“In no case being treated is it necessary to give a patient more than a single simple medicinal substance at one time, and for this reason by itself it is inadmissible to do so. It is inconceivable that there could be the slightest doubt about whether it is more natural and rational to prescribe a single simple, well known medicinal substance or a mixture of many different ones for a patient at any one time. In homeopathy, the only true and simple natural therapy, it is absolutely forbidden to give the patient two different medicinal substances at any one time”
Here Hahnemann makes his thoughts regarding combinations of remedies abundantly clear. There has been discussion regarding his possibly meaning allopathic medicines and not applying the same thoughts to homeopathic medicines, however most homeopaths agree that when he talks of medicinal substance he is referring to all substances, remedies included, which have a medicinal effect. With this being the case how is it that some homeopaths choose to utilise combination remedies and companies choose to manufacture them to be sold over the counter in stores?
In clinical practice I have witnessed the use of different combination remedies, among them:
Nux vom 30c
Travel sickness Combination:
Nux vom 30c
Arg nit 30c
Case SC – Female aged 34
Presenting Symptom – Anxiety
- SC was referred to the clinic by a counsellor due to great anxiety after a counselling session. It was difficult to get anything coherent out of SC as her mind was much fractionalised after her counselling session. She shook uncontrollably throughout and looked around her anxiously believing that others were viewing her with distaste. Asking her questions did not help as she was much disjoined in her answers and her thoughts did not follow the conversation. Anxiety Remedy – administered in pillules and in H2O for sucussion during prolonged use
- Return 1 wk later, she was very loud and bubbly and chatted with many of the women at the centre. She was quite brash in her demeanour and told us that she wasn’t bothered what people thought, she was herself and they had to accept this. She chatted aimiably and said the remedy had helped her enormously. She was coherent in her thought processes and followed the conversation very well, however expressed that she still felt very anxious. The anxiety causes her heart to race and and a pain to the chest which she found hard to describe, her hands become clammy and she shakes. Advised using remedy in pillule form when needed
- Return 1 wk later – greatly distressed. She revealed that she’d had an uncomfortable relationship with her mum but wouldn’t elaborate because it was ‘personal stuff’. Her mum is deceased and SC believes her mum is taking over her mind in a possession type manner. She began shaking and couldn’t breathe having to be taken into a separate room to ground herself with deep breathing exercises. Anxiety Remedy daily H2O
- Return 1 wk later – quiet and subdued. SC seemed upset but repeatedly said she didn’t want to talk about it. She felt unhappy and had been cutting her arms and scratching her face, something which she has done intermittently for some time. Eventually she stated that she had been close to suicide over the past week and it scared her that she had no energy for life. Aurum 30c H2O administered daily
- Return 1 wk later – hyperactive and excitable. SC kept saying that although she was happy on the outside she was upset that people couldn’t see how unhappy she was within. She then said she didn’t want people to notice when she was upset as this makes her paranoid. She felt Aurum had not helped and requested the anxiety combination in pillules as she feels these were more effective than in water. Anxiety combination in pillules administered with advice to contact a mental health advocate or CPN
- Return 1 wk later – distressed but calm. SC had been to a spiritualist church and had received a ‘message’ from her mum. This had upset her greatly and since she has been seeing things in her home. She says that items have moved from their original place and this has ‘freaked’ her out. She is greatly anxious and fears she will be seen as mad, she refuses to see any other professionals as she doesn’t trust them. She ran out of pillules a few days ago and says the anxiety had been much worse without them. Anxiety combination in pillules administered.
When I questioned the homeopaths about the use of combination remedies I was given two ideas. One surrounded the complexity of the case and the complete disarray of the patients vital force. It was felt that this disarray indicated a depth of disturbance which prevented a positive response using a more constituional form of prescribing. The constitution was thought to be so masked by the presenting symptoms that it was impossible to determine who SC really was. Using a combination remedy was seen to address the presenting symptoms while waiting for a clearer constitutional picture to emerge. The other idea surrounded the immediacy of needed action when there were next to no information to prescribe upon. SC had felt unable to respond in her anxious state and therefore the combination remedy was seen as addressing the immediate situation through the action of one or more of the remedies within it.
One of my main concerns about this case was the repetition of the combination remedy. It felt as though the case stopped responding after the initial relief and it was difficult to elicit exactly which medicine to prescribe for the future and which potency to give because there was confusion over which medicine in the combination worked for SC. The case shows an amelioration in the initial severity of anxiety but subsequent returns show that it has not cured the problem, and although I understood the idea behind giving the combination it felt like an allopathic way of working producing a very much hit and miss affair. For a student practitioner, observing the use of combination remedies makes it difficult to learn how a remedy presents or works, and prevents the ability to learn from successes and failures in order to become a better homeopath.
Generally manufacturers of combination remedies tout them as useful for the patient when they do not have direct access to a qualified homeopath but are in need of symptom relief. The majority of homeopaths believe they can at best palliate which may be ok in some acute situations but in a majority of chronic diseases, the prolonged use of combinations could lead to suppression of the disease and subsequent complications. Homeopathy teaches that all medicines have the power to either provoke or relieve the same symptoms. This provocation is proportional to the number of separate ingredients to which a sensitive patient could respond, the larger the dose and the more times it is repeated.
The premise behind remedy combinations is that each remedy cures different elements of the disease however the other remedies contained may complicate the condition or may even prevent the right remedy from working. The main issue being that when placing substances together we are sure of their individually proved actions but have no knowledge of exactly how the various medicines interact with each other and what their combined effect is as no provings have been done. For example the Biological Homeopathic Industries Hay fever Nasal Spray combines 6 different remedies in 4 different potencies; they give no information on provings of this remedy and no explanation of their choice of potencies to make it up. The question that manufacturers of combination remedies should be finding the answer to is, do they remain a collection of separate remedies or merge into a new one?
To me combinations seem to focus on one or two common disease symptoms rather than looking at the person holistically making the practice non homeopathic for the patient. Multiple complaints may not be healed with a single remedy but it is important to prescribe one single remedy at a time to see which symptoms subside and which persist. The symptoms that remain should be prescribed upon again according to the current state of the patient. In this way multiple diseases can be cured with multiple remedies but only by prescribing one remedy at a time.