Introduction
We sometimes hear (and indeed a little too often) that homeopathy, as Hahnemann is said to have actually practised it, involves administering several remedies at once. This would imply that anyone who has studied and endeavours to follow the Founder is either mistaken or has become entrenched in somewhat fanatical practices. Neither this «argument» nor the debate is new. The usual justifications are mutually contradictory:
- Either we are trying to portray Hahnemann as a dangerous dogmatist clinging to his ideas – in particular, the practice of prescribing just one remedy at a time.
- Either we are interpreting Hahnemann’s own writings in a biased manner. This is precisely what those who wished to prescribe multiple remedies to justify their deviant and unscientific practice were already doing whilst Hahnemann was still alive.
It is worth quoting Kent here, who writes of Hahnemann:
«All the evidence supports the historian’s assertion that Hahnemann never admired metaphysical speculation; that he always drew conclusions based on the facts, never on theory or speculation.».
Simple scientific logic
There is a growing body of evidence based on simple logic in favour of prescribing one medicine at a time.
(a) To begin with, how can one conceive of intervening in a system as complex as a living organism by acting on several parameters at once? This makes no scientific sense, as Professor Marc Henry points out on the AIMSIB website:
I emphasise the term ‘SINGLE’ because it is here that homeopathy reveals its scientific nature. Prescribing several remedies to be taken simultaneously for the same patient is already an admission of ignorance and failure on the part of the doctor. However, it is important to remain humble, for whilst knowledge belongs to the realm of science, success (in medicine, a cure) belongs entirely to the realm of art, as human beings (both the doctor and the patient) are not machines.
(b) Conversely, the investigation of medicines was carried out using only one substance at a time. A note in §101 of the *Organon* (4th Edition) states:
«There is therefore no surer or more natural way to reliably determine the specific effects of medicines on human health than to test them separately from one another, in moderate doses, on healthy individuals, and to note the resulting changes in their physical and mental condition.».
Healthy subjects were thus poisoned in order to demonstrate the artificial drug-induced illness. How can we predict how these substances interact with one another when administered simultaneously? By prescribing «as one sees fit», are we not disregarding the suffering voluntarily endured by these men and women in order to demonstrate the curative properties of medicinal substances?
(c) Homeopathy inevitably leads us to view living organisms from a dynamic and energetic perspective. It is as though the living organism picks up the signal emitted by the potentised substance. The interactions between multiple medicinal signals have never been explored. Furthermore, we know that two substances capable of producing similar symptom pictures cancel each other out. Prescribing two antidotes at the same time does not seem like a particularly good idea.
Monopharmacy in the *Organon*
Hahnemann clearly sets out the principle of monopharmacy in Aphorism 273, which, strangely enough, is never cited by revisionists:
273.— Under no circumstances during treatment shall it be necessary, nor therefore permissible, to administer more than a single medicinal substance to the patient at any one time.
It is inconceivable that there could be the slightest doubt as to whether it is more reasonable and more in keeping with nature to prescribe a single, simple and well-known medicinal substance (a) for an illness, or to prescribe a mixture of several medicines with different modes of action. In homeopathy—the only true, simple and natural art of healing—it is absolutely forbidden to give a patient two different medicinal substances at the same time.
The Founder is therefore very clear when he states that «it is absolutely forbidden in homeopathy to give a patient two different medicinal substances at the same time. » By adding that homeopathy is «the only true, simple and natural art of healing», he reminds us that we must adhere to this simplicity, to the very etymological roots of the word «simple», which means «one». « It is always striking to see how polypharmacy opens the door to personal interpretations: »I give this and that for such-and-such a condition«, »Not at all, my dear, you must add this and that.’ In short, polypharmacy leads us astray:
- in the arbitrariness that prevails in conventional medicine, and
- in the symptom-based or organ-based approach that also characterises traditional medicine.
This constitutes a twofold betrayal of the fundamental principles set out in the Organon (and one might even add in all the *Organons*, since the principle of unity has remained unchanged since the first edition).
Historical evidence amply confirms the above. I have personally transcribed several volumes of Hahnemann’s Parisian clinical cases, and nowhere in them is there any mention of prescriptions involving multiple medicines, even though Hahnemann sometimes changed his prescription very quickly (See Patient records. Edited by Robert Jütte. Heidelberg 1992–2005, Haug).
Rima Handley had, at the time, attempted to distort the interpretation of the Parisian case studies in an attempt to demonstrate that Hahnemann prescribed several remedies at once (See In Search of the Later Hahnemann). But none of his arguments stand up to an honest analysis of his sources.
A classic trick
We can therefore imagine the extent of the manipulation on the part of the French school to get Hahnemann to say the exact opposite of what he explicitly and formally advocates. Historically, there has been debate as to whether it was Aegidi or Stoll who first came up with the idea of combining several remedies.
Hahnemann and the Baron
No one disputes that Boenninghausen and Hahnemann exchanged extensive correspondence on the concept of polypharmacy. At a time when very few remedies had been tested, it had indeed seemed logical to them to cover one aspect of a case with one remedy and another with a different one, in order, as it were, to fill the gaps in the fledgling materia medica of the 1830s.
At first, the results seemed so promising that Hahnemann wrote to the Baron saying that he reserved the right to include a note in the 5thth The *Organon* is due to be published. But the two were soon disillusioned by the irreproducibility of the results and abandoned the technique. This single episode serves to formally refute the accusations of dogmatism levelled against Hahnemann and to confirm that throughout his life he experimented without ever relying on theories when prescribing – In this regard, the First Aphorism represents the cornerstone of Hahnemannian thought, defining the role of the physician whilst calling for the abandonment of all theory.
Alternating between Bryonia and Rhus-tox
The classic argument used to try to justify polypharmacy stems from a deliberate misinterpretation of Hahnemann’s account of his results during the typhus epidemic following the famous Battle of the Nations in 1813, a battle which claimed at least 140,000 lives in the Leipzig region. Hahnemann treated 180 cases with only two deaths, one of which was a very elderly patient. He even had the luxury of brilliantly curing the supreme commander of the coalition, the Prince of Schwartzenberg, who had in turn contracted typhoid. These results still astonish modern doctors who verify these indisputable facts.
In 1814, Hahnemann published his treatise «Curative Therapy for Nervous Fever… prevailing today», in which he recounts that, although the indications for Rhus tox clearly predominate over those for Bryonia, symptoms sometimes change in such a way that it becomes necessary to alternate between the two remedies.
I shall now quote Farrington to enlighten readers who are not familiar with homeopathy. The man who was undoubtedly one of the greatest teachers of homeopathy tells us in his lecture on Rhus:
‘Many lives have since been saved by alternating between these two remedies: an alternation that involves administering Bryonia when Bryonia symptoms are present, and Rhus tox when the patient exhibits symptoms requiring that remedy. This is a legitimate method of alternation…’
‘You will notice that this delirium is accompanied by agitation, not only mental but also physical. The patient is constantly tossing and turning in bed. One moment they are lying on one side, the next on the other. One moment they are sitting up, the next they are lying down. You will then observe a constant urge to move, and it is even possible that the patient finds relief in changing position. Occasionally, and quite exceptionally, at the onset of the illness, we find that the patient wishes to remain completely still. This is due to extreme weakness. They feel utterly prostrate. They are indifferent to everything. This feeling of weakness is completely out of proportion to all the other symptoms. Sometimes, the patient experiences hallucinations. They fear they are being poisoned. They will not take any medication you leave for them, nor will they accept any food or drink offered to them, as they fear that those caring for them may wish to poison them.”
In short, Rhus corresponds to the typhoid state characterised by great restlessness. However, there is a whole category of Rhus symptoms that can also be aggravated by movement, and in some cases patients are clearly prostrate. It is at this point that Bryonia may become indicated, as it literally takes over.
The case, which was initially characterised by restlessness, has evolved under the influence of Rhus, and the clinical picture is now dominated by the opposite symptom—aggravation on movement—which brings Bryonia to the fore.
Farrington describes the Bryonia picture as follows:
‘Sometimes this delirium is accompanied or preceded by irritability. Speech is hurried, as you observe with Belladonna. As the illness worsens, a slight sluggishness, verging almost on stupor, accompanies sleep. The patient has dreams centred on the day’s activities. Often, alongside this delirium, the patient suffers from an excruciating headache, usually in the forehead. If the patient is able to describe it to you, they will say that their head feels as though it is about to burst. There is no better way to describe it than to say that ‘the head is about to split in two’. It is congestive in nature. The face is usually red and of a dark red colour. Like all the other symptoms of this remedy, it is intensified by any movement of the head and is often accompanied by nosebleeds. Epistaxis is particularly likely to occur at three or four o’clock in the morning and is often preceded by a feeling of fullness in the head. In very severe cases, you will notice that the patient places a hand on their head as if in pain, and that their face shows signs of distress. Yet they are so dazed that they complain only of what is expressed by these automatic movements. Another symptom to note in these cases of typhoid fever is dryness of the mucous membranes, particularly those of the mouth and stomach. This is the result of insufficient secretion.”
Under no circumstances was the aim simply to administer one medicine after another in a mechanical manner, but rather to monitor the change in symptoms the case which, in this context, frequently calls for the well-known alternation.
The justifications put forward for the practice of polypharmacy also stem from truncated quotations taken from an article dating from the period when Hahnemann was in the process of revising the principles of homeopathy. [1] [2] In it, the Founder refers to the rotation of medicines preventive cholera. It should be noted here that this applies only in the context of an epidemic[3] that one might claim to find indications for preventive medicines. It is as though taking the medicine saturates the body’s receptivity, so that it can no longer contract the natural disease. In the typical scenario, where most cases are covered by two (or three) remedies, it is understandable that one might suggest taking one remedy once and then the other after a reasonable interval. This is a matter of prevention and not a treatment, where it is understandable that one has to «take a guess» when the patient has not even fallen ill yet. It is conceivable that the patient’s vital force could remain entirely unaffected by a medicine that is foreign to their receptivity, and that no toxic symptoms could arise following a single dose.
When it comes to treatment, the Founder mentions copper on page 252[4] «by alternating between them, depending on the symptoms[5] »with Veratrum album’. This is by no means an arbitrary alternation of medicines. It is nevertheless surprising that this passage, which appears in the very pages from which the quotation is taken, is never mentioned!
I would like to conclude by noting that the words «followers» or «opinions» crop up very frequently in the arguments of those who would like to see the theory of polypharmacy accepted; yet homeopathy is neither a religion nor a matter of opinion. It really does seem that we are struggling to recruit people who are driven by a scientific approach, who are keen to help sick people, but above all who are capable of setting aside their egos to study Hahnemann. It is not possible to call someone a homeopath who has never seriously studied the Organon. Conversely, the current decline of our profession stems exclusively from the fact that teachers have lost sight of the Organon for far too long.
I have never managed to refute Hahnemann during the 30 years I have devoted to studying his brilliant work. Lippe used to say that ordinary people would need the same 55 years that Hahnemann required to compile the Organon in order to study the Organon properly. He was absolutely right.
Consequently, these petty squabbles strike us as rather childish at a time when the entire medical establishment is crumbling and the need for homeopathic practitioners will be greater than ever. I value my own freedoms too highly to deny others the right to prescribe as they see fit, but let us not be led to believe that this practice constitutes homeopathy, nor that Hahnemann showed us such a path.
One might also think that these are merely parochial squabbles. But alas, as Hahnemann has shown, there is only one possible path. Either we follow it and succeed in curing even the most serious cases, or we do not follow it and we will always fail. We cannot, therefore, tolerate revisionist practices masquerading as the authentic approach.
Edouard Broussalian
[1] The article was first published in 1831 in a small German journal.
[2] See the passages on pages 252 and 253 of *Études de médecine homéopathique*, a posthumous work published in 1855 which brings together various articles by Hahnemann translated into French.
[3] See *Organon*, §100 et seq.
[4] Ibid.
[5] Underlined by me.
