What about the Potency? A Comprehensive Guide to Homeopathic Potency and Dosage

Michelle Shine Food For Thought Publications, London, UK, 2004 Price: £20.00, ISBN: 09547033008.

At last, a first ambitious and bold attempt to shed light on one of the most controversial and least understood but also neglected areas of homeopathic practice—the selection of potency and posology. This is a very welcome and timely book, in which the author shares her clinical experience by portraying 19 case histories in the first part, and conclude by interviewing 10 distinguished homeopaths to share their clinical wisdom on the subject.

The one question often dreaded by teachers is also one of the most frequently posed by students of homeopathy: ‘What potency did you use’?

Unfortunately, the supplied answers are diverse and even conflicting or riddled with dogmatism, depending on the school of homeopathy. Confusion about the whole topic potentially sets in, and maybe compounded by different post-graduate opinions, leaving the student questioning the validity of homeopathy. Aspiring practitioners are frequently thrown in the deep end of clinical practice, with only brief guidelines at hand, learning through trial and error as they gain experience. Unfortunately, there is a danger of stagnating in a routine of prescribing strategies, unless we occasionally benchmark our habits against an outside reference. Collectively we need to share our clinical experience by adding to the general pool of successful practice strategies. Shine has achieved this and the book is a great contribution to homeopathic methodology.

The author attempts to cover various aspects of homeopathy and each topic is accompanied with cases from clinical practice. Examples of ‘superficial’ prescribing with low potencies (6c) in contrast to ‘deeper’ prescriptions with higher potencies are defined with clear criteria. The controversial ‘Constitutional remedy vs Pathological prescription’ is also discussed, as are organ-specific remedies and tissue salts. There are numerous cases highlighting the experience with LM potencies, with the mention of ‘plussing’ and the observation that care is required because of the potential for aggravation.

Does the remedy, the patient or even the miasm dictate the potency? Should we prescribe low potencies in Opium cases, because they tend to have low-energy levels? Or similarly with the Sycotic cases, as their tendency to hide information often results in a lack of understanding of the essence, making prescriptions of higher potencies unjustifiable? It is not only the similmum that matters, but the selection of potency and the actual size of the dose, are just as important to bear in mind with every prescription. The, so often repeated advice, ‘Use the potency that you’ve got—as long as you have the right remedy’ is dated, and lends itself to failure, aggravations or an erroneous evaluation of the clinical response.

Another theme that is often avoided is suppression. Shine suggests stimulating suppressed cases gently with low potencies to avoid aggravations. Treating aggravations are also discussed, for instance by giving the same remedy in either a higher or lower potency.

Shine also cites examples of practitioners ‘losing the plot’ by abandoning a successful remedy too soon in favour of successive prescriptions in high potencies (stirring up numerous symptoms in the process) before finding the thread again—we’ve all been there!

Other topics include: the approach in hypersensitivity; adapting potency to the energy and vitality of the patient; acute, chronic and layer prescribing; when to change potency and about obstacles to cure—to name a few. In fact, no stone within the broad theme of prescribing strategies is left unturned. The book is firmly based in clinical practice, without philosophical deviations, questioning every aspect of homeopathy, and addressing just about every practical challenge a homeopath might encounter in formulating a prescribing strategy. The insightful interviews with experienced homeopaths give the reader a glimpse into the thought processes and prescribing rationale from some of the experienced practitioners as they share the gems of their collective experience. New information and strategies are revealed, such as the use of 4C potencies, the effects of olfactation, using ‘in between potencies’ rather than jumping between the big gaps as in the Kentian scale.

This book is a valuable guide to students of homeopathy, beginners and seasoned practitioners alike. The author shares her thought processes, as if thinking aloud, varying between belief, experience, guess work and gut feelings, almost as if the reader is an observer in her consulting room. The author concludes by stating that it is a work in progress and that the last word on potency has not been spoken yet, and that an update is pending. There is an open invitation to readers to share their clinical experience with case contributions that might enlighten our understanding of potency. This book is highly recommended.