Such preparations are generally very safe, if used judiciously. On the other hand, although the Homeopathic Pharmacopoeia of the United States (HPUS) is protected by Federal law, some allegedly "homeopathic" preparations may contain substances not included in it, or may not have been made according to its standards. Both the industry and the FDA are even more concerned about some newer preparations marketed for obviously chronic and dubious indications, such as weight loss, "sexual rejuvenation," and the like.

For all of these reasons, the public is well advised to avoid products in which the ingredients are not specified and the manufacturer does not explicitly adhere to the HPUS rules. All inquiries regarding remedies and preparations should be reported to the American Association of Homeopathic Pharmacists, P. O. Box 2273, Falls Church, VA 22042.

In any case, the standard cold, flu, and other acute preparations are generally reliable and quite safe for occasional use. Under most circumstances they should not be used for more than a few days at a time without professional supervision; and persistence, worsening, or frequent recurrence of any complaint usually indicates the need for professional help, i.e., diagnosis and perhaps treatment.

Prolonged or repeated use of combination remedies for symptomatic relief also favors the conditions in which adverse effects are more likely. Homeopathy teaches that all medicines have the power either to provoke or to relieve the same symptoms, depending on the dosage and the sensitivity of the patient.

A simple rule of thumb is that a medicine will be more likely to produce symptoms, not just relieve them, 1) the more sensitive the patient is to it, 2) the larger the dose, and 3) the more times it is repeated. This common-sense warning of course applies equally to single remedies, herbs, and above all to conventional drugs, whose habituating and addictive powers are directly proportional to their tendency in large material doses to reproduce much the same symptoms that at first they seemed to cure.

The risk of adverse reactions to combination remedies is also proportional to the number of separate ingredients to which a sensitive patient could respond. Nor are these sensitivities readily predictable without detailed study of the ingredients, i.e., exactly the circumstances under which single remedies would do as well or better with far smaller and fewer doses.

In general, then, the combinations are rather more subject to abuse than the single remedies, which are usually taken only for short periods, and only after individualized study. But they are still far safer than the comparable OTC pharmaceuticals, such as anti-histamine cold preparations, which contain much larger doses of potent chemical drugs.

How effective are the combination remedies? For some people, they are very effective indeed. I have always had patients who swore by this or that "teething" combination or cold remedy. Among the newer ones, OSCILLOCOCCINUM and its equivalents have become justly popular in a short time, and I know of many instances in which it saved my patients or their friends a visit to a doctor and a considerable expense, and, above all, helped them to heal themselves without a doctor. I'm all for that, in whatever shape or form -- and the more, the better. In these cases, and many others like them, combination remedies are often effective in just a few doses, and need not be repeated again for a long time. Not a bad "bottom-line" criterion.

Nor can it be held against the combination remedies that they don't always work. Single remedies don't work all the time either, even in hands far more skilled than mine. Like worsening, healing is always possible, never certain: it is a property of individuals, not disease categories. So let me repeat: there is nothing wrong with the acute care combinations, as long as a few simple and obvious precautions are observed, and temporary symptomatic relief is all that is required. But homeopathy is capable of vastly more than that.

Combination remedies palliate because of a crude correspondence between a common symptom or illness category (colds, flu, cough, etc.) and its various ingredients. But homeopathy teaches that each single remedy produces a characteristic totality of responses that is different from that of every other substance. When a remedy can be found that approximates the picture of the illness as a whole, genuinely and profoundly curative responses are often possible, even in obstinate chronic diseases.

Experiences of this kind suggest that falling ill and recovering from illness are concerted responses of the organism as a whole, and cannot simply be programmed or manipulated through temporary relief of a symptom or technological control of an abnormality. This is the best reason for studying and using single remedies, which are distinctive and recognizable totalities that can match and therefore help us understand and work with the unique individuality of living patients.

When patients are truly cured of an illness, they take with them the immunological "memory" of the healing process: their bodies recognize (and their minds often remember) which groups of symptoms traveled together, which separately, what causal factors were operating, and the like. The proof of course is that next time the picture is clearer and the response more rapid and effective. Using remedies effectively for self-healing is essentially a methodology for training this kind of psychophysical awareness, and homeopathy does so chiefly through the discipline of studying and using single remedies.

This study is by no means a simple one. I have been immersed in lt for fifteen years, and have only just begun. Yet the method is wonderfully accessible to lay people, who may study and use remedies at their own pace, as a guide to their experience, not infrequently with results at least as good as mine. The remedies are archetypes of falling ill and getting well again that are profoundly satisfying and worthy of study for their own sake, because they exist in real life -- a most improbable coincidence that partly explains the art and skill and excitement that are given to those who are willing to make the effort.

I know of no other way to explain the equally improbable revival of homeopathic self-care in our recent history, which is almost wholly attributable to the single remedy method. By the 1960's, homeopathic medicine had almost died out as a profession in this country, and survived only because of the dedication of the lay public and a few dozen physicians who clung to the old ways, i.e., to the single remedy. Now it is rising again, thanks largely to the impetus of the self-care movement: groups of interested lay people are springing up everywhere, and are studying and using single remedies with an intensity that leaves the principal manufacturers scrambling to overtake the demand.

So I have no quarrel with the combination remedies They're quite safe, and they work well enough for what they're designed to do. But they are as far from what homeopathy is capable of as is applying a band-aid, or taking a drug to control an abnormality, from learning how to heal ourselves.