by Peter Morrel
The Principles of Homeopathy.
Hahnemann’s Essay on a New Principle, “was the successful attempt of a man buried alive to force his way out into the open air.” [Gumpert, 86]
“Then came the hypothesis—drugs cure disease by causing lesser diseases which the organism can effectively overcome—which is to say, ‘similia similibus curantur’ or ‘like cures like’.” [Cameron, 29]
In his Essay On a New Principle, Hahnemann “does not yet talk about diminishing the dose, but insists on the necessity of administering but one medicine at a time…in all these discoveries Hahnemann was guided by experience, to which he trusted solely.” [Dudgeon, 1853, 49-50]
One of “homeopathy’s prime principles…in a nutshell…is that drugs increase in potency with their dilution.” [Cameron, 30]
The “principle of the infinitesimal dose [is]…an outrage to human reason,” [Forbes, 17 and Nicholls, 121]
The vital force is a “spiritual principle…that rules with unbounded sway.” [Organon, Aph 9]
Lists of his publications [Ameke, 145-7] suggest a definite progression or time-line: 1783 – the move to single drugs; 1788 – the adoption of medical similars; 1790 – the 1st proving and hence holism/case totality; 1798 – the first systematic use of ever smaller doses; 1829 – the miasm theory. Each of these points represents a permanent and irreversible shift in his view and approach, and they comprise the exact sequence of events from which homeopathy, as a complete medical system, emerged.
This essay explores the core principles of homeopathy, guided and amplified by and embellished with a plethora of quotes from reputable sources.
Hahnemann as Medical Philosopher
People seem to easily run away with the unsubstantiated notion that Hahnemann was just a rebel, a pioneer, a revolutionary deviant, an iconoclast and a medical reformer. And they seem far less able to grasp his main aspirations in life. It is true that in due course he became all those things, but these labels, like medals so easily pinned upon his chest, do not clearly reveal or accurately describe who he was and what he sought, which indeed remains completely obscured beneath these secondary aspects about him. His main aim was to establish, for once and for all, the truth about medicine. He was thus not primarily a reformer at all, but a medical philosopher, a person very centrally grounded in trying to define what medicine is, what it is not, what sickness is and what truly cures sickness: which methods are curative and which are not—and why!
Hahnemann identifies the problem with all prior medical systems as not being “in consonance with nature and experience; they were mere theoretical webs, woven by cunning intellects out of pretended consequences.” [Organon, 1] Such a medical art “pluming itself on its antiquity imagines itself to possess a scientific character,” [Organon, 2] when it plainly doesn’t. But “like all other Empirics before him, therefore, Hahnemann insists that therapeutic theory arises out of therapeutic practice. Practice is always prior to theory.” [Coulter, II, 351] Hahnemann “was committed with all his mind to the observational method…he rejected in its entirety the clap-trap of medieval traditions and he made out an eloquent case for the pharmacological experimental method.” [Cameron, 32] He despised “the splendid juggling of so-called theoretical medicine, in which a priori conceptions and speculative subtleties raised a number of proud schools…the art of medicine, was merely a pseudo-scientific fabrication, remodelled from time to time to meet the prevailing fashion.” [Preface to the 2nd Organon, xv]
As far as Hahnemann was concerned, “physiology…looked only through the spectacles of hypothetical conceits, gross mechanical explanations, and pretensions to systems…little has been added…what are we to think of a science, the operations of which are founded upon perhapses and blind chance?” [Hahnemann, 1805, in Lesser Writings, 423-6] Like Paracelsus before him, he was “driven to innovation by dissatisfaction with the limitations of conventional medicine.” [van Haselen, 121-2] The process is therefore akin to “Paracelsus and van Helmont building their systems impertinently amid the ruins of the Galenic.” [French, 211] He condemned “speculative refinements, arbitrary axioms…dogmatic assumptions…[and the] magnificent conjuring games of so-called theoretical medicine.” [Ameke, 134] The uncurative allopathic approach he condemned merely leads to ‘symptom chasing’ palliation and medical dependency: “the champions of this clumsy doctrine of morbific matters ought to be ashamed that they have so inconsiderately overlooked and failed to appreciate the spiritual nature of life, and the spiritual dynamic power of the exciting causes of diseases.” [Organon, 9]
This is a perspective we always have to consider about him; as formerly Francis Bacon in his Novum Organum Scientiarum revealed the psychological and cultural mindset as possible sources of errors in science: “homœopathy was the logical and legitimate offspring of the Inductive Philosophy and Method of Aristotle and Lord Bacon.” [Close, 15] It was “founded and developed into a scientific system by Samuel Hahnemann (1755-1843) under the principles of the Inductive Method of Science as developed by Lord Bacon.”[Close, 16-17] Hahnemann “seems to have been most influenced by the inductive philosophy of Lord Bacon.” [Close, Ch. 3] “Hahnemann began to blaze his way, guided by the compass of logic encased in the inductive method of Bacon.” [Close, Ch. 16]
Likewise, Hahnemann revealed the errors inherent to the inconsistent medical ideas of his time, while searching for a sound and factually-based grounding for medical practice. He “detaches himself entirely from his contemporaries by his conception of the nature of disease.” [Haehl, I, 291] Nonsense, “is his description of the materia peccans, which was then generally accepted as the cause of disease.” [Haehl, I, 291] He dismissed “mechanical or chemical alterations of the material substance of the body,” [Haehl, I, 291] as being the cause of disease, which he did not believe to be “dependent on a material morbific substance…[but resulting from] merely spirit-like [conceptual] dynamic derangements of the life.” [Haehl, I, 291] It is this “morbidly affected vital energy alone [that] produces disease.” [Haehl, I, 291] He “strenuously…rejected and fought against the theories of disease origin and diagnosis, as known in his time.” [Haehl, I, 290] He “had to do with a confused babble of inferences and unproveable assertions.” [Haehl, I, 290] He dismissed “the crass materialism” [Haehl, I, 290] of his day, and “became disillusioned and dissatisfied with current medical practice. He…began experiments, later called ‘provings’, on himself and other healthy individuals.” [Flinn, 425-7]
Disease “is not to him, as to contemporary therapy, an agent distinct from the living whole, from the organism, and from the life-giving dynamis—a being, inwardly concealed however finely conceived.” [Haehl, I, 291] Diseases, he declares, “are not mechanical or chemical alterations of the material substance of the body and they are not dependent upon a material morbific substance. They are merely spirit-like [conceptual] dynamic derangements of the life;” [Haehl, I, 291] “the morbidly affected vital energy alone produces diseases.” [Aph 12, in Haehl, I, 291] Hahnemann rejected the view of such figures as Sydenham that “diseases were specific entities,” [Porter, 1998, 230]; who cited “mistletoe growing on trees, he emphasised how disease was independent of the sufferer.” [Porter, 1998, 230] For Hahnemann, this was merely false and misleading theorising. As with Paracelsus, Hahnemann took the view that “each individuum was wholly peculiar and…[that] there were as many diseases as patients.” [McLean, 170]
He dismisses all prior medicine as “an utterly irrational and useless art.” [Ameke, 134] He exhorts that “facts and experience must be at the root of all revelations of truth.”[Ameke, 134] He regarded the medicine of his day as having “evolved out of physicians’ heads, out of illusion and caprice,” [Ameke, 134] and of comprising “an infinite kingdom of fantasy and of arbitrary assumptions, the parent of disastrous delusion and of absolute nothingness.” [Ameke, 134] What Hahnemann terms “…’experience’ is equivalent to investigation; ‘sciences of experience’ are the same as what are now called the ‘inductive sciences’…or ’empiricism’…” [Ameke, 133] This refers to where Hahnemann says things like “true medicine is from its very nature a pure science of experience,” [Ameke, 134] that medicine “should rest only upon pure facts,” [Ameke, 134] and that medicine should be rooted in “pure experience and observation…and not venture a single step beyond the sphere of pure, carefully observed experience and experiment.” [Ameke, 134] Hahnemann was, “in all essentials, a flawless experimenter.” [Introduction to the 2nd Organon, xxiv]
These empirical methods are those “in the early days of homeopathy, Hahnemann undoubtedly employed,” [Cooper, Feb 1893, 66] for it is indeed axiomatic that “all great improvements in science are made by men who throw off the trammels of previous teachings and begin by a complete and radical overhauling of the entire subject.” [Cooper, 1894, 389] Hahnemann was an “exponent of the empirical…therapeutic method…in which symptoms and signs of the curative effort of the dynamis…must be interpreted as positive or beneficial phenomena.” [van Haselen, 123] “The era of scientific medical experimentation begins with Hahnemann and nobody else. Scientific to the core, Hahnemann experimented scientifically for scientific observation…” [ibid., xxvii] “The true healing art is in its nature a pure science of experience, and can and must rest upon clear facts and on the sensible phenomena pertaining to their sphere of action.’ and that it ‘…dares not take a single step out of the sphere of pure, well-observed experience and experiment, if it would avoid becoming a nullity, a farce.” [Preface to 2nd Organon, xiv]
Like Harvey, Hahnemann professed to learn “not from books…not from the tenets of Philosophers, but from the fabric of Nature.” [Porter, 215] A good example of Paracelsus’ qualification as a radical empiricist, like Hahnemann, is when he “thought he could learn more medicine by travelling and observing than from any library,” [French, 148] which is certainly a sentiment reminiscent of Edward Bach’s travels in the English countryside, or the very peripatetic life of Hahnemann in his ‘wandering years.’ Knowing that “we owe almost all our knowledge of the pure healing forces of nature to the unembellished lore of the common man,” [Gumpert, 24] so Hahnemann “cast tradition aside, and had recourse only to the medicines he had learned, tested and confirmed.” [Gumpert, 67] In his construction of homeopathy, Hahnemann gives “pure experiment, careful observation and accurate experience alone,” [Gumpert, 144] as the sole determining factors, the sole forces that shaped his new system.
Hahnemann demanded that medicine become more empirical, and roots itself more fully in genuine observations. Medicine as a practical pursuit was largely dominated by an “apparent symptomatic and therapeutic chaos,” [Risse, 146] which is a world of “sometimes baffling bedside appearances.” [Risse, 146] For Hahnemann, in their “dealings with the sick…the objects of experience,” [Risse, 152] clinicians should work solely with “the empirical peculiarities of each individual case through observations at the bedside,” [Risse, 152] and dispense entirely with spurious and half-baked theories of disease. Medical knowledge should be more firmly rooted in this empirical sickness data and should therefore be very largely “based on bedside experience.” [Risse, 152] This is clearly at variance with “formal, abstract thought,” [Risse, 152] or “metaphysical speculations,” [Risse, 152] and illustrates quite well the natural gulf that exists between medicine and philosophy.
Initially, he looked for the most simple, comprehensible and trusted principles in medicine, easy to apply, and without any speculative intrusion or unnecessary recourse to the opinion of so-called “authorities,” whose validity he questioned. Therefore, at the start of his career, we find him juggling with medical ideas, straying from the main path of medical practice, certainly, but experimenting and tinkering about with the medicine he had been given and taught. The reason for all this activity is fairly clear—it is self-explanatory: he was far from happy with the medicine he had been given, first, because it did not cure sickness as it claimed, and second because it often proved very harmful to patients.
Thus, at this very early stage, his confidence in using the Galenic ‘bleed and purge’ approach diminished sharply. He soon became very circumspect and inordinately cautious about using such a blunt and dangerous instrument on sick people; he was sufficiently cautious in fact, to abandon medical practice completely for several years, for fear of harming many patients. We can see his high deontological and moral conception: “primum non nocere” was such an important thing for him that he was disposed to leave medical practice in conditions that could be harmful for his patients. He never was a person of half–way truths.
This then accurately describes Hahnemann’s primary motivation: to establish carefully and with some certainty what medical truths really are; to distinguish between cure as opposed to the suppression or mere palliation of symptoms; to establish the core principles of medicine. There is a deeper Hahnemann who lies underneath all those superficial labels. Hahnemann might be said to have scored his first big hits as a rebel, “the Luther of medicine,” [McLean, 78] and as a dangerous iconoclast.
Of course it is perfectly true that Hahnemann was an iconoclast and he did become a major medical rebel and reformer, “a physician at war with the medical practices of his time,” [Brieger, 241] but we must remember that this was a secondary, not a primary aspect, as it flowed from his situation of being the one who had found the truth, and nobody wanted to listen to it. Hahnemann is often regarded as something of a “medical Luther.” [Temkin, 16; Osler] Medical empiricists like Paracelsus, and Hahnemann were “rejecting sterile rationalism,” [McLean, 27] in favour of personal experiment. Paracelsus was referred to as “the Luther of medicine,” [McLean, 78] primarily because he represented a troublemaking tendency, “an anti-authoritarian stance and insisted…on the importance of inner revelation or ‘lumen naturae.’” [McLean, 78] This knowledge-creating power he respected far more, as a fertile and reliable beacon of hope and revelation, than the thunderous hair-splitting rationalism of philosophers and textbooks. He also held that true knowledge of medicine “was not to be acquired from authority, but existed in the natural objects themselves.” [French, 149]
His whole being rebelled utterly against the use of medical contraries, which he felt run entirely counter to the efforts of Nature: “it is improper to treat constipation with purgatives, the excited circulation of hysterical, cachectic and hypochondriacal patients by venesection, acid eructations by alkalies, chronic pains by Opium, etc.” [Ameke, 105] Once he had realised the terrible state of medicine, rooted, as it was, in mixed drugs, and strong doses employed through contraries, and that all so-called cures were actually suppressions that never held any prospect of cure but simply generated more sickness, then what else could he do found a superior method, a superior system? He had no alternative as a man of conscience but to follow the path he did, even though that rendered him a rebel and heretic.
This background provides us with an accurate and insightful model with which to understand most of the events of his early professional life and the many twists and turns of his medical career. What this account reveals and places at centre stage is Hahnemann’s abiding concern with what works and what doesn’t and why, leading him on a trail to experiments with drugs and endless tinkering with different doses, always devised to substantiate this and invalidate that. Therefore, his early concern lay in a long-winded and methodical process of distilling valid therapeutic maxims from the medical literature, using case histories that illustrate points, for example, about single or mixed drugs, large or small doses, similars or contraries, dose repetition and what “a disease” actually consists of as compared with “a sick person.”
In every case, he adopted a meticulous thorough-going process of amassing case histories and examples, from which he could distil clear medical principles, leading in turn to the experiments which confirmed or denied each point he wished to investigate. Only by proceeding in this slow and methodical manner was he eventually able to decide, for example, in favour of single drugs, similars and small doses. So, the real life of Hahnemann—our seeing him for what he really was—supplies an illustration of a man who was primarily a medical philosopher, a dauntless searcher for medical truth and one who regarded the truth above all else as worth searching for relentlessly, resolutely and tenaciously: aude sapere. This gives a more accurate view of him than the idea that he was simply a medical rebel and reformer.
In some respects Hahnemann resembles Galileo: “…’the leitmotiv of Galileo’s work as I see it was his passionate opposition to belief based on authority.‘…” [Einstein quoted by Pietschmann, 156-7] Even though “Hahnemann was…a great experimental scientist…he observed and collected his observations until gradually a pattern showed itself…[yet] observation alone is not sufficient, it must be coupled with right relating,” [Brieger, 241] yet the idea that he was primarily an empiricist and experimental scientist a la Bacon is only a partial truth. He certainly employed inductive methods, but they were always employed to establish some truth, not blindly, pursued as an end in itself, or just because he enjoyed experiments. One struggles hard to find a single example of any experiment he undertook just for the sake of it. Ideas and truths in medicine were thus easily the most important aspects of the man and his mission, not experimental science per se. He was not an empiric per se, but it was an empiricism tempered by and tethered to a specific mission.