The 50Millesimal Scale of Potentization as Described in Sixth Edition of Organon of Medicine

This post is an attempt to give a brief introduction of 50 millesimal scale of dynamization as portrayed in the sixth edition of Organon of Medicine, written by Dr. Samuel Hahnemann. This scale introduced in the sixth edition is called as the perfected method of dynamization by Hahnemann. The name 50 millesimal potencies for this latest and perfected method of potentization of Hahnemann was given by Dr.Pierre Schmidt.

The Organon of Medicine is the reference book for LM potency. Till the sixth edition, the centesimal scale was used often. There were some difficulties while using the medicines in centesimal scale. I know most of us face similar problems. What would they be? It is every sincere physician's wish to provide the gentlest and the swiftest cure to the patient.
It is not advisable to repeat a homoeopathic medicine as long as the action of the given dose lasts. Some medicines may act for several days. Our hands are tied up till we wait for the drug to exhaust its action. How often do you wish to repeat a drug just to releive the patient? This problem is solved with 50millesimal potency; we are now free to repeat the medicine hourly, daily etc. as and when the situation demands. Thus the duration of curative action of the remedy is cut short and the patient is on the path to quickest recovery provided the drug is the similimum to the case. There is a prerequisite for this repetition, "The degree of every dose deviate somewhat from the preceding and following".

How often do you repeat the medicines with this scale? In aphorism 248, Hahnemann gives clear instructions as how this is to be done. In very urgent cases, the medicines could be repeated every hour or oftener. In acute diseases it could be repeated every two to six hours. In chronic diseases a teaspoonful or several could be given daily or every second day.In the footnote to the same aphorism, Hahnemann mentions how the medicine could be administered to suit the highly sensitive patients.A solution of the medicine be made with 7 to 8 tablespoonfuls of water in a glass and stirred. A dose is to be given to the patient. A teaspoonful of this solution mixed with a second glass of water and a dose is then administered to the patient. Likewise, a third or fourth glass could be similarly prepared and used if necessary. In footnote 155 Hahnemann ,after describing the method dynamization in this scale, the practice of repetition of medicines in acute diseases is advocated. In the chronic diseases it is best to begin with the lowest potency and then advance to the higher degrees when necessary. The method of dynamization is described in aphorisms 270 and 271, along with their footnotes.

Homoeopathic aggravations according to the right protocol though a welcome sign of action of the similimum, are often feared by the physician and the patient. It is not always possible to administer the exact potency, to minimize those aggravations. A patient suffering from pain or a skin disease could find it difficult to bear. The cases of a terminally ill or fatal cases are altogether a different matter. The homoeopathic aggravation finds a relief in LM potency. Does it mean there is no aggravations when you use the LM scale?It is that the aggravations are different here. In aphorism 248, Hahnemann mentions that with daily repetition of medicines in chronic cases, there appears homoeopathic aggravation towards the end of treatment. This is the medicinal disease, similar to the original disease. The doses of  the medicines are to be lowered or even stopped for several days. These symptoms would soon subside and restore health. There is now another scenario which needs to be given attention. If with continued administration of higher potencies causes an altered set of symptoms, then a similimum for the new set of symptoms should be selected and administered in increasing doses. In aphorism 249, it is stated that if the given medicine develops new set of symptoms,not contributing to the improvement of the patient, the medicine should be antidoted. Yes, antidotes are necessary when the remedy selection was wrong.

Administration of 50 millesimal potency in increasing dose is a matter of  great importance. Hahnemann gives several instructions in aphorisms 245, 248 and its footnote. This was confusing to me. Even after studying the notes, I find there are shortcomings in my understanding. The 50millesimal potencies could be repeated frequently, in a manner of  changing the dose each time. This is done to prevent unwanted reactions  of the vital force towards unmodified and rapidly repeated doses. In footnote to aphorism 245, Hahnemann says,  The similimum could be given daily and for months in a chronic disease.After the lower degree of potency has been used for one or two weeks, advance is made to the higher degrees. The aphorism248 and its footnote gives an account of administration of the remedy. In the footnote he says, The globule of the potency is crushed in sugar of milk and dissolved in water. The medicinal solution could be prepared with 40, 30, 20, 15 or 8 tablespoonful of water. The difficulty of making a large medicinal solution can be removed by making a solution in only 7 to 8 tablespoonful of water. This is then succused and from it a teaspoonful of this solution is put in a glass  with 7 to 8 spoonfuls,stirred thoroughly and a teaspoon or several can be given to the patient. In the aphorism 248, he says further that in chronic cases when the solution is used up in seven to fifteen days, to the next solution several pellets of  a  higher potency is to be added and used. The medicinal solution to be prepared for olfaction is again mentoned in aphorism 248.

This post is yet incomplete and needs further clarifications. It shall be updated thereafter...