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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