1. UNDERSTANDING CLINICAL
ASPECTS OF FIFTY MILLESIMAL
SCALE OF POTENCIES IN
HOMOEOPATHIC PRACTISE
PRESENTATION BY:
DR. BIPIN JETHANI
Assistant Professor/ Reader,
Department of Organon of Medicine
Nehru Homoeopathic Medical College & Hospital,
New Delhi.
E-mail: drbipin.jethani@gmail.com

2. FIFTY MILLESIMAL SCALE OF
POTENCIES:
HAHNEMANN’S FINAL
REFORMATION IN POSOLOGY

3. ‘What I said in the fifth edition
of the Organon, in a long note
to this paragraph in order to
prevent
these
undesirable
reactions
of
the
vital
energy, was all the experience I
then had justified. But during
the
last
four
or
five
years, however, all these
difficulties are wholly solved by
my new altered but perfected
method. ….. to §246 of sixth edition
Footnote

4. ‘…The same carefully selected
medicine may now be given daily and
for months, if necessary in this
way, namely, after the lower degree of
potency has been used for one or two
weeks in the treatment of chronic
disease, advance is made in the same
way to higher degrees, (beginning
according to the new dynamization
method, taught herewith with the use
of the lowest degrees).
Footnote to §246 of sixth edition

5. EVOLUTION OF FIFTY MILLESIMAL
SCALE OF POTENCIES
WITH ANY PROBLEM THESE QUESTION NEED TO BE ANSWERED

6. TRANSFORMATION FROM
CENTISIMALS TO FIFTY
MILLESIMALS
In light of his experience, Hahnemann suggested
two modifications in the mode of administration
of centesimal scale of potencies :
• ADMINISTRATION of similimum IN LIQUID
FORM
• CHANGING DEGREE OF DYNAMISATION WITH
EACH DOSE ADMINISTERED TO THE PATIENT

7. need to administer medicine
in liquid form
‘Such a globule, placed dry upon the tongue, is one
of the smallest doses for a moderate recent case
of illness. Here but few nerves are touched by the
medicine. A similar globule, crushed with some
sugar of milk and dissolved in a good deal of
water
and
stirred
well
before
every
administration will produce a far more powerful
medicine for the use of several days. Every
dose, no matter how minute, touches, on the
contrary, many nerves.’
§ 272 (Sixth Edition)

8. need to change degree of
dynamisation with each dose
‘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………...
§ 247 (Sixth Edition)

9. § 247 (Sixth Edition) of
organon of medicine
……….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
homœopathic 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 potentized
somewhat higher (§§ 269-270) then the vital principle
may be altered without difficulty by the same
medicine (the sensation of natural disease
diminishing) and thus the cure brought nearer.

10. Change affected in
centisemal scale of
potencies
Hahnemann consequently incorporated
these two principles of posology
(administration of similimum in liquid
form
and
changing
degree
of
dynamisation with each dose) in the
centesimal scale of potencies.

11. ADMINISTRATION IN LIQUID FORM
“Experience has shown me that it is most useful
in disease of any magnitude to give to the
patients the powerful homoeopathic pellet or
pellets only in solution and this solution in
divided doses……….
Preface to the 3rd volume of ‘The Chronic
Diseases - Their Peculiar Nature and
Their Homoeopathic Cure’

12. Preface to the 3rd volume of ‘The Chronic Diseases - Their
Peculiar Nature and Their Homoeopathic Cure’
………In this way, we give the medicine, dissolved
in seven to twenty tablespoonfuls of water in
acute and very acute diseases every six, four or
two hours; where the danger is urgent, even
every hour or every half-hour, a tablespoonful
at a time; with weak persons or children, only
a small part of a tablespoonful may be given as
a dose. In chronic diseases I have found it best
to give a dose of a solution of the suitable
medicine at least every two days, more usually
every day”.

13. CHANGING DEGREE OF
DYNAMISATION WITH EACH DOSE
‘Our vital principle cannot well bear that the same
unchanged dose of medicine be given even twice in
succession, much less more frequently to a
patient…….. But in taking one and the same
medicine repeatedly; if the dose is in every case
varied and modified only a little in its degree of
dynamisation, then the vital force of the patient
will calmly, and as it were, willingly receive the
same medicine even at brief intervals very many
times in succession with the best results….
Preface to the 3rd volume of ‘The Chronic Diseases - Their
Peculiar Nature and Their Homoeopathic Cure

14. Preface to the 3rd volume of ‘The Chronic Diseases - Their
Peculiar Nature and Their Homoeopathic Cure’
…….This
slight change in the degree of
dynamisation is effected; if the bottle
which contains the solution of one or
more pellets is merely well shaken
five or six times, every time before
taking it”.

15. HAHNEMANN OBSERVED
FURIOUS AGGRAVATION IN
SENSITIVE PATIENTS.
‘But with so small a diluting medium as 100 to 1 of the
medicine, if many succussions by means of a
powerful machine are forced into it, medicines are
then developed which, especially in the higher
degrees
of
dynamization,
act
almost
immediately, but with furious, even dangerous
violence, especially in weakly patients, without
having a lasting, mild reaction of the vital principle.’
Footnote to § 270 (sixth edition)

16. SOLUTION TO THE PROBLEM:
INCREASING THE RATION OF DILUTION
‘With this disproportionate higher ratio between
medicine and diluting medium many successive
strokes of the vial filled two-thirds with alcohol
can produce a much greater development of
power…..…The method described by me, on
the contrary, produces medicines of highest
development of power and mildest
action, which, however, if well chosen, touches
all suffering parts curatively.’

17. Birth of fifty millesimal scale of potencies
• Increased diluent ratio.
• Administration in liquid form.
• Changing degree of dynamisation
with each dose.

18. MODE OF ADMINISTRATION
Made in 40, 30, 20, 15 or 8 tablespoons of water with the
addition of some alcohol or a piece of charcoal in order
to preserve it. If charcoal is used, it is suspended by
means of a thread in the vial and is taken out when the
vial is succussed. The solution of the medicinal globule
(and it is rarely necessary to use more than one globule)
of a thoroughly potentized medicine in a large quantity of
water can be obviated by making a solution in only 7-8
tablespoons of water and after thorough succussion of the
vial take from it one tablespoon and put it in a glass of
water (containing about 7 to 8 spoonfuls), this stirred
thoroughly and then given a dose to the patient…….
§ 248 FOOTNOTE – 6TH EDITION OF ORGANON OF MEDICINE

19. MODIFICATION OF DOSE IN
LM POTENCIES
…………If he is unusually excited and sensitive, a
teaspoon of this solution may be put in a second glass
of water, thoroughly stirred and teaspoonful doses or
more be given. There are patients of so great
sensitiveness that a third or fourth glass, similarly
prepared, may be necessary. Each such prepared glass
must be made fresh daily. the globule of the high
potency is best crushed in a few grains of sugar of milk
which the patient can put in the vial and be dissolved
in the requisite quantity of water.
§ 248 FOOTNOTE – 6TH EDITION OF ORGANON OF
MEDICINE

20. HAHNEMANN REVEALED HIS NEW DISCOVERY
TO BARON VON BOENNINGHAUSEN.
Hahnemann shared the methods of the
LM potency with him before he
passed away. Thus other than
Melanie
Hahnemann, Boenninghausen seems
to be the only person who was privy
to this information.

21. HAHNEMANN’S
CORRESPONDENCE
WITH BOENNINGHAUSEN
Hahnemann sent Baron von Boenninghausen
two LM case histories in 1843, shortly before
he left for his Heavenly Abode. The Baron
shared these cases with his colleagues in the
Stapf's Archives, Volume 1 number 1
published in 1844, page 69.

22. BOENNINGHAUSEN’S SILENCE ON 6TH
EDITION OF ORGANON
After Samuel's death Melanie Hahnemann told
the Baron von Boenninghausen that the 6th
Organon would soon be published. When he
announced
this
event
to
his
colleagues, Melanie asked him to remain quiet
on the subject until after she published the
work. Out of respect for Hahnemann's widow
the Baron did not disclose all the information
in his possession.

23. BOENNINGHAUSEN’S KNOWLEDGE OF
LM SCALE OF POTENCIES
"In the new edition of the Organon which will probably
appear yet in the course of this year, improved and
completed by Hahnemann himself, a new simplified
procedure for the potentizing of medicines will be taught,
which has considerable advantages over the former and
yields a preparation as to the efficacy of which I can, from
my own experience, give full praise. I know this
procedure but according to my pledged word of honor,
am not as yet permitted to communicate it to anyone."
The Lesser Writings; C. M. F. Boenninghausen,
Aluminium Metallicum, footnote, page 74.

24. ADVANTAGES OF LM POTENCIES
LM potencies give freedom from the bondage of
medicinal aggravation on account of their mild
action and enable the physician to achieve gentle
cure. It is for this reason that these potencies are of
greatest utility for highly sensitive individuals and
are excellent in palliating incurable diseases (where
there is extensive pathological damage) with least
danger of aggravation.
HIPPOCRATIC NOTION OF ‘PRIMUM NON NOCERE’

25. ADVANTAGES OF LM POTENCIES
• The administration of medicine (in Fifty
Millesimal scale) in frequently repeated
modified doses hastens the process of cure
and paves the way for rapid return to state of
health.
• However; in case of centesimal scale; the
physician and the patient remain arrested in
the hands of medicine for a long time and this
unneccessarily prolongs the suffering of sick
individuals

26. • The selection of potency is much less ambiguous since
LM’s are always started with the lowest degree of
dynamisation (ie LM/1).
• The more frequent repitition of the dose in LM potencies
minimizes the danger of accidental antidoting of the
remedy.
• Moreover; in case the remedy action needs to be antidoted
(due to incorrectly chosen medicine); this can be achieved
much more easily since the involved doses are much
smaller. (Aph. 283).
• In case of administration of LM potency; the patients are
taught to observe their own symptoms and adjust their own
dosage. Consequently; active involvement of patient is
possible which allows for better patient management and
compliance.