Little Miracles

Review

This article is reprinted from The Homoeopath with permission from Nick Churchill of The Society of Homoeopaths.

Reviewed by Penny Edwards

I was asked to write a review of this reprinted book, originally titled LM potencies - A Novice's Quest. As one who has worked with LM remedies a great deal, more on the preparation side at Helios, rather than prescribing (though I have found
them useful), I was looking forward to see what I could glean, and whether it would persuade me to use LMs more than I do at present.

The original book came about as a result of Carole Cook's desire to discover the "whys and wherefores" of LM potencies, driven, as she says, by the uncertainties in the prescribing of centesimal potencies, which probably reflects the reasonings of
many other precribers who decide to go down the same route. She felt that the LM method had more foundations, and quotes
Hahnemann as saying that the LM system was superior to centesimal dilutions, and "almost perfect" (her emphasis).

The history of LMs is dealt with in the first chapter, quoting sources from articles and books by John Morgan, Peter Morrell, and Richard Haehl. This details the differences between the 5th and 6th editions of the Organon, pointing out that the major
changes between the two volumes related to the preparation and administration of remedies, i.e. to LM potencies. We read that Hahnemann reintroduced the concept of giving remedies in solution for 2 reasons: (a) by diluting the remedy in water,
it decreased the amount of the dose, making it milder, and reducing the chance of aggravation, and (b) by taking in liquid form, the remedy would make contact with a larger number of sensitive nerves responsive to the medicinal action. There are references to earlier editions of the Organon and Chronic Diseases, quoting the use of newer solutions of lower potencies (could this be the source of the Singh Method of descending potencies?); but Hahnemann goes on to say all these were superseded by 1837, when he stated "All remedies should be potentised, given in solution, in small frequent, divided doses,
each dose altered in potency by succussion, by mouth, olfaction, or externally." This certainly makes a good case for LMs! The main differences in all the changes, to quote Carole, were "just the dilution factor, and the number of successions.Hahnemann introduced the factor of 1 :50 000, instead of the previously used method of 1:100, and 100 succussions instead of 2, to produce his perfect method."

The second chapter compares the development of potency use in different parts of the world, in the absence of the 6th edition of the Organon, (it was only published in 1922). This precluded Kent and many others from using LMs, with Kent following in
the footsteps of Boenninghausen in the development and use of high potencies, which Hahnemann apparently frowned upon.
The chapter closes with reference to the fact that it was not until the 1970s, with resurgent interest in homeopathy, that LMs really came to light. Since then, they have continued to attract interest. There is also a reference in the appendix, to an article by
Anne Grey, RSHom, from The Homeopath, number 65, 1997, which outlines a very useful summary of reactions and guidelines to the use of LM potencies, which is elucidated further by Carole in a later chapter.

In the chapter labelled, "Technicalities", there is a concise précis of each of the aphorisms of the Organon which are related to the pre-scribing of LMs, detailing the use and recommendations by Hahnemann. (I referred to Wenda Brewster O'Reilly's
recent edition to check for myself, and this confirms that Carole's book is a very clear and accurate interpretation, except for aphorism 249, which O'Reilly heads "What to do when a medicine does not work", whereas Carole's heading reads: "No dose too small to effect amelioration".)

The chapter headed "Preparations - Hahnemann" gives details for pharmacies to create LM potencies according to Hahnemann's formula, as compared with the method of creating centesimals. There is one slight error: once 500 grains have
been moistened to get the 1/500 dilution, before adding 100 drops of alcohol, the grain will first need to be dissolved in 1 drop of water, as these granules do not dissolve in alcohol alone. Although it may be churlish to make a correction to Carole's text, as few practitioners prepare their own higher potencies from LM1. Also, Carole does actually address this point later on in
the text.

It is also interesting to note that Hahnemann suggested only 2 succussions per dilution for the centesimal potencies, whereas most pharmacies today employ anything from 10 to 20 or more.

The chapter titled "Variations - Hahnemann" discusses the scope for individuality in the prescribing of LMs. What could have been explored here, and which would have been of great interest, is a definition of "the dose". If "too large a dose causes
damage" (aphorism 276) and "no dose can be too small to start the process of cure" (aphorism 279), then what is the quantity of a dose? Is it the number of globules, or the amount of liquid in which they are dissolved? This question particularly arises
when we now have pharmacies sending out different sized bottles for prescriptions.

There is the Hahnemann method (discussed in the chapter, "Administration - Hahnemann"), using 1 granule in 7-8 tablespoons of water, and then going on to dilute 1 tablespoon of this in a further 7-8 tablespoons of water. The patient then takes a teaspoonful of this diluent, and throws the rest away (double dilution). The updated additions of the second print now come to
the fore, as Carole gives the results of her experience over the last few years. She goes on to discuss her previous use of 150ml/200ml bottle, from which a teaspoon is taken and double dilution made, and the more common and popular method now of dropper bottles, (she uses 5ml bottles, but 1 5/30ml are commonly ordered from Helios). She still suggests using double dilution, or, as an alternative for very sensitive patients, the olfactory method. She does not mention another possibility, which some practitioners employ, of drops placed directly under the tongue of the patient (single dilution). The issue of single versus
double dilution could be a topic of debate for the future, either on First Class, or in the Newsletter.

Outlining the possibility of 5 different types of homeopathic aggravation, Carole gives sensible advice on how to deal with patients who are particularly sensitive, giving the comparative views of some well known and experienced practitioners, such as
Choudhury and Dey, and two of our own home-grown homeopaths, Angela Zajac and Jane Howarth. On the issue of aggravations, and how to overcome them using ascending levels of LMs, Carole gives some credence to the views of some practitioners, who give successive prescriptions of LM 1,3,5 or 2,4,6, rather than the LM 1,2,3 method. There are also good references on how to recognise, and overcome, proving pictures, which can arise when a patient is on LMs.

Comparisons of different perspectives on handling your patient, and of the case in general, appear in the chapter, "Case Management", which gives advice on changing remedies, the resumption of a remedy at the previous potency, and prescribing LMs after a centesimal potency. These are all good, sound recommendations. This chapter also covers acute situations, with
the suggestion to repeat the chronic remedy more frequently. As I have observed from the cases of Massimo Mangialavori, you will know if the remedy is very well selected, when it works in the acute as well as the chronic situation.

The list of advantages of using LMs is almost impossible to resist, giving very good reasons why practitioners have been so successful in practice with them. Again, there is input from various sources of those who are well experienced in their use, and
the argument is compelling!

The "Instructions to Patients" includes a number of suggestions, again from prescribers who have had a lot of experience with LMs and their administration. Each method has its own advantages, and I appreciate the fact that they are so freely given. Carole has changed her own instructions, written within a standard letter, since she wrote the first book, and I was impressed with the simplicity and clarity (for the patient) of the new instructions. A very useful set of instructions, which I hope she doesn't mind if I plagiarise!

There is a useful section towards the end of the booklet, on supplies and where to get them, with comparative prices; though the danger of mentioning prices is that these will always be out of date soon after publication. Suggestions for purchasing bottle sizes, distilled water and labels provide the necessary information for you to make your own LMs, which you can then send out
to patients.

The booklet finishes with appendices of Carole Cook's own cases, to demonstrate not only the successful use of LMs in practice, but also her own learning from their use in difficult cases, which is always a brave thing to tell to one's colleagues. There is a 'Wow factor' about some of them, which is always wonderful to read!

At the beginning of this review, I was looking forward to see what I could glean, and wondered would this book persuade me to use LMs more than I do at present. Even though I have used LMs over the last 8 years or so myself, I have tended to restrict them to the cases where patients are on drugs/ are old/ have low energy/ or have a lot of pathology - the standard reasons of when not to use a centesimal for fear of aggravation. The other reason for not prescribing LMs was that, according to my understanding, it can be difficult to ascertain whether the remedy is acting effectively or not. According to all I have read,
Carole (and those she has consulted) would say you will see an improvement in a very short space of time - a couple of days! This does not, however fit with what I have heard from the work of homeopaths such as Massimo Mangialavori, who uses LM remedies extensively, and now almost exclusively, in his cases: - he reports that sometimes an LM potency would need to be
taken for up 40 days before there is any reaction.

Carole's views on healing times are also at variance with the evidence provided by Divya Chhabra's work on potency, derived from her provings. She gives a general guidance as follows:

1M: Primarily, they feel emotions so intensely, they tend to deny it: "It's not that..."; "I never"; "I should/should not";
"I want"; "It's very..."

200c: They will express their feelings, they will say "I feel guilty", "I want to/need to..." with little or no denial. Feelings are not
expressed openly until directly asked, but feelings are not denied.

30c: They will speak in direct rubrics: "I am guilty of..."; "I resent..."; "I blame myself".

Divya is now expanding this knowledge by proving potencies of LMs, so it will be interesting to hear her results and conclusions.

At this year's Bombay seminar, we saw a case in which it was possible to compare both potency ranges: - a large lipoma on the neck of a woman did not respond to a 10m potency of Aurum, but reduced quite quickly on LM preparations of the same remedy. Rajan Sankaran attributed this reaction to the intensity of the state of the patient, with the LM potency being so much less intense than the 10M. There are still questions to be answered!

To return to Carole's booklet, there is guidance on how often to give the remedy, what to look out for in terms of aggravation, what response is appropriate, and when to stop, all reinforced by the experiences of practitioners with years of experience.

I would say that this is an invaluable booklet for anyone who is interested in using, or considering using, LM remedies. It is well
researched, and well backed up by references to the Organon, to associated articles, and to the experiences of peers. Students will find that it helps to explain the intricacies of administration, and practitioners will find that it opens up new avenues in treating all sorts of cases. As Carole says of these wonderful, tiny granules: "Once you have found the right remedy (!) the rest is simple and also very flexible."

This review was reprinted from the July 2002 edition of Homeopathy in Practice with permission from the Alliance of Registered Homeopaths.

Reviewed by: Louise Maclean

This self-published book was originally written as a dissertation by Carole when she was a student.

Up until now Robert Barker's book has been the only other definitive study on this subject apart from of course, Hahnemann's work.

Fourteen chapters cover all aspects of LMs. Starting with the background history; Carole includes Hahnemann's development of LMs, his preparation methods, administration and variations. The book then details Carole's own experience regarding methods of preparation, and expands with further chapters on aggravations, case management, the advantages of use, instructions to patients and supplies, ending with a conclusion and case studies.

Carole mentions how Hahnemann became dissatisfied with the action of centesimals mainly because of 'uncontrollable aggravations and taking too long to cure' and felt his two ideals of 'rapid and gentle' cure were not addressed by these potencies.

Throughout the book, reference is made to many famous homeopaths of the past and their use of LMs, for example, Dr S. Dey and Pierre Schmidt as well as contemporary homeopaths such as Robert Barker, Peter Chappell, Kate Carne and Angela Zajac. It seems that because the correct preparation of LMs was omitted from all editions of the Organon except the 6th (published in 1921), many of the great names in homeopathysuch as Kent, Boenninghausen, Hering, Farrington, Lippe, Burnett, Hughes, Allen, Cooper, Dudgeon and Nash - were unaware of the method.

This is a very comprehensive little book, which is well laid out and covers everything you need to know for this mode of prescribing. I found it very useful, well written and informative.