“All this was pure ostentation. It was a mode of treatment that did no good to the patients”. This Hahnemann says in regard to the old school physicians treating the so-called hypothetical – indication with a mixture of medicine for want of knowing a single remedy to effect a cure.

Old school physicians thought that a combination of hypothetical indications like deficiency or excess of oxygen, nitrogen and carbon, exaltation or diminision of irritability, sensibility, derangement of arterial, venous or capillary system, constitutes the disease. In order to cure the disease, each of these disease conditions has to be met with a remedy. One medicine was placed foremost, as the principle remedy (basis) and this was designed to subdue what the physician deemed to be the chief character of the disease, to this is added another medicine (adjuvant) to strengthen the action of the first and for removal of some accessory symptoms, a pretended corrective remedy called (corrigens) was also added. They were mixed together boiled and infused in sugar syrup. This mixture prescription, the physician thought would act in accordance to their imaginations.

Hahnemann says, “ Giving incomprehensible mixtures is a piece of tolly repungent to every reflecting and unprejudiced persons”.

Effects of such mixture prescription
1) One ingredient would wholly or partially suspend the action of another. Therefore it is impossible that a cure could be effected.
2) On repeated and prolonged use of mixtures an artificial disease would be added to the original disease.
3) A further depression of the strength of the patient occurs as this mixtures act in an injurious manner on parts of body least affected with the disease.

Efficacy of mixtures were even doubted by the old school physicians. Mercus Herz (in Hufeland’s Journal) reveals the prick of his conscience when he states, “When we wish to remove the inflammatory state we do not employ either nitre or sal ammoniac or vegetable acids alone but we usually mix them together. If we have to combat putridity we are not content to look for the attainment of our object by the administration of large doses of one of the antiseptic medicine but we prefer associating several of them together. He said “Our knowledge of what is essential to be known respecting all our remedies as also respecting the perhaps hundred fold relationship among each other into which they enter when combined is far too little to be relied upon to enable us to tell with certainty the degree and extent of the action of a substance seemingly ever so unimportant, when introduced into the human body in combination with other substances”. This statement of Mercus Herz betrays the fact that old school physicians were uncertain about their mixture prescriptions. In extremely rare cases cure occurred with mixture prescription and in these cases it was found that the remedy whose action predominated was always of a homoeopathic character Hahnemann says that hence it is important, for the weal of mankind to ascertain what really took place in these extremely rare but singularly salutary treatment.

Hahnemann in §272 lays the guidelines of the doctrine of single remedy §272 “…In no one case it is requisite to administer more than one single medicinal substance at one time.

In §273 Hahnemann says
“…It is inconceivable how the slightest doubt could exist as to whether it was more consistent with nature and more rational to prescribe a single simple medicine at one time in a disease.

§ 274 Hahnemann says
“…It is wrong to attempt to employ complex means when simple means suffix …never think of giving as a remedy any but a single simple medicinal substance”.

In fn to § 274 in 6th edition he says
Two substances opposite to each other united into neutral natrum and middle salts by chemical affinity in unchangeable proportions, sulphuratted metals in the earth, those ethers produced by distillation of alcohol and acids may be considered as simple medicinal substances. But the alkaloids like chinin, strychine, morphine which is exposed to a variety of preparation cannot be together considered as single simple medicine”.

Hahnemann in his essays ‘Are the obstacles to simplicity and certainty in practical medicine insurmountable’? tells us about the impossibility of obtaining definite results unless remedies are given singly.

Richard Hughes in his ‘principle and practice of homoeopathy’ says that medicines have to be administered singly. He says we should never combine in one-prescription two drugs of known action, incapable of entering into chemical combination.

Dr. Ramanlal Patel in his ‘Homoeopathy its principles and doctrines’ gives the following reasons for employing single remedy.
1) The experimental work in constructing the homoeopathic materia medica has been constructed with single medicines and as each medicine has its own definite and peculiar symptoms and sphere of action, and scientific accuracy as well as law of similars requires that the treatment of patients be considered in the same manner.
2) The action of single medicine is certain while of mixtures is uncertain.
3) The homoeopathic medicine is always given single so that its action is complete and unmodified by other drugs.
4) It has been proved experimentally that the sick organism is peculiarly and even painfully sensitive to the action of the single similar medicine and that the curative effects are only obtained by sub-physiological doses of single medicines.
5) The comparison of symptoms of single drugs is easily done and observed. Each drug has its symptomatic individuality.
6) Combination of drugs may contradict each other or antidote or nullify, the action of the other drugs. To give two or more remedies would be to introduce two separate rhythms, partial and disharmonious into the body.. Moreover, if more than one remedy is used the physician is unable to know which element was curative and one source of future guidance is thereby obscured.
7) In a complex prescription one out of many drugs may help to remove certain similar symptoms in a patient but others may do harm to other parts of the body. There cannot be two things most similar to another.
8) By using single medicine we know the action of the medicine and when we find that it does not work or it harms we can change or antidote the remedy but in mixtures we are not able to know which is acting and which medicine is to be given for antidote of mixture if any harm is done.
9) Single medicine we give in minimum dose while mixtures are usually given in large doses and in repeated larger doses, which are often productive of serious danger of life.
10) In homoeopathy single medicine is not substituted for another or mixed with another for the purpose of curing diseases .
11) Without single medicine no estimation of curative drug action can be determined.
12) The single medicine is quite enough to eradicate a disease which is not of a complex character and even when the disease is of a complex character we do not use several medicines in a mixture because the mixture in question has not been proved on healthy human beings and as such the symptoms that it can produce in the system are quite unknown to us.

Sometimes in a case of disease we find that more than one medicine is indicated. We allow one medicine to exhaust its action until its symptoms are removed giving rising to clear indications for some other remedy.

13) We acquire knowledge of medicine by proving on healthy or relatively healthy individuals while in other schools of medicine by experimenting mixture of medicine or medicinal combination on the sick individuals or on animals.
14) A mixture of drugs will only give a mixture of symptoms.
15) It is impossible to foresee the variety of effects that two or more drugs contained in a mixture might have.

Law of single remedy is one of the cardinal principles of homoeopathy. No excuse should be given for the easy way of prescribing mixtures.

Hahnemann remarked that “as long as we do not accustom ourselves to use single remedy our therapeutics will remain a combination of guess, truth and poetry”.

References :
1) Organon of medicine
2) Lesser writings – Hahnemann
3) The principles and practice of homoeopathy – Hughes
4) Homoeopathy, Its principles and doctrines - Patel