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Polypharmacy and the simillimum

 Julian Winston
In "Letters to the Editor", March 2000, Richard T. Clément, MD, ends his letter by saying, "Long live innovation and polypharmacy! For homeopathy to blossom requires homeopaths to follow the path of Hahnemann, then improve upon his work."

I cannot let the slogan "long live polypharmacy" be printed in these pages without a rejoinder.

Homeopathy is a system of therapeutics that was developed by Hahnemann. He coined the word "homeopathy" based on the two Greek words for "similar" and "suffering."

The system has to do with developing the knowledge of the medicines to give to an ill person based upon the knowledge of the symptoms the remedies can produce when tested on healthy people.

Along the way, he codified the system in a book, The Organon. Within the book is the statement, found in paragraph 273: "In no case of cure is it necessary to employ more than a single simple medicinal substance at one time with a patient."

This guideline has been found to be workable by homeopaths for the last 200 years.

To have a truly scientific art, one needs to clearly understand the interaction between the patient and the remedy. When more than a single substance is given at the same time it is impossible to know, from the reaction of the patient, which of the substances caused the observed changes.

The use of polypharmacy is contrary to the ideals that Hahnemann set forth.

To refer to Hahnemann's work as "dogma," as the letter writer does, is common among those who have decided to step outside of the guidelines that Hahnemann suggested, and then refer to all those who work within the framework suggested by Hahnemann as "dogmatic."

When one decides to make that step away from the basic precepts set down by Hahnemann, the practice that results can no longer be called homeopathy. Yes, it might use medicines that are prepared by serial dilution and succussion—in a manner used by homeopathic pharmacies, and it might administer those medicines in a dosage that is ultra-molecular. But doing so does not constitute homeopathy—which is the giving of the remedy similar to that of the disease.

There is nothing said in the letter about how one arrives at the polypharmacy prescription. Is the prescription based on clinical diagnoses? If so, it cannot be homeopathy, because homeopathic prescriptions are based on individualized symptoms. The author infers that conditions such as septicemia and myocardial infarction cannot be treated with the "simillimum." I have known of patients with the clinical diagnoses of "septicemia" or "myocardial infarction" who were given the simillimum—the remedy that was indicated by the symptoms they were presenting—and have done very well. How else do you use homeopathy except by using the simillimum?

To think that a patient needs to know if they are a "Pulsatilla" or an "Arsenicum" tells me more about the letter writer's preconception of what homeopathy is than it tells me about the need to use polypharmacy.

Polypharmacy—the giving of more than one medicine at the same time—was spoken against by Hahnemann and by every follower of Hahnemann since.

In reference to the patient who came after a failed visit to a "single remedy" homeopath … I too have heard of cases like that. Hahnemann discusses them in his work, and comments that the failure is often in the perception of the practitioner. I am familiar with a case of a man with psoriasis who was seen by three or four very well-known homeopaths. The condition persisted for over 20 years. It was the visit to the fifth homeopath that resulted in a clear understanding of the case and a prescription that cleared the condition.

I am sure that many of those that use polypharmacy see the failures from poor single remedy prescribers. I am also sure that many single remedy prescribers see the failures of those who have used polypharmacy. We generally know each other through our failures.

We owe it to the legacy of Hahnemann to explore the boundaries of his system. His system allowed for many variations. There are many prescribing strategies that would all fall under his ken, and there are equally as many posology strategies. But on one thing he was very clear: no polypharmacy—that is, not more than a single remedy at one time.

Polypharmacy is polypharmacy—not homeopathy.

About the author:

Julian Winston has been Editor of Homeopathy Today since 1984. He is currently a Board Member Emeritus of the NCH, having been on the NCH Board since 1982. He is the past-Dean of the NCH Summer School(1988--1992), as well as author of The Faces of Homeopathy (the book and the video) a homeopathic bibliography, The Heritage of Homeopathic Literature, and two instruction books concerning pedal steel guitar. He moved to New Zealand in 1995 where he lives with his 2000+ volume homeopathic library and co-directs the Wellington College of Homœopathy with his wife, Gwyneth Evans. He can be reached at