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'

For the motion

Mr Francis Treuherz:

I am delighted to be here today in this august establishment. In addition to making it a serious debate I was given permission to be a little light-hearted as well. So we will have a combination of both. I looked at this book by a Dr Julian Kenyon who I believe is Dr Lewith's partner, and this is where I first heard the term BER. I don't like abbreviations. I think it stands for Bio Electrical Regulatory medicine. I am not really sure what it is and I discovered a sentence, 'complex homoeopathy is a method of formulating medications which was initially developed by one of Hahnemann's pupils'. Which of Hahnemann's pupils? A little search did indeed reveal Dr Lutze, the same gentleman whom you mentioned. We'll come back to him. But what of the single remedy of experience? Where does it come from? It comes from Hahnemann. It comes from an essay he wrote before the Organon called The Medicine of Experience where he says medicine is a science of experience, its object is to eradicate disease by means of remedies. What we are talking of here is the knowledge of the employment of these remedies.

A single remedy is always calculated to produce the most beneficial effects without any additional means provided it be the best selected, the most appropriate and in the proper dose. It is never requisite to mix the two of them together,said Hahnemann in 1806. But way back in 1797 he said prettywell the same thing:

'Is it well to mingle many kinds of medicines together in one prescription, to order baths, clysters, venesections, blisters, formentations, inunctions all at once or all after the other in rapid succussion if we wish to bring the science of medicine to perfection, to make cures and ascertain for certain in every case what effect the medicines employed produced in order to be able to use them with like or even greater success in similar cases?'

So I think that in homoeopathy Hahnemann was the first to write of the idea of a single remedy. You suggested that things have changed since Hahnemann wrote and I agree. Thanks to his example, homoeopaths have gone on proving and discovering more and more remedies to help the profession catch up with the changes in the nature of human disease. The remedies are indeed proved but there are other ways of obtaining information as to what may be useful about a medicine, including toxicology and clinical experience. One of my heroes is James Compton Burnett and I want to quote from a well known passage where he writes about the discovery by Garth Wilkinson of Hecla lava. Here a homoeopath is having a holiday in Iceland and he has a homoeopathic imagination. He notices that the sheep have bony growths on their jaws and ankles and he realises that this must come from the ingestion of the grass which grows on the volcanic mountain. So he brings back some Hecla and has it run up as a potency.

Burnett writes: 'Hecla lava has been shown to consist of Silica, Alumina, Calcium, Magnesia with some Ferric Oxide.' But it is a single remedy because it is the effect of the very particular combination of these substances form toxicology and later from clinical work that indicates its use not giving an artificially created remedy from Silica, Alumina, Calcium, Magnesia, Ferric Oxide. Brother allopath, this is the science of therapeutics. What have you to take its place? Give absorbents and paint the part with iodine? What guarantee can you give me that your absorbents will not absorb a bit of the pancreas or some small glands in lieu of the exostosis? Or are you also true to your principle 'contraria contrariis curentur'. Then pray tell me what is the contrary of an exostosis? It appears to me that the use of a complex remedy artificially created is in fact the employment of the principle of contraries not of similars and that for me is the philosophical problem.

Back to the historical problem.

According to Haehl's biography of Hahnemann Lutze's edition of the Organon was regarded at the time as spurious:

'In the year 1865 the publication of a sixth edition by the homoeopathic physician Dr Arthur Lutze of Koethen was announced. It was, however, soon evident that his sixth edition of Lutze contained arbitrary alterations. In particular there was interposed a paragraph 274B on the use of double remedies which stood in direct opposition to Hahnemann's accepted principle that only one single and simple medicine at one time should be given to the patient. Dr Lutze supports his inclusion of this paragraph on double remedies by reference to Hahnemann himself but since Hahnemann personally could not be called upon to pass judgement, protestation followed protestation and what protestations there were!'

There was a Dr Aegidi who thought that two suitable remedies might have good results if smelled together. Hahnemann had at various times referred to olfaction, of inhaling a remedy and indeed this has been shown to be effective in the famous case of the man who was found in a stable and who was so hypersensitive, Kaspar Hauser. Boenninghausen, a close friend and colleague of Hahnemann, was one of the protesters:

'It is true that during the years 1832 and 1833 at the instance of Dr Aegidi I made some experiments with combined remedies, that the results were sometimes surprising and that I spoke of the circumstance to Hahnemann, who after some experiments made by himself had entertained for a while the idea of alluding to the matter in the 5th edition of the Organon which he was preparing in 1833. But this novelty appeared too dangerous for the new method of cure and it was I who induced Hahnemann to express his disapproval of it in the 5th edition of the Organon in a note to paragraph to 272. Since this period neither Hahnemann nor myself have made further use of these combined remedies. Dr Aegidi was not long in abandoning this method which resembles too closely the procedures of allopathy opening the way to a falling away from the precious law of similarity, a method which was becoming every day more entirely superfluous owing to the increasing wealth of our remedies. If consequently in our day a homoeopathician takes it into his head to act according to experiments made 30 years ago when our science was still in its infancy and which was subsequently condemned by unanimous vote, he clearly walks backwards like a crab and shows that he has neither kept up with nor followed the progress of science.'

So I say to you, Sir, that we are in the presence of crabs!

What have the crabs come up with? Well, in the 19th century they came up with Munyon's catarrh tablets, price one shilling; Munyon's headache cure, price one shilling; and Munyon's cold cure. And it came with an instruction book, Munyon's homoeopathic home remedies. Now I open it at random -  '...diseases of the kidneys. Are you drowsy? Do you have dropsy? Do you have back ache? Do your limbs feel heavy? Do you have scanty urine? Do you have unusual thirst? Do your limbs or your feet swell? Is your water thick and milky? Do you have severe headaches?'

I have only read about seven but it goes on. These combination remedies appear to be good for so much and who knows what they contain. The British Medical Association (BMA) did a survey, although we all know that BMA surveys are not always reliable, when they looked at these patent medicines. The survey was published in 1909 and it was called 'Secret remedies and what they contain.' Unfortunately all they could find was sugar.

There have been more venerable and carefully thought out approaches to combination remedies. Weleda produce Pertudoron 1 (Belladonna 3x, China 3x, Coccus cacti 3x, Drosera 1x, Ipecacuanha 3x, Mephitis 5x and Veratrum album 3x) as a whooping cough remedy. I imagine that for that we homoeopaths would have to find a patient who was red-faced, hot for the Belladonna, weak and losing fluids for the China, had a string or thread in his throat as a sensation, with stringy mucus pouring out for the Coccus cacti, whose cough began as soon as he has lain his head on a pillow for the Drosera, vomited and felt no better for it for the Ipecacuanha; no doubt for the Mephitis there is yet another strange and peculiar symptom of a thread in the throat or something like that, and for the Veratrum album he may even have chill, cholera and various forms of grief and madness as well! All in the one whooping cough remedy. Among their other combinations which I have seen referred to are metals and plants combined by growing the plant in the soil of the mineral so we have Ferrum per urticam. A strange idea for a combination remedy.

More recently, in fact yesterday in the post from America came news of Invigorol: 'a natural, homoeopathic stimulating tonic: Avena sativa (oats) favourably influences the nutritive function of the body for nervous exhaustion and fatigue; Alfalfa; Echinacea; Hydrastis canadensis; Gentiana and Sterculia (Kola-nut)', with various indications. There is also Protectol , which is 'a formula indicated for the initial phase of cleansing the body from many environmental hazards,' It contains: Benzinum, Cuprum metallicum, Cadmium, Arsenicum album, Chlorum, Plumbum, Mercurius and Nux vomica. The same company makes another combination to calm one down. I expect I shall need it after this debate. Passiflora, Valeriana, Humulus, Chamomilla, Coffea, Ignatia all together. You can peruse them at your leisure after the debate.

Dr Lewith did not say, but might have said, and maybe Dr Burger will say that the single remedy is but a placebo. Who is the arch exponent of the single remedy? No one has referred to him yet. Dr James Tyler Kent:

'I have often had physicians tell me that it was due to suggestion that my medicines acted so well. But my answer to this is that I suggest just as strongly with my wrong remedy as with the right one and my patients improve only when they have received the similar or correct remedy.'

I think that disposes of the placebo issue.

To end, Dr Lewith suggested that the world has moved on and homoeopathy has moved on since Hahnemann. I want to finish by quoting a more modern homoeopath, one of my heroines, Dr Elizabeth Wright Hubbard. Rumour had it she was the first woman to ride a running board on the New York ambulance service and when she finally practised for herself she visited her patients in a white Rolls-Royce. She obviously had a successful practice!

'The term single remedy does not imply that only one remedy should be used throughout a case, although that is the desideratum, but rather that only one remedy should be used at a time. It cannot be too often stated that one must not give a remedy lightly nor change it frequently. In acute diseases the concept of one single remedy at a time still holds good, although the remedy may have to be changed as the case develops.'

In this case some of our master prescribers state that the original remedy may be indicated again at the close of the cycle to complete the case. When one reads about these master prescribers and even mistress prescribers (the homoeopathic medical schools in America were the first of any modern medical schools to admit women) they often talk of the one remedy which will last that patient throughout his or her life. They were dealing with simple societies compared with the ones we have now. In his early days George Vithoulkas was dealing with people from simple peasant society in Greece. As things have changed in Athens, in America, in Britain we indeed have a more complex society and we have to deal in more complex prescribing. The complexity lies in choosing the right single remedy to follow the right single remedy when it is time to change the remedy. The single remedy is the medicine of experience.

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