By Dr. K.P. Majumdar.
The principles of Homeopathy as we understand are (a) the application of law of similars, (b) the use of single remedy and (c) the application of minimum dose. We shall restrict our discussion to the use of single remedy.
The basis of Homeopathy consists of knowledge of the effects of drugs upon the healthy. The practical application of this general conception lies in selecting, out of all the remedies known – the similimum, the one whose symptom complex most closely resembles that of the case to be treated. Our experience of the past many years shows that selection of similimum is no easy exercise but needs a great wisdom and patience. The job is easy if one quickly finds the similimum exactly matching the symptoms presented in a disease. But if it does not, and many remedies come up as close resemblance to each other, then the similimum has to be based on the importance of relative value of the symptoms. The sound knowledge of anatomy-physiology-pathology-drug pathogenesis plays a great part in determining the ultimate importance of various symptoms. A successful practitioner is the one who grasps these correctly in the selection of his remedy. Very often it is the lack of knowledge of the drug pathogenesis that is responsible for our failure in the selection of one and the right remedy. This problem is somewhat solved by the use of repertory. But here, the physician has to be very careful in weighing the relative values of the symptoms before he uses them in right combination. The feedback, therefore, greatly depends upon the right input and programming.
The concept of multiple or combination prescription is not new. Right from Hering, Gross, Rummel, Hartmann, Aegidi, Hirsch, Kaupfer have expressed their opinion in alternating of remedies. All of them have recommended alternating of remedies or giving different remedies in quick succession in a given case for a rapid recovery. However, there is only reason that such a course is adopted and that is a desperate case, where one lacks confidence in waiting to see the action of the remedy prescribed. Griesselich says that in acute diseases where it is impossible to find a right remedy it may be allowable and imperative. But Dr. Trinks says that giving a different remedy without waiting to see the action of the remedy prescribed earlier is contrary to the principle of Homeopathy. In chronic cases such multiple remedies should not be employed even if one remedy does not cover all the symptoms of the case. It not only boils down to one thing that we are not aware of the total pathogenesis of the drug. Very often it will be noticed that after the prescription of a single remedy, the uncovered symptoms also disappear. This should go in record to enrich the materia medica. It needs diligent and devoted practice.
The hint was taken up and slowly instead of alternating the remedies, physicians starting combining the medicines. The combinations were prepared probably from their personal whims and imaginations. Gradually the homeopathic pharmacies started preparing the so-called successful combinations and marketing under trade names.
Hahnemann was against this type of practice. He always insisted that when one single remedy has been used in proving and eliciting its curative signs and symptoms, using of combinations without the full knowledge of their pathogenesis is contrary to the law of similars. It means that the combination can be used in practice provided it is used as a single remedy and after its thorough proving to understand its full therapeutic possibility. More often than not one will find that it demonstrates altogether a different picture than the original symptomalogies of the combining drugs.
The pharmaceutical industry in Homeopathy claims many such combinations which are available for use of practitioners. Unlike pharmaceutical industry of modern medicine which is backed by research, homeopathic pharmaceutical industry has negligible contribution in the field of research. The combinations, which they claim have been the outcome of some imaginary potions, claimed to have relieved some, and such combinations are picked up without carrying out any serious research or proving. The homeopathic physicians fall prey to such combinations when they find difficulty in selecting the right remedy in acute or chronic case and when they are harassed by their troubled patients. Often the patients demand some tonic or a regular medicine ( a legacy of modern medical practice) totally unaware of the homeopathic philosophy. It must be remembered that when the patient comes to homeopathic physician, ha has to be educated in the principles of Homeopathy. This is quite a useful method in the long run.
So-called combination drugs prepared by the pharmaceutical companies are sold in the market. They advertise them under trade names and unwary patients get trapped. It is our experience that one who has taken these combinations poses a serious problem to the physician later. These combinations become a hindrance to the rational cure. When the indicated remedy fails, the cause may be found in the use of combination drugs in ninety nine out of hundred.
In conclusion, one should practice rational Homeopathy by use of a single remedy prescription at any one given time of the case and follow-ups can be done through the related remedies as intercurrents or chronic remedies. People who use the combinations and claim quick and magical success soon realise that their success is short-lived; but they are shy of announcing them.
Ref - Editorial in Hahnemannian Gleaning of Dec 1983