Homoeopathic Potentisation [Potentisation]:

- K. P. Muzumdar.

Dynamization

Hahnemann revolutionized the practice of pharmacy, pharmacology, and posology through his discovery of the process of potentisation.

Hahnemann struck upon the principle of similars as the therapeutic law of cure in 1796. He then administered medicines (homoeopathically) in small doses as compared to the doses then prevailing in the orthodox school. It took quite long him to enter the realm of infinitesimal. The idea of potentisation was not a spark of brilliance but a gradual growth of development. He had to face bitter criticism from his fellow practitioners and also from the practitioners of the orthodox school. The potentisation theory is at once the weakest and strongest point in the theoretical structure of the homoeopathic science. But theory must yield to facts, direct and faithful observation, and truth is not unoften stranger than fiction.

Since 1796 Hahnemann selected remedies homoeopathically but used them in the usual form and in ordinary doses. But he found cure in many cases, preceded by aggravation of symptoms, causing harm to patients and in many cases with no recovery at all. This led him to decrease the dose. He went on experimentation till, in 1812, he confirmed his observation that certain substances generally considered to be ineffective in their natural form such as common salt (Natrum Mur); charcoal (Carbo Veg.); Lycopodium; Silicea, etc.; become available as efficacious medicines only after prolonged friction (trituration) with milk sugar. In 1813 Hahnemann presented in his essay, "The Spirit of Homoeopathy", the clear concept of an organism and its difference from a mechanism.

According to him disease was dynamical derangement of the vital character of our organism. He asserted that a noxious natural agent or a drug produces disease in a similar way by altering the sensations and functions of the individual dynamically, since the organism is something more than just a mechanism. So the drug possesses besides its chemico-physical properties, another property of quality by virtue of which it alters the another property of quality by virtue of which it alters the qualitative state of the organism through its altered sensation and function. This quality, the pharmacological quality of the dug, does not depend entirely on its chemico-physical substraction which we call matter. On the other hand more and more materiality of the drug is reduced by the process of succession / dilution. The greater the pharmacological quality or specific therapeutic quality lying dormant in the drug, the greater seems to be unveiled or liberated for effective action. He makes it further clear that it is not mere dilution that liberates the pharmaco- dynamic property of the drug the friction that the drug takes recourse to with a pharmacological inert substance by the process of succession or trituration. He wanted to stress here that it is the dilution plus friction till homogenous blending that is responsible for bringing out the therapeutic property of the drug, and that it is the qualitative action and not just quantitative. The late Dr.W.J.Boyd of Glasgow was probably the first to conduct systemic fruitful research into the question of potency energy. He could successfully demonstrate the presence of some sort of energy which could deflect the needle of sensitive galvanometer-the Emanometer. When we use potentised remedies we test for their physico-chemical properties, but we step into the field of dynamics well outside the field of conventional pathology. Inspite of this monumental work of Boyd and his associates, our comprehension of potentisation is very poor. Though the energy in the potentised drug is recognized, its nature is still ill-understood.

So we may define potentisation or dynamization as a process peculiar to Homoeopathic, or a mathematico-mechanical process which reduces, according to scale, the inert substance in a crude form to a state of physical solubility, physiological assimibility reduction in the drug substance by a qualitative increase in its medicinal or therapeutic property.

The process of potentisation is carried our by two methods:

(a) Triturations (for dry and crude substances) and

(b) Succession (for liquid)

These processes are carried out in two scales:

(1) Decimals: Where the ratio of drug to vehicle is 1:10 (introduced by Dr. Hering)

(2) Centesimal : where the ratio of the drug to vehicle is 1:100 (introduced by Hahnemann).

The 50 Millesimal scale is a later addition of Hahnemann which he mentions in the VI Edition of the Organon. This is a combination of trituration of a crude substance in a centesimal scale to the level of 3c and subsequently succession in the ratio of 1:50,000.

TRITURATION:

The main object of trituration is to reduce the size of the particles of a a crude medicinal substance to a finer degree and to homogeneously mix them with the vehicle. The finest of particles takes us near to the physical chemistry of colloids. Hahnemann's method of using inert medica (vehicle) in trituration is important, as it helps the proper sub-division. The importance of the sub-division is aptly exemplified where the geometric fact is taken into consideration. If a cube is sub-divided into equal parts, each of 1/10 of its original size, the resulting number of cubes in creases to 1000 times and the surface is 10 times that of the original cube. One can imagine the increase in area in subsequent break-ups (potencies). According to thermo-dynamics,m the progressive mixing of the particles into comparatively vast amount of vehicle, repeated with fresh vehicle, is bound to increase the regularity of distribution more and more. the energy thus stored in such a preparation will readily discharge itself when the sugar-medicine is dissolved on the tongue or mucus membrane in exchange with energy of living cells.

Decimal Scale Trituration :

The decimal scale trituration is conducted by adding one part of the drug substance to nine parts of vehicle, milk sugar. (Thus the ratio is 1:10).

Take one gramme of the drug substance in a thin porcelain or agate mortar and add to it three grammes of vehicle (1/3 of the total of grammes) and rub it with stage crystal pestle in the mortar for six minutes. Scrape it with a spatula for three minutes and mix it for one minute, thus consuming ten minutes of the process.

The same process of rubbing for six minutes, scraping for three minutes and mixing for one minute is carried out to consume further ten minutes of the process. This complete twenty minutes of the process. Repeat the process by adding next three grammes of the vehicle and complete adding next three grammes of the vehicle and complete adding the second twenty minutes. Repeat the process by adding the last three grammes of the vehicle and working with it for another twenty minutes. Thus it completes one hour of trituration. This thoroughly pulverised and homogeneously mixed preparation has attained the first degree of decimal potency known as 1x, or 1D or IHD. (**See appendix for the method adopted by HPI. This method is a little different from the original Hahnemannian instruction.

An identical process is conduction with one gramme of drug substance and thirty three grammes of milk sugar, at every step of twenty minutes of trituration, adding the second one-third and the third one-third of vehicle to raise the potency by one degree known as 1c or IHC.

A very definite method is suggested for triturating the drug substance. In order to prepare a homogeneous mixture of the drug and the vehicle, it is necessary to hold the pestle fully pressed down with a firm grip and thumb on the top and to give uniform anticlockwise movement in a circular fashion, going away from the centre of the mortar and gradually returning to the centre. Scraping of the mortar and gradually returning to the centre. Scraping of the mortar and pestle and mixing eventually helps the drug and the vehicle to come into contact. Potency 3c or 6x thus produced renders the hitherto insoluble drug substance soluble in alcohol or alcohol-water mixture. Though the had trituration are still in vogue, mechanised processes for larger output are now developed, thanks to the increase in demand for these drugs in the wake of industrial development.

SUCCUSSION:

This is a process of potentisation for all soluble substances, may it be in water or alcohol. Excepting in a few cases, alcohol is used as a vehicle in most of the drug preparations. Water soluble drugs, when they attain 3c attenuation, are converted into alcoholic preparations. This transfer is necessary for preservation of drug substance. The technique utilized here is to take one minim of the drug substance and add it to nine minims of vehicle in a clean glass vial filling it upto 2/3 of the bottle.

After carefully corking the bottle ten downward strokes are given either on the palm of the hand or on any soft but firm surface. Every time a fresh bottle is used. This takes the drug-vehicle mixture in the bottle to the level of first decimal potency: 1x or 1D or IHD. A similar process, with the drug vehicle, quantity one minim to ninety-nine minims, with ten downward strokes, given centesimal 1c or IHC potency. Although the process looks to be simple, accurate working is essential.

Regarding the number of strokes to be employed for raising the potency of the drug substances, Hahnemann himself had changed his views from time to time, and went on experimenting. He started initially with 100 strokes but found them too strong as they produced a violent aggravation. He then used only two strokes. He, however, settled at ten strokes per potency rise. American and German pharmacopoeias still advocate ten strokes. The potentisation is to be carried out in accordance with the recipes denoted under each monograph in the pharmacopoeia.

Fifty Millesimal Scale:

The Fifty Millesimal Scale potency has been mentioned in the sixth edition of Hahnemann's Organon of Medicine (Aphorism 270). This edition was published well after death of Hahnemann (1921). It is claimed that Madame Hahnemann was not ready to part when it unless she was paid a very large and handsome royalty. After her death, her heirs, who were more reasonable, gave the copy to Dr.William Boericke for publication.

The following instructions for the preparation of fifty millesimal potency are given in Aphorism 270 of the sixth edition of Organon.

Crude substance is reduced to 3c level by trituration in accordance with the process described earlier. The drug strength is 3c = 1/1000000.

Take one grain (0.063 mg) of this 3c and dissolve in 500 drops (25 g m) of alcohol and distilled water (30 Percent) in a ratio of 1:4.

Drug strength of the mother tincture is:

0.63/25 x 1/10 power of 6

= 1/400 x 1/10 power of 6 (approx) or = 1/4 x 1/10 power of 8.

This is known as "Mother Tincture".

To make 1st potency i.e. LM 1, or 0/1

Add one minim of the mother tincture prepared as above to 500 globules of milk sugar, weighing one grain.

One globule will have drug strength.

= 1/4 x 1/10 power of 8 x 1/500 Add one globule of this to 100 minims of 90 Percent alcohol

Now the drug strength is

= 1/4 x 1/8 power of 8 x 1/500 x 1/100

One minim of this should moisten 500 globules of

No.10 globules size weighing 1 grain.

One globule will posses a drug strength

= 1/4 x 1/10 power of 8 x 1/500 x 1/100 x 1/500

= 1/10 power of 16

= 8c

To prepare the 2nd potency, use the same steps and you will get:

1/10 power of 16 x 1/50000 = 1/5 x 10 power of 20

One should be careful to note that there shall be no comparison of centesimal potencies with 50 millesimal potencies. The calculation shown above is only to bring home the development of power of 50 millesimal potency. It is not the quantity of the drug but how a strength is achieved through succussion, 8c under centisimal is achieved by 80 stroke only, but 1/10 power of 16 under 50 millesimal at 1st potency is achieved after 200 such succussions.

Hahnemann thus proved maximum drug strength with minimum manipulation which bears testimony to his remarkable genius. He kept on searching for a better answer in the drug strength to fight the disease; their scale widens the gap between the medicinal substraction or quantity and diluting medium or menstruum, reducing the medicinal quantity to obviate any furious potency exaggeration. He also changed the number of strokes from 10 to 100 to develop and more rapid and long-lasting penetration. These potencies are labelled as LM potencies 0/1, 0/2, 0/3, 0/30, as they are prepared subsequently in the scale.

Hahnemann instructed that all these potencies be prepared by hand. He did not subscribe to the idea of using any mechanical contrivance. But this is reasonable as long as small quantities are to be prepared. Shaking large quantities of drugs in big bottles cannot be potentised. American Homoeopathic Pharmacopoeia (AHP) and the German Homoeopathic Pharmacopoeia (GHP) have changed from drops or minims to parts by weight. The British Homoeopathic Pharmacopoeia (BHP) and the American Homoeopathic pharmacopoeia have limited the preparation to 10 ml at a time. It is difficult or impracticable to purse Hahnemann's technique for the preparation of high and higher potencies. Whatever is available as high potencies may not be take has purely Hahnemannian. The technique is modified. All the high potencies are prepared by a contraption especially designed for the purpose. The symbols 1m, 10m, cm, mm, are mere denominations but their exact mode of preparation is not disclosed.

Korsakoff's High Potencies:

Count Von Korsakoff, nobleman, was fascinated by Hahnemann's dynamization theory. He was the real originator of high potencies, for he was to conceive and execute the idea of dilutions as high as 1500. He said that Sulphur acted better at that level. He developed a brilliant notion that one single medicated globule when placed among many non-medicated globules communicated its medicinal power to the non-medicated globules. He accordingly placed 1000 unmedicated sugar globules in a bottle and added to them one globule imbibed with Sulphur 100, and shook the bottle for a minute. He claimed that all these globules and been medically activated and that their medicinal strength was almost equal to that of the original globule. He went on to do this with 13500 globules of milk sugar and one globule of Sulphur 30. He warned that the bottle should not be carried in the pocket for fear of the power being enormously increased because of the shaking of the bottle in the pocket. What Hahnemann did with the fluid potencies, Korsakoff did with the solid dry globule. He believed that the material division of the medicine ceases with the 6th potency and the the medicinal power is communicated by a process analogous to infection of this idea. Hahnemann wrote Korsakoff's experiment of dynamization upto 1500 as curious in showing the almost unlimittable extent to which the homoeopathic process can be carried without determining the medicinal effect but useless from the practical point of view.

Herr Stallmeister Jenichen was another admirer of Hahnemann, who pursued an idea of Hahnemann that further attenuation is not necessary through the dynamization of medicine, but continuous succussion without dilution is sufficient. During his lifetime he kept this manipulation a profound secret. Whether it was for the sake of making more money or for the sake of ensuring the genuiness of the preparation he had introduced, is now impossible to say. In the tenth volume of the British Journal of Homoeopathy a full account of his manipulation is given, on the basis of his writings that he left behind.

He adopted the following technique: He took large bottles and holding them in a slant angular direction while shaking them vigorously, he reckoned the number of potencies by the number of shakes that he gave the bottle; 10 one being the increase by one degree of potency. But one thing is clear that there is nothing in common with what Hahnemann understand by that term. It is implies that what Jenichen called his high potencies was quiet arbitrary and unhahnemannian.

Dr. Gross took the Jenichen high potency with great zeal and asserted vehemently the absurdity of Jenichen's potency. Stapf, Hering, Boenninghausen, Reammal, all joined Gran in his Enlogies. However, they asserted that these dilutions, possessed uncontrollable powers, and warned that their used would be dangerous. Jenichem went from 100 to 60000 potency.

Flink's High Potencies:

Flinke was an American physician who devised his own method of dynamic preparations by taking 1000 drops of drug substance in a glass jug. He allowed a stream of water to flow into it. For every dram of water poured in and put of the jug, he would could it as one potency. when 100 such quantities passed out of the jug, he would then cell the drug substances in the jug to have had the strength of 100 potency. He never believed the proposition of the value of the stroke. He advocated only the importance of water and the force that were would exert on a medicinal substance in raising the potency.

Dr. Skinner:

He followed somewhat the same method in his preparation of potencies and called it fluxion method.

Many followers of Hahnemann have tried to modify the process of potentisation but only the one suggested by Hahnemann himself has continued to be the accepted one to-date.

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