Aegidi’s Famous Letter on Dual Remedies: 1833
The above analysis is the complex setting for the momentous receipt by Hahnemann in the Spring of 1833 of a letter from one of his followers, Dr. Julius Aegidi, regarding the use of dual remedies in mixture (aqueous solution).
Aegidi was an Italian doctor converted to homeopathy through Hahnemann�s cure of his psoric disease in 1823. Aegidi subsequently became an enthusiastic convert to homeopathy and a confidant of Hahnemann, perhaps the closest, next to Boenninghausen, in the intimacy of letters exchanged and the personal relationship developed with the founder of homeopathy. At the time of the letter on dual remedies, Dr. Aegidi was working in D�sseldorf, Germany due to Hahnemann�s personal interventions with some of the aristocracy in that city.
Dr. Aegidi wrote to Hahnemann on 15 May 1833 reporting on 233 cured cases by the use of two highly potentized substances at the same time, each from a different side.
Hahnemann replied in a letter a month later, 15 June 1833, no doubt having carefully considered it and the cases, that he welcomed the approach and considered it entirely consistent with his previous teachings.
Dear Friend and Colleague, Do not think that I am capable of rejecting any good thing from mere prejudice, or because it might cause alterations 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 medicinal substances (in smallest dose, or by olfaction) should be given together only in a case where both seem Homoeopathically suitable, but each from a different side.� Under such circumstances the procedure is so consonant with the requirements of our art that nothing can be urged against it; on the contrary, homoeopathy must be congratulated on your discovery. I myself will take the first opportunity of putting it into practice, and I have no doubt concerning the good result. I am glad that von Bönninghausen is entirely of our opinion and acts accordingly. 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. Permit me then to give your discovery to the world in the fifth edition of the �Organon,� which will soon be published. 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.” (Haehl, Vol. II, p. 85) (emphasis added)
Hahnemann then wrote to his friend Boenninghausen, who had already been doing similar work with dual remedies in mixtures, two days later, on 17 June 1833, stating that:
I too have made a beginning with smelling two suitably combined remedies, and hope to have some good results. I have also dedicated a special paragraph in the fifth edition of the �Organon,� to this method, and in this way introduced it to the world. (Haehl, Vol. II, p. 253)
The new paragraph on the use of two remedies together was to have been as follows:
Section 274b. 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 two 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 chronic disease discovered by me, as when in addition of psora we have to do with 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 disease 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.” (Thomas L. Bradford, The Life and Letters of Hahnemann, p. 486) (emphasis added)
Aegidi�s letter of 15 May 1833 marks the formal beginning of the history of dual remedies. However, the origins of the matter can be discerned several years earlier. Both Hahnemann and Boenninghausen were aware of what Aegidi was doing well before Aegidi wrote to him in 1833 about the 233 cured cases. According to Boenninghausen (writing to Hahnemann), a certain Dr. Stoll of Cologne:
�had suggested dividing the remedies into two classes, the one of which should act upon the body and the other upon the soul. He thought that these two kinds of medicine should be combined in a prescription in order to supplement each other. His method making some noise in Cologne, and Dr. Aegidi, then at D�sseldorf, having in vain endeavoured to discover the essential secret of this novelty, the latter induced me to endeavour to find out. I succeeded in doing so. (Bradford, p. 492)
Hahnemann indicates his awareness of the matter in an earlier letter to Aegidi of 28 April 1833. At this point, Hahnemann is cautious about the use of mixtures given his general criticisms of polypharmacy and his wariness over the ability of others to undermine the hard fought gains he had made in medical reform.
Do not cease from announcing publicly in great detail your work in the D�sselthal institution. But do cease to pay any attention to Dr. Stoll�s mixtures; otherwise I might fear that you were not yet convinced of the eternal necessity of treating patients with simple unmixed remedies. I have seen even shepherds and hangmen do some wonderful things now and then. Are we to chance to luck in the same way? (Haehl, Vol. I, p. 393)
In this same letter, Hahnemann indicates his general concern to maintain the purity of his system against allopathy, echoing the struggles he was having in this regard:
The purifying and separating of the true from the false which I undertook with the highest motives and which has the unmitigated approval of the best and most dependable of my students, must draw the world�s attention to real values. What have you to fear from a frank and earnest separation of pure homoeopathy from that humbugging which must be the grave of homoeopathy if it is allowed to continue advertising itself as genuine and gradually insinuating allopathy again — a very convenient resource for the sluggards? The science and I have need of fewer but truer adherents, I do not wish to see my colleagues increased by a large number of those false coiners. I wish to count as mine only a few good men and true. (Haehl, Vol I. p. 256)
The events leading up to Aegidi�s letter of 15 May 1833 were serious indeed. Hahnemann had just announced to the world in 1828 his discoveries of the chronic miasms, in particular psora. This had not been well accepted by many homeopathic doctors, as Hahnemann had feared. At the same time, as a result of his concern over the introduction of allopathic methods of treatment (e.g., blood-letting, crude drugs, emetics, etc.) by those who did not have full confidence in the curative and healing powers of his new system, Hahnemann felt the need to intervene in a dispute between homeopaths in Leipsic attendant on the opening of the first homeopathic hospital in the world in that city. This dispute was highly public and unusually bitter.
As Hahnemann himself reported the matter to Boenninghausen towards the end of 1833:
Already four years ago, I wrote a friendly but forcible pastoral letter to the Leipsic Society, in which I showed them my displeasure at the unscrupulous and criminal behaviour of some of them, who treated their patients with homoeopathic and allopathic measures simultaneously, to the detriment and shame of our science. But I saw no signs that these arbitrary fellows, who boasted of being the most distinguished of all the homoeopathic physicians, took any heed of it. …Yet, what happened? Of course after M�ller�s public declaration of intentions, they dared not be so bold as to use venesection, leeches, emetics, laxatives, etc. in the Homoeopathic Hospital…But now there anger against me became loud…an open revolt against me signed by the whole of the Society…
…This is how I am treated by these ungrateful ones… (Haehl, Vol. II, p. 289-291)
When Aegidi urged Hahnemann to reconcile with the Leipsic homeopaths, Hahnemann reiterated his position against false homeopathy in the letter of 28 April 1833 already referred to above.
You have not judged my proceedings against the pseudo-homeopaths from a right point of view. How can you advise me to offer these public cheats my conciliatory hand? It is just this purging and this division of the true from the false, that I have undertaken from higher motives, and which has met with the unanimous approval of the best and the most reliable of my pupils, that will point out to the world, what is genuine. What do you fear, from a public and serious separation of pure homoeopathy from that imposture, which is bound to become the grave of true homoeopathy, if it were to continue to proclaim itself as the genuine article, and at the same time, overshadow it with allopathic practices, which of course would be very opportune for the lazy ones?
I, and our art, have only need to a few true followers; I do not wish to have as colleagues that large crowd of forgers of base coins. I only wish to number among my own a few good men. Do speak to our worthy B�nninghausen on that subject; he will enlighten you and make you understand what I cannot accomplish by letter owing to the overwhelming amount of other work. Let it suffice that your opinion on this subject, I regret to say, is erroneous… (Haehl, Vol. II, p. 282)
Here is one example of the reaction of those “moderates” who saw much good in homeopathy but also wished to see a union of it and the prevailing medical system, the one thing Hahnemann most feared (that is co-option by the Old School, leaving homeopathy gutted and lifeless).
With this extravagance Hahnemann�s homoeopathy had reached the highest summit, and would have undoubtedly gone under, if sensible physicians had not taken the matter in hand, and protected the great discovery which this genius had made, and saved it for the benefit of humanity. There is indeed something tragic in it, if we consider how Hahnemann himself moved by hatred against the older medical school, developed his own creation more and more one-sidedly, and drove it even to a sharper point, until he nearly destroyed it. (von Brunnow, Haehl, Vol. II, p. 164). Hahnemann remained faithful to his strict dogma in spite of all these letters, and spoke most violently against the behaviour of the more moderate school of homoeopathy… I had prefaced this second translation [in French of the Organon], which came out in 1832, with a new detailed introduction, in which I declared myself a follower of the new moderate ideas, and …he was very irate about it, and demanded from me a repudiation of all the heretical parts that displeased him, in some homoeopathic periodical.” (von Brunnow, Haehl, Vol. II, p. 165)
The Psora Theory, which brought clearly to Hahnemann�s consciousness the supersensible (phenomenal) nature of the constant (tonic) diseases, as opposed to the more sensible dimension of the pathic diseases (symptoms), was difficult for many, still ensconced in the material world of the Old School, to accept. Haehl writes that the Psora Theory “…aroused the criticism of friend and foe to a tremendous extent” right from the start and that these views “seemed to be even more idiotic than the high dilution medicines.” (Vol. I, p. 137) Already, in Hahnemann�s lifetime, once he had moved to Paris for the final stage of his life, the German Central Association (of homeopaths) formally rejected the doctrine of psora, but “recognised fully the efficacy of the psora remedies in chronic diseases,” (Haehl, Vol. II, p. 163) thereby rejecting the concept that had led to the discovery of the medicines themselves.
Here we can see the seeds of a dominant attitude to Hahnemann�s deeper insights, particularly as relate to the tonic side of disease (supersensible domain) in the form of rejection by both followers (reject the theory of disease, but accept the use of the remedies in practice on the basis of the law of similars) and critics (ridicule). His earlier works, on materia medica and on the law of similars leading to the Organon, had been criticised, but had also garnered many followers who saw here a useful and necessary reform of medicine. However, such followers and supporters, headed by Hufeland and his influential medical journal, never ceased to think that the reformers could eventually be reconciled with the mother church of prevailing authority in medicine. If Hahnemann at any time thought this might be possible (and there is no evidence that he did), such thoughts would have been entirely banished by his work between 1810 and 1830 which brought fully to his consciousness the dynamic (non-material), dual (constant and variable) and hierarchical (jurisdictions and layers) nature of disease and medicine.
These new insights, however, could not be grasped by those without the proper capacity to “see” them. For those living in a different paradigm or organising idea, these new insights were ridiculous indeed. They felt that they could use the practical results of the theory without needing to accept the theory itself, a form of empiricism that Hahnemann rejected. Without the strong foundation of the theory, the practical results would simply lead to the absorption of the practice into the all-encompassing power and authority of the Old School.
It is no wonder that Hahnemann felt the need, because of the public nature of the operations of the Leipsic Homeopathic Hospital and its symbolic importance for the advance of homeopathy with the authorities and the public, to attack the Leipsic Homeopathic Society for using allopathic methods simultaneously with homeopathic ones. Hahnemann also warns Aegidi against straying from the true path, telling him that he has nothing to fear from a separation of true from false homeopathy (knowing, already at this point that Aegidi and Boenninghausen are looking into Dr. Stoll�s “mixtures.”). At the same time, Hahnemann is becoming ever more conscious of the dual nature of disease (constant and variable diseases).
His great enthusiasm for Aegidi�s communication of the 233 cured cases using dual remedies in mixture as being “fully consonant with the homeopathic art,” is, in the light of the history of the idea of duality in disease, not at all surprising.
Hahnemann had gained a renewed appreciation for the duality of disease. He was now also more fully cognizant of the dynamic dimension of disease and medicine, and he had begun using remedies in quick alternation in acute self-limiting diseases. While he may have formally considered or intended that such use of two remedies be after the full action of the first remedy, it is conceivable that in practice Hahnemann may have found the need to use remedies in close enough proximity that there was the possibility of overlapping action (that is, that the second remedy was prescribed and ingested while the secondary action of the first remedy had not yet exhausted itself).
In a letter to Dr. Stapf of 24th April 1830, Hahnemann wrote how he had cured himself using Staphysagria and Arsenicum in short alternation. Also, during the cholera epidemic of 1831, we find a recommendation for the use of several remedies in alternation.
This evidence comes from a paper written by Dr. O.A. Julian in 1984, who also lists ten more examples of Hahnemann’s use of remedy combinations. Clearly, the concept of using more than one remedy within the time frame of action of another remedy was starting to form in his consciousness. Certainly, in the new paragraph on dual remedies proposed for the 5th Edition, Hahnemann refers to the use of dual remedies as being similar in concept to his previous use of two remedies in quick alternation in acute diseases. Dr. Julian�s evidence is discussed in an article in Homeopathy On-line:
Homeopathic Polypharmacy When Hahnemann started to develop his homeopathic treatment, orthodox doctors often used many drugs in combination. Hahnemann severely criticized this polypharmacy. In order to study the effects of each homeopathic remedy Hahnemann did not use combinations of remedies in the early years and objected to the use of remedy combinations by other homeopaths. Hahnemann’s warnings against using combinations of homeopathic remedies have become an entrenched doctrine in some homeopathic quarters.
However, combinations of homeopathic remedies have been used successfully for well over a century by homeopaths on the European Continent.
Continental homeopaths have known for over a century that Hahnemann did in fact sometimes use remedy combinations, despite what he wrote in the Organon. This was confirmed by Dr. D. Demarque during the 41st Congress of the International Homeopathic League in Rio de Janeiro in 1986. Dr. Demarque’s statement caused great controversy at the congress and it was alleged that he was advocating �polypharmacy.� However, Dr. P. Fisher, editor of the British Homeopathic Journal, wrote in his report on the congress that: �Demarque’s historical evidence appeared to be irrefutable.� (BHJ 1987, pp. 6-7)
The late Dr. Julian showed clearly in a paper in 1984 that Hahnemann did in fact use remedy combinations. In a letter to Dr. Stapf, Hahnemann wrote on 24th April 1830 how he cured himself during a serious illness by taking Staphysagria and Arsenicum alternatively at short intervals. During the cholera epidemic of 1831 Hahnemann recommended the use of several remedies, among them Bryonia and Rhus Toxicodendron, taken in alternation. (Julian 1984, p. 42)
In the paper referred to, Julian gave ten more examples, with references, showing that Hahnemann did use remedy combinations. Many of the references were to Dr. Richard Haehl’s German biography, Samuel Hahnemann, sein Leben und Schaffen, which was published in 1922. An English translation of this book has only been published quite recently.
The most recent reference to Hahnemann using polypharmacy is the following: �Another extremely interesting feature of Hahnemann’s practice at this time is his use of two remedies at once.� (Handley, 1988)
Continental homeopaths have known from Hahnemann’s own time that he did use combination remedies, and the material in the German biography of Hahnemann by Dr. R. Haehl has been available to homeopaths who can read German for 74 years. But these historical facts have not been easily accessible to English speaking homeopaths who do not read German. So it is not surprising that Anglo-American homeopaths have believed for a long time that Hahnemann never used remedy combinations. The documented historical fact, however, is that he did.� (see Homeopathic Drainage Treatment According to Vannier, Dr. Eddy De Ruyter, Homeopathy On-line, Vol. 6).
Hahnemann had further developed a dual conception of the Living Power of the human being as well as a duality between the Spirit (Geist) pole and the nature (Wesen) pole. Thus, he had come to realise the profound duality of life.