Great example of the cutting wit and irony of Samuel Hahnemann turned upon the mixed remedy purveyors. This from “The Lesser Writings of Samuel Hahnemann” collected and translated by R.E Dudgeon, MD, p. 346—350.
…..to what a zero in point of value must the phenomena sink, which result from the ordinary tumultuous employment of several of such unknown drugs mixed together, in diseases—in diseases, those abnormal states of the human body—the most intricate of all organized beings—that are in truth not easily cognizable in individual cases! It is as though one should throw blindfold a handful of balls of various sizes upon an unknown billiard table with cushions of various angles, and should pretend to decide beforehand what effect they would all conjointly produce, what direction each would take, and what position they would finally occupy after their many deflections and their unforeseen mutual concussions! And yet the results of all mechanical forces are much more easily determined than those of dynamic forces.
“In a mixed prescription the case is far otherwise,” methinks I hear it contended, “for there the prescribing physician determines for each ingredient the part it shall play in the human body: this one shall be the base, this other the adjuvant, a third the corrective, that one the director and this one the excipient! It is my sovereign command that none of these ingredients venture to quit the post assigned it in the human body! I command that the corrective be not backward in concealing the blunders of the base, that it cover all the delinquencies of this principal ingredient and of the adjuvant, and direct them for the best; but to go out of its rank and situation and to take upon itself a part of its own contrary to the base, I hereby positively forbid it! Now adjuvant! to thee I assign this office of Mentor to my base, support it in its difficult task; but mind thou are only to take it by the arm, but not to do anything else of thine own accord, or dare to act contrary to the order which I have given to the base to cause a certain amount of vomiting; but thou must by no means presume in thine ignorance to undertake any expeditions on thine own account, or to do anything different from the intention of the base; thou must, though thou art something quite different, act entirely in concert with it; that I command thee! I assign to you all conjointly the highly important business of the whole expedition: see that you expel the impure humours from the blood, without touching in the slightest degree the good ones; alter, transform, what you discover to be in improper combination, in a morbid state. Remember that the commission to alter and to transform gives you unlimited authority to change, God knows or knows not what (just as in warlike tactics it is usual for the general to possess more knowledge that his sovereign lord). You are to diminish the irritability of the muscular fibre, to lessen the sensibility of the nerves, to procure sleep and rest. Do you see that convulsions in yonder arm? I wish them to be quieted, and the spasm in the sphincter muscle of the bladder to be removed! That fellow there has the jaundice; I command you to bleach him and to deobstruate his biliary ducts, whether their impermeable condition be owning to spasm or to a mechanical obstacle, or to some degeneration of the liver. In that hysterical woman, and in those old skin diseases, all my long years of treatment and my employment of extracts of spring herbs have proved useless, from which I infer that there are obstructions in capillary vessels of the abdomen—my favorite way of accounting for morbid affections. Now you, most worthy base! were, only a fey days since (and that is a great thing in my estimation), accredited to me in one of the latest pamphlets as a sure deobstruent. I therefore give you a commission to resolve those indurations (though I myself am unacquainted with the invisible indurations and know not what menstruum can dissolve them, what liquefier can melt them, or whatever else the comfortable expressions of our school may be)—enough, you will know quite well what is to be done when you yourself get upon the spot. Sommering, to be sure says that hard, swollen glands do not consist of constricted vessels, but on the contrary of unnaturally dilated vessels. But what care we for what that dreamer says. We physicians have been in the habit of deobstruating for so many centuries. Suffice it to say, I command you, base! to deobstruate for me. See yonder typhus patient, my dear base salpetre! I pray you advance and check the putrefactive process, as you did a year ago to my pork ham. Do not attempt to excuse yourself by alleging that hitherto you have always been unfortunate in al you expeditions: I give you for ally the sulphuric acid, to support you in all you attacks, although those fantastic chemists would try to persuade us that you do not agree with it, that neither of you remain what you were, that you mutually change into nitric acid and sulphate of potash. What nonsense! just as if such a thing were possible without the permission of the physician who presides of prescriptions! Enough that I command you to extinguish the putrid fever; for that purpose you have received from me you diploma of base. Moreover, I put at your service a troop of auxiliary, corrective and directions substances.—My dear base, opium! here I have an obstinate, painful cough to combat. You, who have received from the Asclepiades the office of subduing all spasms and pains, be they ever so different in character, just as the seven planets were commissioned in the almanacs a century ago to preside over this and that part of our body—to you I give the commission sanctioned by tradition. But I nave been informed that you have often a bad propensity to constipate the bowels. But in order that this may not happen I give you as auxiliaries this and that laxative ingredient, and that your action may not be disturbed by these, is your own look out; why else should I constitute you the base: Moreover as you sometimes occasion heat, and are given to check exhalations, I give you camphor as a corrective, in order to counteract this bad habit of yours. Some one lately asserted that you lost all your properties when camphor was given along with you. But do not let that lead you astray. How can the saddle-horse allow himself to be obstructed by the draught horse? Each of you must do your duty as it is indicated for you in the authorized Materia Medica, whence our opinion in derived. It has also been told me that the stomach is deranged you, but to prevent you playing this trick I have included in the prescription along with you several stomachic remedies, and will allow a cup of coffee to be drunk after you are taken, which assists digestion, as the writings of practitioners allege—regardless of those newfangled persons who assert of it that it destroys your power: but you must not allow yourself to be rendered powerless; for that reason I have appointed you the base.”
And thus, as though they were independent beings endowed with free volition, each ingredient in a complete prescription has its task allotted to it. For there are many learned considerations in a regular classical prescription. This indication and that one must be fulfilled; three, four and more symptoms must be met by as many different remedies. Consider Arcesilas! How many remedies must be artistically combined in order to make the attack at once from all points? Something for the tendency to vomit, something else for the diarrhea, something else for the evening fever and night-sweats, and as the patient is so weak, tonic medicines must be added, and not one alone, but several, in order that what the one cannot do (which we don’t know) the other may.
But what if all the symptoms proceeded from one cause, as is almost always the case, and there were one single drug that would meet all these symptoms?
“That would be a very different thing. But it would be inconvenient to search for such a one; we put in one prescription something to meet every indication, and thus we fulfill the requirements of the school.”
“No man can serve two masters.”
But do you seriously believe that you hotch-potch will do what you assign to each of its ingredients, just as if they were things that did not mutually react upon each other, that did not influence each other, of that would refrain from doing so at you command? Does it not occur to you that two dynamic agents given together can never effect that which both, given separately at different times, would do—that an intermediate action must ensue which could not have been foreseen beforehand—and that this must be still more the case when several are given together! Who could tell beforehand that opium given along with coffee would in most cases exert merely a strong diuretic action? Who could have predicted it of these two remedies? Will opium still stupefy if ipecacuan be combined with it? You perceive that they do not act according to your will, not according to your atonic principles! The combination of these two dynamic powers causes anxiety and perspiration. ………Know that two, not to speak of three or more substances, when mingled together do not produce the same result that might be expected from them if given singly and at different times, but a different dynamical intermediate action, whether you wish it or not. In that case the systematic arrangement of your ingredients is of no avail, not the part you allot to the base and bases, to the adjuvants, to your corrective, director, and excipient. Nature acts according to eternal laws, without asking your leave; she loves simplicity, and effects much with one remedy, whilst you effect little with many. Seek to imitate nature.
To write very composite recipes, and several of them in the course of the day, is the climax of parempiricism; to administer quite simple remedies, and not to give a second before the action of the first has expired—this and this alone is the direct way into the inner holy place of are. Make your choice!