Introduction
We sometimes hear (and even a little too often) that homeopathy as Hahnemann would have actually practiced it consists of giving several medicines at once. Anyone who has studied and strives to follow the Founder would therefore be mistaken or stuck in somewhat fanatical practices. Neither the "demonstration" nor the debate are new. The usual justifications are mutually opposed:
- Either we try to portray Hahnemann as a dangerous dogmatist clinging to his ideas, particularly the prescription of one medicine at a time.
- Either we draw on Hahnemann's own writings in a biased way. This is what those who wanted to prescribe multiple medications to justify their deviant and unscientific practice were already doing during Hahnemann's lifetime.
Here, a quote from Kent, who wrote about Hahnemann, is appropriate:
"All the facts support the historian's assertion that Hahnemann never admired metaphysical speculation; that he always drew conclusions based on facts, never on theory or speculation."
Simple scientific logic
There are many logical reasons for prescribing one medication at a time.
a) First of all, how can we conceive of intervening in a system as complex as living organisms by acting on several parameters at once? This makes no scientific sense, as Prof. Marc Henry points out on the AIMSIB website:
I emphasize the term UNIQUE because this is where 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 physician. However, it is important to remain humble because, while knowledge belongs to the realm of science, success (in medicine, healing) belongs entirely to the realm of art, because human beings (both doctors and their patients) are not machines.
b) Conversely, the exploration of medicines was carried out with only one substance at a time. In a note in §101 of the Organon (4th Edition), we read:
"There is therefore no safer and 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 state."
Healthy subjects thus poisoned themselves to reveal the artificial drug disease. How can we predict how these substances interact with each other when administered at the same time? By prescribing "as we see fit," are we not disregarding the suffering voluntarily endured by these men and women to highlight the healing properties of medicinal substances?
c) Homeopathy inevitably leads us to view living organisms from a dynamic and energetic perspective. It is as if the living organism picks up the signal emitted by the dynamized substance. The interactions between several medicinal signals have never been explored. Furthermore, we know that two substances capable of producing similar symptoms cancel each other out. Prescribing two antidotes at the same time does not seem like a good idea.
Monopharmacy in the Organon
Monotherapy is clearly expressed by Hahnemann in Aphorism 273, which, strangely enough, is never quoted by revisionists:
273.— Under no circumstances during treatment shall it be necessary or permissible to administer more than one single medicinal substance to the patient at a time.
It is inconceivable that there could be any 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 a disease, or to prescribe a mixture of several medicines that act differently. In homeopathy, the only true, simple, and natural art of healing, it is absolutely not permitted to give the patient two different medicinal substances at the same time.
The Founder is therefore very clear when he states that "it is absolutely not permitted in homeopathy to give the patient two different medicinal substances at the same time." " 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 a word, polypharmacy transports us:
- in the arbitrariness that reigns in allopathy, and
- in the symptom- or organ-based approach that also characterizes traditional medicine.
This is a double betrayal of the basic principles defined in the Organon (and we might even add in all the Organons, since the principle of uniqueness has remained unchanged since the first edition).
Historical facts amply confirm the above. I have personally transcribed several volumes of Hahnemann's Parisian clinical cases, and nowhere can one find the slightest prescription of multiple medications, even though Hahnemann sometimes changed prescriptions very quickly (see Die Krankenjournale. Edited by Robert Jütte. Heidelberg 1992-2005, Haug).
Rima Handley had attempted to distort the interpretation of the Parisian cases in order to demonstrate that Hahnemann prescribed several medicines at once (see In Search of the Later Hahnemann). However, none of her arguments stand up to honest analysis of her sources.
A classic manipulation
We can therefore imagine the effort of manipulation that was required on the part of the French school to get Hahnemann to say the exact opposite of what he explicitly and formally advocated. Historically, there is debate as to whether it was Aegidi or Stoll who first had the idea of combining several medicines.
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 drugs had been tested, it seemed logical to them to cover one aspect of a case with one drug and another aspect with another, in order to fill in the gaps in the fledgling materia medica around the 1830s.
At first, the results seemed promising, so much so that Hahnemann wrote to the Baron that he was considering including a note in the forthcoming5th Organon. But the two quickly became disillusioned when they found that the results could not be reproduced, and abandoned the technique. This simple episode formally refutes the accusations of dogmatism against Hahnemann and confirms that throughout his life he experimented without ever basing his prescriptions on theories—in this regard, Aphorism One represents the cornerstone of Hahnemannian thought by defining the role of the physician while calling for the abandonment of all theory.
Alternating Bryonia and Rhus-tox
The classic argument used to justify polypharmacy stems from a deliberate misreading of Hahnemann's account of his results in the typhus epidemic following the famous Battle of the Nations in 1813, which left at least 140,000 dead in the Leipzig region. Hahnemann treated 180 cases with only two deaths, including that of a very elderly patient. He even had the luxury of brilliantly curing the supreme leader of the coalition, Prince Schwarzenberg, who had also contracted typhoid. These results still astonish today's doctors who verify these undeniable facts.
In 1814, Hahnemann published his treatise "Curative Therapy of Nervous Fever... Prevalent Today," in which he recounts that, despite a clear predominance of indications for Rhus tox over Bryonia, symptoms often change in such a way that it becomes necessary to alternate between the two remedies.
I will now quote Farrington to enlighten readers who are not familiar with homeopathy. In his lecture on Rhus, one of the greatest teachers of homeopathy tells us:
Many lives have since been saved by alternating between these two remedies: an alternation that consists of giving Bryonia when Bryonia symptoms are present, and Rhus tox when the patient exhibits symptoms requiring this remedy. It is a legitimate alternation...
You will notice that this delirium is associated with agitation, not only mental but also physical. The patient constantly turns in bed. First he lies on one side, then on the other. One moment he is sitting up, the next he is lying down. You then observe a constant desire to move, and it is even possible that the patient is relieved by the change of position. Sometimes, exceptionally, at the onset of the illness, we find that the patient wants to remain completely still. This is due to extreme weakness. He feels completely prostrate. They are indifferent to everything. This feeling of weakness is completely disproportionate to all other symptoms. Sometimes, the patient has hallucinations. They fear being poisoned. They will not take the medication you leave them, nor the food and drink offered to them, because they fear that those accompanying them want to poison them."
In short, Rhus corresponds to the typical condition characterized by great agitation. However, there is a whole category of Rhus symptoms that can also be aggravated by movement, and in some cases, patients are clearly prostrate. This is when Bryonia may be indicated, literally taking over.
The case, initially dominated by agitation, has evolved under the influence of Rhus, and now the picture is dominated by the opposite modality, aggravation by movement, which brings Bryonia to the fore.
Farrington describes Bryonia's picture:
Sometimes this delirium is accompanied or preceded by irritability. Speech is hurried, as you can see with Belladonna. As the illness worsens, a slight heaviness, almost bordering on stupor, accompanies sleep. The patient has dreams about the day's activities. Often, with this delirium, the patient suffers from excruciating headaches, usually in the forehead. If the patient is able to describe it to you, they will say that their head feels like it is about to burst. There is no better way to describe it than to say that "the head is splitting in two." Its character is congestive. The face is usually red and dark red in color. It is intensified, like all other symptoms of the medicine, by any movement of the head and is often accompanied by nosebleeds. Epistaxis is particularly likely to occur at three or four 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 puts his hand on his head as if in pain, and his face is contorted with pain. However, they are so confused that they only complain about what is expressed by these automatic movements. Another symptom to note in these typhoid fevers is dryness of the mucous membranes, especially those of the mouth and stomach. This is the result of deficient secretion.
Under no circumstances was it a matter of mechanically administering one medication and then the other, but rather of monitoring changes in the symptoms of the case, which, in this indication, frequently calls for the famous alternation.
The justifications put forward for practicing polypharmacy also come from truncated quotations 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 mentions alternating preventive medicines for cholera. It should be noted here that it is only in the context of an epidemic disease[3] that preventive medicines can be considered appropriate. It is as if taking the medicine saturates the body's receptivity, which can then no longer contract the natural disease. In the common case where most cases are covered by two (or three) remedies, it is understandable that one might suggest taking one medicine and then the other after a reasonable interval. This is prevention, not treatment, where it is understandable that one must "take a guess" when the patient has not even fallen ill yet. It is conceivable that the subject's vital force cannot be affected in any way by a medicine that is foreign to their receptivity and that no toxic signs can occur after a single dose.
When it comes to treatment, the Founder refers to copper on page 252[4], "alternating it, 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 on the very pages from which the quotation is taken, is never mentioned!
I would like to conclude by noting that the words "followers" and "opinions" come up very often in the statements of those who would like to promote the theory of polypharmacy, yet homeopathy is neither a religion nor a matter of opinion. It really seems that we have difficulty recruiting people who are motivated by a scientific approach, who want to help sick people, but above all who are capable of silencing their ego in order to study Hahnemann. It is not possible to call someone a homeopath if they have never seriously studied the Organon. Conversely, the current misery of our profession stems exclusively from the fact that teachers have lost sight of the Organon for too long.
I have never been able to refute Hahnemann in the 30 years I have devoted to studying his brilliant work. Lippe said that normal people would need the same 55 years that Hahnemann needed to complete the Organon in order to study the Organon properly. He was absolutely right.
These squabbles seem rather childish to us at a time when the entire medical system is collapsing and the need for homeopathic practitioners will be greater than ever. I am too attached to my own freedoms to deny others the right to prescribe as they see fit, but let us not be led to believe that this practice is homeopathy, or that Hahnemann showed us such a path.
One might also think that these are just petty squabbles. But unfortunately, as Hahnemann showed, there is only one possible path. Either we follow it and manage to cure even the most serious cases, or we don't follow it and we will always fail. We cannot therefore tolerate revisionist practices being passed off as authentic.
Edouard Broussalian
[1] The article was originally published in 1831 in a small German journal.
[2] See passages on pages 252 and 253 of Études de médecine homéopathique (Studies in Homeopathic Medicine), a posthumous work published in 1855 that compiles various articles by Hahnemann translated into French.
[3] See Organon §100 et seq.
[4] Ibid.
[5] Emphasis added.
