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====== DOSAGE GUIDELINES FOR HOMEOPATHIC REMEDIES ======

Apart from the right choice of a suitable homeopathic medicine, optimal dosage is **very important** in order to achieve the best possible result. Dosage of a homeopathic medicine is optimal, if the following conditions are met: 

  * There is minimal or no aggravation of symptoms after administration of the remedy. 
  * Symptoms are steadily improving. Depending on many factors, the improvement may be slow or quick, but the essential factor is a **steady pace of improvement**, not its speed. 

This article describes various ways of taking homeopathic medicine, but especially the circumstances under which it is appropriate / inappropriate to repeat the dose. The method does not consider LM / Q potencies((due to author's lack of experience in their use)), only centesimal (C / CH)  and decimal (D) potencies (mainly used in German-speaking countries).

===== Methods of taking homeopathic remedies =====

Homeopathic medicines are usually available in form of sucrose-lactose globules (of various sizes), but for the purpose of taking the medicine, dissolving the drug in water (hereinafter referred to as "water dose") is generally preferable method of use. In cases when there is a sufficient time and a suitable container for preparation for administration in water, this method is preferable to the direct use of globules (hereinafter referred to as "dry dose"). Compared to dry dose, water dose method posseses the following advantages: 

  * The possibility of a more precise control of dose rate and thus the intensity of the effect. 
  * Compared to dry dose, more frequent repetition is generally better tolerated. 
  * Lower consumption of the medicine, so one bottle of remedy can be utilized many times.

===== Water dose =====

<WRAP tip round >1. Before the first use of the remedy, allow to dissolve TWO or THREE globules of medicine in a clean glass or plastic bottle filled with water. (Do not touch the globules.) </WRAP>

  * A suitable bottle is any clean container suitable for storage of drinking water, preferably made of glass, plastic bottles are also suitable, for example, (unflavoured) mineral water bottles are satisfactory.
  * The amount of water depends on the expected frequency of use. Make sure the bottle **is not completely filled with water**, max. to three-quarters of the total volume of the bottle. About 300 ml of water in half-liter bottles are satisfactory. 30 ml of water in 50 ml glass vial is also suitable. Of course, a larger volume of fluid will provide a greater number of doses.
  * Clean unused glass vials (volumes ranging from 50 ml to 500 ml, depending on the expected frequency of use) are eminently suitable for the purpose. These can be purchased from pharmacies or medical supplies stores.
  * Regarding the quality of water -- still table water, uncarbonated mineral water (without bubbles) or filtered water are suitable. Do not use chlorinated tap water (unless as a last resort). Highly mineralized waters and not suitable.
  * Medicinal bottle should be stored in a refrigerator (otherwise the water will soon be spoiled). If not possible, store it in a dry and relatively cool place. You can add a little high-proof food-grade unflavoured alcohol for the purposes of preservation. It is useful to label the bottle, noting the remedy name and date of preparation. ** One bottle should only be used to prepare one remedy, and should be discarded after the use! **
  * Make sure not to expose the medicinal solution to direct sunlight, temperatures above 50 degrees Celsius, strong electromagnetic radiation (cell phones, televisions, computers, loudspeakers, wireless routers, microwave oven, electric appliances etc.) - otherwise you may lose efficiency.

<WRAP tip round >2. Before taking a single dose, it is necessary to strike the bottle several times on a hard elastic surface or apply several vigorous shakes (for example 3 - 5 times).</WRAP>

  * Force and the number of strokes/ hits / shakes influence the intensity of medicinal action. More hits result in a more intense effect, but also a carry a higher risk of aggravating the symptoms. In any case, it is necessary to apply at least two strokes.

<WRAP tip round >
3. Take a small sip, about a teaspoonful. Hold the liquid in mouth for several seconds, then swallow. As far as possible, do not eat or drink (except clean water) at least 10 minutes before and after taking the dose.
If oral administration is not appropriate or practical (eg., in cases of painful swallowing) or in very sensitive persons, the remedy can be taken by olfaction -- just place the bottle very close to the nostril and breathe in vigorously. Do not inhale the liquid, just the vapors!
It is also possible to apply the medicinal solution under the nose -- for example, you can soak a pure cotton wool with the medicinal solution and rub it under the nose.
</WRAP>

  * By adjusting the dose volume (one teaspoon / more spoons / small sip / big gulp) you can adjust the intensity of medicinal action. Larger volume results in a more intense effect, but also a higher risk of primary aggravation of symptoms.
  * In particularly sensitive individuals, the dose may be further diluted so that the usual dose (e.g. one teaspoon) is diluted in another container (preferably disposable plastic cup, which is discarded after the use) in a suitable amount of water we give the dose from this diluted version. The dilution process may be repeated with several cups, if necessary.

When taking another dose, proceed from step 2.

===== Dry dose =====

Let 2 or 3 globules of the remedy dissolve in mouth. As far as possible, do not eat or drink (except clean water) at least 10 minutes before and after taking the dose.

===== Repeating the dose =====

This section should answer the question of whether, and if so, when, the dose may be repeated.

<WRAP tip round >
After a suitable time has passed after taking the last dose of remedy, we shall evaluate the changes in character and intensity of the symptoms and assess whether or not the dose should be repeated.
</WRAP>

Suitable time interval varies greatly depending on the nature of the problem. Appropriate criteria for determining the fitting evaluation time interval of medicinal action is the **duration of symptoms** and the **intensity of symptoms**.

The following table shows the proposed indicative value according to two criteria.
Intensity of symptoms is on a scale of 1 to 5, where 1 means "symptoms of mild intensity", 3 means "moderately intense or moderately painful symptoms", 5 means "life-threatening symptoms or unbearable pain." If the table cell contains no value, it means the administration of the remedy and is either undesirable or it is not possible to recommend an appropriate evaluation time interval.

The time interval in the table **does not indicate** the time interval, at which the dose may be repeated, but rather the time when it is **desirable to evaluate the course of the symptoms**! Whether it is appropriate for an dose to be repeated, wholly depends on the direction of the evolving state (see text below the table). 

^ Duration of symptoms ^Intensity of symptoms^^^^|
| |1|2|3|4|5|
|less than 60 minutes|-|-|15 min. -- 6 hrs.|5 -- 60 min.|1 -- 5 min.|
|1 -- 6 hours|-|30 min. -- 24 hrs.|15 min. -- 12 hrs.|10 min. -- 3 hrs.|5 -- 15 min.|
|6 -- 12 hours|12 - 24 hrs.|1 -- 24 hrs.|1 -- 12 hrs.|30 min -- 6 hrs.|10 -- 30 min.|
|12 -- 24 hours|6 -- 24 hrs.|3 -- 24 hrs.|1 -- 12 hrs.|30 min. -- 12 hrs.|10 -- 60 min.|
|24 -- 48 hours|6 -- 24 hrs.|3 -- 24 hrs.|1 -- 12 hrs.|1 -- 12 hrs.|30 -- 180 min.|
|2 -- 5 days|6 -- 48 hrs.|3 -- 48 hrs.|1 -- 24 hrs.|1 -- 24 hrs.|1 -- 6 hrs.|
|5 -- 10 days|12 -- 96 hrs.|3 -- 96 hrs.|1 -- 96 hrs.|1 -- 48 hrs.|1 -- 12 hrs.|
|10 -- 30 days|1 -- 7 days|6 hrs. -- 7 days|3 hrs. -- 7 days|3 hrs. -- 3 days|1 -- 24 hrs.|
|1 -- 3 months|1 -- 15 days|1 -- 30 days|6 hrs. -- 30 days|6 hrs. -- 15 days|3 -- 24 hrs.|
|more than 3 months|1 -- 30 days|1 -- 30 days|1 -- 30 days|1 -- 15 days|6 -- 24 hrs.|

As can be seen from the table, the evaluation intervals are set quite generously, so in practical use, a value is selected according to the tendency, at which the symptoms change in character or intensity. If they change relatively quickly, we rather incline to the bottom of the range, if slowly, we select a value nearing the upper limit of the interval.

== Example 1: ==

An acute influenza state has evolved over the course 10 hours and the intensity of symptoms is less than moderate. Checking the value in the table, at the intersection of "6-12 hours" for the duration of symptoms and "2" for the intensity of symptoms -- the value at the intersection is "1-24 hours". If the symptoms are more or less stabilized, we can select a value, for example, of 12 hours. If they tend to intensify, we select a value closer to the lower limit of the interval, 6 hours, for example. After the selected time interval following the last dose has passed, we re-evaluate and decide whether or not we give another dose .

== Example 2: ==

For 6 months, a patient suffers from slow digestion, heaviness after eating and constipation. The intensity of the symptoms is above moderate, but not life-threatening. We check the value at the intersection of "more than three months" for duration of symptoms and 4 for the intensity of symptoms -- "1-15 days". If the symptoms are more or less stabilized, we can select a value of, for example, 7 days. If they tend to intensify, we select a value closer to the lower limit of the interval, 3 days, for example. After the selected time interval has passed after the last dose, we re-evaluate the symptoms and decide whether or not we repeat the dose.

==== Circumstances excluding the repetition of the dose ====

Repetition of the dose is excluded if:

  - There is a worsening of the character or intensity of symptoms after the last dose and the aggravation still persists.
  - There is an exceptionally marked improvement in the character and / or intensity of symptoms after the last dose and the process of improvement of the condition still persists.
  - There has been a substantial change in the character of symptoms (hereinafter referred to as "image change" of a disease state).

**Note to item 1:** It is necessary to distinguish between aggravation after the remedy administration and aggravation of symptoms caused by the natural evolution of the disease state. Homeopathic aggravation is caused by administering **too much** of the homeopathic medicine and a subsequent overstimulation of the life force, so in case we decide to repeat the dose (when the aggravation subsides), it should be proportionally reduced. If the homeopathic aggravation is too intense, it is necessary to wait until the "shock" settles and a gradual improvement of the condition is started. If the aggravation is too intense, the remedy should be antidoted (in order to cancel its impact on the life force), by using coffee, camphor, another homeopathic medicine or other medicinal substance with a strong physiological effect.

If the aggravation of symptoms is a result of a natural progression of the disease state, the administered medicine was clearly not homeopathic to the state and it is therefore necessary to identify and give a more suitable remedy. Distinguishing between homeopathic and non-homeopathic worsening of the symptoms may not always be easy in practice, but homeopathic aggravations are typically characterized by **sudden** and **unexpected** intensification of the symptoms, considering the present course of the disease.

**Note to item 2:** In case of **marked** improvement of the disease condition, there was an optimal stimulation of the life force and any further intervention could slow down or stop the therapeutic effect.

**Note to item 3: ** In case of a substantial change in the image of the disease state, it is necessary to **wait** until this state is **stabilized and then** identify and give a new remedy that reflects the new image of the disease condition.

==== Circumstances requiring a repetition of a dose ==== 

The dose should be repeated if:

  - An improvement in the character or intensity of the symptoms occurred after the last dose of the remedy, but the improvement has slowed down, stopped or there a re-intensification of the symptoms occurred (relapse).
  - There was no significant change in the character or intensity of the symptoms after the last dose and the character of the symptoms is very acute symptom (e.g. severe pain) or life-threatening. If, after 5 times the upper limit of the recommended interval for the evaluation of symptoms has passed, there is still no change, there is a high probability the selected remedy was inappropriate (not homeopathic) and a more suitable one should be determined.

**Note to item 1:** When repeating the dose, we strive to achieve an optimal dosing with minimal or no aggravations, in other words a stability in the improvent of the disease condition. This is more easily achieved by administering the drug in water -- the effect of a dose being regulated by changing the volume of the dose, the greater dilution with water, and adjusting the number of strokes / shakes before use. When repeating a dry dose in the same potency, there is a higher risk of **cumulative effects** of single doses of the remedy and of subsequent aggravations.

**Note to item 2:** In very acute conditions, repeated doses do not typically result in a homeopathic aggravation since the state is already aggravated almost to the maximum extent possible. Selected remedy should be repeated in order to achieve sufficient stimulation of the life force of the body. If after a reasonable period of time (5 times the upper limit of the recommended interval for evaluation of symptoms) there is no positive improvement, it is necessary to determine more suitable medicine.

==== Circumstances permitting a repetition of a dose ====

The dose may be, after duly considering the circumstances, repeated if:

  - After the last dose, there was a mild to moderate improvement in the nature or intensity of symptoms.
  - After the last dose, there was no radical change in the nature or intensity of symptoms.

Under these circumstances, a repetition should only be considered when usinf water dose and at a suitable dosage / time intervals. The aim is to achieve a stable improvement without undue aggravations. 

A repetition of low to medium potencies (9 CH to 30 CH) is generally better tolerated than a repetition of higher potencies (CH 200 and above), very low potencies (5 CH, CH 3 and below) or mother tinctures / crude substances.

==== Prophylactic use of remedies ====

In prophylactic use of remedies (i.e. which are not indicated by their corresponding symptoms, but only serve as prevention), it is better to choose a single dose of medium-high potency (30 or 200 CH) and not repeat the remedy frequently, in order to avoid overdose and a subsequent formation of undesirable effects (proving). If there is an irresistible desire to repeat the dose (some people just do not believe that a single dose may be sufficient), 30 CH weekly or 200 CH once every two weeks appears to be relatively safe interval of repetition. If any new symptoms appear or are suspected, any further repetition of the dose excluded!

<WRAP important >
Homeopathic remedies are indicated on the basis of specific symptoms and if symptoms are not present, it is not possible (by methods of classical homeopathy) to determine a suitable remedy. Exceptions are conditions whose presence can be **assumed to occur** with certain probability, for example, various post-operative, post-traumatic, prenatal and obstetric conditions, etc., when a prophylactic use of homeopathic medicine appropriately selected can alleviate the condition or completely prevent its occurrence. Another possibility is an epidemic of a disease, when the disease image is known to a sufficient extent and therefore a suitable homeopathic remedy may be determined and recommended.
</WRAP>

====== DOCUMENT DESCRIPTOR ======

^ Description: | Dosage Guidelines for homeopathic remedies. |
^ Author: | Bezemek, P. |
^ Year: | 2014 |
^ Editing: | errors only; interlinks; formatting |
^ Attribution: | Legatum Homeopathicum |
Legatum Homeopathicum

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