A Conversation with Elaine Lewis
Alan: Elaine, do you think all cases can be handled with a single remedy covering all the symptoms?
Elaine: Well, Alan, there are so many different kinds of cases! Andre Saine has a somewhat famous case he tells over and over again. It’s about a patient of his with renal failure. She needed many remedies, he wrote numerous prescriptions for her over the years. Finally one night he was called to her bedside by the husband. The husband says, “She’s really had it this time, Andre, she’s gone.” There she lay in a uremic coma.
Andre gave her Opium CM. Her eyes opened. Andre said, “Do you need air?” She nodded. He gave her immediately Carbo veg. The Carbo veg. Rx immediately led to something else, perhaps chest pain, for which he may have given Naja. Next came nausea, for which another Rx was made, probably Ipecac. What you see here is the unwinding of the case, going back the way it came as per Hering’s Law! It ends in, guess what? Apis, of course, our famous kidney failure remedy! And the renal failure is over and done with and the patient lives! In telling this story, Andre was trying to show that the case was going to go backwards in time, real fast! And that you had to be there, ready, with the next remedy, in seconds! If you were thinking that all you had to do is just show up and give Opium and leave, you would be wrong!
Now, some people actually believe that you’re supposed to give the constitutional remedy to this lady! Of what point or value would that be? But these cases appear before us and what are we going to do? Ask these patients if they like ice cream? If they’re better at the sea or worse for cold damp weather? Should we ask them, “If you were an animal, which one would want to be?”
Most of our patients have something wrong with them! Maybe two or three things wrong! Healing takes place in reverse order. Where does the constitutional remedy come in? At the end! After everything else has been cleared away.
Alan: You’re not talking about combining remedies, correct?
Elaine: Andre wasn’t combining remedies. He saw a state and would prescribe on it. His point was, once you start treating these end-stage cases, they are going to unwind with rapidity and you are going to have to be there every step of the way, ready to treat the next presentation that comes up!
We have to recognize that people in middle age and older are going to come to us with all the disorders associated with poor eating habits, saddled with Rx drug side effects, perhaps years of drinking alcohol, smoking cigarettes, kidney failure from diabetes, digestive complaints, sleep disorders from a lifetime of sleeping pills, etc. What did Hahnemann call this? Complex disease, meaning many diseases existing alongside each other. Drugs and junk food are mostly to blame. You’ve got multiple etiologies.
Unfortunately, in homeopathy today, the emphasis is on finding the “simillimum”, whatever that means in a case like this. There’s nothing wrong with constitutional prescribing when it’s appropriate but I think popular homeopathy is leaning so far towards one side that many homeopaths actually don’t know what to do with patients who have pathologies! They will either mistakenly give them their “constitutional” remedy, or will pass on them altogether!
I recently left an end-stage patient with roughly five or six remedy bottles. I said, “This is for your kidney failure, this is for your liver cancer, this is to antidote the side effects of morphine, this is for the edema in your arm and hand due to kidney failure, this is for the cancer pain, and this one’s for heartburn. Don’t take them all at once, spread them out.” I also gave him vitamin C and acidophilus and told him to eat raw fruits and vegetables, no junk food, and to drink carrot juice. (I seriously don’t think he complied with too much of that advice!) A week later he was remarkably improved. All the edema had gone out of his arm and hand, urination had increased from once a day to four times a day.
I think we’re neglecting the treatment of these types, leaving them to allopaths and certain death while we treat only “healthy” people, matching remedies to their personalities.
Alan: And you’re not suggesting all cases be handled this way.
Elaine: Wouldn’t it be nice if people came to us before they were dying!?
Alan: So, even while adhering to classical homeopathy, we should understand that certain remedies have affinities to certain organs and certain systems?
Elaine: Yes, I do believe we have so-called “disease” polychrests that we rarely, if ever, use as constitutional remedies; remedies like Hydrastis, Conium, Kali bich., Phytolacca, Asterias rubens, Secale and so on; so, I do believe there is a kind of homeopathy for illness which is not about taking a constitutional case, per se.
In some cases, the “essense” remedy will not cure and is inappropriate, as the essence is not the top layer, and healing takes place in reverse order, remember from Hering’s Law? The disease must be treated first. In the case of a person having many diseases at the same time, you may have to ask, “What is the worst thing for you right now?” Or you might have to determine what the worst thing is for yourself.
On the other hand, you may see a clear mental/emotional picture which is part of the pathology! Arsenicum is such a prime example of this, as its mentals are so often seen in end-of-life cases, just as the Pulsatilla mentals are so often seen as concomitants in childhood disease–the clinginess, the crying, the “better for consolation”–making it a prime contender in almost all childhood diseases; similarly, the neediness of the dying patient, the fear of death, the anxiety, the restlessness, the suspicious nature, make Arsenicum a prime contender in end-of-life situations, regardless of what the disease is; so, in that sense, is Arsenicum the “constitutional” remedy at that point in time? Maybe it is! Perhaps we have to rethink what we mean by “constitutional”.
Alan: What does Hahnemann say about treating multiple diseases in the same patient?
Elaine: I’m so glad you asked! In Aphorism 40 of The Organon, Hahnemann talks about “Complex Disease”. He says it is possible for two or more dissimilar diseases to co-exist in the same body and that one remedy won’t cure all of them; remedies for each disease have to be alternated, which is pretty much what I’ve been alluding to here.
There is debate over the use of two remedies in the same patient. Some people say that Hahnemann would never do this. Well, he did! But please don’t confuse “Complex Disease” with your average acute case with many symptoms! A flu which has nausea, vomiting, sore throat, prostration, headache, muscle aches, runny nose with anxiety, restlessness and fear of death isn’t a “Complex Disease”! You don’t give a remedy for the diarrhea, another remedy for the vomiting, another one for the sore throat…. no! This is an Arsenicum flu! One remedy will clear this whole case. There is one diagnosis: flu. One thing. Most patients have many things, many diseases at once.
If a patient comes to you with kidney failure, rheumatoid arthritis, side effects of pain killers among other things–your average case in the USA, basically–then you would most likely have to alternate a kidney failure remedy with an arthritis pain remedy and something to deal with the side effects of Prednisone, etc. and then there’s their diet, which is probably the chief cause of everything that’s wrong with them…..
And the question then is, what do we do, take a constitutional case? I think that that’s what most people think is proper because of this “belief” that Hahnemann is known to have proclaimed that you have to give the single remedy! But we can see in The Organon that this is not ALL that Hahnemann said. Read Aphorism 40.
Here is an excerpt from an article called “Boys Will Be Boys” by Dr. Tim Dooley from Homeopathy Today (April 2003) which I think exemplifies what we’ve been talking about. The author’s son was in a roller skating accident. He had a new pair of skates, and most of his journey into town was all downhill and he didn’t know how to stop!
Boys Will Be Boys
I gave him a dose of 200C pellets because that’s what was in my first-aid kit. I would not have hesitated to give any available potency. I repeated the Arnica every few minutes in the early stages, and then decreased the dose to every few hours as things stabilized. I also repeated the Aconite a couple of times over the next 20 minutes or so until he was calm and reassured.
The point is that in first aid it is perfectly acceptable to repeat remedies frequently and to change remedies freely, as indicated. I mention this because in treating patients with chronic illness, we are more cautious about repeating and changing remedies – and many people are unaware that the rules differ with injured patients.
So! The rules differ with injured patients! In many ways, our patients with multiple diseases and end-stage pathologies are just like injured patients, they’re hurtling from one outbreak of discomfort to the next! And herein lies the conundrum in homeopathy–do I treat the pathology or find out the person’s constitutional remedy? One thing you can do is ask yourself, “This patient’s complaints–where did they spring from? Are these constitutional complaints? Or are they diseases, viruses, bacterial infections, injuries, drug side-effects….?” Whatever the case, you may find a “personality” that goes with it! Think of the Chamomilla patient who’s inconsolable and angry with his pain. Or the Arnica patient saying, “Oh, I’m fine, really, nothing wrong with me!” These people have just told you what their “current” constitution is! Think no further, the case is solved! But what if there are no mentals in the case? Then, as I said before, find out what the worst thing is–it’s usually the most recent thing. What’s the pathology? What’s most striking? Do you see a keynote of a remedy? This information will be more valuable to you than whatever his “constitutional” remedy might have been when he was well.
Alan: So you’re saying that the rules for treating injuries may apply in other kinds of cases.
Elaine: Yes. Should Andre Saine’s patient, who was in a uremic coma and barely breathing, have been given Phosphorus? Because that turned out to be her constitutional remedy! Should that have been given to her when she was in an Opium state?
Now we are again at the place in the conversation where we ask, When is it proper to give the constitutional remedy? I think we may need to redefine “constitutional remedy”. Very often, an illness comes with mentals, and those are the ones we need to be paying attention to. Treat what you see in front of you, is the best advice. You may find a very sick person to be Nux vomica or Arsenicum, because these remedies tend to go with toxicity: Irritable, unpleasant, angry or scared.
The original question was, can you use more than one remedy in a case, and, what would Hahnemann say? Would we be muddying the concept of classical homeopathy, setting a bad example and creating confusion? It appears that Hahnemann was very much familiar with the kinds of cases that we’re talking about, which he called “Complex Disease”. He said that remedies in such circumstances would have to be alternated. Hence, I think we ARE being classical.
Should you give Phosphorus, the constitutional remedy, to a comatose patient who is displaying a keynote of Opium – the puffing of the lips during respiration? Which remedy is homeopathic to the case at that point in time? It’s not Phosphorus.
Alan: Thanks Elaine, we’ll see you in The Quiz section, as always!
Elaine: Let me hurry and get down there then!
Alan: But wait, can I ask one more thing? What about combination remedies, numerous remedies in one “pill”?
Elaine: Alan, I haven’t needed them, except for a few times. All the instances were acutes and it was before I became a homeopath. The first time was in 1980, I had a concussion, and I started taking Bioplasma every 15 minutes, and it worked like a charm! Why? Bioplasma contains Nat-sulph. which is our main “ailments from head injury” remedy! What can we learn from this? That the body ignores all the remedies in the combination that it doesn’t need? Maybe. I don’t know.
The second time I was on a plane, I got sick from eating the plane food, and luckily I had a homeopathic “Indigestion” bottle with me. It worked slowly, but it worked!
Finally, on my honeymoon, I got diarrhea from the hotel water. I had a homeopathic “Diarrhea” remedy with me, and that worked too — again, slowly. Maybe because these combinations tend to be in the 6X potency when what is really needed is a 30 or 200C.
But I can only say that there is a place for these combinations especially when you’re selling to the public. Whether this is the way to treat chronic disease or whether they have any place outside of emergency situations like I’ve described, I don’t know. I do know this, there’s no excuse for homeopaths to be using them. It would be absurd if we didn’t know the difference between Rhus tox and Bryonia, between Pulsatilla and Phosphorus…why would we do that? Don’t we know a Phosphorus case when we see it?
Alan: Thanks again, Elaine!