Why Homoeopathy Excludes Polypharmacy
Posted: Tue Apr 08, 2014 4:11 pm
There are no pathogeneses of MIXTURES!
1. We assuredly do entertain the belief that two or more medicinal forces or we prefer to say morbific forces cannot together act upon the economy without so modifying each other that neither shall produce the effect it would if only one were acting This belief has prevailed among medical men from the earliest ages
It is the foundation of the practice of polypharmacy in all its varieties from the complex prescriptions of the seventeenth century to the alternations of our own colleagues
For we hold with Dr Sorge by no means a Hahnemannian let us add that
the practice of alternation as it exists among homoeopathicians is only another form of mixing remedies with the intention of getting an effect compounded of the action of the two or more drugs that are alternated
We say this belief is the foundation of polypharmacy The rationale of a compound prescription we take to be the following the drug which is regarded as the one chiefly indicated possesses let us suppose certain properties which would be hurtful to the patient Another drug is conjoined with it for the purpose of antidoting those hurtful properties Again it lacks the power to produce certain effects which are deemed desirable Another drug is added to supplement this deficiency and so on ad infinitum
This entire procedure rests on the belief that these medicinal forces will so modify each other in the economy that neither shall produce the effect it would if only one were acting As an example we mention calomel and opium a very familiar combination Certainly the object of giving the opium is that it may modify the action of the calomel and in a way which conforms to the known action of opium when given alone If there were no reason to believe that two or more morbific forces a drug is a morbific agent exciting a morbific force could not together act upon the economy without so modifying each other that neither shall produce the effect it would if only one were acting how could we ever cure disease The morbific force which constitutes the disease is acting upon the economy and we bring to bear upon the economy another morbific force viz a drug Now if the latter be properly selected with reference to the former we know that these forces will so modify each other that on the one hand the manifestations of disease will cease and on the other hand the drug will not produce pathogenetic symptoms as it would on the healthy subject This statement rests on the basis of such facts as our friend invokes On what other theory than the mutual modification of morbific forces acting together upon the economy could it be explained On what other theory could we explain the action of antidotes as homoeopathicians understand and employ them How else could we explain the action of Belladonna in large doses in antidoting poisonous doses of morphine as well as the mutual antidoting powers which allopaths have recently discovered many of the cerebro stimulants and spinant alkaloids to possess How else finally could we explain the efficacy claimed for the practice of alternation in general and for certain instances of it in particular such as the cases related by Dr H and which we fully credit where Belladonna and Bryonia in alternation accomplished what neither could do singly and where Arsenic and China in alternation cured a case which neither alone had cured How else but by conceding that two or more medicinal forces cannot act together upon the economy without so modifying each other that neither shall produce the effect it would if only one were acting The fact that medicinal or morbific influences must be avoided when we are engaged in proving drugs is universally admitted even Dr H assented to it But on what other grounds than the belief already stated That persons long accustomed to use tobacco or coffee are not easily affected by drugs is accounted for probably by the fact that long habit has in so far as those persons are concerned caused tobacco or coffee to cease to be medicinal forces Use has become second nature That in persons not accustomed to the use of coffee a dose of it will modify the action of another morbific or medicinal force is demonstrated by the effect of coffee antidoting opium Nux vomica alcohol as well as in neutralizing the beneficial curative action of many drugs as our clinical observations often satisfy us that it does The same statements apply to tobacco
2 We think we may then assume as conceded the fact that two or more medicinal forces cannot at the same time act upon the human system without mutual modification It is now asked whether granting this modification we may not avail ourselves of it to derive from the alternate use of drugs which modify each other good effects that we have attained in no other way There can be no doubt of the possibility being done has been done with advantage as indeed Dr H shows by two instances But in the present state of our science
it would be impossible for any one to lay down rules for the selection of remedies to be given in alternation with the view of gaining any desired modification of the action of each Nor can we conceive of the possibility of arriving at any such law The rule of the ancient polypharmacy viz to select remedies according to the effects which they produce singly and to combine them with reference to the effect desired does not always work well in practice
For example calomel and opium produce a combined effect which is clearly a modification of the known action of each drug But on the other hand the combined action of opium ipecacuanha and the sulphate of potash in Dover's powder is quite distinct and different from that of either constituent alone and is such as could hardly be anticipated from what we know of these constituents Arsenic and China produced a combined effect which cured an ague that neither singly would cure Now if this fact were to be taken as a guide in selecting a combination for a case of uterine disease for example in which we were at a loss to decide between Sepia and Pulsatilla it might lead us to alternate those two remedies But it is not three months since one of us took charge of a case in which this alternation on this very ground had been employed but the patient had not recovered
We were led to the conclusion that the ability of the organism to drugs indicated with different degrees of accuracy will cause the modification by drugs of each other's action to be different in each individual case we clearly see that we can never be in a position to predicate in advance the effect of the joint administration of several drugs We can never therefore have a scientific indication for such a combination or alternation If we make it it must always be the result of guess work of feeling our way along just as Dr H did in the cases he relates But we claim superiority for Homoeopathy in that it gives us the means of selecting our remedies with a reasonable certainty of their effects and we rightly claim that medicine should not rest content with anything short of a method which given the symptoms of a disease points us to a certain remedy if our materia medica contain it or given the pathogenesis of a drug indicates to us a priori the complex of symptoms which the drug will remove
But the method of alternation throws us back from all such certainty back to the field of unmethodized clinical experience back to the trackless wilderness of polypharmacy and allopathy For these reasons briefly and imperfectly stated from the stand point of science we hold that homoeopathic medicine cannot countenance nor tolerate alternation And we have such a faith in the unity of nature as to believe that what sound reasoning shows to be erroneous accumulated facts will prove to be mischievous and unnecessary
3 But there is another view of this matter from the practical stand point Dr H says Grant that in a given case of the use of two remedies some one remedy might have been found that would as well or better have answered the purpose the question is not Could some other person have done better than I but Have done the best I could Undoubtedly yes And so far as the prescriber's own conscience is concerned this answer exonerates him even though his prescription were a faulty one
And in so far from the practical point of view alternation may be justifiable But will this question Have I done the best I could if affirmatively answered always justify the prescriber The practitioner of one year's experience may commit a sad blunder and yet be fully justified because being inexperienced and young bad though his error was he did the best he could Would this plea justify the same blunder ten years later Obviously it would not Yet is it not the tendency of this plea to satisfy a man with the knowledge he has and with the methods he pursues and thus to blunt his zeal for greater knowledge and better methods
Remonstrate with the allopathist for murdering patients with lancet and purge he replies I act according to my light I do the best I can And so through all degrees of error and imperfect knowledge It is a dangerous plea unless its complement be always added I have done the best I can but please God I will do better next time And here we see the advantage of a sound theory which our friend holds in so light esteem Suppose a practitioner driven as Dr H was driven to alternate The patient recovers He has nevertheless a conviction that drugs modify each other's action in a way that we cannot foretell and that the action of the entire organism is so harmonious that two morbid states cannot co exist independently and that therefore the morbid state being essentially one there must be a possibility of one similar drug disease to oppose it A sound theory compels one And in so far from the practical point of view alternation may be justifiable But will this question Have I done the best I could if affirmatively answered always justify the prescriber The practitioner of one year's experience may commit a sad blunder and yet be fully justified because being inexperienced and young bad though his error was he did the best he could Would this plea justify the same blunder ten years later Obviously it would not Yet is it not the tendency of this plea to satisfy a man with the knowledge he has and with the methods he pursues and thus to blunt his zeal for greater knowledge and better methods Remonstrate with the allopathist for murdering patients with lancet and purge he replies I act according to my light I do the best I can And so through all degrees of error and imperfect knowledge It is a dangerous plea unless its complement be always added I have done the best I can but please God I will do better next time And here we see the advantage of a sound theory which our friend holds in so light esteem Suppose a practitioner driven as Dr H was driven to alternate The patient recovers He has nevertheless a conviction that drugs modify each other's action in a way that we cannot foretell and that the action of the entire organism is so harmonious that two morbid states cannot co exist independently and that therefore the morbid state being essentially one there must be a possibility of one similar drug disease to oppose it
A sound theory compels him to the belief that alternation is not justifiable nor defensible on scientific grounds and that it can do nothing to advance our knowledge of Therapeutics but rather confuses it He enters in his mind a protest against the practice to which the necessities of practical duty and his limited knowledge of the materia medica have constrained him and turns with redoubled vigor to the study of materia medica smarting a little with shame that the exigencies of practice have found him unprepared and have compelled him to a resort which though successful his reason condemns and determined that the next time he will if possible be equally if not more successful and by a method which shall commend itself to his reason and shall add to his stock of knowledge for future use And if while doing the best they can as each case presents itself practitioners will earnestly and systematically study the materia medica determined to do better and better the next time we shall have no word of reproach to utter against their temporary expedient of alternating drugs
With broader knowledge they will alternate less and less and we are very sure that they will see as we have done how in case after case in which they had alternated the recovery was in truth retarded by the mutual reaction of the drugs and how the careful individualization of the case and the painstaking selection of the single drug in the manner that Hahnemann advised will be in their hands the means to a success far beyond any ever reached through alternation For though we have admitted and do admit that success is often attained through alternation and that success is the object of all our labors we are nevertheless convinced through our own experience for we have alternated in our day that a much larger measure of success is obtained by adherence to the rule of administering single remedies and that closer study of the materia medica and sharper investigation of cases will preserve us from those dilemmas in which we are tempted or compelled to resort to alternation
4 And if we appeal to the experience of Hahnemann let it be understood that we appeal to the man who both knew materia medica better than any other man ever knew it and who had more practical experience than any of us has had Let us not indulge in the fallacy of supposing that because we are now practicing in the fifty ninth year since the Organon was published we have had fifty nine years experience in homoeopathic practice and have been studying materia medica fifty nine years
On the contrary our own experience is measured only by the actual number of years we have practiced since in this matter of assimilating to one's own mind the facts of the materia medica and of seeing the correspondence between these and the facts of the disease we can borrow but little from the experience of others If then we from our little experience of fifteen or ten or five years appeal to Hahnemann with his venerable experience of more than fifty years of active practice with his unapproachable knowledge of the materia medica of which he might justly say like Eneas magna pars fui with his unrivaled powers of observation and discrimination if we appeal to him as authority on this question at once practical and scientific can it justly be said that we are seeking some authority outside of and beyond our own reason Our colleague appeals to collections of facts Is not Hahnemann's statement of his practical conclusions a most stupendous collection of facts Who ever observed so many of them Who ever observed so well as he Facts must be received on testimony who ever reported more graphically and more faithfully than Hahnemann If we doubt his ability his capacity his candor what are we doing with his materia medica on the truth of which we risk our patients lives This outcry against swearing in the words of the master has come to have a very different meaning from that of the ancient original protest It was never meant to intimate that the opinion and testimony of him whose abilities had crowned him king of men should not have a royal weight of influence
Homœopathy: The Science of Therapeutics : a Collection of Papers elucidating and illustrating the principles of homœopathy
By Carroll Dunham
VI Alternation of Remedies No i 1863 156
VII Alternation of Remedies No 2 1865 166
VIII Editorial Remarks on Alternation I 1865 215
IX Editorial Remarks on Alternation II 1865 223
CARROLL DUNHAM AM MID GRADUATE OF THE NEW YORK COLLEGE OF PHYSICIANS AND SURGEONS DEAN OF NEW YORK HOMCEOPATHIC COLLEGE PROFESSOR OF MATERIA MEDICA PRESIDENT OF THE AMERICAN INSTITUTE OF HOMCEOPATI IY AND OF THE WORLD'S HONKEOPATHIC CONVENTION HELD AT PHILADELPHIA 1876 AND MEMBER OF VARIOUS AMERICAN AND FOREIGN SOCIETIES
http://books.google.com/books?id=QhROAAAAMAAJ
1. We assuredly do entertain the belief that two or more medicinal forces or we prefer to say morbific forces cannot together act upon the economy without so modifying each other that neither shall produce the effect it would if only one were acting This belief has prevailed among medical men from the earliest ages
It is the foundation of the practice of polypharmacy in all its varieties from the complex prescriptions of the seventeenth century to the alternations of our own colleagues
For we hold with Dr Sorge by no means a Hahnemannian let us add that
the practice of alternation as it exists among homoeopathicians is only another form of mixing remedies with the intention of getting an effect compounded of the action of the two or more drugs that are alternated
We say this belief is the foundation of polypharmacy The rationale of a compound prescription we take to be the following the drug which is regarded as the one chiefly indicated possesses let us suppose certain properties which would be hurtful to the patient Another drug is conjoined with it for the purpose of antidoting those hurtful properties Again it lacks the power to produce certain effects which are deemed desirable Another drug is added to supplement this deficiency and so on ad infinitum
This entire procedure rests on the belief that these medicinal forces will so modify each other in the economy that neither shall produce the effect it would if only one were acting As an example we mention calomel and opium a very familiar combination Certainly the object of giving the opium is that it may modify the action of the calomel and in a way which conforms to the known action of opium when given alone If there were no reason to believe that two or more morbific forces a drug is a morbific agent exciting a morbific force could not together act upon the economy without so modifying each other that neither shall produce the effect it would if only one were acting how could we ever cure disease The morbific force which constitutes the disease is acting upon the economy and we bring to bear upon the economy another morbific force viz a drug Now if the latter be properly selected with reference to the former we know that these forces will so modify each other that on the one hand the manifestations of disease will cease and on the other hand the drug will not produce pathogenetic symptoms as it would on the healthy subject This statement rests on the basis of such facts as our friend invokes On what other theory than the mutual modification of morbific forces acting together upon the economy could it be explained On what other theory could we explain the action of antidotes as homoeopathicians understand and employ them How else could we explain the action of Belladonna in large doses in antidoting poisonous doses of morphine as well as the mutual antidoting powers which allopaths have recently discovered many of the cerebro stimulants and spinant alkaloids to possess How else finally could we explain the efficacy claimed for the practice of alternation in general and for certain instances of it in particular such as the cases related by Dr H and which we fully credit where Belladonna and Bryonia in alternation accomplished what neither could do singly and where Arsenic and China in alternation cured a case which neither alone had cured How else but by conceding that two or more medicinal forces cannot act together upon the economy without so modifying each other that neither shall produce the effect it would if only one were acting The fact that medicinal or morbific influences must be avoided when we are engaged in proving drugs is universally admitted even Dr H assented to it But on what other grounds than the belief already stated That persons long accustomed to use tobacco or coffee are not easily affected by drugs is accounted for probably by the fact that long habit has in so far as those persons are concerned caused tobacco or coffee to cease to be medicinal forces Use has become second nature That in persons not accustomed to the use of coffee a dose of it will modify the action of another morbific or medicinal force is demonstrated by the effect of coffee antidoting opium Nux vomica alcohol as well as in neutralizing the beneficial curative action of many drugs as our clinical observations often satisfy us that it does The same statements apply to tobacco
2 We think we may then assume as conceded the fact that two or more medicinal forces cannot at the same time act upon the human system without mutual modification It is now asked whether granting this modification we may not avail ourselves of it to derive from the alternate use of drugs which modify each other good effects that we have attained in no other way There can be no doubt of the possibility being done has been done with advantage as indeed Dr H shows by two instances But in the present state of our science
it would be impossible for any one to lay down rules for the selection of remedies to be given in alternation with the view of gaining any desired modification of the action of each Nor can we conceive of the possibility of arriving at any such law The rule of the ancient polypharmacy viz to select remedies according to the effects which they produce singly and to combine them with reference to the effect desired does not always work well in practice
For example calomel and opium produce a combined effect which is clearly a modification of the known action of each drug But on the other hand the combined action of opium ipecacuanha and the sulphate of potash in Dover's powder is quite distinct and different from that of either constituent alone and is such as could hardly be anticipated from what we know of these constituents Arsenic and China produced a combined effect which cured an ague that neither singly would cure Now if this fact were to be taken as a guide in selecting a combination for a case of uterine disease for example in which we were at a loss to decide between Sepia and Pulsatilla it might lead us to alternate those two remedies But it is not three months since one of us took charge of a case in which this alternation on this very ground had been employed but the patient had not recovered
We were led to the conclusion that the ability of the organism to drugs indicated with different degrees of accuracy will cause the modification by drugs of each other's action to be different in each individual case we clearly see that we can never be in a position to predicate in advance the effect of the joint administration of several drugs We can never therefore have a scientific indication for such a combination or alternation If we make it it must always be the result of guess work of feeling our way along just as Dr H did in the cases he relates But we claim superiority for Homoeopathy in that it gives us the means of selecting our remedies with a reasonable certainty of their effects and we rightly claim that medicine should not rest content with anything short of a method which given the symptoms of a disease points us to a certain remedy if our materia medica contain it or given the pathogenesis of a drug indicates to us a priori the complex of symptoms which the drug will remove
But the method of alternation throws us back from all such certainty back to the field of unmethodized clinical experience back to the trackless wilderness of polypharmacy and allopathy For these reasons briefly and imperfectly stated from the stand point of science we hold that homoeopathic medicine cannot countenance nor tolerate alternation And we have such a faith in the unity of nature as to believe that what sound reasoning shows to be erroneous accumulated facts will prove to be mischievous and unnecessary
3 But there is another view of this matter from the practical stand point Dr H says Grant that in a given case of the use of two remedies some one remedy might have been found that would as well or better have answered the purpose the question is not Could some other person have done better than I but Have done the best I could Undoubtedly yes And so far as the prescriber's own conscience is concerned this answer exonerates him even though his prescription were a faulty one
And in so far from the practical point of view alternation may be justifiable But will this question Have I done the best I could if affirmatively answered always justify the prescriber The practitioner of one year's experience may commit a sad blunder and yet be fully justified because being inexperienced and young bad though his error was he did the best he could Would this plea justify the same blunder ten years later Obviously it would not Yet is it not the tendency of this plea to satisfy a man with the knowledge he has and with the methods he pursues and thus to blunt his zeal for greater knowledge and better methods
Remonstrate with the allopathist for murdering patients with lancet and purge he replies I act according to my light I do the best I can And so through all degrees of error and imperfect knowledge It is a dangerous plea unless its complement be always added I have done the best I can but please God I will do better next time And here we see the advantage of a sound theory which our friend holds in so light esteem Suppose a practitioner driven as Dr H was driven to alternate The patient recovers He has nevertheless a conviction that drugs modify each other's action in a way that we cannot foretell and that the action of the entire organism is so harmonious that two morbid states cannot co exist independently and that therefore the morbid state being essentially one there must be a possibility of one similar drug disease to oppose it A sound theory compels one And in so far from the practical point of view alternation may be justifiable But will this question Have I done the best I could if affirmatively answered always justify the prescriber The practitioner of one year's experience may commit a sad blunder and yet be fully justified because being inexperienced and young bad though his error was he did the best he could Would this plea justify the same blunder ten years later Obviously it would not Yet is it not the tendency of this plea to satisfy a man with the knowledge he has and with the methods he pursues and thus to blunt his zeal for greater knowledge and better methods Remonstrate with the allopathist for murdering patients with lancet and purge he replies I act according to my light I do the best I can And so through all degrees of error and imperfect knowledge It is a dangerous plea unless its complement be always added I have done the best I can but please God I will do better next time And here we see the advantage of a sound theory which our friend holds in so light esteem Suppose a practitioner driven as Dr H was driven to alternate The patient recovers He has nevertheless a conviction that drugs modify each other's action in a way that we cannot foretell and that the action of the entire organism is so harmonious that two morbid states cannot co exist independently and that therefore the morbid state being essentially one there must be a possibility of one similar drug disease to oppose it
A sound theory compels him to the belief that alternation is not justifiable nor defensible on scientific grounds and that it can do nothing to advance our knowledge of Therapeutics but rather confuses it He enters in his mind a protest against the practice to which the necessities of practical duty and his limited knowledge of the materia medica have constrained him and turns with redoubled vigor to the study of materia medica smarting a little with shame that the exigencies of practice have found him unprepared and have compelled him to a resort which though successful his reason condemns and determined that the next time he will if possible be equally if not more successful and by a method which shall commend itself to his reason and shall add to his stock of knowledge for future use And if while doing the best they can as each case presents itself practitioners will earnestly and systematically study the materia medica determined to do better and better the next time we shall have no word of reproach to utter against their temporary expedient of alternating drugs
With broader knowledge they will alternate less and less and we are very sure that they will see as we have done how in case after case in which they had alternated the recovery was in truth retarded by the mutual reaction of the drugs and how the careful individualization of the case and the painstaking selection of the single drug in the manner that Hahnemann advised will be in their hands the means to a success far beyond any ever reached through alternation For though we have admitted and do admit that success is often attained through alternation and that success is the object of all our labors we are nevertheless convinced through our own experience for we have alternated in our day that a much larger measure of success is obtained by adherence to the rule of administering single remedies and that closer study of the materia medica and sharper investigation of cases will preserve us from those dilemmas in which we are tempted or compelled to resort to alternation
4 And if we appeal to the experience of Hahnemann let it be understood that we appeal to the man who both knew materia medica better than any other man ever knew it and who had more practical experience than any of us has had Let us not indulge in the fallacy of supposing that because we are now practicing in the fifty ninth year since the Organon was published we have had fifty nine years experience in homoeopathic practice and have been studying materia medica fifty nine years
On the contrary our own experience is measured only by the actual number of years we have practiced since in this matter of assimilating to one's own mind the facts of the materia medica and of seeing the correspondence between these and the facts of the disease we can borrow but little from the experience of others If then we from our little experience of fifteen or ten or five years appeal to Hahnemann with his venerable experience of more than fifty years of active practice with his unapproachable knowledge of the materia medica of which he might justly say like Eneas magna pars fui with his unrivaled powers of observation and discrimination if we appeal to him as authority on this question at once practical and scientific can it justly be said that we are seeking some authority outside of and beyond our own reason Our colleague appeals to collections of facts Is not Hahnemann's statement of his practical conclusions a most stupendous collection of facts Who ever observed so many of them Who ever observed so well as he Facts must be received on testimony who ever reported more graphically and more faithfully than Hahnemann If we doubt his ability his capacity his candor what are we doing with his materia medica on the truth of which we risk our patients lives This outcry against swearing in the words of the master has come to have a very different meaning from that of the ancient original protest It was never meant to intimate that the opinion and testimony of him whose abilities had crowned him king of men should not have a royal weight of influence
Homœopathy: The Science of Therapeutics : a Collection of Papers elucidating and illustrating the principles of homœopathy
By Carroll Dunham
VI Alternation of Remedies No i 1863 156
VII Alternation of Remedies No 2 1865 166
VIII Editorial Remarks on Alternation I 1865 215
IX Editorial Remarks on Alternation II 1865 223
CARROLL DUNHAM AM MID GRADUATE OF THE NEW YORK COLLEGE OF PHYSICIANS AND SURGEONS DEAN OF NEW YORK HOMCEOPATHIC COLLEGE PROFESSOR OF MATERIA MEDICA PRESIDENT OF THE AMERICAN INSTITUTE OF HOMCEOPATI IY AND OF THE WORLD'S HONKEOPATHIC CONVENTION HELD AT PHILADELPHIA 1876 AND MEMBER OF VARIOUS AMERICAN AND FOREIGN SOCIETIES
http://books.google.com/books?id=QhROAAAAMAAJ