Single or Multiple Medicine Prescribing - A Debate
at the Royal London Homoeopathic Hospital on 7 July 1992.
The debate was chaired by Dr Peter Fisher.

'This House believes that the single remedy is the
medicine of experience'

Opposing the motion

Dr George Lewith:

Thank you for inviting me, Ladies and Gentlemen. I feel a bit like Daniel in the lion's den here. I knew it was going to be a bad day when it started. I put on this nice white suit and promptly spilled ink all over my trousers when I saw my first patient. You have days like that, they usually start of badly and get worse. The medicine of experience, but whose experience? We've heard an interesting view of an individual practitioner's experience and opinion about why to prescribe singles. Fundamentally because they wish to learn more about the remedy. That's in summary what we have been told. I'd like to treat this as a classical debate and I will return you to the motion that this house believes the single remedy is the remedy of experience and, as I say, the argument that we have heard is that the single remedy is useful in terms of practitioner learning.

Now classical homoeopathy has got a big part to play. I use classical singles, I also use complexes. Horses for courses. I would like to give you a little idea about how I use complexes. I use complexes in a way that might be better termed functional medicine. It is really a derivation of homoeopathy and it is how many people on the continent, particularly if they are using Bioelectric Regulation (BER) techniques, medicine testing techniques, use complexes. They will attempt to define how the patient is functioning, what level of intoxification they have, whether they have a problem with an overdose of chemicals, or a problem with chronic low grade infection, be it with a virus or with a bacteria. They will attempt to define that. Very often they will then prescribe a nosode. Having used a nosode the principle, particularly the principles expounded by Dr Reckeweg, of a complex approach to a problem, will then involve using drainage, drainage from a particular organ, perhaps support using a probiotic such as an acidophilus preparation, or one of the many probiotics that may be used for the gut along with liver, kidney, pancreas remedies. So there will be a range of remedies used.

The first confusion I think that exists between single and complex is that they are different approaches. They are different approaches based on different philosophies and are not mutually exclusive. One is looking at the patient with one particular language, one particular philosophy and the other is looking at the patient with another particular philosophy and another particular language. The philosophy of the classical Hahnemannian approach uses was developed 200 years ago and I would argue strongly that things have changed a little in the last 200 years. I would also argue that there are different kinds of problems which confront us now; physiologically and biochemically our problems are different from those which confronted us 200 years ago. Consequently we may need different tools to approach them. Again I emphasise that I don't see those tools as mutually exclusive. I see them as living side by side quite happily. But I do not necessarily find that a classical Hahnemannian homoeopathy includes, for instance, the kind of approach that I find useful in chronic viral infections which I believe are a very new phenomenon. I don't believe that we have the kind of single provings that really help us enough in that area and it is here that complexes can work well, not used just on a symptomatic basis, but used on a structured basis, on a basis of trying to understand function, on a basis of trying to understand toxins, on a basis of trying to understand organ support.

In many ways functional medicine, and that is how I see complex homoeopathy being used, has a great deal in common with conventional medicine. It learns from conventional medicine. It learns from pathology and microbiology, it learns from organ function. For instance, let us take a case of rheumatoid arthritis in a person who has had a series of recurrent tonsillitis infections in their youth. You will look at this patient and you will say to yourself 'Well, this patient has a malar flush and they've got chronically enlarged tonsils. Somebody forgot to take the tonsils out and they are getting hot spots in their joints and I actually think they've probably got a streptococcal toxicity, that is probably what is wrong'. Now a conventional doctor may well be able to make that link, make that diagnosis but complexes actually give you a treatment handle. They give you an approach. You may give nosodes and you will combine those with drainage remedies.

Hahnemann's experience is very interesting because here we are back to the debate between classical homoeopathy and Hahnemannian homoeopathy and the first thing for us to remember is that on a world-wide basis complexes are used much more widely than singles. That may not be the case in the United Kingdom but it is certainly the case on the Continent. Secondly, I think we should remember that complexes have been being used for at least as long as singles, so I don't think you can turn round and say: 'Oh well, single remedies were first, complexes are just some modern invention, some crazy idea.' that is not true. So complexes and singles have both been used for similar periods of time and if we wish to look at practitioner experience we can make the same arguments as David Curtin. Complexes have something to offer and it was quite clear, from very early on in Hahnemann's ideas, that he did not believe that single remedy had all the answers. I am not a great scholar or a great academic but I would like to quote from the Organon. In the fifth edition of the Organon of Practical Medicine one can read an entire paragraph on multiple prescriptions. Here Hahnemann is reported as saying that for acute conditions two or three remedies are to be used in alternation. Whereas for chronic illnesses two remedies that may well have differing approaches, are both indicated, are to be administered together. That is the great master.

Lutze takes a very interesting view on this because he had exactly the same debate, you can almost picture yourself back about 150 years here in this room. Because this debate was going on in 1874 and I quote from a letter that Lutze subsequently wrote. In this manner we and indeed the entire world were deceived for twenty one years. We were defrauded when this most important discovery by Hahnemann was concealed by homoeopaths. The author goes on to say that the writings in 1833 by Boenninghausen and the following year, by Jahr, homoeopathy's two heavyweights, dealing with homoeopathic treatment using more than one remedy, were vigorously criticised and then censored by the homoeopathic community of the time. That has since been passed over, a complete silence. So there are a whole pile of homoeopaths who are totally unaware of this debate. Are we going to go back 150 years or are we going to see things progress a little more?

We can use many different approaches to get a patient better. And that does not just mean using singles and complexes it might mean for instance, heaven forbid, combining acupuncture and manipulation so you get a back better quicker or, goodness me, taking somebody with a homoeopathic indication for colitis and putting them on a food exclusion diet to maintain them. I mean that must be heresy to the unicist homoeopath yet it makes logical common sense. One combines therapies to get the best deal for the patient, the quickest deal, the best deal, one combines approaches. As a doctor you don't stick to a single approach. You use your experience and your experience nearly always involves using several different approaches to deal with an individual, ideally to give them an understanding of their illness, to give them an approach that they can use in the long term.

Lutze's tone in the subsequent part of his letter becomes vehement; 'The scientific fraud relative to Hahnemann's supplementary enlargement of the ambit of homoeotherapeutics was suppressed and omitted from the Organon with intent to defraud in relation to using multiple remedies'. So here we have somebody in 1874 knowing full well that Hahnemann used multiple remedies as part of the strong Continental tradition of multiple remedy use, accusing Hahnemann of defrauding people when he knew perfectly well that in a number of instances there were indications for using multiple remedies simultaneously. So I leave my case there, I don't think that single remedies are the remedy of experience, I don't think that they were even the remedy of Hahnemann's experience. Ladies and gentlemen the decision is yours.

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