Dienstag, 20. Dezember 2011

Re: [H] Susan's question [was: Combos vs. Singles

Shannon,


> As to why it shouldn't (strictly speaking, per Hahnemann) be
> considered homeopathic, is simply that he specified giving *one remedy
> at a time*. From the historical record, it appears that he made that
> choice somewhat arbitrarily--not because one *can't* use remedies in
> combination -- quite obviously, one can -- but because there are some
> disadvantages, and he felt that keeping simplicity was both
> advantageous, and sufficient.
>

Yes, one *can* use any number of medicines at once. One can't do so and be
practising *homoeopathically*, as you've acknowledged. Hahnemann did not *
choose* that, and it's disingenuous of you to state that he did. (Where do
you dredge up such garbage?) Rather, because without knowing the effects
of the medicine, you can't prescribe it on the basis of similarity to the
entirety of the patient's state, so no other option was available to him.
No other option is likely to become available in the near future or ever,
either, for reasons that have been explained to you countless times in
pervious iterations of discussions attempting to educate you in this
matter. (I hear that you led Julian Winston to tear his hair out by
pursuing exactly this same course of self-contradictory blather about
"combos" when he was alive! Does it not concern you that you have learnt
nothing in all the years since despite all the crazes and fads that enthuse
you?)

One reason he gave was the vastly increased complexity of prescribing
> remedies in tandem; this wasn't with reference to "combinations" as
> we've been talking about them; it was with reference to what... I
> forget who the contemporary was that had discussed it with him...
> whoever, referred to as "dual remedies" -- remedies chosen to be given
> at the same time, complementing each others' effects. (Having been
> proven only singly, not in tandem.)
>

This does shed some light on the origins of the persistent confusions here.
Complementarity of remedies is something that refers to one medicine's
effect in continuing and completing the work of another. This means
actually waiting till the first one has had the chance to exhaust its
secondary (curative) effect, not waiting merely till the primary effect has
passed, and not waiting merely long enough to open a second bottle.

Hahnemann was *not* opposed in any sense to prescribing a different
medicine the second time around. Let's be clear about that. He was
explicitly opposed to doing so without checking the altered state of the
patient's derangement -- something inherently impossible, of course, when
the second medicine does not even wait five minutes for the first to act.
But his most vehement opposition was reserved for the practice of
prescribing medicines with no known relation to the patient's entire
derangement -- a practice he named allopathy -- and prescribing again
without learning from the consequences of the first mistake. (If that
sounds as if it describes the practice too of the "homoeopathic" polypaths
you're so keen to "understand", it's because it does.)

Mixing two or more known medicines does not give you a known medicinal
agent; it gives you an unknown one. That was the chief basis of
Hahnemann's objection to polypharmacy of all stripe, under any name, of any
philosophical origin.

Secondarily, of course, comes the minor objection of the difficulty of
attempting to understand what the heck happened after the prescription -- a
task of such subtlety, even after a legitimate prescription, that it
comprises the chief obstacle that most contributors on this list encounter
once they have prescribed homoeopathically.

The difficulty of ascertaining and understanding what has occurred in
response to the effects of *two* medicines -- even two with no chemical or
dynamic effect on each other -- is of such difficulty that nobody has ever
claimed to be able to do it.

Yet you suggest complicating the matter further still, with your
"understanding" (!) that medicines combined in potentised form and
administered together -- thus altering each other dynamically and producing
synergistic and antergistic effects ad hoc without foresight, perception,
or comprehension of the fact by the practitioner -- will self-eliminate and
that it is possible to rationally interpret that the consequent
disappearance of the symptom under attack is a curative response.

The problem in making these double leaps of faith is *not only* that they
remain unfalsifiable and therefore pose illegitimate modes of
experimentation; it is *also* that *the experiment occurs at the patient's
expense, without the patient's informed consent, and **very possibly** if
not certainly to the patient's detriment*.

Other reasons were more "political": he feared (and I would think
> probably quite rightly) that part of what distinguished the practice
> of homeopathy from the practice of the "mainstream medicine" of his
> day (applies also to ours), was the principle of *single* remedy,
> chosen to have a deep, subtle and specific effect of causing "the
> whole" to rebalance -- really amazingly elegant, isn't it! I think
>

Actually, that sounds exactly like biomedicine, and not like homoeopathy at
all. It even describes quite well the prescription of penicillin for ear
discharge that you called homoeopathic but that was not. Is that because
you forgot *again* what homoeopathy is while you were writing that
sentence? Homoeopathy is not a practice that aims to have any
*specific*effect, and it certainly doesn't aim to cause the whole to
rebalance.

But if by this you meant what I hope you meant -- that the intent in
choosing the most homoeopathic (i.e. *symptomatically* similar) medicine is
to dynamically annihilate the entirety of the natural derangement to which
it is similar -- then it's an important concept to remember when
considering the basis for combination prescriptions, which never (because
they cannot) take into account the entire derangement.

the power and beauty of that approach (when it is working well) is
> really something quite special. Maybe that could be replicated with
>
skillfully chosen combinations, but Hahmenann made the choice to
>

In relation to the proposal that homoeopathy *could* include or *could
have*included polypharmacy, please see above.


> bypass that field of complexity, stating that the approach he was
> outlining -- using *single* remedies, and changing the remedy only if
> and as required by the change of symptom picture -- was sufficient,
> and therefore preferrable to the (far less tested, generally unknown,
> and still very uncertain and, he felt, ultimately more difficult) path
> of complexes.
>

Do you know better? Was he wrong about that? And did you happen to
overlook again the *chief* obstacle (hint: read above) to using more than
one single, simple medicine in a prescription made homoeopathically?

Sooooo.......... That's why it is not strictly homeopathy -- because
> of the definition Hahnemann gave.
>

To be clear, then: the necessity for polypharmacy's exclusion from
homoeopathy was a matter of neither politics nor practicality nor
simplicity; it was not a *rule* arising from *reasons*. It was, and
remains, the consequence of definition: the consequence of the
unknowability of the deranging effects of a medicinal mixture on the
healthy, which homoeopathic practice necessarily requires.

Will it work as billed? I have no idea! Seems plausible to me that
>

You said it.


> it *could*, but I would think that individualizing with single
> remedies would still be preferable *if* it is an available option. Do
>

And when is it not an option, Shannon? When is it not possible to take the
patient's case? What amazing circumstances could conspire to give you a
moment in which to learn that the patient is threatened with a terminal
wart but no opportunity to learn more?

Could it be the kids? The television? Perhaps you've encountered a wart
doubling in size every 15 seconds and realised that there are times when
there's *no other option* but to prescribe on the basis of that symptom and
hit it with the combined cannon at your disposal?

John

--


"And if care became the ethical basis of citizenship? Our parliaments,
guided by such ideas, would be very different places."


—Paul Ginsborg, *Democracy: Crisis and Renewal*, London: Profile, 2008.
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