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Perennial Problem Of Potency Selection In Homeopathic Prescribing



Usmani Resource Page

Copyright 2013/All rights reserved © Dr Usmani 
Contact author for permission to use


Quandary, compunction, bewilderment, with pricks of conscience have been apportioned by the Destiny for a scrupulous homeopath in practice. Even after more than a century this problem remains quite unsettled as ever. A homeopath is never free from the agony of whether has selected the right dose or potency in a trying case. This problem remained as a faddish issue.


We can divide homeopaths in three classes as regards potency selection.


First, mother-tincture to low potency users: Among them, we can count a good many of Hahnemann’s immediate disciples and contemporary practitioners who refused to grow and keep pace with the Master. Later on such luminaries as R.T. Cooper, J.H. Clarke, Dudgeon, William Boericke, Guernsey, Blackwood, and legion others preferred to remain confined to potencies near to mother-tinctures.  Hughes was the most staunch crusader against high potencies, brandishing the sword of Avogadro’s numbers.


Second, exclusive users of high to highest potencies: with the thought that a true and competent homeopath is he who employs exclusively high and the highest potencies. Among these were great and famous homeopaths like James Tyler Kent, and all the Kantians, Dr. E. B. Nash, Dr. Skinner, Gibson Miller, John Weir (single remedy and high potency advocate), Lees Templeton, Boyd and so many others, whom Dudgeon labeled as ‘high potency fanatics’.


Third, the so-called ‘medium potenciers’, like Hering, Jahr, Farrington, Boericke and Burnett, who used from mother-tincture to medium potencies, mostly 30c, and rarely 200. Dr. Burnett and Cooper, two bastions of the Cooper Club, were two bodies and one spirit. Their universes of interests were akin. Both had impetus to explore new territories in the field of therapeutic. Cooper was a bit more dogmatic as regards the dose and potency—drop doses of mother-tinctures and 3x potencies as single doses. Burnett was a balanced personality. He used all the potencies except the highest. He could repeat the doses which Cooper preferred not to do. Both were equally ingenious, who have given the profession many indispensable medicines. Homeopathy was immensely enriched by these two wizardries.


There are some natural limitations to potency selection. There are a category of patients whom we call sensitive patients, who can tolerate neither repetition nor high potencies. Kent recognizes this class of patients, and recommends not to use higher than 200 potencies in such cases. I’ve written a separate article on this topic, cf  Sensitivity Problem Such patients are comfortable from mother-tincture to 30th potencies, and can bear repetition of the dose of the same remedy, if it is alternated with another indicated remedy, for another set of symptoms.    


Many homeopaths have tried to lay down some principles for potency selection and dispensation. But this ‘fluid problem’ could not be confined to some ossified rules and regulations. Clinical practice is so kaleidoscopic and so unpredictable that it can never be given any mould, especially in acute cases and acute practice. Vithoulkas, in modern times, (and many other people in the past), has tried to give it a mould, (cf. his article: Selection of the Single Homeopathic Remedy and Potency, on his site, on the internet), but every practicing physician knows that it is a futile exercise. Acute cases are changeable, and cumulative. In the treatment of one condition, some other accidents can happen. You are, for example, treating a case of enteric fever; but during the treatment the patient gets a severe attack of lumbago, or severe toothache, or sore-throat, owing to some cold and sour drink, or any other eventuality. Medicine will have to be changed, or another must be added, to be alternated with the already working one. Condoning this alternation, question of potency will arise. The potency of the new drug should be at level with the previous one or lower, or higher?


Making a strict rule of using one remedy and one dose; and one potency for this kind of case, and that potency for that kind of case, does not work in acute practice; and it reveals of such practitioners, as being non conversant with the acute practice on routine basis. There are no hard and fast rules for fixing potency and dose in dealing with and treating acute cases. The safest rule is: Whenever you find that you have to repeat the medicine many times a day, or after every few hours, to subdue the disease, use low potencies from 6 to 12; even lower than that, or at most the 30th, (as Jahr would prefer). And when another strain of disease is added, that is not in line of the progress of the present disease that you are already treating; and the intensity is so severe that you cannot ignore it, or postpone dealing with it; give the indicated second remedy, on the basis of the latter, either in alternation with the first, or morning and evening, according to the severity of the case.


Low potencies are easy to change and make amends, as wrong selection does not drain the system unduly, and does not go deep to complicate the case. Using unnecessarily high potencies puts a drain on the system and complicates the case. Moreover I suspect—especially in rapidly changing acute symptoms scenario—the next selection, after the first selected  high- potency dose, wrongly or rightly, the case would no more be the simple original case, but a changed or a complex one—as this is now composed of  the original natural disease plus the residual effects of the wrongly selected high potency drug.; (after all, it was the indicated remedy, though imperfectly). So it must leave some imprints on the patient. This unnecessary confusion and complication would have been avoided or, at least, much mitigated if we have used low potencies, at the first instance. We could easily add or subtract remedies without much spoiling the case if we had used low potencies as 3X, 6X, or 6 or 12. Use of high potencies has the potential to spoil acute cases by throwing the patient in a quandary of unnecessary turmoil of proving the drug which will not fail in complicating the case. At the bed-side, factualism works, not the idealism. Knowing these pitfalls one must not give unnecessary hassle to the suffering mortals.


These were my musings after my encounter with a perplexing case. My grand daughter, age one and a half year, very active and frolicking specimen of humanity, fell with a sudden attack of vomiting, as it is usual with infants of this age, as they put in their mouth everything that they find lying on the ground. And this had occurred many times previously; and Ipecac. and Nux Vomica, always settled it right. Even catarrhal symptoms were usually cured by Ipecac. or Nux v. This time nothing worked. She was throwing every bit that got down her gullet. She was being rapidly drained and dehydrated. Analysis of the case brought out two remedies conspicuously: Arsenic Alb., and Cadmium sulph. Both failed. I was quite at loss. An observation suddenly occurred to me. I found that she didn’t vomit unless something is fed to her. Now there is only one remedy in the whole Materia Medica for the symptom ‘vomiting only after eating or being nursed.’ And it is Ferrum Met. A dose was given which gave relief for two to three hours. Then again the same symptoms reappeared. Now Ferrum did nothing. She was transferred to hospital. With the usual hospital methods and anti-emetic drugs the disease was controlled.


Now coming home she suddenly developed diarrhea, with copious alvine movements seeing which, and the painlessness of the motions, I decided Podophyllum, which I gave in 6th. potency. One dose sufficed. (I never used Podo. below 30, till this day.) Afterward, I gave her China for recuperation. This and suchlike experiences in the past convinced me of the desirability and efficacy of low potencies in acute cases. Reasons for which we have discussed above. Clarke, as has been told above, was ‘low potencier’, tells us somewhere that there was no end to changing of medicines whenever his wife fell sick. This was only possible with the use of low potencies. Acute cases are in flux, cumulative, and constantly changing. Only low potencies can keep them from complications.


There are three levels of actions of homeopathic medicines:

1)    Therapeutic Level: for which we use mother-tinctures to low potencies, from 3 to 12, up to 30th. (in acute cases), and from 200 to CM, or MM (for chronic diseases).

2)    Therapeutic cum Nutritional level: Example can be given of Digitalis, which is a heart tonic (from its organs specificity) and also one of the best remedies for senile hypertrophy of the prostate. I utilize it in 3X to 6c potencies, for this purpose in the old people. It miraculously helps them.

3)    Nutritional Level: All the cell-salts of Schuessler are at nutritional level. As Calc.Phos., from medium to high potencies is a therapeutic agent, and from 3X to 6X is nutritional salt. For example, we can use it from 30 to 200 potency for the

open fontanelles, in growing children; with 3X potency, 6 pellets, thrice a day, to enhance calcium level in the blood.

Phosphoric Acid: 3X is at nutritional level. I use it for debility of the aged; and after prolonged disease; and, for impotence I give it in high potency (therapeutic), one dose, followed by 3X , t.i.d. as nutritionand supplement; and also for incontinence in the aged.

China 3X: as a general tonic after exhausting disease or loss of fluid; and 30 and higher for therapeutic purposes.

Berb. Vul. 3X: as an organ affinity drug for kidneys and liver; and high potencies for therapeutic purposes. Cf. my article: Look Younger Live Longer, The Homeopathic Way: Look Younger Live Longer


In case of retarded growth in a child with Tubercular background, one dose high of Tuberculinum, which will bring rapid changes in him, and this process can be helped and accelerated by supplying the raw material in the form of cell-salts of Calc.Phos. 3X, and Calc. Fl. 3X, singly or in combination, 4 tabs. each, b.d. or t.i.d.


Homeopathy is very enigmatic, and the potency phenomenon is quite a riddle.

  • There are some remedies that work well in certain potencies, and not in others. Boericke’s Materia Medica, can tell many such remedies.

  • Some people use high and the highest potencies in repeated doses, thrice or four times a day, for weeks and moths, with excellent results. I’ve used Rhus Tox. CM in arthritic eczema, for many weeks, t.i.d. with some positive results; but more than this it was wonder that it did no harm. No implantation of any drug disease, as Farrington feared.


The real mark of homeopathy is in curing chronic diseases. My passion lies in this field. I enjoy giving placebo week after week, and month after month, till the patient is cured, with the initial prescription of one or two doses, in rapid succession, at the beginning of the case. Such a feat can never occur in any therapeutic of the world. It is mark of homeopathy and the proof of its veracity.


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Comment by Dr. M. A. Usmani on February 5, 2013 at 4:40am

Dear Debby, many times it works, some times it doesn't. Nosodes like Carcinosin, or Tub., prescribed, according to the case, they go on working, without being disturbed by massive allopathic drugging. But the thing is, as I've described it in my previous article, Cure Mania, it is usually a very insignificant part of the whole case. But this was not the important part of my present article. The thesis that I put forward was: 'Low potencies should be used for acute cases, which are, ipso facto, evolving, cumulative, changing and diversifying cases. Low potencies do not spoil cases and influence them deeply to change their real character.’ It was very lucidly discussed therein.. You can make this a proposition to be put on the ‘Discussion Forum', with an hyperlink to my article so that people may discuss it in an ' informed way'.

Dr. Kempson remarks require discussion,which we would put off for future.








Comment by David Kempson on February 4, 2013 at 11:57pm

What really needs to be done, are potency provings. I really don't understand why this was not tackled much earlier on rather than just leaving it in the mess it has become. Since the potency a patient needs is clearly one aspect of the case alongside the symptoms, it is the kind of information that should have been drawn from provings. Dr Divya Chhabra actually presented the results of several potency provings at one of her seminars which was very interesting. She used very well proven polycrests, but assigned a specific potency to certain patients. She found that patients expressed their symptoms differently at different potency levels.

However this only just scratched the surface of the problem. What needs to be done are not only reprovings of remedies with the potencies clearly marked against specific symptoms, but also provings need to be done where the various (well-proven) remedies are used in a single proving, but all participants are given the same potency. This way, just as provings are currently done, we can look for common features which may lead us to clear and precise indications for particular potencies.

It is strange that we have been so determined to make sure our other proving information is accurate but not this.

Comment by Debby Bruck on February 3, 2013 at 11:51pm

Dear Dr Usmani - can you use this placebo method when the person is taking allopathic drugs all the time?

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