ALTERNATION OF

REMEDIES II
• This lecture is given by Dunham when he
came to know that his remarks on Coxe’s
article aroused enough
misunderstanding
 Statements of general
principles
• The business of the physician is to cure the patient . Like
allopaths ,Homeopathists who mix medicine ,whether in
the tumbler or in the patients stomach (conglomerators
or alternators) do often “cure” their patient .

• From the ethical stand point it may be concluded that it

is better to have erred and cured ,that never to have
cured at all .But the mind of a man of science must be
stored with an array of facts carefully observed by others
as well as by himself
5 types of mental processes possible
in a physician who had performed a
cure
1. One thinks of the cure as a lucky accident ( e.g. giving
ledum)

2. One thinks that the cure occurred due to the

alternation of Bryonia and Sepia done by him. Further
he arrives at the conclusion that two partially similar
remedies will cure a case , if they are given in
alternation
3. One thinks that the cure happened because he gave
lachesis which covered the whole case ,instead of
alternation Bell and mercurius which were partially
similar in case of angina. From this he learns that
alternation is equally wrong like the polypharmacy of
old school and results will be obtained if sound
principles are followed in practice .

4. The symptoms of the patient indicated Colocynth. But

the patient in addition had an enlarged ovary. The
physician has never heard of this symptom in
connection with colocynth. Even then he gave that
medicine based on his knowledge that individual man
is not an aggregations of independent monads and
thereby learned the unity of disease.
5. The symptoms of patient indicated Cyclamen . But the
chief complaint of dysmenorrhea associated with other
female sexual complaints were not found in the
Materia medica pura under cyclamen .Instead this
complaint was found recorded under Pulsatilla .
Cyclamen was given with the faith that future proving's
will develop the female sexual symptoms of
cyclamen .The case speedily recovered and the
physician learned that in many cases alternation is
thought of, when the whole case is not covered by a
single remedy. But in many cases, the real
characteristic symptoms will be fully met by a single
remedy
• Dr Hawley says “The homoeopathic system bases itself
not on theories but on faiths as they are observed in the
world of man . It frees its disciples from all dogmas and
simply asks them to look and see”
• But what we see is Hawley giving Bryonia and Sepia in
alternation . From this he and the London Homoeopathic
Review concludes that the use of a single remedy and
cases now and then occur which can only be cured by
such alternation . This is a broad generalization on a very
narrow basis. We can accept them as facts, as it proves
that ,cases may be cured by alternation. But it never
proves that a more rapid cure by a single remedy is
impossible .
The term alternation is used in
different senses as follows
1. Dr. Coxe ,scouts the idea of any real distinction
between alternation and succession

• e.g. A patient recovering under Merc cor in dysentery is

attacked by rheumatism and Rhustox given. Similarly
Eupharsia was given for ,measles during convalescence.
This is not alternation, but succession which is
homoeopathic.
2. Dr. Quin calls the method of prescribing successive
remedies – alternation a posteriori and he sanctions
and defends it .But he reprobates alternation a priori
ie alternation

3. Dr Dysdale defines alternation to be the giving of a

second medicine while the sphere of action of the first
is still unexhausted
• But Dysdale , in many cases ,used to reexamine the case
before second prescription .So it is not true alternation
What do we mean by alternation?
• The true alternations is illustrated by the prescriptions of Dr. John
Doe and Dr Busy
• Dr John Doe
• No1 Acon ; No2 Bell; of each , twelve powder .Take the powders alternately
as numbered , every four hours

• Dr Busy
• Merc hydriod , every night for seven days;
• Then Suplhur , every night for seven days;
• Then Collinsonia , every night for seven days;
• Then Podophyllum ; every night for seven days;
• Then Ignatia and China , alternately every night and morning , for seven days;
• Then Aurum met , every night for seven days;
• Then Pulsatilla , every night for seven days;
• Then Phytolocca , every night for seven days
• Hahnemann says in Materia Medica Pura of alternating
aconite and Coffea in his introduction to Bell. But he also
gives instructions to distinguish between them

• Aconite- heat , increasing restlessness, agonizing anxiety

• Coffea- over excessive pains with a lachymose humour.
London Homoeopathic Review omitted this last part and
published it to favour alternation
Conditions of true homoeopathic
prescription
1. Before every prescription ,the symptoms of the patient
shall be studied a new .

2. The totality of symptoms must not be divided arbitorily

into groups to select analogues to be given in
combination or alternation

3. Proved drug is to be selected .Sulphur and calc carb in

combination will never work instead of Hep sulp
Definition of homoeopathic
prescription
• A homoeopathic prescription is a deduction from a
generalisation which has been established by induction
from a multitude of instances.

Why do we oppose alternation

• It doesnot meet the requirements of the law
• It doesnot take the aggregate of symptoms as the single
basis of prescription
• It doesnot give the remedy single and simple such as it
was used in the proving
Advocates and defenders of alternation

• Divided into two classes

• alternation on the basis on the simple ground of

experience

• Alternation based on principles

• Eg for meeting complication
• Dr Drysdale mentions of an instance of a case of
pneumonia (indication phos)with a traumatic
complication such as burn in hand (indicating urtica
urens) with a contused vulva (indicating Arnica) and milk
fever ( indicating Aconite)

• In the above case , if the burn is not so severe as to cause

any modification of symptoms or complications, simple
protection from atmospheric air will be needed

• If on the other hand , the burn is serious ,it can be well

managed by an internal remedy (topical application must
not be repeated inhaste)
• The second principle on which the alternation rests is the
“maintaining of susceptability or awakening of exhausted
susceptability

• Eg case of dysentery clearly indicating Nux vom or Merc.

When improvement ceases with one of these remedies,
Opium is given to arouse the susceptability .This may
succeed in many cases, but the rationals of the process is
by no means satisfactory to us
• Dunham opposes the above method with the following
experience in his practice

• A patient with constipation having indication of Conium

mac . Opium has been used intermediately to arouse the
susceptability. But the remedy , later selected , Alumina
did the work of both .Such an Alumina will be present in
the Materia medica , which would effect a cure in as few
days as the most sanguine alternate would expect to
accomplish it in months
2 types of medical philosophers

1. Analytic philosophers
• Will versed in Histology both physiology and pathology
• Alternation exclusively directed to material changes.
They overlook 2 points

• A) there must have been a change in vital force

preceeding every structural change

• B) sympathy of vital force by which arise modification in

functions of the body along with alternation in tissues
• Dr. Cate tells of alternating Merc cor and Sulphur for
inflammation spreading from mucous coat to peritoneal
coat

• It gives rise to the uncertainty of double hypothesis

• 1st to assume that inflammation has extended from

mucous to serous membrane
• 2nd to assume that inflammation has extended from
mucous coat to serous coat
• Specific relation to the tissue was considered as the basis
of drug action and attempt was made to reconstruct the
materia medica pura [American materia medica ]
• If we find clear characteristic of any drug in the
symptoms of any organ of the body no matter what
symptoms may be presented by other parts of the body ,
and no matter how little these latter symptoms may
seem to indicate this same drug. We never dream of
alternating remedies. We thoroughly believe in the unity
of disease
2.Synthetic philosophers

• They underestimate structural changes .They study the

perversion of vital force in its various manifestations
i.e. ,the symptoms. They don’t admit hypothesis into
there method
2 principles on which alternation has
been sought to be defended
• Each drug has its own sphere and manner of action
• Alternated remedies act by virtue of their
homoeopathicity
Principle 1 may also be stated as follows. A disease has its
own specific sphere and manner of action
Corollary: 2 or more disease can coexist in the body
without affecting each other. Similarily 2 or more drugs ..
[This is the idea of Dr.Drysdale and Dr Russel
• It follows that medicines can be proved even on sick
persons .But Dr.Russel et.al are not accepting clinical
symptoms. Typhus and small pox having their separate
course simultaneously has been quoted by Dr Murchison

• Alternation leads to laxity of practice. No one who deals

conscientiously with himself will deliberately approve of
so simple a method of evading the difficulty of choice
• I will take no man’s liberty of judgement from him ;
neither shall any man take mine from me. I will think of
no man the worse for differing in opinion from me. And
what measure I meet to others, I expect from them again