Minutus

From 'On the Value of the Speculative Systems of Medicine' - Hahnemann's Lesser Writings.
[Concerning the mixing of medicines]
"...For how complicated must the interaction be of so many ingredients; how impossible to trace back the combined effect on the patient to them each individually, in order, in the subsequent treatment, to omit or diminish the one and increase the other! But this will not do with these hotch-potch doses; they produce, thus united, such a resultant, that no one can tell what is owing to this or the other ingredient in the combined effect. No one can tell which ingredient vitiated the action in such and such a manner, or which altogether antagonized the other, and neutralized its effect...
Now, to mix in a prescription a number of such strong disordering substances, whose separate action is often unknown, and only guessed and arbitrarily assumed, and then forthwith, at a venture, to administer this mixture, and many more besides, thick upon one another, without letting a single one do its work out upon the patient, whose complaint and abnormal state of body has only been viewed through illusive theories, and through the spectacles of manufactured systems - if this is medical art, if this is not hurtful irrationality, I do not know what we are to understand by an art, nor what is hurtful or irrational.
It is usual at this point, for want of anything else to say, to excuse one's self by saying, "the several ingredients in a prescription are to be chosen with reference to the various aspects of the (hypothetically assumed) inward condition of the body, or, indeed, of the symptoms."
Just as if one single simple substance, if it were but rightly known, might not conform to several, many, or all...aspects of the complaint, - as if all the numerous symptoms could be covered by a medley, whose ingredients, so unknown in their action, in combination counteract and, in an unforeseen manner, vitiate and neutralize each other!
This motley mixing system is nothing but a convenient shift for one who, having but a slender acquaintance with the properties of a single substance, flatters himself, though he cannot find any one simple suitable remedy to remove the complaint, that by heaping a great many together there may be one amongst them that by a happy chance shall hit the mark.
Whether this mode of treatment be successful, or the reverse, in neither case is anything to be learnt from it, nor can it cause the medical art to make a hair's-breadth of progress..."

Don't the second- and third-last paragraphs resound of the pathos we've been reading here for years!

Thanks, Chris! Nicely expressed, isn't it. I wonder whether this too will somehow be found to actually support the idea of polypharmacy. Perhaps if we have some guru's "deep" understanding of what Hahnemann means in the third-last paragraph by "rightly known", we'll realise that he was saying that pathological trials are no longer necessary, as one need only "rightly know".
For those who may think that Hahnemann had recanted from polypharmacy (and no, Soroush, that term is not confined to the modern idea of combining potencies of various substances!) by the time he wrote the Organon, the following appears in the 6th editions' Introduction:

"The mixture of several medicines... therewith in order to obtain some purposed, certain, curative effect, is a piece of folly repugnant to every reflecting and unprejudiced person." (Organon Introduction, p. 75.)

And from the footnote to that page:
"In fact, our knowledge of what is essential to be known respecting all our remedies, as also respecting the perhaps hundred-fold relationship among each other into which they enter when combined, is far too little to be relied upon to enable us to tell with certainty the degree and extent of the action of a substance, seemingly ever so unimportant, when introduced into the human body in combination with other substances."
No doubt that too can be twisted to mean its very opposite, but those interested to know Hahnemann's actual reasoning may follow it most straightforwardly by simple reading it.
Cheers --
John
2009/7/30 Christine Gillen >

"Whether this mode of treatment be successful, or the reverse, in neither case is anything to be learnt from it, nor can it cause the medical art to make a hair's-breadth of progress..."
And there in the last line you have the true problem for Hahnemann, who was still working on refining his masterpiece.
He says:
- using combos won't teach you anything about classical homeopathy (agreed, but you'll know that particular combo has worked in a specific situation)
- it won't advance medical art (well, not classical homeopathy - again, agreed, but it will if you work out a system of combos, which some people have done).
I think helping the patient should be the aim - not learning from them. That is always a secondary consideration.
Liz
_

Hi, Liz --

Yes, it may appear that Hahnemann's emphasis is on the advancement of the art, but the word "learnt" concerns the future of the patient rather than of the art; and Hahnemann shows even in § 274 -- in which he describes in greater detail the kind of contribution to advancing the art that is impossible when one is unfamiliar with the pathogenesis of the medicine used -- that his emphasis is on the impossibility in using such a medicine of conscientiously treating the patient.

Nevertheless, that minor point is in itself significant.

A lot goes unsaid in discussions of combinations. One of those things is that the kind of "specific situation" that such a medicine appears to "work" in (if we except the odd effect rare enough and explicable enough to be coincidence) is one in which a specific symptom is in the sights of the prescriber or user. So one learns that the combination Gutwrench "works" to overcome a vigorous wet cough in one patient. One may learn that it has "worked" ten times in ten patients. But so what? What has one learnt, except to prescribe to remove a symptom without learning anything at all? It can only go downhill from there.

Another matter largely unacknowledged by the promoters of combinations is that everything stated about their action is conjectural. Even the one or two provings that have been done remain unreplicated; and the well-known phenomenon of synergy, by which even two drugs "hinder and alter" each other's action, as Hahnemann puts it (§ 274 again) makes impossible any prediction of a primary action of the combination -- as, I believe, Fran described recently. The understandably popular doctrine that the correct drug in the mixture selects itself alone to affect the patient unfortunately overlooks that point.

A third matter that combination promoters never discuss is follow-up, usually entailing the need for a second prescription. This is no trifling matter. Consider drug relationships alone. At the second prescription, drug relationships will have to be taken into account. One problem there is that essentially there are not just have half a dozen drugs to consider in a combination of six; the patient may already be experiencing many dozens of relationships between each drug in the combination and combinations of two, three, four, or five other drugs in it. How is it possible to gauge the later effect of just one other drug on that unmapped territory?

So -- no, nobody has any least clue yet to a system by which combinations might be prescribed with reasonable expectation of a cure, and they would not have any least clue yet even if the law of similars could be depended upon (another unknown) in some parahomoeopathic sense.

And this is the subject of the loudest silence in the piddling about that passes for discussion by those lauding combinations: that, due to the complexities introduced, first by any kind of polypharmacy and second by combinations in particular (due to the many further possibilities for potency interactions in vitro and in vivo), the work required to establish such a system would exceed by many times the work Hahnemann and his dedicated network of intelligent, conscientious, educated, and thoughtful physicians put in to establish homoeopathy as a useable art.

The suggestion that lies in that silence (though not plausibly) is that such a vast work will be undertaken on behalf of suffering humanity for the sake of those cases in which somebody -- supposedly (and, at least, partly, often in truth) due to incomplete provings -- is unable to select the single most homoeopathic medicine. These same people don't suggest that a fraction of the requisite proving work will be undertaken to more thoroughly prove single medicines, and that therefore they will learn how to use them better to cure. Nor do these same people suggest that -- rather than pretend, in prescribing Gutwrench, Breatheasy, or Poopstop, that they know something they in fact do not -- they recognise the ethical superiority and moral obligation to refer the patient to another practitioner, one who may spot what the combinator has overlooked.

So the justifications, as Hahnemann observed in his own way, have no legs. They are just another storey on the castle in the air.

Cheers --

John
2009/7/30 Liz Brynin >
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"Nothing is so fatal to the progress of the human mind as to suppose that our views of science are ultimate; that there are no mysteries in nature; that our triumphs are complete; and that there are no new worlds to conquer."

— Sir Humphry Davy, in "An Account of some Galvanic Combinations", Philosophical Transactions 91 (1801), pp. 397–402 (as quoted by David Knight, Humphry Davy: Science and Power, Cambridge, 1998, p. 87)

"This motley mixing system is nothing but a convenient shift for one who, having but a slender acquaintance with the properties of a single substance, flatters himself, though he cannot find any one simple suitable remedy to remove the complaint, that by heaping a great many together there may be one amongst them that by a happy chance shall hit the mark.
Whether this mode of treatment be successful, or the reverse, in neither case is anything to be learnt from it, nor can it cause the medical art to make a hair's-breadth of progress..."
"

Thanks Chris for taking the time to find this & share this with all.
Sheri

At 09:17 PM 7/29/2009, you wrote:
------------------------------------------
Sheri Nakken, R.N., MA, Hahnemannian Homeopath
http://www.wellwithin1.com/vaccine.htm & http://www.wellwithin1.com/homeo.htm
ONLINE/Email classes in Homeopathy; Vaccine Dangers; Childhood Diseases Reality
Next classes start July 29 & 30

Thank you from me as well - in a nutshell as always ) Do hope people will learn from this

Joy

http://www.joylucashomeopathy.com
http://health.groups.yahoo.com/group/homeopathystudy/

They work - that's all. And there's increasing evidence for this.
Liz

but what is work? antibiotics work in getting rid of symptoms.
Steroids work in getting rid of symptoms.
But is there cure?

This list is on Hahnemannian homeopathy and now all the latest fads that people love to embrace.

Why can't we have the list be Hahnemannian as intended.
There are many other lists where all of you who resist Hahnemannian homeopathy can go
Why do you persist on pushing non-Hahnemannian homeopathy at us?

Again, with my metaphors - its like joining a breastfeeding list and insisting on talking on benefits of formula; or a vaccine dangers list and talking about the benefits of vaccines; or joining a canning your own fruit list and insisting on pushing dried fruit.

Please leave this list to those who are here to discuss Hahnemannian homeopathy. Is that too much to ask?

http://groups.yahoo.com/group/homeopathy_open

is a list where you can discuss all of this non-Hahnemannian stuff
Sheri

At 01:34 PM 7/31/2009, you wrote:

I see. Then we can take it there is no substance to your own assertions. You haven't a clue, you just *want* it to be that way.
Thanks anyway.
Chris.

No - I don't just 'want' it to be that way. It IS that way - as I said, there's increasing evidence for this.