सेंकेंड प्रिसक्पशन और सही पोटेन्सी का चुनाव (Second Prescription & selection of potency)

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सेंकेंड प्रिसक्पशन और सही पोटेन्सी का चुनाव एक होम्योपैथिक चिकित्सक के लिये हमेशा से सरदर्द रहा है । आज के दौर मे मे वह हैनिमेन या हेरिग के बताये रास्ते पर चले या अपना स्वयं का विवेक लगाये , यह भी एक प्रशन है । संम्पूर्ण होम्योपैथिक फ़िलोसफ़ी मे और पूरे होम्योपैथिक जगत मे कोई भी पोटेन्सी और औषधि के रिपीटीशन पर एकमत नही है। कम से कम मै तो स्वयं कई बार इस परेशानी से दो-चार हो चुका हूँ । अभी दो महीने पहले की ही बात लें , जिस chronic allergic rhinitis के रोगी मे रिपर्टारैज करके मैने सलफ़र 1000 का चुनाव किया था उसने दो दिन बाद से ही अपना असर दिखाना शुरू कर दिया ,लगातार छीकों का दौर जो पिछ्ले 15 सालों से रोगी को परेशान कर रहा था और शायद ही कोई दिन ऐसा रहा हो जब उसको antiallergic जैसे cetrizine लेनी न पडी हो , इस एक हफ़्ते के दौरान कोई भी लेनी न पडी, लेकिन ठीक सातवें दिन लक्षण सब दोबारा आ गये। एक ही हफ़्ते मे सल्फ़र का काम समाप्त ! आशचर्य ! क्या करें दोबारा सल्फ़र दें कि इसको complementary medicine से follow करें। वैसे मेरे पास follow करने के पर्याप्त कारण थे जैसे जिस दिन लक्षण रिपीट हुये उस दिन लखनऊ मे पानी और ओले गिरे थे , एक बार सोचा कि rhus tox , rhodo या dulcamara मे से चयन करें लेकिन अगले दिन तक दूसरी राय ( 2nd opinion ) लेने की सोच ली थी, इन्टरनेट के माध्यम से बने मेरे अभिन्न मित्र डा प्रवीन गोस्वामी जो गया से हैं मुझे आन्लाइन मिल गये और बाद मे प्रवीन की राय से इतफ़ाक रखते हुये सल्फ़र 1000 को दोबारा 7 दिन के अन्दर ही रिपीट किया । दो दिन बाद रोगी की प्रतिक्रिया मे संन्तुष्टि थी लेकिन अब की बार सल्फ़र का काम मात्र मात्र 4 दिन मे ही समाप्त हो गया, पोटेन्सी को बढाया और अब की बार सल्फ़र की 10000 क्रम की पोटेन्सी का चुनाव किया । इस बार सल्फ़र का काम स्थायी रहा और फ़िलहाल इधर एक महीने से लक्षणों मे पुनरावृति नही हुयी हैं लेकिन हकीकत मे पोटेन्सी के चुनाव और सेकन्ड प्रिसक्पशन मे सर्वसम्मति नही दिखती , नीचे कुछ पुराने और नये चिकित्सकों के नजरिये हैं , आइये अवलोकन करें।
हैनिमैन की नजरिये से

HAHNEMANN हैनिमैन

जब तक एक सही चुनी दवा का काम चल रहा हो तब तक चिकित्सक जल्दबाजी मे औषधि के बीच मे न तो किसी और औषधि के रुप मे अडंगा लगायें और न तो औषधि को बीच मे रीपीट करें।

आर्गेनान आफ़ मेडिसिन (Organon of medicine) मे हैनिमैन ने पृष्ठ संख्या 209-213 मे इस बात को साफ़ तौर पर लिख दिया है। बतौर उनके जब तक एक सही चुनी दवा का काम चल रहा हो तब तक चिकित्सक जल्दबाजी मे औषधि के बीच मे न तो किसी और औषधि के रुप मे अडंगा लगायें और न तो औषधि को बीच मे रीपीट करें। आगे देखें:


Organon of medicine पृष्ठ संख्या 209-213
“The third leading mistake that the Homoeopathic physician cannot too carefully or steadfastly avoid is in hastily and thoughtlessly giving some other medicine … but if once a medicine … is acting well and usefully, which is seen by the eight or tenth day, then an hour or even half a day may come when a modern homoeopathic aggravation again takes place. The good results may not appear in their best light before the twenty-fourth or thirtieth day. The dose will probably have then exhausted its favorable action about the fortieth or fiftieth day, and before that time it would be injudicious and an obstruction to the progress of the cure to give any other medicine. Experience teaches that a cure cannot be accomplished more quickly and surely than by allowing the suitable antipsoric to continue its action so long as improvement continues … Whoever can restrain his impatience as to this point will reach his object the more surely and the more certainly … periods of aggravation will occur, but so long as only the original ailments are renewed and no new, severe symptoms present themselves, they show a continuing improvement, being homoeopathic aggravations which do not hinder but advance the cure. The physician must; therefore, in chronic diseases, allow all antipsoric remedies to act thirty, forty or even fifty and more days by themselves, so long as they continue to improve the diseased state perceptibly to the acute observer, even though gradually; for so long the good effects continue with the indicated doses and these must not be disturbed and checked by any new remedy.”

और आगे पृष्ठ संख्या 212 मे चिकित्सकों को सावधान करते हुये कहा कि जो ऐसा नहीं करगें वह उन जटिल रोगों को मंझदार मे ही छोड कर जायेगें।

In footnote, page 212, we find: “But he who will not allow himself to be convinced of this and imitate what I now teach, he who is not willing to imitate it exactly, can leave the most important chronic diseases uncured.”

केन्ट का नजरिया:
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केन्ट ने हैनिमैन की अवधारणा को बढाते हुये एक चयन की गई औषधि के देने के बाद 12 अवलोकनो (observations)उ को संज्ञान मे लेने के निर्देश दिये, जो बाद मे Kent’s Lectures on Homoeopathic Philosophy मे संग्रहित किये गये। आज के दौर मे अधिकतर होम्योपैथिक चिकित्सक केन्ट के इन अवलोकनो (observations) को पालन करने की कोशिश करते दिख जाते हैं।

संक्षेप में-
1-रोग के लक्षण बढें और साथ ही मे रोगी की स्वास्थ क्षीण होता जाये।
2-रोग के लक्षण बहुत अधिक बढ जाये और रोगी को धीरे-2 लाभ दिखना शुरू हो।
3-किसी भी औषधि को देने के बाद अगर रोग के लक्षण तुरन्त अल्प काल के लिये बढ जायें और उसके कुछ ही दिन के बाद रोगी को लाभ दिखने लगे।
4- किसी भी औषधि को देने के बाद अगर रोग के लक्षण मे बढोतरी न दिखे और रोगी को तुरन्त लाभ पहुंचे ।
5-रोगी को लाभ पहले दिखे और कुछ ही समय के बाद लक्षण बढ जायें।
6-बहुत ही कम समय के लिये लक्षणों मे कमी दिखे।
7-रोग के लक्षणों मे तो कमी दिखे लेकिन रोगी का स्वास्थ क्षीण होता जाये।
8- औषधि के स्वयं के लक्षण रोगी मे दिखने लगे।
10-औषधि देने के बाद नये लक्षण दिखने लगे।
11-रोगी के ऐसे रोग जो पहले हो चुके हों , दोबारा दिखने लगें।
12 -रोग आरोग्य होते समय लक्षण हेरिगं नियम के विपरीत चले।


केन्ट के अनुसार:
1- a prolonged aggravation and final decline of the patient
2- long aggravation, but final and slow improvement.
3- the aggravation is quick, short and strong with rapid improvement of the patient.
4- no aggravation, with recovery of patient.
5- The amelioration comes first and the aggravation comes after .
6- too short relief of symptoms.
7- full time amelioration of the symptoms, yet no special relief of the patient
8- Some patients prove every remedy they get
9- action of the medicine upon provers (
Similar agg after every dose, no matter
which potency)
10- new symptoms appearing after the remedy
11- old symptoms are observed to reappear
12- symptoms take the wrong direction

इन 12 अवलोकनों के निष्कर्षों को पूर्णतया जानने और समझने के लिये यहाँ और यहाँ देखें।

लुक डी शेफ़र ( Luc De Schepper’s)

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लुक डी फ़िशर ने अपनी पुस्तक “Achieving and Maintaining the Similimum” मे हैनिमैन की अवधारणा को आसान शब्दों मे रखा और उसके बाद का काम बेल्जियम के मार्क वान विजिक (Marc Van Wijk) ने एक power point presentation के जरिये किया । यह एक interactive power point prsentation है और विशेष कर B.H.M.S. के छात्रों के लिये तो अमूल्य ही है । इसको डाऊनलोड करने के लिये नीचे दिये चित्र पर किल्क करें।
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हाल ही मे लुक डी फ़ेशर ने अपने चिट्ठे के जरिये पोटेन्सी और repetition पर अपने विचार रखे। वह क्या कहते हैं , इसको देखने के लिये यहाँ किल्क करें।

The Potency of the Remedy (How Strong?) and the Repetition of the Dose (How often?)

Part One: The Potency Selection (how strong?), the greatest confusion among homeopaths
When it comes to potency selection of the remedy, the homeopathic society never agreed much about this issue, not in the past and certainly not now! There always has been a division between two camps: the high and low potency prescribers. Both parties indeed can demonstrate success but there has to be some kind of middle path, a clear guideline for homeopath and patient alike to bring harmony in this world of madness. I intend to bring enough clarity to unite homeopaths and at the same time to give enough clarity to the patient who deserves the right information……………..
Treatment for Acute diseases
The potency choice for acute diseases (less than 3-4 months old) is simple: use at least a potency from 30C upwards to 200C and 1,000C. Always use the watery method by putting two pellets of your chosen remedy and potency in an 8 oz bottle (Remedy Solution Bottle or RSB), stir well and take one tsp directly from the RSB. Do not repeat earlier than two hours after first dose. When you see a similar aggravation in the first hour (in other words an aggravation of your symptoms during the first hour) this first dose will cure and no further dose will be needed (A157-A158). If symptoms are not entirely gone after two hours, you can repeat the same procedure every two hours after succussing each successive dose (hitting RSB against your palm) 8 times. ……

Chronic Disease treatment
The treatment of chronic diseases (>than 3-4 months existing) is very different. The potency selection (how strong?) will depend on the reactivity of the patient (the reactivity of the Vital Force, Qi in Chinese medicine and to some extent the immune system in allopathy). If the reactivity is good, a stronger potency can be applied. Here are some general guidelines.

ALWAYS Low potencies (starting with 6C and not higher than 30C) are indicated and a must in the following conditions (these three conditions supersede any other indications following further!):
· The patient is a hypersensitive patient: such patient reacts to perfumes, environmental factors like carpets, bleach, newspaper, etc.) or people who react strongly to regular doses of medication and vitamins as well as those that reacted strongly to anesthesia
· The patient has strong pathology: this usually means, he already has received a medical diagnosis and there is extensive pathology involved like destruction of tissues (Multiple sclerosis, Parkinson,etc.) , formation of tumors, deficiency of factors like in diabetes, hyperthyroidy or Basedow disease, autoimmune disorders with destruction, asthma, etc. Also in chronic diseases affecting the heart, brain, eyes, pancreas, lungs
· The patient has a chronic skin disease, especially when treated in past with cortisone: chronic eczema from young age on and psoriasis, just to name two common diseases. Often the symptoms were controlled by cortisone intake/creams and in this case the dose should be minimal (drops instead of tsp) and definitely not higher than 6C potency to start
· Elderly patients: rather start with low potency

Higher Potencies (starting with 30C, then 200C, 1000C, etc.) are indicated in the following conditions:
· In young children (babies included) as long as the three previous conditions are not present; the choice of high potency includes ASD, ADHD, ADD, OCD, etc.
· Adults with functional diseases (no pathology has been shown) like vertigo, gastrointestinal problems, hypertension with no pathology yet, inflammatory processes like Bell’s palsy, etc. or adults with only mental/emotional problems such as depression, grief, lack of self confidence, lack of motivation in life, timidity, loss of meaning of life, etc.
· Patients under stress (worries at work, home, in relationships, etc.)

Part Two: the repetition of the Dose (How often), in chronic diseases

The most important thing to remember is that the repetition of a dose is determined on an individual basis. This is quite different than when we take allopathic drugs where your physician tells you to take the drug at a certain time (3 times a day, every evening, etc.), usually based on weight and age of patient……….

……आगे देखने के लिये लुक डी फ़िशर के ब्लाग पर जायें।

मै समझता हूँ कि हमारे देश मे अधिकतर होम्योपैथिक चिकित्सक लुक के तथ्यों से अलग हट के चलते हैं।
लेकिन फ़िशर अपने चिट्ठे मे जाते- 2 एक बहुत महत्वपूर्ण बात कह गये ।

जो रोगी ऐलोपैथिक चिकित्सा करा के होम्योपैथिक चिकित्सा के लिये आ रहे हैं उनके साथ चिकित्सा का रुख क्या हो। त्वचा के रोग, साँस संबधी रोगों आदि मे हम अक्सर देखते हैं कि cortisone के अंधाधुध प्रयोग से रोगी प्राय: इन औषधियों पर निर्भर हो जाता है , यही स्थिति लगभग मानसिक रोगों मे भी देखी जा सकती है जहाँ antidepressants और tranqulisers के चलते रोगी को इन औषधियों को चाहते हुये भी छोडना संभव नहीं होता ।

जो रोगी ऐलोपैथिक चिकित्सा करा के होम्योपैथिक चिकित्सा के लिये आ रहे हैं उनके साथ चिकित्सा का रुख क्या हो। त्वचा के रोग, साँस संबधी रोगों आदि मे हम अक्सर देखते हैं कि cortisone के अंधाधुध प्रयोग से रोगी प्राय: इन औषधियों पर निर्भर हो जाता है , यही स्थिति लगभग मानसिक रोगों मे भी देखी जा सकती है जहाँ antidepressants और tranqulisers के चलते रोगी को इन औषधियों को चाहते हुये भी छोडना संभव नहीं होता । यह स्थिति कमोबक्श उन pseudo mental cases की भी है जहाँ मानसिक रोग न होते भी sedatives जैसे alprozalam आदि का का सहारा लिया गया। वहाँ क्या करें। लुक कहते हैं:

NEVER stop your allopathic medication when starting homeopathic treatment with your chronic patient. Cooperation with your allopathic physician is a must!

दोनों चिकित्सा पद्दति भले ही सिद्दातों मे अलग दिखें लेकिन clinically एक दूसरे की पूरक हैं , अकसर बहुत से रोगों मे जहाँ चिकित्सा की सीमा जटिल परिस्थितियों (chronic stage )पर जा कर ऐलोपैथिक मे फ़ँसती है वहाँ होम्योपैथी उन परिस्थितियों मे बखूबी काम करती है और यही बात होम्योपैथी मे भी है कि पुराने रोगों की acute stage से उबरने मे ऐलोपैथिक चिकित्सा की आवशयकता पड सकती है।

100% खरी बात ! अगर cortisone या antidepressants को आप एकदम से हटा रहे हैं तो इसके परिणाम भी भुगतने को तैयार रहें। जाहिर है कि इन ऐलोपैथिक औषधियों को हटाने की प्रकिया धीरे -2 करनी चाहिये । और इसके लिये आप को अपने ऐलोपैथिक चिकित्सकों से सहयोग लेने मे हिचकना नही चाहिये। इस बात को हमेशा ध्यान रखें कि दोनों चिकित्सा पद्दति भले ही सिद्दातों मे अलग दिखें लेकिन clinically एक दूसरे की पूरक हैं , अकसर बहुत से रोगों मे जहाँ चिकित्सा की सीमा chronic stage पर जा कर ऐलोपैथिक मे फ़ँसती है वहाँ होम्योपैथी उन परिस्थितियों मे बखूबी काम करती है और यही बात होम्योपैथी मे भी है कि पुराने रोगों की acute stage से उबरने मे ऐलोपैथिक चिकित्सा की आवशयकता पड सकती है।

डा राजन शंकरन का नजरिया:
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डा राजन शंकरन का नजरिया एकदम हट कर है जहां अन्य होम्योपैथिक चिकित्सक पुराने ढर्रे पर चलना पंसद करते हैं , वहीं राजन नई सोच को चिकित्सकों के समक्ष रखते हैं।

लेकिन डा राजब शंकरन बिल्कुल ही हट के बात करते हैं और बात भी बहुत वजनी !
कुछ वर्ष पूर्व होमयोपैथिक लिंक्स मे एक पत्र डा गेर्हर्डस लैंग का डा राजन शंकरन के नाम छपा था । डा राजन के विचार आज की परिस्थितयों को देखते हुये बहुत ही महत्वपूर्ण हैं।
मुझे ध्यान पडता है कि ऊ प्र मे गोरखपुर से दिवगंत वयोवृद्द चिकित्सक डा हेमन्त बैनर्जी का औषधि देने का तरीका भी कुछ ऐसा ही था । repetition की परिभाषा को डा शंकरन ने बडे आसान से शब्दों मे रख दिया, ” Repetition is giving a reminder (an awareness) and is needed as fast as the person forgets the previous lesson. ”
संक्षेप मे डा राजन शंकरन का नजरिया:
क- जटिल और पुराने रोग जैसे hypertension ( उच्च रक्त्चाप),vitiligo(सफ़ेद दाग),osteoarthritis ( गठिया) आदि , जहाँ रोग की चाल धीमी हो वहाँ औषधि का repetition औषधि के कार्यकाल को पूरा हुये बगैर भी कर देना चाहिये।
ख- पुराने और जटिल रोगों में जहाँ कारक ( excitng factor ) मौजूद हो वहाँ भी औषधि का repetition जल्दी होना चाहिये। कारक या excitng factor वह हैं जो आम स्वस्थ मनुष्य में प्रभाव नहीं छोडते लेकिन एक रोगी मनुष्य में समस्या पैदा करते हैं।

बाकी आगे आप स्वयं देखें:

डा लैंग ने डा राजन से जो सवाल पूछे वह कुछ इस तरह से थे:


Gerhardus Lang, M.D., Klinge 10,
D- 7325 Boll

Dear Rajan Sankaran, How often can we repeat a dose? You wrote in your book The Spirit of Homoeopathy that we have to repeat when the dose is exhausted. In chapt. 25 you describe a case of Aurum met. and you gave him Aur.m.200 and 1 M over a period of a year in weekly doses. I should like to know if Aurum was always exhausted after a week and if you did really observe the patient to be sure if the dose was exhausted.

डा राजन शंकरन का उत्तर:

Rajan Sankaran,Mumbai
I have, in the past ten years of practice, in some chronic cases of definite structural pathology, repeated the dose of the indicated remedy despite amelioration. I did this because I found that sometimes by not repeating the dose of the medicine progress comes to a standstill and despite the patient feeling better the pathology remains the same. Further, I found that such repetition did not seem to create any kind of trouble. I must also state that in some cases I found even chronic structural pathology reversing with a single dose. I therefore started thinking in which case a repetition is needed and in which case it is not needed. My conclusions are as follows:
One of the cases I would definitely repeat regularly would be osteoarthritis that requires a remedy like Calc.fluor. A similar example would be a case like hypertension which is chronic and persistent. A third example would be a case of vitiligo. These kind of cases which share a common feature, namely they are chronic and slow in progression. I found in such cases that even though a single dose acts, its action seems to stop after some days or weeks and another dose takes it one step forward, its action lasting for another few weeks and so forth. Gradually I started experimenting with repeating doses even when the person was improving as if anticipating that the dose would exhaust its action. I found this kept the progress uninterrupted. It seemed to depend upon the onset of pathology. If the onset was slow and gradual, repetition was needed in days or weeks. If the onset was sudden and the exciting factor was not there, then repetition was not needed, e.g. sprain or an injury or a fright etc. If the exciting factor was present e.g. certain severe infective pathology as in severe tonsillitis, severe pneumonia, typhoid etc. then repetition would be called for every few hours. The same happens in chronic cases especially in cases where the exciting factor is found in the life of a person, these cases require definite repetition. One must remember that an exciting factor is one that excites a sick person – the same factor may not excite healthy people.
Another factor that influences repetition is excitability of the root within. If the root is strong, the dose exhausts its action quite soon. The excitability of the root can be judged by how sensitive the person is to the exciting factor. Taking all these above factors into consideration, when we look at the case of Aur. given in my book we find
1) Very excitable Aurum root as shown in the fact that increased responsibility excited in him a intense state of Aurum.
2) Such a responsibility was still present (felt by him) as a continuous exciting factor.
3) The pathology was slow and gradual showing the need of repetition. Pathology in the form of IHD (Ischaemic Heart Disease) HT (Hypertension) and diabetes and also peripheral vascular disease – all slow progressive pathology which I feel cannot be reversed by a single dose.
In such cases I can anticipate that the dose will be exhausted very soon. I judge how long to wait by seeing how long the first dose lasts. When its action is over I repeat the dose at the same interval each time, even before the improvement stops. If I know that the first dose lasted two weeks I would repeat the remedy once in 12 days in anticipation.
From experience I found that if other things are constant, i.e. there is no new addition or subtraction of exciting factors, the dose acts for almost the same amount of time. There comes a point, after a few days, months or years, where the dose stops acting or acts for a much shorter time. This is the time to raise the potency. Each time the potency is raised it is advisable to again wait and watch for how long the dose of the new potency works and to repeat at this interval.
The logic of repetition.
What I have stated is from clinical experience of innumerable cases. I have thought about this phenomenon and explain it thus:
1) What is repetition?
Repetition is giving a reminder (an awareness) and is needed as fast as the person forgets the previous lesson. Who is likely to forget and need a reminder? The one who has fallen into such a pattern that just telling him once doesn’t make enough impression. There is a tendency to fall into the same pattern again and again and we see this in a chronic or acute case which has a strong exciting factor.
For example, a person coming for an interview is nervous for 3 days before. You give an awareness and his nervousness recedes until he is faced with the interview. His nervousness returns and he needs to be reminded again. As the period of interview comes closer and closer he needs repeated doses of awareness. So, in such a case you might have to repeat Gelsemium again and again.
Where is repetition not required?
An acute where the exciting factor which is not repeated, can easily be dealt with in one dose. Even a chronic case which began with one exciting factor which is no longer there needs very little repetition, I have seen this with Carcinosin. E.g. Carc. is a situation of a child where the parents are asking for perfection and the child fits into this pattern, but if in adulthood this exciting factors no longer exists a single awareness is enough. Here the exciting factor doesn’t exist in the present, and little or no repetition is necessary. If you see a case of Calc.fluor where the fellow is struggling about money, with an excitable root from the past plus exciting factors from present, it is impossible to cure with a single dose and the dose will exhaust its action very soon. Even when there is no pathology, but there is only a prominent state, repetition may be needed if the state has come from a very excitable root and there are continual exciting factors around e.g. we see a very strong Bar- carb child coming from a very strong Bar-carb mother. This child is slow dull, laughed at, criticised which makes him even more vulnerable to criticism. People start laughing at him, his family itself considers him an idiot, this child surely requires repetition of Bar-carb very often to get out of this state. The same child in the family which is encouraging and doesn’t laugh at him will require less repetition of Bar-carb. Similarly if the child’s state has resulted from a strong state of the mother during pregnancy this child is likely to require repetition. If the child’s present state resulted from some incident in the child’s own past, one isolated incident like fright, this child is not likely to require repetition.
“It is impractical to repeat the same unchanged dose of a remedy once, not to mention its frequent repetition (and at short intervals in order not to delay the cure). The vital principle does not accept such unchanged doses without resistance, that is, without other symptoms of the medicine to manifest themselves than those similar to the disease to be cured, because the former dose has already accomplished the expected change in the vital principle and a second dynamically wholly similar, unchanged dose of the same medicine no longer finds, therefore, the same conditions of the vital force. The patient may indeed be made sick in another way by receiving other such unchanged doses, even sicker than he was, for now only those symptoms of the given remedy remain active which were not homoeopathic to the original disease, hence no step towards cure can follow, only a true aggravation of the condition of the patient. But if the succeeding dose is changed slightly every time, namely potentised somewhat higher then the vital principle may be altered without difficulty by the same medicine (the sensation of the natural disease diminishing) and thus the cure brought nearer” – said Hahnemann in the Organon. This goes against not only my experience, but that of many homoeopaths. As far as I know no homoeopath has refrained from repeating the same dose and so not only Hahnemann’s explanation goes beyond logic but goes beyond experience also.

प्रो. जार्ज विथेलीकोस ( Prof. George Vithoulkas)
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अप्रैल 2007 की hpathy e magazine मे जार्ज विथेलीकोस का फ़ास्फ़ोरस पर एक केस प्रकाशित हुआ था । यह एक लाइव डिसक्शन है जिसमे कई होम्योपैथिक चिकित्सकों ने जार्ज के साथ वार्ता-विमर्श किया था। कुछ सवाल अत्यन्त ही महत्वपूर्ण थे जो उस कान्फ़्रेन्स मे उठाये गये । पूरा लेख पढने के लिये यहाँ जायें
संक्षेप मे :

………..The danger comes from the kind of homoeopathy which is
given, say, in the morning Mag-C. 200; at noon, Calc-c.1m; and in the evening, Graph.1m. And in the morning we have another course where Ant-c. 200m. is given, then Gels. 10m; and then Phos. 200m. On the third day we have another scheme and then we repeat it again. We start from the first day. Who knows what is happening? If that person continues to take all these remedies for six months or a year, you have a person who is proving. God knows what!

जार्ज कहते हैं कि जिस तरह कि होम्योपैथी आज हो रही है जहाँ कई सारी औषधियों का समावेश या पर्याक्रम से एक दूसरे को देने का चलन बढा है वह रोगी के लिये बहुत ही घातक है। आगे आप स्वयं ही अन्दजा लगा सकते हैं कि जब यह औषधियाँ मानव शरीर पर अपनी proving करेगीं ।

………..You have to remember that the more clear the case is, the higher you can go, and the more immediate will be the effects. Even in organisms which are exhausted and which are weak.
If you read all the literature, you will see that all the good homoeopaths who were living around the 19th century and the beginning of the 20th were very good and they gave very high potencies. If we had given in that case 200, before we reached 50m, where the child needed action, it would have taken us 3,4 or 5 days. If we give that with little effect, then you have to wait for the return of the symptoms, repeat 200, then 1m, then 10m and then 20m.

आपका यह भी मानना कि जितने लक्षण साफ़ दिखें उतना ही पोटेन्सी को उच्च क्रमांक मे दें ताकि औषधि की क्रिया तुरन्त दिखे। जार्ज इस संदर्भ मे उन पुराने होम्योपैथिक चिकित्सकों की उच्च क्रम की पोटेन्सी के चुनाव की याद दिलाते हैं ।

……..This is a general rule. When a remedy has acted. Do not give up the potency immediately. Try it once. If there is a relapse, go one step higher.
……..When you have started with one remedy and it has an effect, do not discontinue it immediately and jump to another. When you have given a remedy and it has acted beautifully in one potency, try it again in the same potency before you jump to the higher potency. This is a general rule for acute and chronic cases.
……..
Anyhow, you cannot avoid losing sometimes, especially with chronic cases. Because there are no clear indications which will tell you to repeat the same remedy, the same potency, or go one step higher. There are no such indications which I can give you to work with where you will avoid repeating the first potency. A good strategy is to go up. You have given one remedy in a chronic case in a potency. Then he comes in after six months and says, ” I have relapsed.” You may go to 50m. If that does not work, then go back to 10m. Usually that 50m will cover the case and will work. So you can avoid the one step. You have 10m here. Then there is a relapse and you give 10m. Then there is another relapse and you use 50m.
If you go from 10m to 50m immediately, you have nothing to lose. Sometimes, but seldom, you will have to come back to 10m. But there are other old master homoeopaths who would say, “Never change your potency as long as it is working even a little.” They say, “Even if it works for one month or twenty days, do not give it up. Then you can go higher.”

जार्ज का मानना है कि पुराने और जटिल रोगों मे अगर रोगी कुछ महीने या दिन के बाद लक्षणों की पुनरावर्ती की बात कह रहा है तो आप बिना औषधि को बदले इसी औषधि को एक क्रम ऊपर दे अगर लग रहा है कि वह औषधि उन परिस्थिति मे काम नही कर रही है तो आप नीचे भी आ सकते हैं।

जार्ज का मानना है कि पुराने और जटिल रोगों मे अगर रोगी कुछ महीने या दिन के बाद लक्षणों की पुनरावर्ती की बात कह रहा है तो आप बिना औषधि को बदले इसी औषधि को एक क्रम ऊपर दे अगर लग रहा है कि वह औषधि उन परिस्थिति मे काम नही कर रही है तो आप नीचे भी आ सकते हैं। लेकिन सबसे विशेष बात याद रखें कि कि एक चयनित औषधि अगर अपना कार्य सुचारू रूप से कर रही हो तो उसको बदले नही।
और चलते -2 जार्ज केन्ट की भी बात को याद दिला देते हैं :

Kent was talking about that same thing, about doctors who would prescribe high potencies haphazardly, and too many at the same time. There can be real trouble! There can be no trouble in giving one remedy and waiting for one month to see in a chronic case.

उच्च क्रम की पोटेन्सी के साथ अंधाधुध खिलवाड कदापि न करें , यही आपके और रोगी दोनों के लिये ही बेहतर रहेगा।

होम्योपैथी पोसोलोजी प्रो (Homeopathy posology pro ) -आनलाइन साफ़्टवेएर
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होम्योपैथिक औषधि की पोटेन्सी और रिपीटिशन की समस्या को सुलझाने हेतु कुछ नये आनलाइन साफ़्टवेएर भी हैं । इनमे हाल ही मे जारी किया गया होम्योपैथी पोसोलोजी प्रो (Homeopathy posology pro ) नाम का साफ़्टवेर भी चर्चा मे है। इससे संबधित पूरी जानकारी के लिये यहाँ , यहाँ , और यहाँ देखें। होम्योपैथी पोसोलोजी प्रो (Homeopathy posology pro ) साफ़्टवेएर के तीन प्रमुख खंड हैं :
1- Case Management Module
2- Potency Selection Module
3- Sensitivity Meter

फ़िलहाल इसका प्रयोग मैने अभी नहीं किया है , आगे कभी बाद मे इस पर चर्चा करेगें।

19 responses to “सेंकेंड प्रिसक्पशन और सही पोटेन्सी का चुनाव (Second Prescription & selection of potency)

  1. Sir agar aap pahle aa gaye hote to organon me supplementary na ati .:) . I must say this is an excellent article on untouched homeopathic subjects.

  2. … great effort to bring different views in one page.

  3. Sir mai baroda se hoon aur 3rd year B.H.M.S. ka student hoon . Orkut mein maine apko dekha hai , itni sari jankari dene ke liye thanks. Main bhi hindi mein likhna chata hoon kaise likhoon ?

  4. Dear sir,
    aapne 2nd prescription par bahut hi badhia collection kiye hain iske liye aapko dher sari subhkamnayen… ye ham sabhi ke liye kafi useful hai…
    pravin gaya, bihar.
    http://www.esnips.com/web/REPERTORY/

  5. काफी मेहनत और शोध से लिखा गया लेख, श्रेष्ठ प्रयत्न।

  6. very good work done by dr.prabhat…keep it up

  7. Really a commendable job Dr. Tandon.
    But the concept of Posology is incomplete without adding something about Susceptibility of a person.
    I had recently posted an article on Susceptibility & Homoeopathy in Homoeopathy….Beyond Horizons Community.

    Susceptibility & Homoeopathy

    Susceptibility is the combination of hereditary dyscrasia & adaptability.
    Whenever any pleasant incident occur, we feel pleasure, sorry for other’s grief, we feel chilly in cold, we perspire in hot etc. all these are due to this susceptibility. So we can say susceptibility is the power of reaction of the body of a living organism against an external stimulus. This susceptibility may increase or decrease due to many a cause, e.g.: environment, habit, occupation, mode of living, mental stress & strain etc. etc.
    After the heavy exposure to rain most of us become somehow sick, but on slight exposure if anybody suffers from Pneumonia or tonsillitis, then it is clear that he/she is hyper-susceptible to rain. And this is the reason, it is not the fact that each & every member of a family will suffer from a same disease. It absolutely depends on the susceptibility of each individual member. On the contrary those who are susceptible to particular medicine he/she will be cured by that particular medicine when diseases (remedy). If the particular patient is not susceptible to a specific remedy, he will not be cured by that. In homoeopathy it is essential for the selection of potency also. Now if we discuss how it helps in the selection of potency, it will be cleared about the importance of susceptibility also.
    Medicines are the weapon to us in fighting against diseases; no doubt, but to restore the sick to health, we will have to possess perfect knowledge about the application of each medicine which remains inherent in each of their respective medicinal substances. This inherent and latent curative power, i.e. the strength of a drug or the potency of a drug is the main thing in the modus operandi of a cure.
    So, a homoeopathic practitioner should have to keep in mind that the speed with which the cure will be affected depends on the potency of the remedy. Now question is how this selection is to be made? We will be able to select a correct potency of a medicine on individual patient if we consider the susceptibility of the patient seat, nature, intensity stage and duration of the disease & lastly whether any treatment has been done previously or not.
    There is no such instrument or anything else by which we will be able to measure the susceptibility of a patient. But as it is a vital thing in selection of potency as well as in simlimum, a physician will have to observe or to perceive the different factors which modify the susceptibility to a drug of an individual. The more similarity to a drug indicates the greater susceptibility of that and in that case the higher potency is required.
    This susceptibility is modified by age. The children and young vigorous persons are most susceptible. Children become very much sensitive during their development, specially the organs which are being developed. So due to this hyper-sensitivity, medicine also have a special or peculiar affinity for those organs which are being developed. So due to this hypersensitivity, medicine also have a special or peculiar affinity for those organs for which – medium or higher potency is required. Susceptibility also depends upon the constitution & temperament of the individual. Nervous, Sanguine, jealous, impulsive, intelligent and intellectual persons being choleric temperament requires higher potencies whereas lower potencies are best adopted to torpid, phlegmatic individuals and the persons who are full of comprehension, slow in work, persons who are robust require higher potencies. In some cases where structural pathological changes have already been occurred in the organism, there susceptibility becomes so low that the medicine must be given in low potency.

    The persons, who have already taken many crude drugs, require high potencies but who are exposed to continual influence of drugs require low potency due to little susceptibility to the medicines.
    As the potency depends upon the seat, nature, intensity, stage & duration of the disease, certain destructive & fatal diseases like malignancy & cholera respectively require low potency even in material doses, where the intensity of the disease condition is high which have diminished the vital power to react, the low potency is required there, on the contrary increased vital reaction respond better to higher potencies.
    In some cases, where many treatments have been already done and due to abuse of too many crude drugs the patient may lose their susceptibility for the time being. In that case we should wait for a few days without giving any medicine, but with careful observations in diet & regimen. After that medicine is to be given according to the need depending on the several factors either in low or medium potencies.
    So, we can well assess that the susceptibility is nothing but the universal faculty of sensitivity which is qualitative. The basic difference of each individual develops mainly on this faculty. And also incidence of any disease as well as the action of curative dynamic remedy depends slowly upon this very faculty of the living organism.

  8. Dr.prabhat sir ji,nice work as usual.

  9. Dhanyavad Dr. Tondon, The questions raised regarding the second prescription and allied points, I agree on some points with you, but again I would like to point out that this nature of controversies are always raised by the side of the Homoeopaths and therefore they are responsible to make the Homoeopathic doctrines with full of controversies. Since commence of Homoeopathic doctrine in existence from Medicine of Experiences upto the appearance of the Organon of Medicine 6th edition, Hahnemann have changed many times his doctrine and philosophy, which he laid down in earliest period in their subsequent editions. These changes are itself prooved that there is need to make much more changes in the practicle way. Why we forget that Boenninghausen convinced Hahnemann for alternation of medicine rule inclusion in Organon. If you go Hahnemannian Life History and also in some writtings, Hahnemann himself used and advocated alternation of two remedies at a time. Why you forget the famous trio of Boenninghausen, which is still effective in Spasmodic croup.But due to opposition of the then followers Hahnemann geared back to include this law.

    Let us not make the points crucial for mental apeasment solution , but they should be solved as easy as possible. Academic discussions should be practicable and not controversial. This is bad habit of the Indian Homoeopaths that they discuss much much more but they do nothing on ground lvevel exept the controversies. That’s why Homoeopathy is not accepted as a medical science all over world except in India.

  10. @. Dr Desh Bandhu Bajpai

    Why we forget that Boenninghausen convinced Hahnemann for alternation of medicine rule inclusion in Organon. If you go Hahnemannian Life History and also in some writtings, Hahnemann himself used and advocated alternation of two remedies at a time. Why you forget the famous
    trio of Boenninghausen, which is still effective in Spasmodic croup.But due to opposition of the then followers Hahnemann geared back to include this law.
    Let us not make the points crucial for mental apeasment solution , but they should be solved as easy as possible. Academic discussions should be practicable and not controversial. This is bad habit of the Indian Homoeopaths that they discuss much much more but they do nothing on ground lvevel exept the controversies. That’s why Homoeopathy is not accepted as a medical science all over world except in India.

    I agree , my next post on leucoderma & homeopathy , which will shortly publish probably on next week ,will deal into this matter, There are large number of homeopaths who practice polypharmacy in their practice , but when they appear in the public platform , speak otherwise.
    About the Boenninghausen’s method of trio , I have used from time to time & these trios work really well. Read the post :
    https://drprabhattandon.wordpress.com/2007/03/10/relationship-of-homeopathic-medicines/

  11. धन्‍यवाद डा0 टन्‍डन, मैं आपको यह सूचना देना आवश्‍यक समझता हूं कि मैंने इसी ई0टी0जी0 तकनीक में थोड़ा सा सुधार करके ‘’इलेक्‍ट्रो-होम्‍यो-ग्राफी ई0एच0जी0‘’ तकनीक विकसित की है, जिसके जरिये होम्‍योपैथी के तीनों मियाज्‍म सोरा, सायकोसिस और सिफलिस, इन तीनों का शरीर में कितना कितना प्रभाव है, यह मापा जा सकता है और इसे साक्ष्‍य रूप में प्रस्‍तुत कर सकते है । ई0यच0जी0 तकनीक में और आगे शोध कार्य जारी हैं । होम्‍यापैथिक औषधियो का सटीक चयन भी केवल ट्रेस रिकार्ड के आधार पर किया जा सकता है ।

    Dr. Desh Bandhu Bajpai http://etgind.wordpress.com

  12. धन्‍यवाद डा0 टन्‍डन, मैं आपको यह सूचना देना आवश्‍यक समझता हूं कि मैंने इसी ई0टी0जी0 तकनीक में थोड़ा सा सुधार करके ‘’इलेक्‍ट्रो-होम्‍यो-ग्राफी ई0एच0जी0‘’ तकनीक विकसित की है, जिसके जरिये होम्‍योपैथी के तीनों मियाज्‍म सोरा, सायकोसिस और सिफलिस, इन तीनों का शरीर में कितना कितना प्रभाव है, यह मापा जा सकता है और इसे साक्ष्‍य रूप में प्रस्‍तुत कर सकते है । ई0यच0जी0 तकनीक में और आगे शोध कार्य जारी हैं । होम्‍यापैथिक औषधियो का सटीक चयन भी केवल ट्रेस रिकार्ड के आधार पर किया जा सकता है ।

    Dr.Desh Bandhu Bajpai, http://etgind.wordpress.com

  13. पिंगबैक: सफ़ेद दाग और होम्योपैथी- आशा की एक किरण -भाग-१ (Leucoderma & homeopathy- an ultimate hope -Part-1) « होम्योपैथी-नई सोच/नई दिशायें

  14. Sir Do U have any treatment for Severe OCD please help me if u can I am suffering a lot

  15. Sir,
    Kindly give me the advice as i am having three to four white patches on the fingers .it had started since 2002 . which homeopathic & in what potency should i take

  16. GOODMORNING
    BE CONFIDENT & EVALUATE THE Pt. TO FIND THE REMIDY.

  17. good article but we have to follow dr. kent and our father else all is only commentry.

  18. पिंगबैक: सेन्टिसमल स्केल से LM स्केल तक का सफ़र | होम्योपैथी-नई सोच/नई दिशायें

  19. Dr.Prabhat sir, Thank you for the most precious information and a great deal of work. It’s worth known.

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