violent energy of the higher doses. Hahnemann was looking for a way to increase the dilution with out so much violent succussion, and a way to progress more gently from one potency to the next in the course of treatment.
• Hahnemann, one of the master pharmacists of his era, came up with a simple and ingenious solution for increasing the dilution, thus making the remedies ever safer (especially considering that some were made from poisons) while holding back on the succussions, thus keeping the energy at a gentler level. Instead of succussing 10 times for each 1 in 100 dilution, the LMs are only succussed 100 times for each 1 in 50,000 dilution.

Administered in water (a development of the 5th edition, as we have seen), the LMs became a truly revolutionary tool- within a healing system which was revolutionary in itself-for healing at a deep level while controlling aggravations. Putting the remedies in water accomplished several things at once:

• It enhanced the effectiveness of delivery, since the teaspoon of water could touch many more nerve endings than a tiny pellet.
• It allowed a single dose to be split into many administrations; a single pellet of a potency would be “spread out” into an entire bottle.
• Succussing the bottle allowed minute upward adjustments of the potency (finer tuning than the 10 succussions between centesimal potencies) in keeping with Hahnemann’s 6^th edition dictum never to give the same potency twice.
• It thus allowed for highly refined adjustments to respond to aggravations and to the individual temperament.

Putting LMs in water allows for many ways to adjust both the potency and the dose, thus allowing these as well as the remedy itself to be individualized to the patient. The practitioner can adjust the size of the remedy bottle (usually 4 or 8 oz.), while the patient can adjust on a daily basis if necessary-the number of succussions, the number of cups it is dissolved in, and the quantity taken (1 tsp. 1/2 or 1/4 tsp., etc.). The patient can take the remedy once a day (chronic) or several times a day (acute) and can “plus” the remedy when the bottle is nearly finished. (All these adjustments are described in detail below.) The simple fact that the remedies are gentle enough to be taken daily allows much more freedom for adjustments.

The tedious part of this process is making LM1. Practitioners usually purchase an LM1 kit and make the LM2, LM3 etc. by hand as patients need them. Making the higher LMs only takes a few minutes to make enough to last for years. If your 500 pellets run out you just use drop from the appropriate LM stock bottle to impregnate another 500 pellets.

REFERENCES

• TAFEL LH, HUGHES R, DUDLEY P. THE CHRONIC DISEASE THEIR PECULIAR NATURE AND THEIR HOMOEOPATHIC CURE, BY DR. SAMUEL HAHNEMANN. B. JAIN PUBLISHERS PVT. LTD, NEW DELHI 1995.
• DAS AK. A TREATISE ON ORGANON OF MEDICINE. 2^ND KOLKATA: BOOKS AND ALLIED (P) LTD, 2006.
• K. SARKAR, HAHNEMANN’S ORGANON OF MEDICINE. 9^TH EDITION, BRILA PUBLICATIONS PVT. LTD. NEW DELHI.
• E. DUDGEON, WILLIAM BOERICKE, DR. SAMUEL HAHNEMANN ORGANON OF MEDICINE. 5^TH AND 6^TH EDITION COMBINED, NEW DELHI: B. JAIN PUBLISHERS PVT. LTD, 1995.
• LUC DE SCHEPPER, HAHNEMANN TECTBOOK OF CLASSICAL HOMOEOPATHY FOR THE PROFESSITIONAL. B. JAIN PUBLISHERS (P) LTD.
• https://www.homeobook.com/?s=evolution+of+potentisation.