Combination Remedies - Duration

Popularity does not equal effectiveness of course. If popularity did equate to ability to cure, then orthodox medicine would have no competitors or opponents. I do not believe that big manufacturers have the best interests of the sick in mind when they start mass producing and marketing a product. If anything this makes me suspicious of their support.

That aside, the only way you can ever decide on how to progress with a therapy is to exactly measure what has happened. It is difficult to apply the homoeopathic standard for improvement and the guidelines we use for management when the medicines are not being prescribed homoeopathically.

So the real question is 'what do you mean by effective?'. What the medicine is doing needs to be determined before deciding on how to proceed.

If the remedy is palliating the symptoms, when you stop the symptoms will return, often in the same intensity as before, sometimes worse. Palliation requires constant or at least frequent use of the medicine to maintain it. Palliating is often only just one part of the total disease, typically the physical or local parts, and the mental, emotional and general symptoms remain.

If the medicine is suppressing the symptoms, what you need to do depends on the vitality of the patient. A low vitality patient will be suppressed easily and you may see the original symptoms disappear. They usually do not require redosing, or if they do it is at longer intervals.

A high vitality patient on the other hand will keep producing those symptoms for much longer, and often requires more frequent or even continual dosing. At some point the symptoms will not return and that medicine can be stopped.

In both cases you will not know it is time to stop until you actually stop, and see what happens.

Palliation may become Suppression the longer it is continued. Palliation and Suppression works via the Law of Opposites (Antipathy) which is the main principle of Orthodox medicine.

Suppression will lead to new symptoms, and a new medicine will need to be prescribed to deal with those generally, unless (or until) the new disease is incurable/untreatable.

If the medicine is actually curing the patient, then a number of things should happen.

Firstly, the symptoms should worsen before the improve. This would mean stopping the medicine immediately and allowing the improvement to show itself. Since genuine cure does not need to be maintained by constant dosing, the amount of improvement and the stability of the changes would decide how you progress from that point.

Aggravation first shows that at least one of the components in the combination is homoeopathic to the disease (even if only partially homoeopathic) and presuming that one of the other components is not going to antidote it, you may get some stable improvement.

I have never seen cure take place without aggravation first. Aggravation may happen for other reasons of course, but it is a necessary first step towards cure if you are approaching a case homoeopathically.

Where that improvement takes place may also be important in making the decision. If improvement is taking place in the mental and emotional state then you can often stop and wait for that to flow down into the physical state (Direction of Cure).

If the improvement is taking place in the newest symptoms first, you can usually continue until the older symptoms start to budge, unless there is marked aggravation. Aggravation should always result in a halt to treatment.

So basically measure the exact response to the medicine. Then decide if continuing, changing the medicine, or waiting to see what happens is appropriate.

The problem with combinations is that it is the long-term management that is an issue. What if a patient gets new symptoms or a serious aggravation of their pathology? Which remedy is doing that? How do you antidote it if you need to? Which medicine are you antidoting? If you want to use a complementary medicine, which medicine do you complement? How do you know which medicines might act antagonistically to one or more in the combination? Whatever advantage combining medicines might have, it creates a number of significant problems too.

So without entering too much more into the pros and cons of all these different approaches, a summary would be:

1. To keep palliating, you will need to keep dosing. If the illness is acute, it will be self-limiting and once it is over the medicine can be stopped. If the disease is chronic, it will not be self-limiting and will probably require continued dosing. However, because our medicines are potentized, if you do not cure the underlying cause, they tend to become ineffective after a period of time. In homoeopathy you then increase the potency, which with combinations is pretty much impossible to do unless you make up your own. Then of course you must deal with possible side effects from higher potencies of inappropriate medicines.

2. To keep suppressing you need to determine whether it is necessary, which will be based on the vitality of the patient. You should stop the medicine and see if the symptoms return. If they do then begin dosing again. You can also try to reduce the vitality of the patient to more easily enforce suppression - various activities and substances and drain vitality, and this will make the patient more susceptible to suppression (orthodox medicine does this in various ways)

3. If the medicine is curing (starting with aggravation, then following with improvement), then you should stop when the aggravation starts, and wait until it finishes. The measure the improvement. If it continues to improve, continue waiting. If the improvement stops and then stays that way, this is a good sign, and often requires a short period of redosing (once, or a few days). If the improvement wears off, assessment needs to be made of whether it is cure or palliation or suppression. Often if the cure is real, you will see only a return of some of the physicals, but the general and emotional/mental state remains improved. This would mean that a repeat (one or a few doses) should bring them back to that point of improvement.