by Peter Morrell
Dream of Egypt, 1995 – Peter Morrell
This short piece brings to the attention of others the useful work of Wilhelm Ameke from his little known book ‘A History of Homeopathy.’ Being out of print for over a century and hard to obtain, this useful text illuminates Hahnemann’s life in a fresh and masterful way. This is an interim piece I compiled recently for some lectures, and which will be extended as time permits. In due course, it is hoped that the full text of Ameke might be placed online where all can admire its many gems. This selection mostly focuses upon Ameke’s description of Hahnemann’s views on many clinical matters and snippets regarding the origin of homeopathy. It also highlights what is unusual, important and remarkable in his character as a physician.
Although Hahnemann retained enormous affection and respect for his teacher at Vienna, Dr von Quarin, it remains certain that von Quarin “was an advocate of bleeding till the day of his death,” [Ameke, 59] in 1812. Hahnemann stated, “I owe to him whatever there is of physician in me.” [Ameke, 58] Although Hahnemann “employed bleeding…but he always applied it cautiously.” [Ameke, 67] Though as early “as 1784 he contended…against bleeding,” [Ameke, 67] yet “he still bled in 1797…and [even as late as] 1800 he was not an absolute opponent of it.” [Ameke, 67] But he always felt it was abused and used to excess by most physicians. He “was a great enemy of coffee, but a great advocate of exercise and open air…change of climate and residence at the seaside.” [Ameke, 60] On the therapeutic use of cold water “Hahnemann writes at length…and gives exact instructions.” [Ameke, 62] He always gave “only one remedy at a time, and carefully watched its effects.” [Ameke, 74] For every addition of a “second or a third [remedy] only deranges the object we have in view.” [Ameke, 86] Giving only one drug, we must “wait till its action is exhausted before giving another.” [Ameke, 87] Once he was convinced of something “he enunciated it with the greatest precision, and did not easily allow himself to be turned from it.” [Ameke, 63]
Even as a young physician, Hahnemann seems to “have been unaffected by the prevalent belief in authority,” [Ameke, 59] preferring instead to formulate his own medical views, very largely based upon his powers of reflection and his very keen observational powers.
Tendencies Hahnemann condemned
In 1808 Hahnemann sharply condemned the main method of “treating most diseases by scouring out the stomach and bowels.” [Ameke, 94] This is also the “method which regards the diseased body as a mere chemically decomposed mass,” [Ameke, 94] and which regards diseases as having “no other originating cause but mucosities…[inspiring treatments that seek the] combat of putridity.” [Ameke, 94] Such a view also pretends that only by “the strength of the doses of most powerful and costly medicines,” [Ameke, 94] can such disease ever be subdued or cured. Hahnemann bemoans the “search into the internal essence of diseases,” [Ameke, 95] which he regards as an utterly futile endeavour. He also condemns this system as one that respects only “the mechanical origin of diseases…[and] which derives diseases from the original form of the parts.” [Ameke, 95] Such a view he regards as too simplistic, too mechanistic and not sufficiently holistic in its perception of the living organism.
Hahnemann condemned those medical systems that claimed “most diseases were produced by impure and acid humours which were to be expelled from the body,” [Ameke, 42] or which claimed that “most illnesses resulted from gastric impurities, especially bile,” [Ameke, 43] and which therefore believed that “the removal of these matters by emetics and purgatives was the principal means resorted to.” [Ameke, 43] As far as Hahnemann was concerned, such medical systems incorrectly concluded, “purgatives and emetics demonstrated the truth of these theories.” [Ameke, 43] One such idea was “infarcts…an unnatural condition of the blood vessels…distended in various places by ill-concocted, variously degenerated, fluid-bereft, inspissated, viscid, bilious, polypous and coagulated blood…” [Ameke, 43] Hahnemann had nothing but contempt for such theories and regarded them as entirely imaginary concepts and dangerous fantasies with no reality whatever. Therefore, he was equally dismissive of the methods employed such as “clysters…to which various appropriate drugs were added…employed to disperse these infarctus.” [Ameke, 44] This treatment with clysters [enemas] “was much in vogue among physicians, patients and even healthy persons, for many years.” [Ameke, 45]
Hahnemann was as dismissive of clysters and the theories of infarcts as he was of the strong mixed drugs also in vogue at the same time. Such remedies as “senna, spirits of wine, dandelion, rhubarb, sal-ammoniac, mercury, dog’s grass and antimony…which were supposed to cleanse the tubes and passages of the human body from their foul accumulations.” [Ameke, 45] Hahnemann simply did not believe the monstrous theory that every patient had these mythical obstructions and poisons. He was therefore wholly opposed to the idea that they must all be “sweated and purged, puked, bled and salivated,” [Ameke, 45] back to health by these heroic measures.
It is no surprise therefore that he roundly condemned and dismissed on instinct “bleeding, cold, emetics, purgatives, diaphoretics.” [Ameke, 46] He denounced the “vomiting, purging and sweating,” [Ameke, 46] view that “inflammatory matters, impure fermenting substances, acridities and degenerated bile,” [Ameke, 91] were the causes of disease or that they should be “energetically evacuated,” [Ameke, 91] in order to cure the patient. All such talk he depicts as merely a “euphemism for emetics and purgatives,” [Ameke, 92] and indeed, for “the lancet, tepid drinks, miserable diet, emetics, purgatives…[which] threatened to destroy our generation.” [Ameke, 96]
He denounced the use of “blisters, baths, fomentations, anodynes, and repeated enemata,” [Ameke, 68] just as he maintained that “refrigerating and laxative salts, watery drinks, and bleeding act as poisons. Emetics and blisters do harm.” [Ameke, 68] To most practitioners it must have been “very tempting to utilise the great chemical discoveries in the treatment of disease,” [Ameke, 50] but Hahnemann [almost alone] successfully resisted this temptation. Most physicians were “too impatient to utilise,” [Ameke, 50] new discoveries, too eager “to reap when they had barely finished sowing.” [Ameke, 50] They dismally failed to “observe how the functions of their patients were carried on.” [Ameke, 53] Even at this early stage, one can see that Hahnemann was cautiously and judiciously trying to work out precisely why the medicine he had been taught did not work and one can detect his endeavour to find a harmless yet efficacious therapeutic method.
In the early 1790s, he “gave one remedy at a time, and carefully watched its effects.” [Ameke, 74] This sums up his approach very accurately. He also “succeeded in achieving many splendid cures by his simple method of treatment…[soon having] the reputation of a careful and successful practitioner.” [Ameke, 74-5] His basic powers of patient observation were truly remarkable. Not only did he want to know “what is hurtful or irrational,” [Ameke, 87] in the medicine of his day but why and how one can proceed to escape from such a useless muddle. In medicine, he despised whatever was harmful and what did not make sense, usually both together. “That is the essence of science: ask an impertinent question, and you are on the way to a pertinent answer.” [Jacob Bronowski (1908–1974), The Ascent of Man, ch. 4 (1973)] Hahnemann had the immense audacity and conviction to “prescribe one single, simple medicament and nothing more,” [Ameke, 97] and then simply wait and observe. This was the essence of his approach for the reform of medicine.
Other influences were also at work in their impact on medicine. One problem that reared its head was “the whirligig of natural philosophy” [Ameke, 48] which had taken hold of many people, most of whom were “suffering from the spirit of the age.” [Ameke, 48] None of this brought any benefit to medicine, according to Hahnemann. It just gave the signal and increased the tendency to invent more wild theories. Yet, in therapeutics, disease was increasingly regarded as a “departure from normal form and composition, that is, anatomical and chemical change.” [Ameke, 49] Consequently, “one theory was superseded by another,” [Ameke, 53] and people frequently switched sides many times. As a result, “dogmatism and a persecuting spirit,” [Ameke, 57] became the dominant spirit, just as if religious sectarianism were breaking out in medicine and inspiring many unnecessarily “embittered disputes.” [Ameke, 58] Eighteenth century medicine was crisis-torn, with rival theories pitched against each other in an unseemly battle for supremacy.
As early as 1784, he “speaks contemptuously of fashionable physicians.” [Ameke, 76] He also tried to “direct the attention of his fellow-practitioners to the many absurdities of the day.” [Ameke, 77] Why? because he wanted them to be more critical. A good example is when he says, “we must forcibly sever ourselves from these deified oracles if we wish to shake off the yoke of ignorance and credulity.” [Ameke, 77] He rebelled against any deference to medical authority [because so and so says this] as a means of validating a method or concept. He insisted on thinking for himself and experiment as a superior path. He infinitely preferred consulting “nature and experience,” [Ameke, 126] to any medical theory.
Hahnemann was taught the medicine of mixed strong drugs, which he confessed, “clung to him more obstinately than the miasma of any disease.” [Ameke, 78] Although in the first few years of his practice he adhered to this approach, “he was gradually emancipating himself from this bad system.” [Ameke, 78] It did not work, in spite of his best efforts. As early as 1784, “he advocates a simple method…instead of the farrago of contradictory prescriptions.” [Ameke, 78] In the year 1798, “he inveighs against the physicians who love prescriptions containing many ingredients…[regarding it as] the height of empiricism…the employment of mixtures of strong medicines.” [Ameke, 81] He was realising that the chief problems were mixed drugs, strong doses and damaging methods like blood-letting, purges and enemas. Nothing in the medicine of his day was either curative or gentle.
Instead of mixed drugs he would increasingly “give only one simple remedy at a time…[Ameke, and so] in these simplest maladies he gave single simple remedies out of the store of existing drugs which was then small.” [Ameke, 80] His careful and methodical approach reveals just “how earnest was his striving after truth and how great his anxiety for the improvement of therapeutics.” [Ameke, 85] He especially “surpassed his mixture-loving contemporaries in the gifts of observation and investigation.” [Ameke, 85] Hahnemann confidently declares that, “using several drugs at once…is the true sign of charlatanism. Quackery always goes hand in hand with complicated mixtures…[which is] so far removed from the simple ways and laws of nature.” [Ameke, 86]
In 1805, he states “a single simple remedy is always…the most beneficial…it is never necessary to give two at once.” [Ameke, 86] He denounces “drugs…which must fight against diseases,” [Ameke, 87] as deriving from a misunderstanding of sickness with such doctors viewing patients “through glasses tinged with ideal systems,” [Ameke, 87] which are utterly useless means to cure sickness. They did this rather than investigate matters for themselves, as he was doing. They obstinately clung to theory and eschewed the spirit of empiricism Hahnemann loved and which was the guiding beacon of his life. No physicians other than Hahnemann “preached this important truth with such energy and such conviction.” [Ameke, 87] He “attacked deference to authority in therapeutics as early as 1786 and 1790.” [Ameke, 87]
It is perfectly true that “no physician since Paracelsus had dared to expose with such frankness and boldness the miserable condition of the medical treatment of the period…[and] that requires a thorough reform from top to bottom.” [Ameke, 98] Is modern medicine really any better? Is it less harmful, more logical or more curative? Which, if any?
In therapeutics, Hahnemann regarded the many who became “involved in gossamer subtleties,” [Ameke, 97] as fools, because such was “a misdirection of mental energy,” [Ameke, 97] that might be much better employed for the more serious task of observing patients and using single drugs in small doses. Rather than do that, they foolishly preferred to use “sweetening, diluting, purifying, loosening, thickening, cooling and evacuating measures,” [Ameke, 95] that would not cure the patient anyway. Therefore, in his view, patients faced “the wretched and hopeless choice of one of the numerous methods, almost all equally impotent…[with] no fixed therapeutic principles of acknowledged value.” [Ameke, 99] In medicine, such was the outrageous state of affairs in the early years of the 19th century.
Hahnemann “acquired a great reputation for his improvements in the practice of medicine, in pharmacology, and especially in hygiene.” [Ameke, iv] Hufeland, for example, “never lost respect for Hahnemann’s genius and services to medicine.” [Ameke, iv] As a translator Hahnemann always “intercalates various improvements and inventions.” [Ameke, 12] He was widely regarded as “a writer who has improved and perfected,” [Ameke, 14] any text translation he undertook. This was no chance comment. Numerous examples exist of this observation. Numerous honours and accomplishments in chemistry and pharmacy preceded his discovery of homeopathy, what Ameke calls “his pre-homeopathic labours.” [Ameke, x] Various writers refer to “Hahnemann’s superiority,” [Ameke, 18] or to this “very valuable book by my esteemed friend, Dr Samuel Hahnemann.” [Ameke, 18]
These comments mostly allude to his innumerable minor discoveries and embellishments to the art of chemistry, or to the value of his translation footnotes all completed before the emergence of homeopathy. For example, “in 1788, Hahnemann discovered the solubility of metallic sulphates in boiling nitric acid.” [Ameke, 28] Another is “the test for wine invented by Dr Hahnemann [which] has especially pleased me.” [Ameke, 29] Or “Hahnemann’s mercury, an excellent and mild preparation, the usefulness of which has been proved.” [Ameke, 32] He is variously described as “a capable physician,” [Ameke, 75] and “one of the most distinguished physicians of Germany…of matured experience and reflection…a man rendered famous by his writings.” [Ameke, 75]
In 1799 one writer alludes to Hahnemann by calling him “a man who has made himself a name in Germany both as a chemist and a practitioner [who] deserves especial recommendation,” [Ameke, 37] and adds that “every article gives evidence of having been written with the greatest care.” [Ameke, 37] Another critic expresses his admiration for “a man who has conferred so many benefits on science…by his valuable translations…that are faithful and successful…[who has] added precious notes which expand and elucidate [the original]” [Ameke, 40] such that “he has thus enhanced the value of the work.” [Ameke, 40] So highly regarded were Hahnemann’s translations “which he has enriched with his own notes.” [Ameke, 40] These “great many explanatory and supplementary remarks…give the translation a great advantage over the original.” [Ameke, 40]
Such writers could clearly appreciate the “thoroughness of his emendations…his short notes…[which] serve to explain the text…and which is enhanced by the translator’s notes.” [Ameke, 40-41] Such comments reveal the clear and unambiguous recognition which he received for his “thorough pharmaceutical knowledge and industry…this celebrated chemist…this meritorious physician…the meritorious Hahnemann…whom chemistry has to thank for many important discoveries.” [Ameke, 41] He is unanimously applauded as one who “has won for himself unfading laurels,” [Ameke, 42] for his contributions to science. Hahnemann was “so much respected and renowned for his valuable services,” [Ameke, 90] that he did not require to “to make himself more popular with the German public.” [Ameke, 90]
When Hahnemann correctly stated that “Arsenic does not contain muriatic acid…[this showed] Hahnemann’s superiority,” [Ameke, 18] in points of chemistry. In all his translations, “accuracy prevails everywhere,” [Ameke, 22] and reflects the “extreme care he employed in his labours.” [Ameke, 22] As early as 1784, “Hahnemann advocated the crystallisation of tartar emetic.” [Ameke, 24] It was in the fine details of his corrections and footnote additions that he earned his reputation as a meticulous, highly knowledgeable, diligent and thus reliable scientific translator. In time, he garnered a similar reputation for his work reforming pharmacy, for example, “the regulation and sale of poisons,” [Ameke, 34] the “preservation of odoriferous substances,” [Ameke, 34] and the “evaporation of extracts over water baths.” [Ameke, 34] Ameke also lists many pages of examples of his contributions to pharmacy and examples of his recommended small doses for drugs of all types.
In such innumerable ways Hahnemann was considered to have “enriched our therapeutic thesaurus.” [Ameke, 35] In every case, they all prove “how thoroughly Hahnemann had studied the subject,” [Ameke, 34] in question, whether it was botany, pharmacy or chemistry. It meant that when he made a statement “every page shows that the well informed author speaks from experience,” [Ameke, 37] it shows his great diligence, that he composed work of more than “an ordinary character,” [Ameke, 37] that he always produced “useful work,” [Ameke, 38] and that “he surpassed most of them in knowledge of the subjects,” [Ameke, 38] on which he expounded. Such factors considerably enhanced his scientific credentials.
Hahnemann “even wished to see the names of diseases abolished.” [Ameke, 116] Though he recognised the obvious convenience of disease classification schemes, he “always advocated individualisation and taught it systematically.” [Ameke, 116] He felt that giving diseases names was a highly misleading habit that inevitably led to disreputable rote prescribing, and to viewing a sickness as an actual thing. Though he did use crude drugs throughout the 1790s, he developed a peculiar method of administering the drug “in very small but continually increasing doses, till some severe symptoms manifest themselves.” [Ameke, 119] He later called this the ‘primary toxic action’ of a drug. Then the dose was abruptly stopped and beneficial results awaited. He later called this the ‘curative secondary reaction’ of the vital force elicited by a drug [see Organon §57, 59, 63, 64-6, 69, 112, 114-5, 130, 133, 137-8, 161 for primary and secondary effects of drugs]. He gradually diminished the doses he used throughout that decade. He always used smaller doses than his contemporaries, and experimented a great deal in achieving good results from the tiniest doses. These trials obviously flowed from his conviction that large doses were intrinsically harmful and felt it was his duty to find a saner, more rational and less damaging approach to the whole question of dosage of drugs. He soon saw the reform of drug dosage as absolutely crucial for any reform of medicine itself.
Mercury in syphilis is probably “the only instance after 1799 in which he recommends stronger doses.” [Ameke, 121] His method “began with small ones and gradually increased them up to the point of slight toxic action.” [Ameke, 121] In this manner he aimed to transform himself into “the zealous, careful observer, the conscientious physician.” [Ameke, 121] Though he had not as yet “raised the smallness of the dose to a general therapeutic principle,” [Ameke, 121] yet this practice of unrelenting dose experimentation “was peculiar to him, and distinguished him from all his colleagues.” [Ameke, 121] He also “noted accurately the duration of action,” [Ameke, 121] of drugs that he used. No-one else was doing this. And all the while these experiments formed an essential part of “his laudable endeavours to attain to simplicity of treatment.” [Ameke, 121]
In recommending smaller doses for numerous drugs, Hahnemann was basing his view on direct observations of the actions of drugs on the body. Repeatedly, he grounds his medical views not in high-faluting theories but through consulting “nature and experience,” [Ameke, 126] as his chief guides in all that he says. In the footnotes to Cullen , Monro  and the Edinburgh Dispensatorium , he disagrees with almost every dosage listed by the original author, concluding always that “large doses…must do harm.” [Ameke, 126] Instinctively, he rebelled against large doses as harmful.
In every case, therefore, he recommends “an incredibly small quantity,” [Ameke, 127] of the drugs he discusses, because the large doses “multiplied experience will not allow me to advise.” [Ameke, 127] The results “of the zealous and careful researches of our genial investigator forced upon him…the conviction that the doses…accepted as normal, were much too large.” [Ameke, 127] History records “no instance…of a physician ever having attempted to determine the question of the suitable dose with such zealous endeavour as the clear-sighted, indefatigable and thoughtful Hahnemann.” [Ameke, 127]
Severing his link with tradition, and basing his views solely upon direct observation and experience, he “proceeded still further in the diminution of the dose.” [Ameke, 128] Nor did he recommend drugs on the old basis. He did not aim “to produce emesis, purgation, or narcosis; neither did he employ them to cleanse the blood of acridities…cutting the phlegm, softening of indurations, or destroying parasites.” [Ameke, 128-9] What such low dose preparations he used did, was to “favourably influence the curative process.” [Ameke, 129] This means they assist the natural healing powers. This was a radically new therapeutic concept.
Furthermore, he found that small doses of the best remedy would create “as great an impression as if they were infants at the breast.” [Ameke, 129] By this he meant, “the sensitiveness of the human body to medicines…transcends all belief.” [Ameke, 129] He especially means sensitivity to similar medicines. He himself was “astounded at his discovery.” [Ameke, 129] He too regarded as incredible “the results obtained by a millionth, a billionth, etc, part of a grain of medicine.” [Ameke, 129] As is now well known, he soon went on to obtain “results which could not be obtained with the crude substances.” [Ameke, 131] Drugs, which obviously contained no detectable substance, still “possessed great healing power.” [Ameke, 131] They heal by their similarity to the case totality and by stimulating the innate self-healing powers.
This breakthrough in dose reduction and medicine preparation also meant that many previously “highly poisonous substances,” [Ameke, 131] could now be brought into harmless use as healing agents. They could indeed be “converted into…powerful remedial agents in the hands of a skilful physician.” [Ameke, 131] Dismissing the views of his “dogmatical and credulous predecessors,” [Ameke, 133] whose theories and “deductions ran counter to the maxims of experience,” [Ameke, 133] Hahnemann, as “a practical physician,” [Ameke, 133] grounded his medical views solely in the “science of experience.” [Ameke, 133] He roundly condemned the “imaginings of physicians,” [Ameke, 133] which he felt to have no place in any rational healing art. What he also called “speculative refinements, arbitrary axioms…dogmatic assumptions…[and the] magnificent conjuring games of so-called theoretical medicine.” [Ameke, 134] Instead, Hahnemann had respect solely for “a science of pure experience…knowledge of the disease to be treated and the actions of drugs.” [Ameke, 134] These, he insists can only be deduced “from pure experience and observation,” [Ameke, 134] rather than from signatures or ‘old wives tales,’ which he despised.
In his own house “he liked to wear a brightly-flowered dressing-gown, yellow slippers and black velvet cap.” [Ameke, 157] His long pipe “was seldom out of his hand, and this indulgence in tobacco was the only relaxation from his abstemious mode of life…his food extremely frugal.” [Ameke, 157] When seeing patients, instead of a bureau, “he used a large plain square table on which three or four huge folios lay, in which he had entered the histories of the maladies of his patients…[and] in which he wrote down their cases…with the exactness which he recommends in his Organon.” [Ameke, 157]
Wilhelm Ameke, History of Homœopathy, with an appendix on the present state of University medicine, translated by A. E. Drysdale, edited by R. E. Dudgeon, London: E. Gould & Son, 1885.