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Little's Arguments Against Dual Remedy Prescribing
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Few homeopaths are aware of the use by Hahnemann of dual remedies, that is, two remedies at a time. It has been either ignored or presented in a distorted fashion by those who write about homeopathic history and philosophy. The following is our reply to the latest attempt to dismiss this seminal event and its radical implications for homeopathic philosophy and prescribing. The use by Hahnemann over an extended period of dual remedy prescribing is completely consistent with his principles right from the start of his writings around 1790 to his death in 1843. Extensive research on the whole matter, including the full text of documents often quoted only in part, is now finally available in the book, The Dynamic Legacy: Hahnemann, from Homeopathy to Heilkunst. For information on accessing this electronic book please contact .


The following quotes sections from the extensive comments by David Little on the issue of dual remedy use by Hahnemann. It represents the most extensive effort of the classical viewpoint to try to explain this fact within the accepted tenets.

THE EXPERIMENTS OF THE 1830'S

Overcoming Obstacles to the Cure

by David Little (posted on homeopathy@lyghtforce.com in December 1999)

[our commentary is in square brackets]

The epoch around the publication of the 5th Organon was one of great experimentation. In the Chronic Diseases Hahnemann introduced the theory of infectious miasms and became the founder of modern epidemiology. By 1830 he had recorded the symptoms of the prodrome, primary, latent, and secondary stages of several acute, half-acute, and chronic miasms. Now that the Founder know he was facing auto immune disorders and immuno-deficiency syndromes, he felt restricted by his limited materia medica. How could one always find a simillimum that fit the complete case with less then 100 remedies in 30c potency? The first area where Samuel looked for an answer was in the medicinal solution and the repetition of the remedy to speed the cure, if and when necessary. At the same time, Hahnemann ran trials using double remedies, alter[n]ations, intercurrents, and a series of remedies in an effort to remove the seed, roots, and branches of the chronic miasms.

[Comment: Little makes it sound as if the main problem was one of a lack of remedies. If this is true, why would the medicinal solution and remedy repetition be an answer to this? Little also implies that Hahnemann's use of double remedies is in the same league as his use of alternating and intercurrent, as well as sequential remedies. This argument is dealt with in the full analysis above.

Indeed, the problem is a much more profound one than simply that of the number of remedies. Hahnemann himself dealt with this argument of numbers (quantitative aspect) in his treatise on the discovery of the chronic miasms. He stated that the problem he faced was one of quality (understanding of the nature of disease and its manifold dimensions), not one of quantity (the number of remedies available). Hahnemann made this statement at a time when the number of remedies he had to work with was less than one hundred, compared to the at least ten-fold number of substances available to practitioners today. The solution to the problem of disease, Hahnemann understood here and elsewhere, required a deeper insight into the dynamic polarity of the nature of disease.

That it is useful to have an enlarged Materia Medica is not at issue. However, the problem of disease, namely how to cure the many difficult and seemingly unresponsive cases of disease that remain, cannot be reduced, as it is in "classical" homeopathy, to a problem of quantity (the need for more proved substances). In the uniformitarian world of disease = patient = one remedy, the problems of disease are reduced to the search for more medicinal substances, rather than to a search for a better understanding of disease in its hierarchical and dynamic nature. Where Hahnemann searched for a multidimensional,qualitative solution, his presumed heirs only search for a unidimensional, quantitative one.

43.1 Whence then this less favorable, this unfavorable, result of the continued treatment of the non-venereal chronic diseases even by Homeopathy?

43.2 To what were the thousands of failed endeavors due to so cure the other kind of protracted diseases that lasting recovery might proceed therefrom?

44.1 Perhaps by the still too small number of homeopathic remedial implements so far proven as to their pure actions!

45.1 Students of Homeopathy have hitherto thus consoled themselves; but this excuse, or so-called consolation, never satisfied the founder of Homeopathy — particularly because even the ever increasing store of proved powerful medicines has not advanced the cure of chronic (non-venereal) diseases by a single step, while acute diseases (unless these, at their commencement, threaten unavoidable death) are not only passably removed, by means of a correct application of homeopathic remedies, but, with the assistance of the never-resting, living, Sustentive Power in our organism, find a speedy and complete cure.

46.1 Why, then, cannot this Living Power, efficiently affected by homeopathic medicines, bring to pass any true and lasting recovery in these chronic maladies even with the aid of the homeopathic medicines which best cover their present symptoms, especially since this same power, created for the restoration of the integrity of our organism, is nevertheless so indefatigably and successfully active in completing the recovery even in severe acute diseases? What prevents this?

47.1 The answer to this so very natural question led me to the nature of these chronic diseases.

48.1 To find out then the reason why all the medicines known to Homeopathy failed to bring a real cure in the above-mentioned diseases, and to gain an insight more nearly correct and, if possible, quite correct, into the true nature of the thousands of chronic diseases which still remain uncured, despite the irrefutable truth of the Homeopathic Law of Cure, this very serious task has occupied me since the years 1816 and 1817, night and day; and behold! the Giver of all good things permitted me within this space of time to gradually solve this sublime problem for the welfare of humanity through unremitting cogitation, indefatigable research, faithful observation and the most accurate experiments.*

Such a view only leads to the statement told on occasion to patients that "your remedy has not yet been proved." The patient is then placed in a similar situation to the patient waiting for an organ transplant or for the latest allopathic research on synthetic drugs. That the problem is reduced to one of quantity is consistent with unresolved allopathic thinking extant in classical homeopathic philosophy.]

Throughout Samuel Hahnemann['s] long career he performed countless experiments with the use of homoeopathic remedies. With the publication of the miasmic theory in the Chronic Diseases in 1828 a new era of homoeopathy began. In line with the new doctrine of the chronic diseases the Founder began a radical set of experiments to try and overcome the limitations imposed by his materia medica of around 100 remedies.

[See comments above regarding this argument of numbers.]

The most controversial of these experiments was the double remedy experiments carried out in the early 1830's.

[The changes in method by Hahnemann were not experiments in the sense of trials with sick patients just to see what might happen, but were grounded in a deeper understanding of disease or informed by insight, imagination and intuition — valid aspects of knowledge Hahnemann called kennen.]

THE DOUBLE REMEDY EXPERIMENTS

The double remedy method originated with Dr. Aegidi, one of Hahnemann's disciples, who forwarded the Founder 233 case[s] of his new method.

[The method originated with Dr. Stoll and possibly was the result of work and comments Hahnemann himself undertook in using two remedies in short intervals. Drs. Aegidi and Boenninghausen, based on the evidence of correspondence between them, likely used such methods in difficult cases for at least a year prior to 1833 with Hahnemann's knowledge and tacit support.]

In cases where he could not find a single remedy, which match[ed] the complete symptoms, he combined two homoeopathic remedies that fit the symptoms.

[There is no evidence that the issue was one of lack of a single remedy that covered the complete symptom picture, as is alleged here. Aegidi, quoted in Hahnemann's reply of 15 June 1833, stated that he gave the "two medicinal substances ... only in a case where both seem Homoeopathically suitable, but each from a different side." Hahnemann calls the practice a "discovery." If both remedies are homeopathically indicated, they must both correspond to a disease (the different sides here are not a partial symptom picture of one disease). This cannot be the same situation covered by Hahnemann's section in the Organon, which had been there since the beginning, dealing with cases where there is no one remedy homeopathic to the disease (Aphorisms 162-170). If it were, Hahnemann would not have greeted it as a new "discovery."]

Hahnemann wrote [a] passage on the double remedy experiments that was removed from [sic] before publishing the 5th Organon. This is confirmed by a letter he wrote to Aegidi in 1833.

"Do not think that I am capable of rejecting any good thing from mere prejudice, or because it might cause alternations in my doctrine. I only desire the truth, as I believe you do too. Hence I am delighted that such a happy idea has occurred to you, and that you have kept it within necessary limits; "that two medicines substances (in smallest doses or by olfaction) should be given together only in a case where both seem homoeopathically suitable to the case, but each from a different side." Under such circumstances the procedure is so constant with the requirement of our art that nothing can be urge against it; on the contrary, homeopathy must be congratulated on your discover. I myself will take the first opportunity of putting it into practice, and I have no doubt concerning the good results. I think too, that both remedies should be given together; just as we take Sulphur and Calcarea together when we cause our patients to take or smell Hepar sulph, or Sulphur and Mercury when they take or smell Cinnabar. I am glad that von Boenninghausen is entirely of our opinion and acts accordingly. Permit me then, to give your discovery to the world in the fifth edition of the 'Organon' which will soon be published."

[Note:There is a missing section, which we reproduce here: "Until then, however, I beg you to keep it to yourself, and try to get Mr. Jahr, whom I greatly esteem, to do the same. At the same time I there protest and earnestly warn against all abuse of the practice by a frivolous choice of two medicines to be used in combination."]

Samuel Hahnemann

finis

[Aside from the numerous errors of transcription, we note that parts of the letter are missing. The missing section emphasizes Hahnemann's concern that others will not understand the difference between dual remedies and polypharmacy. The missing section is placed between square brackets in the letter. Hahnemann's concern is the same terminology used by Little above, but he completely misunderstands the context, taking it as a means of suppressing, through confusion, a valid, dynamic approach to the cure of disease.]

Many of Hahnemann critics constantly say that the Founder was close minded, dogmatic, and against any innovations in his new medical system, Homoeopathy. The above letter puts such myths to rest. He was so open to Aegidi['s] idea that he offered to publish this method without even trying it first in the clinic.

[This last statement seeks to fix as fact that Hahnemann had little or no experience with dual remedies before making his decision to write a new paragraph on this clear departure from past teachings. However, this opens Hahnemann to the charge that he was acting precipitously and unwisely (possibly even being senile at this time as some have alleged, which the full history belies). Hahnemann makes clear in a subsequent letter of 17 June 1833 that he had started to use the method of dual remedies, the same letter in which he notes that he had written a special paragraph. In a letter of 19 August 1833, after the peace conference in Köthen, Hahnemann confirmed that he sent the completed 5th edition, with the new paragraph on dual remedies, to the printer with orders to "print it soon." Hahnemann has now had several months of trials before making his formal decision to include the new practice in the Organon. Of course, we see later, when he decides to remove the new paragraph on dual remedies, that Hahnemann does not feel that this clinical evidence of his is yet sufficient to base a new rule on in the face of political concerns and the concern that others will misuse the new insight. Thus, he is convinced of the truth of dual remedy prescribing, including in mixtures, but is not yet in a position to defend it against opposition because his clinical work has not yet allowed him to fully grasp the principle behind the practice so as to explain it in a manner to protect against misuse.]

He was hopeful it would help him to overcome the obstacles to the cure that he faced curing the miasms. Lutze published an aphorism on the double remedies called * 274b* in his spurious publication of the "6th edition of the Organon." Lutze claimed that the reason Hahnemann removed the passage was that his colleagues dis[ap]proved but Boenninghausen wrote that it was "condemned by a unanimous vote." The following is Lutze's aphorism 274b. We do not know at this time if this paragraph is authentic or fraudulent at this time. It seems to be quite in line with the [sic] Hahnemann's letters and comments on the methodology of the double remedies. It is not wildly incorrect as to the information.

[This is a rather convoluted approach to a paragraph that has not been proven invalid.Perhaps the attempt here is to sow doubt where none is justified based on the evidence at hand. As for the first sentence, why would Hahnemann be hopeful unless the approach provided a qualitative therapeutic discovery to match the qualitative discovery of the chronic miasms? He had rejected the problem in his treatise, Chronic Diseases, as being one of quantity — number of medicinal substances — for this was a technical matter, not one of "discovery." The only obstacle, given a full understanding of the history of Hahnemann's life work, was that of coming to grips with the dual nature of disease. This was the basis for Hahnemann welcoming Aegidi's announcement on dual remedies in early 1833 as "a happy idea." Lutze, who had an association with Aegidi dating from 1853, must have been made aware of the new paragraph, as Aegidi would have had a copy of its contents. Indeed, we can rightfully ask where else would he have gotten it from?].

"There are several cases of disease in which the administration of a double remedy is perfectly Homoeopathic and truly rational; where, for instance, each of the medicines appears suited for the case of disease, but each from a different side; or where the case of disease depends on more than one of the three radical causes of the chronic disease discovered by me, as when in addition to psora we have syphilis or sycosis also. Just as in very rapid acute diseases, I give two or three of the most appropriate remedies in alternation; i.e. in cholera, Cuprum and Veratrum; or in croup, Aconite, Hepar sulph and Spongia; so in chronic diseases I may give together two well indicated Homoeopathic remedies acting from different sides in the smallest dose. I must here deprecate most distinctly all thoughtless mixtures or frivolous choice of two medicines, which would be analogous to allopathic polypharmacy. I must also, once again, particularly insist that such rightly chosen Homoeopathic double remedies must only be given in the most highly potentized and attenuated doses."

This paragraph, of course, is pointed to by some as proof that Hahnemann used polypharmacy. They claim that Hahnemann, Boenninghausen, and Aegidi's dual remedy experiments were a "great success", but they kept them secret solely for political reasons. Of course, there was serious political considerations concerning the misuse this information, but is that the whole truth?

[The claim that the dual remedy use was a great success is made by Boenninghausen and Aegidi themselves! Hahnemann had less time to work on cases let alone to fathom the principle before political circumstances led him to retract the disputed paragraph on dual remedies in mid-September 1833.]

HAHNEMANN'S PERSONAL LETTERS

In 1833 Hahnemann and Boenninghausen performed a set of clinical experiments to test Aegidi's hypothesis in the clinic.

[Boenninghausen had started to use dual remedies prior to 1833, as had Aegidi.]

The following is a personal letter from Samuel Hahnemann to Baron von Boenninghausen on the subject of the double remedies, i.e., the administration of two remedies at the same time. The letter finds the Founder offering the Baron his opinion of how well the dual remedies really worked in the clinic now that he had personally tried them, and the nature of the comments he wrote for the 5th Organon. Let's let Samuel Hahnemann speak for himself.

[What is important here is that the letter was written after Hahnemann's decision to withdraw the new paragraph on dual remedies for political reasons, which decision he communicated on 15 September 1833 to Boenninghausen. At this point,the issue being raised by Boenninghausen cannot be whether or not there should be a new paragraph in the new edition of the Organon. What was it about then? Boenninghausen, in a letter to Dunham of 1865 (disputed letter as the date is after Boenninghausen's death) claims that he urged Hahnemann to express disapproval of the method. This, again, is done for political reasons. The issue must then be the addition of critical language to the existing text of the 5th edition. However, Hahnemann had already told Boenninghausen in his 15 September 1833 letter that he had done so, though not the language he had written. The reference to Boenninghausen's eloquence must then be related to trying to convince Hahnemann to include a strong condemnation. Hahnemann, in effect, replies that he doesn't need Boenninghausen's eloquence as he is not as convinced as Boenninghausen of the "great utility" of dual remedies in mixture. Thus, he is saying that Boenninghausen's eloquence is not necessary to induce him to do what Boenninghausen is urging. He only needs a small "momentum" to alter the existing language of the 4th edition on the single remedy for the 5th. However, Hahnemann also still admits the utility of the dual remedy approach, despite all this, in order to do "justice to truth."]

Hahnemann to Boenninghausen:

C[ö]then, October 16, 1833

Your eloquence would have easily persuaded me, if I had been in your position, that is, if I had been as much convinced as you are from a large experience of the possibility or even great utility of giving double remedies BUT FROM MANY ATTEMPTS OF THIS KIND ONLY ONE OR TWO HAVE BEEN SUCCESSFUL, WHICH IS INSUFFICIENT FOR THE INCONTROVERTIBLE ESTABLISHMENT OF A NEW RULE."

Hahnemann experiments with the dual remedies proved a failure because they did not work as well as his single remedies. If the Founder thought there was a need for a two remedy he preferred alternations to mixing the two remedies together. He was even more critical of the double remedy experiments then Boenninghausen, who is often blamed by the polypharmacist for talking Hahnemann into removing the passage. The following quote offers more clues.

"I was therefore, too inexperienced in this practice to support it with full conviction. Consequently it required only a slight momentum to induce me to alter that passage in the new "Organon" which results in this, that I concede the possibility that two well chosen remedies may be given together with advantage in some cases BUT THAT THIS SEEMS TO BE A VERY DIFFICULT AND DOUBTFUL METHOD. And is, this way, I believe I have done justice to truth on the one side and to any inner conviction on the other."

Samuel Hahnemann.

finis

[the all caps are added by Little]

In the beginning, Hahnemann was open to the idea of the double remedy, in the middle he could not support it we [with?] full conviction, and in the end he found it a "very difficult and doubtful method."

[Hahnemann all along had warned against abuse of the practice of dual remedies. (See: the letter of 15 June 1833 to Aegidi.) It is disingenuous to argue that this practical problem is a condemnation of the approach itself. First, the reason for retraction is political (namely loss of face with the allopaths and likely abuse of the method, as the principle underlying it has not yet been discerned). Second, Hahnemann also made clear that the finding of even one remedy homeopathic to a disease was not an easy matter. (See his letter to Aegidi of 9 January 1834): "For my part I find the discovery of the right remedy difficult and laborious in every case." Such a statement is not here to be taken as a condemnation of the use of the single remedy, just because of practical problems! Also, we should note that he said that he was "too inexperienced" to support dual remedies in mixture "with full conviction." His response was to remove the paragraph announcing the practice of dual remedies to the world as the principle was yet unknown to him (too inexperienced), but not to cease work on dual remedies altogether. He had already begun his exploration of dual remedies in terms of overlapping action and had a profound appreciation of the dual nature of disease.]

On August 10th at Coethen, 1833 Samuel Hahnemann held a meeting to discuss the double remedy experiments, and the offer the Founder had made to include reference to Aegidi's double remedies in the 5th Organon.

[The meeting of 11 August 1833 was not held to discuss the dual remedies, but to conclude a peace treaty with the Leipzic homeopaths after a long and acrimonious public debate over what was true homeopathy. Notably, the peace agreement defining the pillars of true homeopathy did not cover the issue of dual remedies at all. Indeed, Hahnemann had raised the matter at the meeting out of his enthusiasm for the approach after Aegidi's letter with the 233 cured cases earlier that year. If the dual remedy approach had been counter to Hahnemann's conception of homeopathy, why would he then have proposed the idea to a group he was just patching up a quarrel with over being "half homeopaths?"]

The following was written by Richard Haehl in 1921:

When, however, his followers congregated around him on 10th August in Coethen, they voiced their objections. Hahnemann could be convinced by their arguments that it was necessary to remove the paragraph in question from the 5th edition then in print; all the more easily, since he himself had made but few experiments with double remedies and only in very special cases had given them any validity. The allopathic doctors, foremost Hufeland, who very likely by a leak through one of the type setters, had got to know about the recommendation of double remedies thus planned, had triumphed already: "Hahnemann and his crew are about to return to allopathy."

Haehl writes that Hahnemann was easily convinced because he only made a few experiments, and considered them of only a limited use in the clinic. Hahnemann clearly writes that out of the MANY ATTEMPTS ONLY ONE OR TWO WERE SUCCESSFUL and he was going to write in the Organon THAT THIS SEEMS TO BE A VERY DIFFICULT AND DOUBTFUL METHOD.

[Of course one would wonder how ANY successes could be had, let alone hundreds, except on some principle. At the same time, Haehl's views are themselves suspect as he does not provide all the evidence available from all sources (and gives no connected account of the whole story), and we have to question what other evidence available in Hahnemann's correspondence to which Haehl had access he effectively left out. It is true that Hahnemann had not made as many successful experiments as Boenninghausen and Aegidi, but they had started earlier and he never questioned the cures from these two followers closest to him. He must have wished to continue his own experience with dual remedies, witness his delay in acceding to the political concerns of the Leipzic homeopaths. Haehl makes it sound as if Hahnemann had agreed right away. The time frame is more nuanced here. The issue of "difficulty" is dealt with in the comment immediately above. It is reasonable that under attack and with yet no clear understanding of the principle for dual remedy prescribing, Hahnemann would agree to forego a public declaration. However, this did not mean that he ceased dual remedy prescribing, shifting only to simultaneity of (overlapping) action from simultaneity of ingestion (mixture).]

From this letter it "seems"that the Baron had more hope in the method then the Founder! Yes, if Hahnemann 'had been as much convinced", as him, "of the possibility or even great utility of giving double remedies." The Founder goes on to say clear that from the vMANY ATTEMPTS" only "ONE OR TWO" have been successful, and that this is INSUFFICIENT for the ESTABLISHMENT OF A NEW RULE. This is the Founder's real reason for removing his reference! The double remedies did no[t] work very well when compared with the single remedy, two remedies in alternation, and remedies in a series over time. It was the [sic] fact that Hahnemann's clinical trials failed to produce good results!

[And is this why he decided to continue and then resumed the successful aspect of this method in his Parisian period? Boenninghausen must also have had many cured cases, perhaps as many at least as Aegidi, having used the method with great success, by his own admission, likely as long. He had more than "hope!" But the issue here is not the number of cured cases, which Hahnemann hardly disputed, but Hahnemann's own experience, which had not yet provided the needed insight into the principle behind dual remedy mixtures, thus, not providing sufficient basis for the establishment of a rule. This is far from a condemnation of dual remedy prescribing!]

During the meeting at Coethen in 1833 all at the meeting agreed on removing the passage as the clinic trials had failed, and the method had become a liability to homoeopathy rather than an asset.

[There is no evidence that the clinical trials had failed at this point or at any point. Aegidi had 233 cured cases, Boenninghausen had "been convinced ...from large experience...of the possibility and even great utility of giving double remedies," (written in October of 1833, thus several months after the August meeting!) and Hahnemann was highly enthusiastic about the method by his own admission (otherwise he would undoubtedly not have raised it, given that the meeting was called to deal with divisions within homeopathy - why would he raise a method that went seemingly counter to the single remedy orthodoxy of that period in such a meeting if "the clinic trials had failed" as Little contends?). It is true that the others at the meeting, having just come through an acrimonious debate over the allopathic tendencies in homeopathy, feared that this new approach could be abused, leading to the condemned polypharmacy. They had a uniformitarian view of disease, and thus, feared that dual remediation was the beginning of a slippery slope from unipharmacy to polypharmacy. Hahnemann, for his part, had allowed his enthusiasm (based on kennen) to run ahead of his conscious understanding of the method and could not assuage their concerns. Thus, the reason that the disputed paragraph was withdrawn had nothing to do with the supposed clinical failure or medical dangers. Indeed, Hahnemann himself continued dual remedy prescribing but in a different format, moving from mixture (simultaneity of ingestion) to overlapping action (simultaneity of action), with which he felt more comfortable given his insights into the dual nature of the disease and remedial process involving the initial and counter actions. The reason for the withdrawal of the disputed paragraph was political and no other reasons are included in the record.]

They were very concerned that the pseudo-homoeopaths would try to imitate the failed double remedy experiments, and introduce polypharmacy to homoeopathy. This, of course, has happened and we have combination practitioners who claim they are practice [sic] the way Hahnemann really intended.

[See note above. It should also be noted again here that dual remedy prescribing is not limited to simultaneity of ingestion.]

The Baron wrote a letter to Dunham in the USA about this meeting in which he stated:

But this novelty [the double remedies] appeared to [sic] dangerous for the new method of cure, and it was I who induced Hahnemann to express his disapproval of it in the fifth edition of the Organon in a note of [to] paragraph 272."

[The reference by Boenninghausen is to "combined doses" not to all dual remedy prescribing in the full letter here only partially quoted.]

Note that the Baron is not speaking about the 'removal of the paragraph' but the addition of critical comments about the double remedy experiments to aphorism 272. He say[s] he induced Hahnemann to express HIS disapproval in this footnote. Vide the 5th edition of the Organon.

"In no case is it requisite to administer more than ONE SIMPLE medicinal substance at one time." 2 (a)

[all caps are by Little]

2 (a) Some homoepathists have made the experiment, in cases where they deemed one remedy homoeopathically suitable for one portion of the symptoms of a case of disease, and a second for another portion, of administering both remedies at the same time; but I earnestly deprecate such a hazardous experiment, which can never be necessary, though it sometimes may be of use.

[The reference here is to two remedies at the same time, that is, in mixture, what Boenninghausen referred to as "combined doses." Again, Hahnemann cautions against the procedure because of its practical difficulties, not because it is condemned in principle. The use of combined doses is not necessary as one can resort to simultaneity of action. The use of combined doses is hazardous precisely because, as Hahnemann states earlier, it is difficult enough to find just one remedy that is homeopathically indicated in a case, much less two. Better to give the one and wait to see a clearer image of disease emerge on which to prescribe a second.]

This footnote express the thoughts Hahnemann wrote in his letter to the Baron in Oct 1833. He still did not wish to say that all of Aegidi's work never got 'any results', but he knew that a fully trained homoeopath could do much better with just one single remedy at a time.

[The implication here is that Hahnemann continued with the single remedy, and yet we have already seen Little admit that Hahnemann continued to give two remedies within the same period of action (simultaneity of action). This is quite a departure from Hahnemann's previous position of waiting until the full action of the first remedy had exhausted itself or had somehow come to an end, as in intercurrent diseases, before giving a second. The position here also begs the issue of what "at a time" means. If it means no overlapping action, then this is contrary to what Little says elsewhere. If it allows for overlapping action, then we face the problem of how much time must elapse and what is the principle for deciding. Without this, a nano-second would suffice just as much as a day, for example.]

He also realized that there were inherent hazards in given [sic] a double remedy, and wanted everyone to be very careful with their patients so he advised against the method.

[And where exactly does Hahnemann state these "inherent hazards" that are referred to here?]

A concern was that those who used the double remedies would 'never' learn how to use a single remedy correctly. It would become a self-defeating process in homoeopathic education.

[Yes, without the requisite principle of application. This paragraph by Little reinforces the practical basis for the opposition to dual remedies,or at least for not promoting it publicly in a formal statement, which was Hahnemann's position in the Fall of 1833. Presumably, if the practical concerns were removed, this argument would fall by the wayside. The concerns will remain so long as the secondary teachings of the classical school fail to grasp the dual nature of disease and the promulgators fail to give up their uniformitarian view of prescription which cannot conceive of dual remedies without seeing it as a slide into polypharmacy. That the use of dual remedies is "self-defeating" is because the homeopathic teachings to date have hobbled themselves with faulty tenets rather than the truth based on Hahnemann's own writings and insights.]

For these reasons the aphorisms on the single remedy was then strengthen [sic] further in aphorism 273 of the 6th Organon.

"In no case of cure is it necessary to employ more than a SINGLE SIMPLE medicinal substance at one time with a patient. FOR THIS REASON ALONE, it is INADMISSIBLE TO DO SO. It is inconceivable that there could be the slightest doubt about whether it is more in accordance with nature and more reasonable to prescribe only a SINGLE SIMPLE, well know medicinal substance at one time in a disease or a mixture of several different ones. In homoeopathy-the only true and simple, the only natural medical art-it is absolutely prohibited to administer to the patient, AT ONE TIME, two different medicinal substances."

[We have provided a full analysis of the meaning of Aphorism 273 in the light of dual remedy prescribing by Hahnemann elsewhere in this work. The only other place that Hahnemann uses this term is in the context of the initial action. Thus, "at a time" means not within the initial action of another remedy, which is consistent with Hahnemann's practice between 1836 and the final years of his practice in Paris.].

Hahnemann now was so confident in the methods he developed between 1833-1843 that he removed all reference to the double remedy experiments, and strengthen [sic] the aphorisms on the single remedy further.

[Hahnemann's changes to the 5th edition and his rewrite of the 6th edition on the issue of the "single remedy" show, on close analysis within the overall context of the dual nature of disease, that he explicitly linked prescribing to disease and that he allowed for dual remedy prescribing in the form of consideration for the initial action of the first remedy. There is no evidence that Hahnemann removed all reference to dual remedies as alleged by Little. On the contrary, Aphorism 273 fully allows for the giving of dual remedies in terms of simultaneity of action.]

He replaced the critical note about the double remedies with a comment which reminds us that mineral compounds like, Hepar sulph, are single remedies as they are prepared and then proved as one substance.

The four cardinal principles [tenets] of [classical] homoeopathy are the similars cure similars, the single remedy, the minimum dose, and the potentised remedy. These principles [tenets] are the checks and balances that make homoeopathy a safe and effective healing art. Without them the use of similars can be quite dangerous. [Where is the justification for this?] Hahnemann was of the opinion that it was never really necessary to give two remedies at the exact same time once a healer mastered the Homoeopathic Gestalt.

[Little interprets "at a time" as meaning the exact same time. If this is the case, then waiting a nanosecond to give a second remedy would cover any objection. Prescribing becomes only a matter of technical details, not principle. There is no evidence for the supposed cardinal principles of homeopathy here alleged. Indeed, other than the first, they do not appear in the statement of the main pillars of homeopathy produced by the Köthen meeting of 11 August 1833, nor are they supportable in the Organon as shown elsewhere. The final statement is an example of Little imposing on Hahnemann positions that have no basis in fact, an all too common practice in much of the homeopathic literature.]

Hahnemann's experiments with the double remedies were a clinical failure.

[The truth is rather that the results did not lead to many successes, "only one or two" before the political considerations led to Hahnemann continuing his work with dual remedies behind closed doors. The results between May 1833 and October 1833 were simply "insufficient to support the establishment of a new rule," a reasonable enough position in light of the political concerns, but they hardly amount to an admission of clinical failure. As we have seen, Hahnemann continued the dual remedy work, albeit in the form of simultaneity of action, not ingestion.]

He and his colleagues all realized that the 'pseudo-homoeopaths' would abuse the dual remedies, and the allopaths would call it a return to the polypharmacy. For these reasons the passage was removed from the manuscript of the 5th Organon and the aphorism on the single dose strengthened. The Hofrath wrote about the originator of the dual remedies:

"Dr. Aegidi (who introduced the idea), after much reflection, abandoned such anabominable hearsay [sic] which gives the death blow to true homeopathy, and throws it back to blind allopathy"

Dr. Aegidi the creator of the double remedies, wrote in 1865 "I loudly and publicly made known the disapproval of the administration of the so-called double remedies, as an abuse and mischievous procedure."

[Little fails to note the careful reference by Aegidi to "so-called double remedies." This means that Aegidi is being careful to distance himself from the abuse of dual remedies, very much consistent with the reason why the disputed paragraph for the 5th edition was eventually withdrawn by Hahnemann and why Hahnemann continued the dual remedy approach in terms of simultaneity of action rather than simultaneity of ingestion. Little also fails to note that it was Aegidi who made the use of dual remedies known to Lutze in 1853, who then went on to achieve thousands of successes of his own.]

Yes, nature cures with single simple remedies given at the right time. When one has not mastered homoeopathy it seems like everyone needs so many remedies. After one has mastered homoeopathy they all only need 'one'.

[The first statement is consistent with what Hahnemann stated. The last statement is not consistent with what Hahnemann taught. Hahnemann makes clear that in chronic diseases there is a need for a sequence of remedies. Hahnemann moved from the "one remedy fixes all" model to the need for dual remedy prescribing and for a series of remedies over time. The abstract notions of classical homeopathy, derived from the uniformitarian notion of disease (patient = disease) drives them to this fancied notion of the silver bullet with no grounding in reality.]

To use combination medicines is *unnecessary* for a trained Homoeopathician. Aegidi himself realized this as he gained more experience, and returned to the single remedy.

[Aegidi's condemnation was of "so-called double remedies", that is the wrong use of this concept. There is no evidence that he turned to using only one remedy or to even using only a second remedy when the full action of the first had been completed, whichever meaning of the term "single remedy" Little intends here.]

The are those who have not mastered a return [to] polypharmacy with potentized remedies as a short cut. Some of them become the biggest critics of classical homoeopathy only because they did not learn it correctly. One [sic] the other hand, there are some who are working toward mastering classical homoeopathy who use a double remedy or combination on occasions. We would suggest that they experiment with alternations, intercurrents, or series of remedies rather then mixing remedies together. I[n] this way they will grow beyond this stage of practice. If this is done carefully, they will soon see better results then mixtures.

[Given Little's views that the simultaneity of action is acceptable, it would be useful to have his view as to the principle behind the concept promoted here ("experiment with alternations, intercurrents, or series of remedies") and what time frame is also to be respected regarding the giving of two remedies within such overlapping action.]

I will close with the words that Baron von Boenninghausen expressed toward the end of his life about those early days, and the double remedy experiments.

"If consequently in our day, a homoeopathican takes it into his head to act according to experiments made thirty years ago, when our science was still in its infancy, and which were subsequently condemned by a unanimous vote, he clearly walks backwards, like a "crab", and shows that he has neither kept up with, nor followed the progress of our science.

[This letter is highly suspect given that its date is after the death of Boenninghausen. Even if the year ascribed to the letter is wrong (1865), and it is dated a year earlier to March of 1864, this still does not explain how it came to be written two months after his death. Further, this is the final paragraph of the letter and the tone is inconsistent with the record, namely that Boenninghausen continued to use dual remedies even after it was "unanimously condemned" — presumably a reference to the 10 August 1833 meeting in Köthen. Since Hahnemann had resisted withdrawing the paragraph, it is doubtful that the vote was unanimous. The only view that perhaps could be considered to be unanimous was one that worried about the political hay their allopathic enemies would make of it and the abuse it might be put to by some.]

Today we have many "Crustaceans" in healing who claim they are advancing homoeopathy by going straight backwards 170 years! Some cry "Hahnemann, Hahnemann, Hahnemann" and claim they are doing the work that Hahnemann really intended but they are actually polypharmacists They can not master homoeopathy, so they must change it to suit their own self made concepts.

[The record is clear: Hahnemann used dual remedies starting around 1830 and continuing into his Paris period, close, if not right to the very end. There is no record of his having denounced the practice in any of his writings. The only evidence we have is his concern to denounce its possible abuse by those less knowledgeable, a reasonable concern. If the record is being changed, it is by those who deny this fact.]

They must use combination remedies because they do not have the experience to see the single remedy in every case. Such a short cut completely stunts their growth, and makes it impossible for them to become real homoeopaths. Some have now decided to not only "walk backwards", but now they wish to rewrite the history of homoeopathy in their own image. The true homoeopathic community will not let this disinformation stand unchallenged by documented material based on eyewitness accounts, personal letters, Hahnemann's casebooks, and his writings.

[Yes, let the record stand based on ALL the evidence, not just parts of it!]

Summation of the double remedy experiments.

1. As Hahnemann pointed out that the dual remedies *DID NOT WORK VERY WELL* He found the double remedy experiments a failure! [rather simply a puzzle yet to be solved] He said out of his many attempts, "IT ONLY SEEMED TO WORK IN *1 OR 2 CASES.*" The Founders left the dual remedies behind because they did not work as well as the single remedy in their hands. As the materia medica expanded they found that it became easier to find a remedy that matched the complete symptoms. In those rare cases where two remedies seemed needed, they found that alternations and intercurrents worked better then combinations. [verbal legerdemain]

2. Secondly, the Founders knew the pseudo-homeopaths and allopaths would misuse his comments in the text and say Hahnemann approved of polypharmacy. Today there are teachers who are spreading this misinformation throughout the healing community. The single remedy is one of the four cardinal principles [tenets] of [classical] Homeopathy. Some are using the term, polypharmacy, to describe Hahnemann use of alterations and intercurrents but this is also incorrect. In most cases one find that these 'scholars' use combination remedies and have an agenda. Today's pseudo-homoeopaths are now trying to resurrected the double remedy experiments as a means to support their own combination practice. Their material is agenda driven as they wish to use Hahnemann good name as a cover for their own new methods. Such Hubris Knows No Bounds.

The dual remedy experiment was a clinical failure and a political liability, so they were discontinued and the paragraph m removed and replaced cautions about their hazards [??] in manuscript of the 5th Organon (1833). Some others are confusing the method of alternation with the double remedies and saying that Hahnemann did not publish the method of alternation because of political reasons. This is untrue as the information was published in Hahnemann's Chronic Diseases (1828) and the 5th Organon (1833). For a historical review with documentation please refer to the companion document, Hahnemann on Alternations and Intercurrents. It is for serious historians and practitioners to set the historical record straight.

[The arguments used above have been responded to in the main body of the paper. To the extent that the call is made for the historical record, it is instructive to compare the evidence presented to date by Little and ourselves — see comparative table. If the historical record is to be set straight as Little calls for, then it must be done on the basis of all the evidence available, not fanciful interpretations based on prejudice.]


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