Homeopathy Papers

Using More Than One Remedy In A Case: What Would Hahnemann Say?

Hahnemann at writing desk
Written by Elaine Lewis

Alan Schmukler has a discussion with Elaine Lewis about using more than one remedy in a case.

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


After the Aconite, Conan’s fear seemed to subside somewhat and he began to complain more of pain, both the burning abrasions and general bruised-up sensation. Even though it was just minutes after he’d taken Aconite, I gave him a dose of Arnica. …
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!

About the author

Elaine Lewis

Elaine Lewis, D.Hom., C.Hom.
Elaine is a passionate homeopath, helping people offline as well as online. Contact her at [email protected]
Elaine is a graduate of Robin Murphy's Hahnemann Academy of North America and author of many articles on homeopathy including her monthly feature in the Hpathy ezine, "The Quiz". Visit her website at:
https://elainelewis.hpathy.com/ and TheSilhouettes.org


  • hello, i read your article fully and i flt nicely. and i got yhe use of combined med, where to use, how to use.it was rally a prompt article to disclose some secrets about how to use our(homoeopathic) drugs in combination.thank you ,,,,,,,,,

  • Thank you. It’s actually in the Organon, aph. 40; so, it apparently is part of Classical Homeopathy.

  • Dear Doctor,

    I just read your article on using more than one remedy in a case. I am a practicing homeopath and I have been using the same method as you have described right from the beginning of my practice with amazing results and I am so happy to read that you also agree on this.

    I want to consult you for a case of one of my patient who is suffering from Diabetes who is not responding to Homeopathic remedies.

    Can I consult you ? Please confirm.

    Thanks & Regards

  • this article made me think, if u take CM potency of Arsenica
    AL- which is supposed to relax the patient WILL IT WIPE OUT ALL THE MEDS THEY TOOK BEFORE TAKING ARSENICA AL.

  • the word classical in homeopathy refers different connotations.But in my mind there is always a word “cure”ringing that this is more important than being classical,miasmatic,constitutional,pathological and so on.Cure the patient is our prime and main aim and be it by any means through homeopathy remedies constitutes one cure and and if Hanahneeman were to be there we could imagine what changes would have been brought about.I visualize that the old school remedies would have gone to the oblivion and entire world would have seen only homeopathy as the quickest palliation,relief and cure and top most of the crust is the drainage of thousands of millions of dollars towards medical expenses would have been cut to mere thousands yet with great recovery and solace to the not only human race but to the entire being in this world.I hope this would come true in my life time itself.Hare Krishna


  • First of all, as it says at the bottom of all my articles, I take online cases; all you have to do is send me an email at [email protected]

    Secondly, regarding the question from Dorothy (If you give Ars. CM which is supposed to relax the patient, will it wipe out all the remedies given before it?) I have to say that there are a lot of assumptions here. Arsenicum won’t relax anyone who isn’t in an arsenicum state, which is: fear of death, anxiety, restlessness, thirst and in desperate need of company and reassurance. If you’re in this state, you need Arsenicum and any other remedies you’ve taken in the past would seem irrelevant at this point. Arsenicum would work on the present state and cancel IT, not something unrelated to it.

    However, I would first have to ask why we were giving such a high potency without having even tried Ars. 200C or 1M which would probably work just as well with less chance of aggravation.

    Secondly, I would wonder why it is that you’re only concerned with Arsenicum’s ability to cancel out remedies as if only Arsenicum can do this? Generally, if you’re in a clear state, you need the remedy for that state. If you drop something heavy on your toe and you need Hypericum, you’re not going to worry that if you take it, it could cancel out the Ruta you took for your knee when you fell on it. If you should happen to notice that after your toe got better your knee began to hurt, you would simply repeat the Ruta.

  • Use of more than one remedy ………is the most truthful and practical way of treatment…and very effective too. I too have seen many serious cases getting benefit this way.

    Though i must add it all depends on type of case….there are cases where single remedy is enough…than there are cases where one will have to use more than one remedy.

    Clinical observation is most authentic verification of truth.

    I congratulate Elaine for presenting the topic in practical way, and interesting way.

    Homoeopathy has cured not ONCE Renal failure or any other serious disorders….it has done it often…………if the practitioner become more truthful in their CLINICAL OBSERVATIONS….and do away with prejudices…it will increase the scope of homeopathy …and win the trust….by showing the result …..which it does in the hands of skilful practitioners.

  • it is exactly the same way i have been treating the patients.
    this article is really giving mental support to the doctors who are treating patients in this method because we are often commented and critisized by the impractical and biased classical homeopaths.
    it is impossible to prescribe constitutional drug in all patients since they suffer by more diseases at a time and never give uncommon symptoms.
    however i thank you for giving this article and ask you for more.

  • Dear Dr. Kumar,

    I think people must finally realize that this IS classical homeopathy. It’s described in the Organon as Complex Disease–dissimilar diseases existing side by side; and Hahnemann says remedies have to be alternated. Again, we are not talking here about a virus with many symptoms, a migraine headache with many symptoms, etc. I just hope people are able to discern the difference.

  • Thanks Elaine for those words of wisdom. Treat what you see, has always been the way I,ve worked, and with so many maintaing causes around at the moment, one remedy and wait doesn,t always do the job.

  • Wonderful enlightening discussion about single use remedies, acute situations, rapidly changing remedy picture and course of action and controversial combination remedy use.

    I’m studying the Organon with homeopath Vera Resnick and invite listeners to tune in to the radio show “Who’s Reading the Organon.” We recently talked about single versus mixed remedy in a light hearted discussion. We do not claim to be “the experts,” just two people reading Hahnemann’s words and trying making sense of it all. We welcome comments.


  • Debby, thanks for contributing to the discussion. I don’t believe I mentioned combination remedies. Heaven knows there are combination remedies out there in the market place! I am not talking about those. I am only talking about the situations where giving the constitutional remedy is inappropriate in the case. I have a client right now who has diabetes, kidney failure, a bladder infection, side effects from prednisone, insomnia, pains in the legs, tendency to hemorrhage under the skin, over-active digestive system …. Yes, I repertorized all the symptoms in the case including the mentals and came up with a remedy. But I am not confident! This is NOT a constitutional case! But you have to start somewhere with something and see how much mileage you get out of that and see what you’re left with.

    The DRUGS! Oh, the drugs! The antibiotics alone! How much of the case are they responsibie for??? How much of the case is the prednisone responsible for? Am I going to need a separate remedy for the bladder infection? Am I going to have to give Apis or Ser-a. for the kidney disease? Does anybody seriously think that this patient’s constitutional remedy is going to affect this whole case? This is what I’m talking about.

  • Constitutional remedy…..In terms of Hahnemann …Constitutional remedy is different, than the constitutional remedy..of modern times.

    Dr Hahnemann ….used to prescribe on characteristic totality of symptoms…

    and searched for miasma indications.

  • Dear Elaine,
    Thanks for making me feel better! Having learned only constitutional prescribing for chronic cases I found that it was not always possible to prescribe only 1 remedy to cover all the conditions. What I am wondering about is what books have clinical homeopathic remedy information? Do you know of any sources?

  • Marilyn, I think you’ve just expressed the feelings of a lot of homeopaths in what you’ve said! Many feel obligated to find the constitutional remedy in cases like these, but they know that something doesn’t feel right! They might wonder, “What does the constitutional remedy have to do with a broken rib, or with convulsions after vaccination; or these and-stage cases where the patient seems to have a dozen things wrong all at once, or the cases which seem to consist mostly of the side-effects of drugs?” Then you have to also ask, “How much of this case has to do with life-style: junk food, no vegetables, no fruit, nothing but cooked food and dessert items, too much coffee drinking, alcohol, recreational drug use, cooking in aluminum pots, sleeping under electric blankets…?” The homeopath really has to be a detective on top of everything else!

    Marilyn, your question is so important, it’s probably worthy of another article; so, I should probably get to work on that. But suffice it to say for now, since you asked for the name of a book, Roger Morrison has written a book you might want to buy called, Desktop Companion to Physical Pathology; and, Jonathan Breslow has written a book showing how to take an acute case, which is called, Homeopathic Medicine in the Home, which is currently on sale at http://www.minimum.com for $27.00, usual price is $35.

  • Another great article from Elaine! I love the way Elaine writes. Clear, to the point and always in a way I can understand. I wish there were more articles such as this in the E-zine and less “technical” ones. These are what the majority of us read and learn from. Way to go Elaine and keep it up!

  • This article was very informative, this show that still there’s a lot to discover, we are just seeing the tip of iceburg

  • Thanks Kelly! Next time, see if you can work in concepts like gallantry, discernment, sophistication…you know, the other crap I’m known for. Oh, and, shouldn’t you be at a soccer game?

  • Dr Hahnemann no where had said only single remedy single dose need be given, he had advocated while proving –to use single drug,
    During second prescription we do give,if need be complimentary drug, follow up, antidote, or change the potency or give placebo.
    Lot need to thought of unprejudice and prejudice observation, if a physcian is prejudice he may prescribe multiple medicine justifying his prescription,
    We have yet to put our heads together to know more about the action of various potencies.

  • Good, informative article, but….
    In allopathy, the pharmaceutical mafia develops a drug and everyone is brainwashed of it’s magical “cure”. They buy into it – this is power in numbers. BUT in homeopathy, everyone has a different opinion causing division and a dissolving effect (excuse the pun!). This causes confusion among homeopaths and the public, which is not good if we want to make homeopathy a household name. Homeopaths need to collaborate and join forces in order to spread the power of this amazing healing art – one voice. There is just ONE homeopathy, just like there is only ONE allopathy. They stick together while we bicker.
    Having said that, still a great article, open discussion is needed to work towards a common goal. Regards.

  • Dear Gunther,

    We bicker because we haven’t read the Organon. Some read it perfunctorily without digesting it. For example, why didn’t Kent know about water potencies? It was in the 5th edition of the Organon which he had access to! A lot of the disagreements among homeopaths stem from those who follow the Organon and those who follow Kent. Kent introduced this one-dose-high and wait concept, which everyone follows, but it is not Hahnemannian. Getting people to see what Hahnemann taught has been a crusade for many of us.

  • Thank you, thank you, thank you, Elaine. In my practice I have made believers out of many skeptics by using a combination remedy I put together for trauma. There is nothing quite like the feedback you get when someone slams their finger in a door, takes the combination remedy and the pain and swelling goes away, the nail doesn’t fall off, and the feeling comes back quickly. Or someone is going to the dentist full of fear and anticipation, always reactive to the needles and always ending up with nerve and ligament pain…they take the remedy before and after the appt. with none of the above happening. They become believers in homeopathy and the next time they have a problem they wonder what else is possible with our medicines. It is sad to have to convince people, but the more who are convinced, the greater the preservation of our profession in the bigger scheme of things. Part of the beauty of homeopathy is that there are many ways to practice and any one of those ways may be helpful at any given time. I find my method of looking at a case may vary with the individual and what is going on, just as you have described. Thank you again for the validation!

  • Though I am late on reading this Ezine issue, this article by Elaine, as usual, is so informative. Thank you for sharing this and may God bless and continue using you as his servant in Homeopathy.

  • Excellent article. Would like to add similar comments by Dr. J. Ellis Barker:

    “There was a celebrated homoeopathic doctor, a strict Hahnemannian, who was opposed to giving disease products because they were in his opinion opposed to the principle that ” like cures like”. He proclaimed that nosodes should not be given because the prescriber would not practise Homoeopathy, but
    Isopathy. He wrote a number of books in which he described cases where unfortunate tuberculous patients were never given Tuberculinum or Bacillinum which they ought to have had. These might have been cured if the prescriber had condescended to give Bacillinum. But such an action was in his opinion irreconcilable with the teaching of Hahnemann, and to please the spirit of the deceased founder of Homoeopathy the unfortunate patients had to die.

    I take it that the first duty of a doctor or lay prescriber is to cure his patient, not to please the spirit
    of a great genius, who has been dead for more than a hundred years. The patient pays his doctor in order to be cured, not in order to be experimented upon by allopaths or homoeopaths.”

  • People say they’re against isopathy but how many of us have given Apis for bee stings? And I just heard a conference case where Medusa (potentized jelly fish) was given for multiple jelly fish stings. So, I don’t know….

  • Elaine, I am right there with you. Cases today are very complex so it is only common sense that more than one remedy is often needed to address the states that come up or co-exist. Thanks for writing a really informative article on this subject.

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