Category Archives: Homeopathy
By Vera Resnick
I have recently been asked about changing potencies in LMs, with people mentioning using odd numbers, even numbers, going up in steps of 2 potencies (LM1 – LM3 – LM5) etc.
I came across this issue before I started studying with David Little, from a post he wrote on the Minutus list, sometime around 2005. He mentioned that while most people do just fine on a series of ascending potencies (LM1 – LM2 – LM3 etc.) he had noticed that some seem to do better on odd or even numbers of dilutions or succussions. He also noted that Hahnemann didn’t always start with LM 1.
There are two issues in play here, in my view.
The first is the risk of putting theory before experience. The beauty of homoeopathy is that Hahnemann first observed, then developed a way of harnessing the power of the similar stronger artificial disease without harming the patient, and what he thought was the most probable explanation for what he was observing. In Aphorism 28 (and elsewhere), Hahnemann sets out the basis for his thinking on experience versus explanations of how something happens:
“As this natural law of cure manifests itself in every pure experiment and every true observation in the world, the fact is consequently established; it matters little what may be the scientific explanation of how it takes place; and I do not attach much importance to the attempts made to explain it. But the following view seems to commend itself as the most probable one, as it is founded on premises derived from experience.”
The second issue is the sensitivity of the patient, something that is difficult to assess ahead of time. In Aphorism 278 Hahnemann explains that individual sensitivity can’t be deduced through “fine-spun reasoning” or “specious sophistry.” In order to learn the appropriate dose, “pure experiment, careful observation of the sensitiveness of each patient and accurate experience can alone determine this in each individual case…”
To my mind it comes down to “specious sophistry” if we adopt a theory of odds and evens, where there is no solid backing for the theory, or to apply it and then say it worked – especially when there is a body of material showing that many patients do well just going up through the potency scale. On the other hand, some patients do especially well on a particular potency, but we cannot know if it was the potency itself or if the improvement was built up by the work of the previous potencies and only manifested itself with the current one.
And furthermore – although it is natural to look for protocols, for theories which provide rules for action which can be employed in every case, we will then have moved away from the individualization of the patient, and of the patient’s sensitivity.
In my own experience, many patients do very well going up the scale, some seem to advance more with specific potencies in the scale, and if the remedy is going to help it is usually already visible in the patient’s response to LM1.
However, looking for a pattern in the sensitivity of individual patients and developing theories to govern posology rather than drawing on pure experiment, careful observation and accurate experience on an individual case-by-case basis seems to be a case of putting the dazzling cart of theory in front of the plodding hardworking horse of experience. Specious to say the least.
Its 4:53am. I am awake and my mind is thinking back to my childhood My mother would treat all our minor illnesses with different ‘natural’ products. My hay fever was ‘cured’ with a polypharmacy over the counter homoeopathic product. I grew up having a great respect for non mainstream medicines, but conversely would use the doctor when something non resolvable occurred. It was at this point in my late teens that I observed a difference in ‘alternative medicine’ ie herbal, and a medical treatment following a defined curative path, like acupuncture and homoeopathy.
Therein lies the dichotomy and the answer to mankinds choice. Modern medicine has decreed that it is the ONLY solution to all disease and is squeezing out everything that does not follow the allopathic mode. They point to ‘lifesaving’ medicines and treatments, ignoring the fact that the patient might be on a suppressive regime of medicines to quell the symptoms of whatever ails the patient for the remainder of their shortened life, only to succumb to an iatrogenic ending.
The strange thing is that medicine per se comes down to, not as one would expect, medicines, but to a choice of protocols. One involves a natural law and the other does not.
Hahnemann, in his monumental works, The Organon of Medicine, and the Chronic Diseases, gives a completely researched and science based observation of how living Organisms function in health and disease. I find it sad that this work which actually outlines the theory of modern disease processes is the most attacked medical practice today. Maybe its accuracy yet individualised treatment of a person is the root of the discontent felt by medical professionals. These professionals who believe that a blanket approach to drug therapy for the disease in question is the required response. It is a an easy solution. To treat a named disease instead of the individualised reaction to a named disease.
With the passing of years and growth in experience Hahnemann came upon to regard man more as an organism than as a machine. A machine is composed of many parts, originally separate. Once these parts are put together, its manifoldncss becomes unity. Like the human individual, it is assembled for a specific purpose.
It is both simple and complex. A machine is primarily complex and secondarily simple. However to the contrary, man is primarily simple and secondarily complex. He originates from a single cell. His growth means multiplication and self-differentiation of the primitive cell to form diverse tissues and organs. Thus an organism is not artificially made, but grows, not put together by the force from the outside, but develops from the centre to the periphery or from the whole to the parts.
In disease, we find the disturbance located in the ‘central like mechanism’ which is manifested through perceptible sensory and functional changes of the body as a whole; here nosology fails to be applied as the symptoms do not refer to any particular organ or tissue; and the man, though showing deviations from the perfectly healthy state, is not termed as specifically diseased.
This is the stage of Latent Psora. (INFECTION) In course of time the disharmony of the whole or central life is reflected on to the disharmony of life in the tissues or organs; and the disorder is manifested more on the functional plane related to tissues or organs. This is the stage of secondary psora (INFECTION DEVELOPMENT) when the disease is predominantly functional in nature without proportionate structural changes in the tissues and organs. This is followed by the tertiary stage of psora (DISEASE MANIFESTATION) where the gross structural changes in the tissues or organs appear—the domain of pathology proper and nosology. Central functional changes.
- functional changes of individual tissues or organs.
- gross anatomical/pathological changes of individual tissues or organs.
this seems to be the order of progression in chronic diseases. Here the disease process starts in a simple way and ultimately develops into multilateral directions accordingly as different tissues or organs (though originating from a primordial cell) are affected simultaneously or successively in course of time.
Hahnemann contends that the miasms (INFECTIONS) responsible for psora, syphilis and sycosis are of such a nature as they attack the central life-force at the outset and the primary derangement of the central life-force thus produced, makes the organism susceptible to many other agents to develop functional and structural changes in individual tissues or organs, thus providing occasions for diverse naming or labeling of diseased conditions corresponding to diverse tissues or organs damaged. So in Chronic. cases the central life-force is primarily disturbed.
As there is a central life mechanism corresponding to the whole, there is life in the parts, tissues or organs and there is life in every cell. Life is a scale of energy forming a sort of hierarchy from cell-life to collective or central life. Disease is disorder in any plane—material, vital or mental—as a whole or as a part constituting or conforming to the whole. In acute diseases, the disorder starts from lower scale of life in the tissues or organs and this disorder acts on the whole or central life, here the disease process is the resultant of the action of the part and the reaction of the whole to it. Here the disease process seems to start from outside to within or in the ascending order in the hierarchy of life. The central life mechanism is disturbed eventually but the change is of more a superficial nature analogous somewhat to the condition of “induced magnetism”.
In chronic cases, the whole or central life is attacked and disturbed first by some morbific agent of a miasmatic (INFECTIOUS) nature; this central disturbance leads to disturbance in the life of tissues, organs or cells.
Here the disease process seems to start from within outwards or in the descending hierarchy of life. That is why, in chronic diseases, constitutional symptoms (i.e., symptoms indicative of the disturbance of the central life mechanism) are more marked; whereas in acute cases, structural and functional changes of the tissues and organism overshadow the constitutional symptoms. Herein we get clues for evaluation of symptoms in case-taking to treat patients homoeopathically.
As is patently obvious, a person does not have to accept any of the above. Modern medicine accepts its own version and perception and stays within the bounds of its own concepts.
One thing I am sure of, the terminology gives it away. A ‘curative response’ comes from the organism and not from a medicine. Ergo a medicine CANNOT cure, it can only stimulate an organism to cure itself. If it does not follow this protocol, it is suppression.
We left off in the preceding post after bringing up the subject of Miasms. The intention is that students of Homoeopathy obtain accurate understanding of Hahnemanns words and meaning, so as to be confident practitioners in the therapy.
Let us begin by giving you facts to consider.
Hahnemann published a pamphlet in 1831 regarding what he then thought to be the mode of propagation of the Asiatic Cholera (see Lesser Writings, page 753 Pages may vary in different printings.) In this work he used such expressions as “excessively minute invisible living creatures so inimical to human life of which the contagious matter of the cholera most probably consist. The physicians and nurses take away with them in their clothes in their hair, probably also in their breath, the invisible [probably animated) contagious matter surrounding the cholera patient”.
you cannot take Hahnemann’s conjecture resting on probabilities in 1831 to be his real conviction or his assumed foreknowledge of modern Bacilli to be the cause or spreading agent of cholera. Evidence shows that Hahnemann never repeated or confirmed by his subsequent writing up to 1843, (the time of his death) what he had tentatively written in 1831.
Hahnemann eschewed the materialism of his time and promulgated that it is the vital force, (Life Principle, Immune system) the immaterial, invisible force which keeps man alive, happy and prosperous in health to realise the higher purposes of his existence. but when deranged by the dynamic influence of morbific agents inimical to life, it produces disagreeable sensations in the organism and bends it to irregular processes which the physician can ascertain symptoms to render aid.
These disagreeable sensations etc. occur during an overpowering attack of immaterial miasm (infection) on the immaterial vital force on the invisible immaterial plane.
For infection takes place by affection of the Vital Force (Life Principle, Immune System) with immaterial, invisible, miasmatic (infectious) influences which lead ultimately to material changes, where you find Bacteria, Bacilli etc in the human economy.
The meaning of the dynamic influence has been clearly explained byHahnemann in the foot-note of aphorism 11 (6th edition Organon). There he writes, “The dynamic effect of the sick making influences upon healthy man as well as the dynamic energy of the medicines upon the vital principle in the restoration of health, is nothing else than infection and so not in anyway material, nor in any way mechanical, just as the energy of a magnet attracting a piece of iron or steel is not material or mechanical. It is purely specific, conceptual influence that communicates to a near child, small-pox or measles in the same way as a magnet communicates to the near needle, the magnetic Property . Again, if one looks upon something nauseous and becomes inclined to vomit, did a material emetic come into his stomach which compels him to this antiperistaltic movement? Was it not solely the dynamic effect of the nauseating aspect upon his imagination ?”
Thus we see, Hahnemann speaks of vital force, disease producing force and medicinal force—all these are invisible, immaterial, conceptual and spirit-like forces.
To drag him down to the material plane of Bacteriology, is an error which every thinking rational Homceopath should avoid religiously. To inaugurate the bacteria theory and infuse it into the minds of innocent students instead of susceptibility or vital weakness as cause of disease (as said by Hahnemann) is simply to axe out Hahnemannian Homceopathy.
Hahnemann’s statement from his Lesser Writings published in 1831 regarding the spread of Cholera occurring on board the ships in the river Ganges in India.
He is reported to have said: “In the confined spaces, filled with mouldy, watery vapours the cholera miasm finds a favourite element for its multiplication and grows [Please note here, the real meaning of The invisible cholera miasm” gradually developing into material form from internal, invisible, immaterial state
(as is natural in every infection) into an enormously increased brood of these excessively minute, invisible living creatures so inimical to life of which the contagious matter of cholera most probably consists. The cause of this is undoubtedly the invisible cloud that hovers closely around the sailors who have remained free from the disease composed of probably millions of the miasmatic (Means—developed from miasm, or resultant disease from an infection) animated beings which at first developed on the broad marshy banks of the tepid Ganges always searching out in preference the human being to his destruction. This pestiferous, infectious matter as he calls it, “which is carried about in the clothes, hair, beards, soiled hands, instruments of physicians, nurses and others seems to spread the infection and cause epidemics. “
Hahnemann never saw or admitted any material cause, Bacteria or Bacilli, as is clearly apparent from quotations from his subsequent writings in the Organon without any doubt 0r probability as shown above. Here, I should again draw the attention to the fact that this statement in the Lesser Writings naturally of lesser importance and authenticity was never referred to by Hahnemann in his future writings.
It was made, without actually seeing a case of cholera, without visiting India, without having a glimpse of the Ganges, without feeling the temperatures of the waters of the Ganges so pleasant and something more than pleasingly cool (Hahnemann described it as tepid) without having the good fortune of knowing the wonderful antiseptic properties of the cold stream which comes down from the Himalayas. But Hahnemann describes it as tepid for want of actual experience. Another wonderful feature of the statement is that it is qualified by the words “Seems”, “Probably”, “Most probably” as stated above. To make a passing remark without actually seeing a disease or anything connected with it, is one affair and solid opinion formed after close observation and handling it, is certainly essentially different. The theoretical assumptions are liable to be falsified by cool thinking, practical and repeated observations or experience extending over a length of time. Maybe the reality is that Hahnemann was passing through a doubtful state of mind but he never settled into a solid opinion as it appears from later writings.
But correctly speaking his assumption is due to misinterpretation.
In the preface of the the sixth edition of the Organon published in 1843 Hahnemann says: “It can easily convince every reflecting person that the diseases of man are not caused by any substance, any acridity, that is to say disease matter but they are solely spirit-like (dynamic) derangements of the spirit-like power [vital principle) that animates the human body (Aph 11.).
Here, please notice, there is no word “probably” etc. in the assertion of Hahnemann. This was written in 1833 and published in 1843, that is, at least two years if not ten years after Hahnemann’s observation regarding the probable affection and spread of Cholera published in 1831.
In the 11th para of Organon Hahnemann says—“When a person falls ill it is only the spiritual self-acting (automatic) vital force everywhere present in the organism that is primarily deranged by the dynamic influence of morbific agent inimical to life, it is the vital principle deranged to such an abnormal state that can furnish the organism with its disagreeable sensations and incline it to irregular processes which we call disease.”
Again in the 12th para he repeats the same thing “it is morbidly affected vital forces alone that produces the disease.”
In a foot-note to the 12th para Hahnemann says “How the vital force causes the organism to display morbid phenomena, that is how it produces disease, it would be of no utility to physician to know.”
This remark was made by Hahnemann here only because he had bitter experience in trying to explain how cholera spreads or affects persons with a probable, i.e., doubtful theory.
Now what was the bitter experience he had? It was the challenge by Dr. Hufeland, of his theory of the “Probable” cause of the spread of cholera. quoting from the Lesser Writings of Hahnemann,. At para 758 Hahnemann says:—
” The Only fact brought forward by Hufeland against my proofs that on board an English Ship in the open sea about the latitude of Riga that had no communication (?)with the town two sailors were suddenly seized with the cholera, proves nothing, for it is not known how near the ship came to the infected town of Riga so that the sphere of miasm exhalation from the town although diluted might yet have reached and infected the sailors who were still unused to the miasm (infecting agent) especially if they as is often the case were rendered more susceptible to it from intemperance.”
Here Hahnemann being cornered by Hufeland has been compelled to admit that sailors on board the ship near Riga were attacked with cholera not from infectious matter washed out from the town, a far-fetched idea, but was attacked with the miasm (infecting agent) of cholera being susceptible to it from the lowered vitality or vital weakness due to their intemperance, etc. Now everybody with common sense is bound to admit that sailors on board the ship in the Ganges were also affected with cholera, from the same cause of lowered vitality caused by intemperance, etc. The dismal unhealthy condition which helped the growth of cholera miasm (infecting agent) certainly lowered the vitality of sailors also on the Ganges. Of course, the bad odour, mouldy atmosphere, etc., added fuel to the fire in spreading the disease. So the meteoric or telluric influences causing sporadic or epidemic attacks of Acute diseases cannot be thrown overboard with bad logic or fallacious arguments. What Hahnemann had published in 1843 in Organon must have greater authenticity than what he gave out in his Lesser Writings.
The most striking example of infection and rapid spread of cholera as is well-known and as the journals inform us in this way:
“On board ships in the confined spaces filled with watery vapours the cholera miasm (infecting agent) finds a favourable element for its Multiplication, etc.”
If the sailors on the sea near Riga are liable to attack of cholera without any actual contact due to intemperance lowering the power of vital force to resist the disease miasm (infecting agent) the sailors on board the ship near the shore of the Ganges living under same unhealthy condition and character had their vitality lowered by intemperance. The same causes have been expressed in paragraph 73 of the Organon of epidemic diseases which prevail among thickly congregated masses of human beings. That calamities of war, inundations and famine also produce Acute diseases by lowering the strength of the vital force and thereby developing susceptibility to diseases when innumerable persons gather together and live under unhealthy conditions and privations, is readily understandable.
Morbific noxious agents do not possess the power of morbidly deranging the health of man unconditionally but we are made ill by them only when our organism is sufficiently susceptible to the attack of the morbific cause—(Organon aph 31).
The truth is unless the vital force is weak and susceptible, no acute or chronic miasm can ever affect the vital force.
To clarify further.
The second edition of Hahnemann’s “Chronic Diseases” was published by parts between 1835 and 1838. In that edition Hahnemann retained those passages in the body of his book, which refer to “the parasitic existence” of Chronic miasms (vide p. 9, para 2, Chronic Disease, Second Edition 1835) and not merely the very suggestive foot-notes In the sixth edition of Organon (the manuscript of which he was supposed to have completed in 1843 or in February1842, according to Haehl) in a foot-note to sec. 80 he refers the readers to the above-mentioned 2nd edition of “Chronic Disease”.
This shows that what he conceived of the nature of miasms was maintained by him till his death. During the Cholera Epidemic years of 1831 and 1832 Hahnemann was a resolute, clear thinking man of seventy-six. So his writings during this period came out of a mature brain and were not of “lesser” importance just because his scattered articles were collected and published in a book form by Dr. Dudgeon under the name “Lesser Writings”.
Dr. Dudgeon, for instance, charged Hahnemann with “frequent changes and repetition of the same thing, etc.” He certainly failed to reckon the necessities for introduction of a perplexing new thing in questions of life and death. Others with more profound knowledge found in Hahnemann’s huge writings which they mostly misunderstood unwarranted presumption, dogmatic assertion, obscure conception, undue generalisation, incomplete formulations and arguments in a vicious circle.
We point out that Hahnemann was a cautious scientist. How could he write otherwise in absence of positive visual observation? But his intuition and clear logic led him to hint about the invisible living beings which had something to do with incidence and spread of the Cholera disease in an epidemic form. Here a bit of medical history will clarify the situation. Long before Hahnemann’s birth the microscope was invented. The researches of Kircher, Malphigii, Leewenhoek, Hooker etc. (during 1626-1651) established the existence of microbes. But till Hahnemann’s time it was not definitely known whether pathogenic micro-organisms did exist or in the event of their existence whether they had any causal relation with the human organism in the production of diseases. The idea of infection by micro-organisms was also hinted at by G. Fracastoro when he published his book “De Contagione” in 1546 after the great plague epidemic in Europe. Hahnemann was a scholar and a voracious reader. He must have known about Fracastoro’s writings. During the Cholera epidemic the people and medical men were confronted with the same problems of checking the spread of the disease as during the previousplague period. Though Hahnemann, in the beginning was against all classification and nomenclature of diseases, the epidemic diseases where many persons were simultaneously attacked with a very similar type of disease set him thinking deeply and led him to conclude about the existence of “fixed miasms”—proofs of which are before our eyes in his writings of Sec. 73 (Organon, 6th Ed.). Hahnemann came to fix the nature of these “fixed miasms” as living micro-organisms. He wrote four letters concerning Cholera during June to October in 1831—where he not only gave clear hints about the nature of the causative agents, their mode of transmission, their curative treatment but also about the preventive steps to be taken to check the spread of that terrible disease. He wrote about sterilising the infected clothes with a heat of about 80°C; and certainly Hahnemann did not think of sterilising “immaterial, conceptual, spirit-like dynamic forces” with heat (Haehl’s Biography of Hahnemann).
The then medical profession including the great Dr. Hufeland stood for the atmospheric-telluric theory for the cholera epidemic and decried the preventive measures suggested byHahnemann. It was Hahnemann alone who stood for the microbic nature of infection which has been proved up to the hilt by systematic researches of Pasteur and Koch. That Hahnemannwas cornered by Hufeland in certain points proves nothing but the fact that the full and precise knowledge about transmission of infecting organisms was not known to the former. Hahnemann through sheer intuition and clear logic and correct observations anticipated their works.That Hahnemann meant by “miasm” what we mean by microbes is established beyond any doubt.
Negatively it is an action other than mechanical, physical or chemical. Positively it is a qualitative action. If the drugs can possess dynamic action, if the human organism can exert dynamic action, why not the living micro-organisms no matter whether they are visible or invisible ? Allopathy tries toexplain the modus operandi of the process of infection by the interaction of the chemistry of the body with the toxins secreted by the microbes. Hahnemann, on the other hand, claims that the chemico-physical processes just fall short of the total and complex living phenomena. As the drugs act on the living body through their essential qualities besides their physico chemical properties, so the living microbes can also act through their essential qualities (possessed by their life-force) to change the qualitative state of the organism. That’s all, where is the
difficulty to understand this simple thing? During Hahnemann’s time the word “miasm” was used loosely to express many things viz., morbific emanations from putrescent organic matter, animal or vegetable, and sometimes the effluvia arising from the bodies of those affected by certain diseases some of which were regarded as infectious and others not. Hahnemann fixed the connotation and denotation of this vaguely used word—miasm. From the Organon it can be clearly proved that Hahnemann included physical, psychic and these biological causes under the general name of morbific noxious agents. But all these agents act on the living organism through dynamic (i.e., qualitative) actions and interactions to alter the state of health of the organism. The inclusion of biological agents i.e., miasms (in old terminology) or microbes (in modern terminology) in the list of the morbific noxious agents i.e., “contagium Vivum” is the greatest contribution of Hahnemann in the field of medical thought. Dyna- mis means force and force is always invisible and imperceptible to our senses but their existence is inferred through their workings. The immaterial force must have a material vehicle. As substantial entity of a drug is the vehicle and carrier of its dynamic property, so the microbic body is the vehicle and carrier of their dynamic property. Where is the difficulty to understand this?
Hahnemann talked about “Dynamic influences of morbific agents”—and we tried to establish the identity of one group of the morbific agents. Bacteria etc., are living beings and not material substances. Bacteria belong to the group of fission-fungi of the plant kingdom. Hahnemann could not possibly know that but surmised that they must be living beings. He used the word “animated”.
Our human organism is an integrated indivisible whole of mentalised
living matter. It presents different aspects—material, vital and mental—which we take as distinctive entities for the facilitation of our comprehension (aph 15 of Organon 6th Ed.), but which are not so in factual reality. Here, again, we give credit to Hahnemann for anticipating the psycho-somatic conception of modern times. The truth is that the human organism is neither a machine nor a chemical factory nor a vital or psychic being, each to the exclusion of all others but it is a whole including all aspects and at the same time transcending them all. But towards the end of his life Hahnemann leaned more and more to the pure vitalistic school whereas the rapid advances in the knowledge of physical sciences tipped the balance on the side of the materialistic school. History reveals that he was more influenced by the theories of Stahl, Barthez and Hoffmann , who all belonged to the animistic and vitalistic school though
he tried to keep away from the irrational parts of their theories.
Comparative study of the successive editions of Organon shows that this allusion to “vital force” occurs first in the 5th Edition (1833) as “vital force” has often been substituted for the words “Organism”, body, state of health of the previous
edition. In the 6th edition he came to believe in the substantial entity of the vital principle. But this trenchant division into rival schools of thought has lost its significance as the latest development in the knowledge of physical sciences has served to dematerialise matter and found mass and energy to be convertible terms and as theoretical physics pushed to its extremes is on the point of losing itself in the realms of metaphysics. We feel a contradiction and conflict in Hahnemann’s ideas if we read sees. 11, 12, 13 with 15 of Organon, (6th edition). In sec. 15 we read the body-life as a complex indivisible whole, although “in thought our mind separates this unity into two distinct conceptions for the sake of easy comprehension. Here the factual reality is that the body and life are not two entirely separate substantial entities; whereas in aphs. 11, 12, 13 we are given to understand that it is only the vital principle which is primarily affected in disease and which leads to subsequent disorders in the material body. There is a mechanical view of cause and effect implicit behind this statement which Hahnemann shared with the sixteenth and the seventeenth century physicians that the living body did not work itself but it was tenanted by a principle that made it “live”, something immaterial that used the body as a craftsman uses a tool. But if life and body are inseparable and one cannot exist without the other what happens when a man dies ? Surely something which kept the organism alive is missing and the vitalistic school pounced upon this phenomena and asserted the independent existence of the life-principle.
Neither the science nor the philosophy of the West could explain this apparently anomalous phenomenon. For an explanation we have to delve deep into the
realm of metaphysics which is just the thing Hahnemann wanted us to avoid. That is why in a footnote to aph. 31 he wrote that he did not wish to give a hyper-physical (i.e., metaphysical) explanation of the internal nature of the disease or the essential nature of life-force in healthy or unhealthy condition. To him disease is just a state of alteration in health i.e., a qualitative change comprising sensational and functional changes which are perceptible to our senses. The human organism has a material part (body) which is also liable to change but it is the qualitative change which the patient feels and suffers therefrom. But here Hahnemann apparently forgets his body-life integration and like a pure vitalist asserts that this qualitative change is absolutely independent of physico-chemical alterations of the physical body.
This statement has served to make the confusion worse.. The real truth is that though life can never be adequately explained through physico chemical processes it is as futile and untrue to say that life does not consist of chemico-physical processes as to say that poetry does not consist of words. In our Surface-existence mind, life and body are integrated into an indivisible whole. To our senses are perceptible the phenomena of physical mind and physical life which do not exist apart from the material body. But the true mind and true life can exist apart from the body which go away in the event of death. ‘All diseases with which we medical men are concerned belong to our physical nature, whether in the gross physical or vital physical or the mental-physical level. We do not treat mind and life as such but as a mentalised living body. For in this world of matter everything is manifested through it. We do not see Life or mind existing by itself but always as a ‘bodied’ life and embodied mind. How the mind or life has come to be embodied is a metaphysical problem beyond our ordinary mental conception. Hahnemann referred to this fact in his foot-note No. 8 to sec. 12 of Organon, 6th Edition.
Hahnemann did not, could not, and wanted not to delve into these metaphysical questions. He stuck to the plane of phenomena on which he could tread with surer steps and he was satisfied to deduce only those conceptions which were warranted from his observations. Still he was a child of his times and leaned to vitalistic school in his later years. That is why Hughes regarded Hahnemann’s vital theory as a physiological hypothesis.
In aph 31 of Organon 6th Edition, Hahnemann writes that the action of drugs on the living organism is almost unconditional whereas the miasmatic infection is very much conditional, the susceptibility of the organism being a prior condition. As it takes two hands to produce a clap so we require the living body’s susceptibility on the one hand and the miasm, on the other for eventual pro- duction of disease. Leaving the miasm or microbe out of consideration and talking about the production of diseases only with the living body’s susceptibility is one-sided and incomplete. This distorted view axes out the Hahnemannian Homoeopathy. Hahnemann perfectly anticipated that the miasms (microbes) were not the absolute cause but only a conditioned cause in the production of diseases.
Bacteriology has solved the problem to a great extent of prevention of acute diseases, whether sporadic or epidemic; and Bacteriology has rounded off the theory of chronic diseases as propounded by Hahnemann. Whatever may be Hahnemann’s conception of the nature of the morbific agents his approach to the therapeutic problem is different from that of the Allopathic School.
Truth never cramps anyone’s mind; reception of truth leads to further mental expansion. The Organon is a critique of medical philosophy for all times.
A proper and accurate study of Hahnemann’s writing will never lead to difficulty but on the other hand will serve to clear away many misconceptions that have accumulated round the Homoeopathic philosophy.
- Samuel Hahnemann
- Richard Haehl
- Clements Boenninghausen
Many homoeopaths hold the viewpoint that diagnosis of a ‘disease’ is not important. By disease, I mean the descriptive name for a collection of symptoms that individualise a known condition, ie pneumonia, measles, eczema etc.
The reality is, and always has been, as taught by Hahnemann, to treat the DISEASE that the has destabilised the health of an individual. We do not take the collective totality of the personality, the likes and dislikes of the person, we take only the altered state CAUSED by the disease and expressed by the individual affected person.
The two single most useful Aphorisms in case taking are ~5 and ~6. It is beyond the scope of this post to discuss in detail, if truth be told it requires time in a seminar to expand the writings and demonstrate fully so as to inculcate the understanding to reach the heart of a practitioner. If assimilated incorrectly, you will find that a lot of misprescriptions will be made based on faulty comprehension of Hahnemanns words.
This leads me to my next point. I ask a question: Are you a real homoeopath?
Firstly, after many years of thinking on this question, I realise that the question is incorrect. It should be: Are you a real believer in the law of similars?
The scope and sphere of Homoeopathy must be clearly expressed. In a wider sense, Homoeopathy, in the first place, means a method of scientific study and therapeutic practice; in the second place, it means the facts discovered by this method; and thirdly it signifies the theories that have been propounded to explain and correlate these facts. In other words, Homoeopathy implies a particular way of applying drugs to diseases according to a specific principle viz., “Similia Similibus Curentur”, and of potentitiation (dynamisation) of drugs. In a narrower and stricter sense, Homoeopathy means a specialised system of drug therapy, nothing more or nothing less.
As Homoeopathy looks upon diseases as an altered condition of the life principal of a living being, Homoeopathy, as a therapeutic method, is concerned primarily with the morbid vital processes in the living organism which are perceptibly represented by the symptoms irrespective of what caused them. Homoeopathy then is concerned only with dis-eases, per se in its primary functional or dynamical aspect.
With the morbific agents themselves Homoeopathy has no more to do than it has with the tangible products or ultimates of disease. It is taken for granted that the physician acting in another capacity than that of a prescriber of Homoeopathic medicines will remove the causes of the disease and the obstacle to cure as far as possible before he addresses himself to the task of selecting and administering the remedy which is homoeopathic to the symptoms of the case by which the cure is to be effected. Thus Homoeopathy deals directly with disease itself, morbid vital processes manifested by perceptible symptoms in the functional side of disease. In fact, Homoeopathy might well be defined as the science of vital dynamics.
It is confined to and operative only in the sphere of vital dynamics.
As Homoeopathy is primarily and pre eminently a specialised system of drug therapy, it is not a complete system of medicine (in the wide sense of the term); but it might legitimately claim itself to be a complete system of therapeutic medication.
It is supreme within its legitimate sphere because it is a method of therapeutic medication which is based on a fixed and definite law of nature. The time has come for defining the scope and limits of Homoeopathy. Wide as its scope is, it has its limitations as well and we have to be cognisant of this fact.
Homoeopathy may have many gaps which need be filled; may have many points of obscurity which need illumination and clarification and may imply many directions in which researches can be carried out—but it is and will continue to be a distinct system of healing art; it is uncompromising with regard to following items which can be claimed as specialities for itself. The most important speciality of Homoeopathy lies in the distinctive mode of approach to the study of diseases and drug actions. It is a clinical method of approach and the art of individualising patients and drug-actions.
The clinical phenomena are those which render themselves perceptible to our senses as a resultant of the actions and reactions of forces, physico-chemical, vital and psychological operating in and through the diseased human organism.
Homoeopathy disregards all the hypothetical and ever-changing explanations of physiology and pathology and uses this plane of clinical phenomena as a guide to reach the unseen activities operating below the surface.
The second speciality is with regard to classification of diseases. The dominant school of medicine follows the system of classificatory sciences of botany and zoology. It classifies diseases into genus and species. But Homoeopathy goes further and concentrates its attention on individuals—so it is closer to factual concrete reality. The “Totality of symptoms” is taken to be a guide for individualisation.
The third speciality is with regard to this: The essential question in Homoeopathy is not what the patient is suffering from, but in what kind of way he reacts.
Diagnosis in Homoeopathy does not mean the labelling of the patient with the name of a disease and then treating that nominal entity, but diagnosing the patient in terms of drug reaction, which would restore his vital equilibrium. The patient is to be diagnosed in terms of treatment. This is Homoeopathy in a nut shell.
But “it is a shell which some find hard to crack, but when cracked it is found to be packed full of sweet and wholesome meat with no worms in it”—as Stuart Close points out in his book ‘Lecture on Homoeopathic Philosophy”.
The selection and administration of remedies constitute the science of therapeutics, as the investigation of the properties of drugs constitutes the science of Materia Medica. It is impossible to conceive of a science i.e., systematized knowledge, which is not based on some fundamental principle correlating the series of phenomena concerning any particular branch of study. The therapeutic branch of medical knowledge consists of a study of disease phenomena on the one hand and that of positive effects of drugs on the healthy human beings on the other. Hence any therapeutic study is incomplete and unscientific if a general law be not discovered between a natural disease-condition and the action of a drug that will be curative. Homoeopathy supplies such a law—though the orthodox school of medicine apparently denies the necessity for such a general therapeutic law and relies only on unmethodized experience and fallacious reasoning and presumes to claim utter scientificity for itself by borrowing from chemico-physical sciences.
The therapeutic law of Similia Similibus Curentur is a scientific law as justified by the following considerations:
- It is based on observation, correct logical principles of induction, deduction and experimental verification.
- It is based on no hypothesis or speculation but it is just a statement of inter-relation between two series of phenomena viz-, the natural disease and drug-action.
- Like any other scientific law it is made use of in the matter of predicting future results.
- Like any other scientific law it does not attempt to explain the “how or why” of drugs curing diseases but rests contented with giving a clear indication of what drug would be curative in which disease condition.
This therapeutic law of cure, as discovered in Homoeopathy, as regards the treatment of diseases by drugs which, when proved on healthy human beings, possess the power to produce symptoms similar to those found in persons suffering from natural diseases—pursues at its every step the scientific methods of observation, classification, comparison of phenomena perceptible to our senses and does not attempt to enter into the misty realm of metaphysical speculation to divine the essential secrets of nature viz-, life, mind and body and their nature of inter-relationship and the “modus operandi” of drugs in producing symptoms in healthy human beings or curing disease conditions brought on by natural causes.
This law takes into account only the clinical phenomena (i.e.,perceptible alterations of sensations, functions and of tissues) in patients and drug provers—which hold good so long as observations are correct and complete and which are not liable to be changed with every altered biological conception, newer medical terminologies or newer discoveries in physiological and pathological sciences. The clinical symptoms are facts—they do not change but may be added to.
With the help of this Law of cure the study of therapeutic branch of medicine has been raised to an independent status having a life of its own. While deriving its sustenance from truths and conceptions of other sciences auxiliary to medicine it possesses freedom from whatever new knowledge might be acquired in those sciences in course of time.
On comparison with other therapeutic systems (with or without any basic law underlying) the Law of Simile stands out boldest and most free from uncertainties, imperfections and irrationality inherent in others.
The more I read the writings of modern day homoeopathic ‘experts’, the more I realise that we cannot trust in their utterances. A simple thing like translating Boenninghausens Therapeutic Pocket Book from German to English by Allen was mangled. First by the grading system, then incorrect English translation of the German rubrics, and finally by the addition of extra remedies in a manner in which did not reflect the accuracy of the carefulness of grading the symptoms.
It is always best to go to source in order to establish the accuracy of the situation. Here is Boenninghausens own words in the preface to the 1846 edition.
“On account of the large number of remedies, under nearly every rubric, it has been thought indispensable, on account of both the above-mentioned objects, to distinguish their relative values by means of various types, as I have done in my former repertories, and which Hahnemann has repeatedly shown to be necessary. So, throughout the whole work, there will be found five classes distinguished by the type, of which the four most essential ones are in the first division,
Mind and Disposition, under the rubric ” Covetousness,” which may serve as an example. The word Puls, in spaced Italics, occupies the highest, most prominent place. After this follow, in descending order, in simple Italics, Ars. and Lyc, as less important, but still especially distinguished by the characteristics of the remedies as well as by practice. Of a still lower order are the spaced Roman letters in N a t r. and S e p., and in the last rank will be found Calc, printed in Roman letters not spaced. The fifth place, the last of all, contains the doubtful remedies, which require critical study, and which occur most seldom; these are enclosed in parentheses”.
Logic: Why would Boenninghausen include a grade for doubtful remedies? Doubtful remedies can not be graded for usefulness. Why did he state that The four most essential remedies are in the first division?
Further investigation from the handwritten copy of the 1846 printers edition, shows clearly what is meant. The underlining system was like this. Grade 1, no underline. Grade 2, one underline, Grade 3, 2 underlines. Grade 4, 3 underlines.
Further, 20 year later in the reprint, Boenninghausen removed the remedies in paranthesis and left the main work intact. One can only assume that the original parenthesis remedies were included for further study and research. NONE were added to the repertory.
Other homoeopaths of the time acknowledged the grading system. Hering for one.
Herings foreword to His Guiding Symptoms.
Is the same as that in the “Analytical Therapeutics” and in the “Condensed Materia Medica.” A more complete and concise review of the arrangement will precede the Repertory, which is to follow close upon the last volume of this work.
To facilitate the study of the relative value of symptoms, four marks of distinction have been adopted, “Text, Text, Text, Text”, which correspond to the four degrees in Bœnninghausen’s Repertory….”
There is no more to say.
The IHM does not endorse all the views of Peter Morrell as stated in this article. However in respect and fairness we felt it necessary to publish his words as written. We are extremely grateful for Peters work regarding homoeopathy.
Health & Disease
Commencing any assessment of the principles of homeopathy one has to consider the notions of health and disease, not only because they are central to medicine in general, but also because the concepts of health and disease in homeopathy are different from these concepts as they exist in common usage in allopathic medicine. Therefore, it is quite an imperative task to explore and discuss at the outset the specific meanings of these concepts as they exist in homeopathy.
For the homeopath, the state we call health is that natural and dynamic attunement of the whole organism in a harmonious state of smoothly coordinated functioning and balance. Health is thus by definition the state of the whole organism, the whole person, mind, body and spirit, and is not simply the absence of sickness symptoms. By contrast, disease is depicted as any state of disharmony and imbalance in the person manifested by signs and symptoms of disorder, imbalance and malfunction, some coarse or gross and others fine and subtle, some physical, some mental. Sickness is again a state or condition of the whole person and should never be conceived of as being confined solely to certain localised symptoms or to a specific cluster of symptoms that have been given a specific name [so-called disease label] or which are conceived of as an invading entity [named disease] that can, for example, affect whole populations in much the same way. These are entirely allopathic notions, rejected by homeopaths. He dismisses as irrelevant “the name of the disease, sought after so blatantly by his contemporaries.” [Haehl, I, 299] He “despises every useless name of a disease.” [Haehl, I, 299]
Homeopathy eschews broad disease labels, but treats each individual as a unique case of sickness. It regards that there are as many diseases as there are patients. It therefore resists any temptation to clump together cases of a similar type or give them a name or treat them with the same drug, such as has become the standard practice in allopathic medicine.
One ineradicable problem with all taxonomic schemes is that to some degree it is “a system of idealised entities…fictions compounded out of observed uniformities…concepts and categories…conditioned by human aims.” [Berlin, 1997, 301] Because all such systems are “a set of formulas, of imaginary entities and mathematical relationships,” [Berlin, 1997, 302] so to the same degree it is always in part a false and abstract system imposed upon raw reality itself, an “artificial construction of our intellect,” [Berlin, 1997, 302] that is not so much found but made. In reality, “nature is not a perfect machine, nor an exquisite organism, nor a rational system,” [Berlin, 1997, 302] it is rather “a savage jungle: science is the art of dealing with it as best we can.” [Berlin, 1997, 302]
By overlooking “that the disease classification is man-made…they assume…that disease entities somehow have an independent existence,” [Wulff et al, 82] which of course they do not. They are human constructs with no more reality than pipe dreams. The “disease classification is still largely a mixture of disease entities defined in anatomical, physiological and microbiological terms,” [Wulff et al, 77] which is indeed “a man-made classification of individual patients.” [Wulff et al, 77] True and natural disease “classifications are not arbitrary but must be moulded on reality as it is.” [Wulff et al, 88] Thus far, these do not exist.
Sickness in homeopathy is always individualised and idiosyncratic and never a pooled entity based on averages of large numbers of people, a population, as is the regular practice in allopathic medicine. Likewise, in homeopathy there can only be one person with one disease and each person presents a unique combination of symptoms; they do not have several diseases residing in the same person. Everything wrong with one person comprises their ‘disease.’ In homeopathy, there are no ‘diseases’ as such, but just ‘sick persons’ as individuals. In homeopathy, it is not valid to consider disease as external to the patient, or driven by external events, but as resident within the individual and driven mostly by internal processes. This might seem a hairs-splitting difference, but it proves to be both a subtle and also a pivotally insightful distinction between homeopathy and allopathy. It is clear from this why Hahnemann dismissed the very idea of classifying broad categories of so-called ‘diseases,’ and the disease entity model, as ridiculous, unnatural and arbitrarily fabricated human constructs, deriving from a fundamentally false perception of the human organism in health and in sickness.
The body is a dynamic structure constantly being made and being demolished; it is in constant motion just to stand still. It never stops creating and destroying itself at the same time. This means it has a balance of construction activity and destruction activity going on all at the same time. Cells are dying and new cells are being made all the time. Catabolism and anabolism balance each other but are in constant motion. This also gives an insight into the incredible complexity of the organism but also the smoothly coordinated operation of its processes.
The single drug was really the first emerging axiom of homeopathy. In many respects, Hahnemann’s conviction in the use of single drugs sprang independently and with deeper and more impassioned conviction as compared with all other axioms of homeopathy. He strove even from a very early stage in his medical career to simplify the complex medicine of his day, and was inspired always to obtain simplicity in his treatment of the sick.
“A single simple remedy is always calculated to produce the most beneficial effects without any additional means…it is never requisite to mix two of them together.” [Hahnemann, 1805, 469] “An equally important reason for prescribing only the single remedy was that all the provings were of single substances – not of mixtures.” [Coulter, II, 391] “…we must only give one single simple substance at a time.” [Hahnemann, 1805, 469] “Hahnemann insisted that only one remedy be given at a time and continually belaboured his allopathic colleagues for their multi–ingredient prescriptions…” [Coulter, II, 390] “Then let us…agree to give but one single, simple remedy at a time, for every single disease…” [Hahnemann, 1797, 320]
One key aspect of this impulse is his simple, possibly naive, notion that the drugs in use in his day were far too complex mixtures for them to bring any predictable benefit to the sick patient. He maintained that no true knowledge of the effects of drugs existed, that it was all based on hearsay, on tradition and speculation. Therefore, it followed from the critical approach he adopted that he decided that any true understanding of the nature and action of drugs should be based upon single drugs first and that the data so generated must be obtained PRIOR to their use on sick persons, rather than the reverse situation, which had pertained for centuries in a completely corrupt and unquestioned tradition. Drugs were simply used in mixtures and in a somewhat entrenched rote manner as based upon unquestioned and centuries-old formulas. This approach he detested, and rejected passionately, as a major obstacle to medical advance.
He rebelled most forcefully and at the earliest stage in his career against the apothecaries and their wonderful mixtures, which Hahnemann declared to be a bogus profession peddling dangerous mixtures that nobody knew the true therapeutic actions of. He was outraged by and rebelled against the whole tradition and privileges of the apothecaries, who he accused of being fools and of enjoying a wholly corrupt and cosy, parasitic relationship with the equally foolish physicians. He never lost his passionate opposition towards apothecaries and what he saw as their vile and murderous trade. He gave them no quarter and was unrelenting in the venom and bile he unleashed on them even to the end of his long life.
Therefore, in this manner, the first aspect of homeopathy to be truly enunciated was that of single drugs, because it was the first and most powerful conviction that Hahnemann had formulated from his very unhappy engagement with Galenic medicine: “homeopathy is more closely related to the medicine of Hippocrates and of Paracelsus than to that of Galen…and [thus] has much in common with two ideographic periods.” [Guttentag, 1178] “Galen’s dogmatisation of the doctrines of Hippocrates had been a sacrosanct, unassailable property of humanity,” [Gumpert, 14]
He became deeply and intuitively convinced that mixed drugs were fundamentally wrong and that single drugs alone spelled the true path for a sane and rational medicine. He condemned the allopathic use of unrecognisable mixtures of drugs by the “commingling of several such unknown substances in one prescription.” [Organon, xxviii] the therapeutic effects of which were inevitably unknown. He “was a most passionate opponent of mixed doses that contained a large number of ingredients.” [Gumpert, 96] Hahnemann “was the first to raise his voice against the compounding of prescriptions, holding that the effects of compounds on disease could never be known precisely.” [Coulter, II, 335] Then “let us…agree to give but one single, simple remedy at a time, for every single disease.” [Hahnemann, 1797, Lesser Writings, 320] He condemned the “employment of the many-mixed, this pell-mell administration of several substances at once…these hotchpotch doses.” [Lesser Writings, 1808, 498] He was very “outspoken in his contempt for every mixture of medicines,” [Haehl, I, 308] revealing his “rejection of compound medicines.” [Haehl, I, 308] On this point he never deviated during his long life and was disposed on only the slightest provocation to pour tremendous scorn on the pharmacy of his day.
How true this is even in our day too! But the simple apothecary is now replaced by huge pharmaceutical enterprises, a billion dollar affair and an immense political, media and social influence. So, in principle here is a serious problem Hahnemann put for the first time…WHO is managing health, the doctor or the big-pharma business?
One later reason for single drug use was also his theory about the vital force. The homeopathic remedy doesn’t act directly but by intermediary action and reaction of Vital Force of the patient. As diseases are viewed as “dynamic derangements,” so a single drug at once is to restore in a unique and coherent way the action and direction of the Vital Force. More than one remedy would create confusion, like an army conducted by more than one commander, which, at the same time tries to act on more than one front spreading and so diluting its forces. However, we have to mention that, for a short period of his life H was attracted by Aegidi to the idea of two simultaneous remedies, but he abandoned the idea because he was convinced by Boeninnghausen and others that accepting two drugs at a time could re-open the Pandora’s box of polypharmacy, which was not a suitable option.
On the other hand, the “single drug” principle doesn’t mean that he did not sometimes use remedies in alternation or in short succession. The change in the aspect of Vital Force—the image of the sickness—demands a change of remedy. On the other hand, as he stated in the 4th Organon, the remedy must be left for enough time to act.
Similars and single drugs really emerged together in Hahnemann’s scathing analysis of allopathy. It is hard to separate them even for convenience. The law of similars was first formulated by Hahnemann through a prolonged literature search which then inspired trial and error, and experiments, gradually revealing to him, and convincing him of, the superiority of similars as a medical maxim over contraries, which was the central axiom of Galenic medicine in which he had formally been trained.
“One should apply in the disease to be healed…that remedy which is able to stimulate another artificially produced disease, as similar as possible; and the former will be healed—similia similibus—likes with likes.” [Haehl, I, 66] “The primary characteristic of homeopathic medicine was the law of similia…” [Rothstein, 165-6] “Hahnemann called the ‘law of similars’ a ‘law of nature’ discovered ‘by the observation of nature and my own experience.” [Defence of the Organon, 1896, USA, 76, in Coulter, II, 362] “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] There occurred to him an “association of ideas that led him to suppose that he could cure fever with fever, instead of by the brutal current method of the evacuation of ‘pernicious juices.” [Gumpert, 68] When he published his Essay on a New Principle in 1796, “this work was the successful attempt of a man buried alive to force his way out into the open air.” [Gumpert, 86] Similars was indeed “the doctrine which was to redeem him from the medical nihilism of despair.” [Gumpert, 104]
“Hahnemann considered the production of his ‘mercurial fever’ necessary for the cure of syphilis;” [Ameke, 103] “a kind of artificial fever must be produced by Ipecacuanha, in order to cure certain forms of intermittent fever.” [Ameke, 104] He held “the view that in insidious fevers from unknown causes in which the vital force is sluggish, a new, strengthening and efficaciousfever must be excited.” [Ameke, 104] He “remarks that the mercurial disease resembled that of syphilis.” [Ameke, 104] “By choosing a remedy for a given natural disease that is capable of producing a very similar artificial disease, we shall be able to cure the most severe diseases.” [Ameke, 107]
Because Hahnemann was in a state of profound dissatisfaction with Galenic medicine, so he had in effect been rendered deeply sceptical of the therapeutic legitimacy of its core maxims, viz: mixed drugs in strong dose based on contraries, and its main therapeutic method: bleed and purge. This fact must naturally and inevitably have inclined him sympathetically towards consideration of the potential usefulness of the opposite maxims to Galenism: small doses of single drugs, employed through the more Hippocratic notion of similars.
Hahnemann instinctively detested the use of strong doses of mixed drugs so much in vogue at that time: “the prolonged use of violent, heroic drugs in strong, increasing doses, the abuse of calomel, corrosive sublimate, mercurial ointment, nitrate of silver, iodine and its ointments, opium, valerian, cinchona bark and quinine, foxglove, Prussic acid, sulphur and sulphuric acid, perennial purgatives, bloodletting in torrents, leeches, fontanels, setons, etc.” [Hahnemann, Organon, v.74] It is interesting, if not ironic, that many of these drugs whose over-use he condemns were the first to be proved and incorporated into the homeopathic materia medica!
Therefore, as he set out on his quest for medical enlightenment, it is fair to say that he was already naturally predisposed against the Galenic maxims and leaning more towards those which duly became the core maxims of homeopathy. This was the situation he naturally found himself in even before he set out on his search. Yet, even in spite of this statement of the situation, we must dismiss immediately any notion that he had a predetermined vision of what homeopathy was, before he independently validated each separate axiom of it, and which simply unfolded for him quickly under its own momentum.
This is an incorrect view of the facts. In reality, he still took a very long time to independently verify, through observation and careful experiments, each separate strand of what eventually became homeopathy. He chose to very thoroughly test and validate each axiom over a period from roughly around 1783 to 1801, starting with similars and single drugs and ending with small doses. Such a slow process of unfoldment clearly does not support the notion that he merely followed a simple, predetermined plan, and such a notion must therefore be dismissed out of hand at the start.
Hahnemann had noticed, “a drug imposes its own disease on the patient and wipes out the natural disease.” [Wheeler, 1944, 170] He observed that “the symptoms of Mercury poisoning were very like those of secondary syphilis. That was noticed by John Hunter long before Hahnemann.” [Wheeler, 1944, 170] A similar notion flows from the observation that “the children who did best on tartar emetic in pneumonia were those who had as well gastro-enteritis, i.e. presented more symptoms similar to those of the remedy.” [Wheeler, 1944, 170] Homeopathy then “is exclusively the science and art of the investigation and application of the similia similibus curentur phenomenon.” [Guttentag, 1176]
Similars should also be profound not superficial. This means that the similarities between drug and patient must be deeper and more extensive than just a few broad symptoms. It is also clear from this account that Hahnemann did not construct a theory of medicine first and then find facts to support it, as has been claimed in some less informed quarters [e.g. “Hahnemann had cast homeopathy in substantially the same eighteenth century mold that had given shape to the systems of Cullen, Brown and Rush.” Warner, 1986, 52-3] On the contrary, he distilled each axiom separately and directly from an extensive body of medical literature, from cases, from observation and experience, and thus from considerable reflection upon a large corpus of evidence. Such an approach is certainly an inductive approach a la Bacon, but it was based initially upon a deep dissatisfaction with the medicine of his day, which inspired his search, rather than upon a pure devotion to the methods of experimental science per se as defined by Bacon and Galileo, for example.
Similars must cover specifics and generals, modalities and rare or peculiar symptoms as well as the ideas presented above. This is what Hahnemann discovered. It is not simply a similarity confined to a few symptoms here and there. In other words, some broad and general similarity between patient and drug does not at all form a sufficient basis for a prescription. A much deeper, more detailed, individualised, specific and idiosyncratic level of similarity is required for a “true fit” to be seen to exist between patient and drug. Partial similarity will improve or palliate temporarily, but not cure. The best and most detailed similarity is always correct and curative.
There is a however another corollary of similars that needs some amplification. Similars necessarily embraces case totality both in the drug picture and in the patient. This means that there must exist a deep similarity or resonance between the case in total, as a whole, and the drug picture of the most suitable remedy. Similars does not therefore simply mean the similarity that might exist between a few specific symptoms here and there or based upon some arbitrarily defined named disease entity.
All these points illustrate quite well the interconnectedness of homeopathic ideas as forming a general continuum or whole system of tightly cohesive ideas and notions, which blend neatly into each other. It is a coherent and holistic system and it is thus difficult to separate any one aspect of it and isolate it from all the rest to which it is intimately related and connected.
Provings, Poisonings and Signatures
Having decided that only single drugs were to be employed in a sane and rational medicine, the next task Hahnemann encountered was how to decide what healing properties any drug actually contains hidden within it, and how this information might be obtained. Dismissing at the outset such ideas as the doctrine of signatures, the answer to this problem came to him from consideration of the effects of poisons, in which he had had a long interest and fascination.
In turn, the law of similars springs first from Hahnemann’s studies of poisonings and second from his proving experiments. Another stream of ideas flowed from his deep interest in poisons, which reveal the effects of drugs upon the healthy. For example, his publications: On Arsenical Poisoning, 1786; The Complete Mode of Preparing The Soluble Mercury, 1790; On The Best Method of Preventing Salivation and The Destructive Effects of Mercury, 1791; What Are Poisons? What are Medicines? 1806. There seems little doubt that these studies formed an important prelude to his provings, which are afterall merely mild forms of self-poisoning for experimental purposes. He therefore decided that the only way to accurately determine the detailed ‘sphere of action’ of any single drug was to take some yourself in small doses and accurately explore and record how it can temporarily derange one’s own health.
Heuristically, he found that yes indeed, all drugs are ‘poisons’ that can more or less derange health and induce artificial illness states. The provings were partly inspired by accounts of accidental poisonings—thereby opening up an entirely new pathway to therapeutic knowledge. This meant that many previously “highly poisonous substances,” [Ameke, 131] could now be safely brought into use as harmless healing agents. They could indeed be “converted into…powerful remedial agents in the hands of a skilful physician.” [Ameke, 131] Hahnemann felt that “medicines become poisons simply by imperfect use; in themselves no medicines are poisonous.” [Haehl, I, 75] “He zealously occupied himself…with the collection of cases of poisoning.” [Ameke, 101] His view was that “those substances which we term medicines are unnatural irritants…[that] disturb the health of our body…and excite disagreeable sensations.” [Ameke, 101] “Within the infant rind of this small flower Poison hath residence and medicine power.” [Shakespeare] “Day after day, he tested medicines on himself and others. He collected histories of cases of poisoning. His purpose was to establish a physiological doctrine of medical remedies, free from all suppositions, and based solely on experiments.” [Gumpert, 92] “Hahnemann very carefully argues the question of the new law; he adduces many results of poisonings by drugs, gives his experiences in the uses of medicines…and records the symptoms that certain medicines produced on himself and others.” [Bradford, 58]
The proving was just the start. “Hahnemann having, by his simple and rational experiment with Cinchona bark in 1790, conclusively established the great therapeutic law, that to cure diseases medicines must be used which possess the power of exciting similar diseases, at once perceived that the whole edifice of the old Materia Medica must be rebuilt from the very foundation, as that Materia Medica furnished nothing positive regarding the [true] pathogenetic actions of drugs.” [Dudgeon, 176] Clearly also, “Hahnemann’s dose reduction made possible the systematic use of poisons in medicine. While this had been recommended by von Stoerck and others, it could not be practised as long as large doses were considered necessary…the homeopathic pharmacopoeia later used dozens of the most powerful poisons: Belladonna, Aconite, Arsenic, Strychnine, Rattlesnake.” [Coulter, II, 403-4]
Provings and poisonings reveal Hahnemann’s abiding interest in drugs and their actions and his Pharmaceutical Lexicon was in many respects the forerunner of his Materia Medica Pura, and it is this deep interest in drugs and their effects that reveals and explains the basis of his enormous respect for Albrecht van Haller. What Hahnemann did with this interest was to explore the primary and secondary effects of drugs and poisons—that is where it took him—and from there he went on to observe and distil great principles about the actions of single drugs on healthy people and in turn on the sick. These can all be found in great detail in the Organon.
Homeopathy uses provings of single drugs to determine their precise sphere of action; these provings have been conducted upon healthy human volunteers, and do not employ animal experiments, for example: “his great endeavour was to found a physiological materia medica.” [Ameke, 101] Hahnemann “neatly and conscientiously assembled and numbered his observations of the symptoms excited in himself and his children by the most varied of medicines.” [Gumpert, 114] There followed “a period of twenty years during which Hahnemann worked prodigiously to accumulate data in support of his ‘law of similar’ as it came to be called. An immense Materia Medica was compiled, and he conducted continuous experiments on himself, his friends and those of his colleagues who were curious and willing.” [Cameron, 29]
The proving can be said to arise at the point of convergence of Hahnemann’s detailed knowledge of sickness, poisons and drugs and his uncompromising desire to ground medicine solely in empiricism, that is, observation and experiment. He reserved his greatest respect 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] The proving idea mirrors exactly the incredible information Hahnemann had unearthed in the literature of cases of poisonings, but in provings this is expressed in a muted and more subtle form.
By ingesting a small dose of a substance over a few days one can begin to gain great insights into the nature of a drug, because what is revealed in the proving is the drug’s sphere of action within the body, what organs and systems it affects [resonates with] most strongly and what subtle impacts it has on likes and dislikes, modalities, sleep, dreams and mental states. When compiled together, this information translates into the drug picture [therapeutic image] of the drug in question as recorded in the materia medica. In many respects, this image represents the inner essence of that substance. And it is here perhaps that we can see a subtle connection between the proving and poisoning with the more ancient doctrine of signatures. “According to the doctrine of signatures, widely believed in many cultures, features in the appearance of a plant indicate its utility,” [Steiner, 26] Hahnemann “definitely rejected [the law of signatures]…in his Materia Medica Pura we read under Chelidonium…’the ancients imagined that the yellow colour of the juice of this plant was an indication (signature) of its utility in bilious diseases…the importance of human health does not admit of any such uncertain directions for the of medicines. It would be criminal frivolity to rest contented with such guesswork at the bedside of the sick.’’ [Hahnemann quoted in Hobhouse, 1933, 137-8]
“Paracelsus was also a firm believer in the doctrine of signatures, and in illustration of it explained every single part of St. John’s Wort [Hypericum perforatum] in terms of this belief “…the holes in the leaves mean that this herb helps all inner and outer orifices of the skin…the blooms rot in the form of blood, a sign that it is good for wounds and should be used where flesh has to be treated.” [Griggs, 50]
Arguably, it shows an underlying essence of the substance common to both and which might also be intuitively realised from observation and deep reflection as well as from actual provings. This also connects homeopathy with the various Flower Essence remedies now in quite widespread use.
We can also say that Hahnemann was a pioneer of the “medicine based on fact” or “evidence based medicine.” Hahnemann’s primary aim or ambition was to base medicine solely on solid ground, on facts and therefore he had toxicology and provings as pillars to build a solid data-base of all actions of substances on man.
Toxicology and the so called “side-effects” of drugs represent the involuntary, accidental, uncontrolled side of this topic, and reveal the gross and lesional aspect of the effects a substance can induce. Provings are the voluntary, controlled, conscious and experimental side, and so to say, the more subtle physiological and psychological side of the same phenomenon. Another point that came from provings is the idea of some specific reactions of individual nature, coming from susceptibility and sensitivity of individuals. From these arise the later notion of “sensible typologies,” which denote a complex description of the most reactive individuals to some remedies.
Not only in the case of the provings of drugs, but also with regard to the detailed study of medical similars, there has probably never been in the entire history of the world a single person who has studied the effects of drugs on the human subject more thoroughly than Samuel Hahnemann. In provings and in poisonings, Hahnemann’s pioneering work noted—dissected in detail—both the primary and secondary effects of drugs, and in studying the cures of the past he was able to show that the secondary effects usually mirror the primary and are often curative responses initiated by the vital force, opposite in their nature to the primary effect of the drug on the human system. Nowhere else in the medical literature, outside of his writings, has this information been studied and tabulated in such detail. Nor anywhere else has this data been slowly distilled to engender core therapeutic principles of such awesome predictive power.
This can be seen to derive in part from having no concept of a disease entity acting as the cause of a sickness. It comes from having no disease label and it also springs naturally from the provings, from observation in clinical practice and is thus primarily an empirical idea. It also derives from the conceptual meeting point of his translation work and the provings. It is important to understand why.
While working on translations, Hahnemann found and collected numerous references to specific drugs for specific symptoms, ailments or specific disease labels, and to examples of the effects of poisonings. What exactly did this material mean to him and how did it affect his thinking? Once he came to prove a drug [e.g. Cinchona in 1790], he then saw its effects really comprised a case totality rather than a specific for a named disease or group of symptoms. In other words, in proving a drug he found its action was not to create specific symptom clusters, but to impact more broadly on all mental and physical aspects of organism functioning, and thus creating an image of totality rather than merely being confined to a narrow range of specific actions. Therefore, there was a certain disparity between the references he found to the use of drugs, as found in the literature, which tended to be specific, and their actual effects in the provings. This disparity must have changed his views, probably radically.
His findings therefore meant that in similia such proved drugs were suitable to be employed not for quite narrow specific groups of symptoms [= named diseases], but only for a broader case totality. Then in using these proven drugs in clinical practice, via similia, he accidentally encountered the incredible sensitivity a patient manifests towards their specific similimum. Therefore, he also saw that any new ‘medicine of specifics,’ could not conceivably be a medicine of a specific drug fro a specific disease label, as he had probably imagined, but for a specific drug profile delicately matched and appropriate for a specific individual patient, as a holistic entity. The distinction between these two categories might seem subtle and thunderously hair-splitting, but in reality it is a crucially significant difference, that was to cast asunder the allopathic from the homeopathic systems. This distinction in fact creates a wide gulf between the two both at the conceptual level and at the practical level. Hahnemann saw that there would henceforth be no possibility, no option ever to treat a small group of localised symptoms with homeopathy; it would be case totality or nothing.
Basically, what Hahnemann showed is that all cases of what we term ‘disease’ are ‘totalities’ of symptoms or totalities of health disorder and NOT named diseases as conceived in allopathic practice. He could see the wider picture of each individual case rather than the narrowly fragmented view that naturally follows from the named diseases approach to the sick person. They are different ways of seeing the sick person and hence quite different ways of looking at the very nature of sickness. One is fragmentary and concerned with parts, and the other is holistic and concerned with wholes.
Hahnemann took the view “that physicians assess not only the cause of the illness, but all aspects of the patient,” [Porter, 172] As with Hegel’s philosophy, the “central thought is, then, that only the whole is real; the partial fact is only an abstraction, which needs to be brought into connection with the whole in order to gain validity. ‘The bud disappears in the bursting forth of the blossom, and it may be said that the one is contradicted by the other; by the fruit, again, the blossom is declared to be a false existence in the plant, and the fruit is judged to be its truth in the place of the flower…” [Rogers; 409] He believed that “the disease is reflected in the totality of the symptoms,” [Haehl, I, 292] Hahnemann “was very conscious of the danger,” [Guttentag, 1187] of focusing too narrowly on “one symptom rather than of the whole symptom complex.” [Guttentag, 1187] “not only a single symptom or a single chain of symptoms must be removed,” [Guttentag, 1187] one must remove “the totality of symptoms.” [Guttentag, 1187] For “the whole clinical picture guides the homeopath toward the proper drug…[one that can] produce a similar sum total of signs and symptoms,” [Guttentag, 1187] this is the similimum. Homeopathy “prefers to explore rather than to explain. It emphasises exhaustiveness in observation and stresses the significance of phenomena in terms of the organism as a whole,” [Guttentag, 1176-7] rather than a fragmented view of its parts. It seeks to describe rather than explain. It “considers the single patient as indivisible and unique…as not accessible to the method of measuring,” [Guttentag, 1177] so beloved of the allopaths.
Case totality principle (“Inbegriff des Symptome“) comes also as a direct consequence of the ‘totality of actions’ of remedies as revealed from provings. The differential diagnosis in homeopathy is not based on theoretical nosologic “standards” but on real symptoms, sometime not in a direct connection with the basic affection, that reflects the individual and specific reactional patterns. Because these patterns are external, observable symptoms that reflect in their turn the subtle and unobservable mis-attunement (Unstimmung) of the vital principle. Such semiological notions as modalities, localities, sensations, etc, have all to be carefully observed because they are the expression of the individual vital force reactions. One remarkable point in Hahnemann’s perspective that comes from this is the principle of coherence: disease is not a mere mix of symptoms, but a coherent reaction of the vital force as a consequence of its inner perturbation, of its ‘functional turbulence’ that we call sickness.
Homeopathy looks for the totality of the case because it has significance from the therapeutic point of view. In allopathy, to collect all the symptoms has no real therapeutic meaning; it collects symptoms to eliminate them afterwards because the only symptoms it considers are the common ones, the “disease symptoms.” On the contrary, in homeopathy even the most minor and peculiar symptoms are potentially of greatest importance; they reveal the individuality with its peculiar determination.
In his work with single drugs Hahnemann soon discovered that the process of matching a drug and a patient requires much greater subtlety and skill than is imagined. In particular this includes the idiosyncratic element of individuality and the rare and peculiar symptoms. Idiosyncrasies reflect also the fact that, from a reactional point of view, humans are not a tabula rasa, they come with inherited traits, they acquire others during the events of life in such a way that every individual is highly personalized and unique. This view stands in the starkest contrast to allopathic view of health and sickness viewed as they are solely through the filter of averages. Propria and communia, what is idiosyncratic and unique to an individual case, and what is common to all cases of a ‘disease;’ this connects with concomitants and ancillary drugs used in the medieval approach.
The inability of scientific medicine to individualise induces a focus not upon “the common symptoms [communia]…” [Coulter, II, 249] those common to many people [the communia]—as in allopathic medicine—but a focus upon “the symptoms peculiar to the individual,” [Coulter, II, 250] case [the propria symptoms]. The latter are much “more reliable criteria…for distinguishing one patient from another,” [Coulter, II, 250] and in most cases “the patient’s habits and mode of life were the most important of the propria.” [Coulter, II, 250] In ancient medicine “they separated the propria from communia with the aim of coming as close as possible to the idiosyncrasy of the patient.” [Coulter, II, 250] It is “that which distinguishes him from all similar patients,” [Coulter, II, 251] and which distinguishes this “patient from all others of his class. Each sick person is unique in his sickness, and the sickness is unknowable in its essence.” [Coulter, II, 251] By relying on “propria over communia they incorporated into their method precisely the characteristics which distinguish the individual patient from all others like him.” [Coulter, II, 498] Allopathy is more properly rooted in an impulse “to note the number of similarities in the behaviour of objects and to construct propositions…” [Berlin, 1996, 21] By contrast, homeopathy is rooted in an opposite principle “to bring out what is specific, unique, in a given character or series of events…respects in which it differs from everything…[and] conveys the unique pattern of experience.” [Berlin, 1996, 22]
All homeopaths become cognisant of “the large amount of individualisation demanded by Hahnemann.” [Haehl, I, 92] Osler when he said that “it is much more important to know what sort of patient has a disease than what sort of disease a patient has.” [Maizes & Caspi] Therefore, we can say that Hahnemann makes a clear and wide deviation from all previous medical systems by insisting that disease is an individual phenomenon and that medicine must primarily base its rational and truly curative treatments upon the unique aspects of each case and not upon the aggregated ‘common symptoms.’ For clearly, what he is saying is that the true nature of any case of sickness lies primarily and fundamentally in its unique individuality and not in the symptoms common across many various cases of a similar type.
Idiosyncrasies form a common basis for the most peculiar symptoms coming from provings and those coming from sick persons. The same principle reveals a mirror-like situation: the most sensitive or susceptible individuals will reveal the most peculiar symptoms in provings, but the most peculiar symptoms in disease are signs that the individual is highly sensitive to a substance.
An interesting rapport between idiosyncrasy, individuality and wholeness is the main core of Hahnemann’s consideration: idiosyncrasy individualise, disrupt the uniformity of reactions, the persons, healthy (in provings) or ill (in therapeutics) are different. But as long as one consider the totality, individuality expresses itself as a wholeness, such that the person is never cut into pieces and all his/her parts remain integrated in a more comprehensive understanding, or fully rounded picture. This is a recuperation of the phenomenological view about humans and therefore homeopathy has less to do with the abstract notion of MAN, but with the more concrete individual man “as such.”
Allopathy, ever since the days of Sydenham, makes the exact opposite claim, and all its treatments are based solidly upon the notion of pooled data, averages, l’homme moyenne and what is common to each so-called “disease entity,” a concept Hahnemann derided as a ludicrous and quite arbitrary human construct, something unnatural, made and not found. Therefore, in this topic we begin to see one of the very strongest contrasts between the conceptual views of the allopaths and homeopaths.
The small doses of homeopathy were the last axiom and were entirely arrived at empirically through the desire to reduce [alleviate, and avoid] the impact that doses of the most similar remedy can have upon the patient. One of “homeopathy’s prime principles…in a nutshell…that drugs increase in potency with their dilution.”[Cameron, 30] Here we have to emphasise the high moral and deontological aspiration of homeopathy, which completely considers as valuable the Hippocratic principle of “primum non nocere“. This is part of the basis of the small dose: a small dose that can induce healing, does the least harm. Hahnemann found that the most similar drug had a uniquely powerful [often astonishing] ability to elicit strong reactions in the patient and for this reason could elicit aggravations of symptoms.
Hahnemann “advocated ever more definitely the administration of small doses.” [Gumpert, 96] “It is in his little work on Scarlet Fever, published in 1801, that we have the first forebodings of an unusual mode of preparing the medicines…the dose of Opium there recommended…is very small compared with the ordinary dose…the object of this dilution was to diminish the power of the medicine chiefly…for patients of very tranquil disposition.” [Dudgeon, 338] “Hahnemann…perplexed by the aggravations resulting from ordinary doses, seeking to find a dose so small that it would not endanger life and desiring to accurately measure his degree of dilution so that he might repeat or retrace his steps, invented or adopted the centesimal scale…” [Close, 218] “His discovery of the principle of potentisation came about gradually as he experimented in the reduction of his doses, in order to arrive at a point where severe aggravations would not occur. Gradually, by experience, he learned that the latent powers of drugs were released or developed by trituration, dilution and succussion.” [Close, 190] “Hahnemann’s final views and practice in regard to the dose were arrived at gradually, through long years of careful experiment and observation.” [Close, 189] “A hint of his growing conviction that remedies should be prescribed in high dilution was given in..(an article)..published in 1788.” [Cook, 51] “Hahnemann’s dose reduction made possible the systematic use of poisons in medicine. While this had been recommended by von Stoerck and others, it could not be practised as long as large doses were considered necessary…the homeopathic pharmacopoeia later used dozens of the most powerful poisons: Belladonna, Aconite, Arsenic, Strychnine, Rattlesnake.” [Coulter, II, 403-4] “In the Organon, however, he stated that trituration and succussion release the ‘spirit-like power’ of the medicine – which is compatible with his assumption that medicines act through their spiritual [geistlich] or dynamic impact upon the organism.” [Coulter, II, 403] “His discovery of the principle of potentisation came about gradually as he experimented in the reduction of his doses, in order to arrive at a point where severe aggravations would not occur. Gradually, by experience, he learned that the latent powers of drugs were released or developed by trituration, dilution and succussion.” [Close, 190]
He was alarmed and amazed to observe the great sensitivity a patient shows towards even small doses of the most homeopathic remedy for their case. Ever smaller doses were conceived by him for the pragmatic purpose of alleviating or avoiding these bad reactions evoked in patients by the most similar remedy. Already naturally inclined in the direction of adopting much smaller doses than his medical peers [e.g. Mercury], he was thus inspired to find ways of reducing dosage progressively and also in a mathematically precise way. This is how and why he first entered the field of dose reduction. The tiny doses of homeopathy can also be said to reveal a link to the more metaphysical ideas like vital force and miasms because they all partake of a subtle and non-molecular dynamic.
In his later views, the dose reduction is a problem of attunement between the subtlety of the target (vital force) and the subtlety of the means [the potentised drug]. Both vital force and potentised remedies are dynamic “spirit-like” entities and to use the second to correct the ailments of the first might be said to proceed as a natural consequence of his spiritualistic view. Actually, the diluted and potentised remedies of homeopathy are the greatest problem of its acceptance by the scientific world, because many of the remedies used are beyond the Avogadro number or, so to say, “ultra-molecular,” beyond the limit a molecular and materialistic paradigm can conceive. The fact that, however, they are therapeutically efficient opens a great problematic field about this paradigm itself, and creates a deep tension between homeopathy and conventional science.
The basis of these small doses was empirical, that is to say, they were arrived at through experience and trial and error; the doses were arrived at by Hahnemann in an attempt both to progressively reduce the toxic action of the drugs, but also to retain the therapeutic action; the result was smaller and smaller doses. “no poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly,” [Simpson, 11]
In his ‘Essay On a New Principle’ of 1796, 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, 49-50] The small drugs homeopathy employs are produced in a unique way by shaking and diluting in a serial manner in dilute ethanol; the chemical and physical basis of this method—in terms of modern scientific conception—remains a mystery, but was also arrived at empirically, by trial and error. This potentisation method somehow imprints the essence, or energy pattern, of the plant, mineral or animal drug upon the dilution medium, which can then be transferred to lactose pills. “We cannot fail to be struck by the sudden transition from the massive doses he prescribed in 1798 to the unheard of minuteness of his doses only one year later, and we can but guess the causes for this abrupt transition.” [Dudgeon, 395 6] “Hahnemann’s idea at first was simply to reduce the “strength” or material mass of his drug, but his passion for accuracy led him to adopt a scale, that he might always be sure of the degree of reduction and establish a standard for comparison.” [Close, 216] The “principle of the infinitesimal dose [is]…an outrage to human reason,” [Forbes, 17 and Nicholls, 121] and “the doctrines of potentiation and the infinitesimal dose has always been the central point of attack upon homeopathy by its enemies.” [Close, 215] “In the United States, regular physicians…found Hahnemann’s theories absurd and incredible. Reasoning that no one in his right mind could believe such arrant nonsense, they concluded that homeopaths must be either knaves or fools.” [Blake, 86] “His discovery of the principle of potentisation came about gradually as he experimented in the reduction of his doses, in order to arrive at a point where severe aggravations would not occur. Gradually, by experience, he learned that the latent powers of drugs were released or developed by trituration, dilution and succussion.” [Close, 190]
This crucial concept is mostly derived from empirical observation and experience with cases, especially when taking into account longitudinal case studies [through time] which show that suppressed foot sweats can lead to asthma, for example, or suppressed skin rashes, etc can lead to respiratory conditions [tonsil or sinus troubles]. Any set of symptoms removed by a crude drug can be regarded as a form of suppression.
As with chronic miasmata, the conceptual model of suppression probably first arose in Hahnemann’s mind from his extensive knowledge of venerology, where, for example, the suppressed chancre of syphilis leads to further secondary morbid manifestations or morbid alternations; likewise with the suppressed gleet of gonorrhoea. The main problem of this principle is a well balanced primary treatment of the acute diseases. As long as the primary conditions are treated in their natural extensor, as a condition that regards the whole organism itself, then treatment leads to cure. Suppression only arises when the disease is not treated in its whole extent, and instead of treating the complete condition, some local symptoms alone are treated. In this way, the named symptoms are excluded from their deeper context, the disease remains hidden in the interior and develops stronger and deeper forms. Hence, whenever the treatment is aimed at parts, mere symptoms, superficial physiological or pathological manifestation, it is suppressive. This doesn’t mean that homeopathy doesn’t treat acute or partial conditions, but its aim is to treat the integrity, the causes and the profound layers.
Hahnemann took the view that chemical drugs “suppress and hide the morbid symptoms by opposition [contraria contrariis] for a short time [palliatives].” [Organon, xxviii] Old school medicine considers disease as being “purely local and existing there independently, and vainly supposes that it has cured them when it has [merely] driven them away.” [Organon, xxviii] Allopathy turns one disease into another [metastasis] and makes a bad situation even worse by using “corrosive sublimate and other mercurial preparations in large doses,” [Organon, xxix] thereby “continually weakening and tormenting the debilitated patient.” [Organon, xxix] Hahnemann regarded this approach as indeed a “most senseless mode of treatment…[and a] mischievous so-called art.” [Organon, xxix] Homeopaths have always regarded drug-induced changes in cases as fundamentally uncurative acts: any “removal of the tangible products of disease…does not cure the disease, but does the patient a positive injury.” [Close, 73] As Close then adds, “the suppressed case always goes bad,” [Close, 75] to which Kent adds: “all prescriptions that change the image of a case cause suppression.” [Kent, 661] Suppression or palliation of disease “is the removal of the external symptoms of disease by external, mechanical, chemical or topical treatment; or by means of powerful drugs, given internally in massive doses, which have a direct physiological or toxic effect but no true therapeutic or curative action.” [Close, 75- 76] Kent exhorts: “The healthier the patient becomes the more likelihood there is for an eruption upon the skin. The vital energies must be sufficient for this. A cure progresses from within outward.” [Kent, Aphorism 442]
In the example of a skin disease being treated by lotions and creams externally applied, the symptoms are removed from the skin, and the condition alleviated or palliated, but the deeper internal cause of the malady is still present and its true focus is then moved inwards away from the skin. As Hahnemann discovered, and later homeopaths confirmed, the true cure of a skin disease, like any other, lies within, by correcting the deranged vital force, and cannot be cured with material doses of any drug. A view of disease as a “dynamic derangement of the life force,” [see Close, 37-8, 74]
Suppression “or palliation of disease, is the removal of the symptoms of disease by external, mechanical, chemical or topical treatment; or by means of powerful drugs, given internally in massive doses, which have a direct physiological or toxic effect but no true therapeutic or curative action. The suppressed case always goes bad… the abscess and fistula, act as if they were the vent or exhaust of the disease, affording temporary safety to vital organs. Close the exhaust and an explosion follows.” [Close, 74-5] However, “the mere removal of the tangible products of disease by mechanical means as in the case of tumors, or of the external visible signs of disease by topical applications as in the case of eruptions and discharges, not only does not cure the disease, but does the patient a positive injury and renders the case inveterate or more difficult to cure…to the death of the patient from metastasis and the complications which result from such treatments. Disease is only cured by the internally administered similar medicine…” [Close, 73] As an example, “some chronic disease of the liver, kidneys, spleen or lungs [can] be traced back to an initial attack of malarial fever checked by massive doses of quinine or arsenic. The patient has ‘never been well since’…” [Close, 120]
Once this pattern had first been seen and identified, and then became an expected pattern, so it was then found all over the place. Hahnemann soon realized that all changes brought to a case by crude drugs are in fact suppressions because they do not lead to true cure but only to temporary relief followed by relapse, or followed some months later by another disease of a more interior and more serious character or of a more intractable kind. Thus, the idea of suppression goes back to the beginning of homeopathy because it reveals a fundamental problem Hahnemann had identified with Galenic medicine that just removes symptoms [palliates] and then regards that as a cure, when in fact, as he showed, it is merely a suppression. Symptoms are removed or suppressed inwards, but the actual invisible cause of the disease [in the vital dynamism] is still present and dynamically active. It has by no means been cured, but has been forced inwards and upwards to a more sinister and intractable layer of organism functioning.
Hahnemann thus realised later in life that suppression is the very thing which he had instinctively disliked and rebelled against so ferociously in his early days, when he criticised the Galenic ‘purge and bleed’ methods as being both “fundamentally uncurative and harmful” to patients. He realised that his critique showed so-called allopathic cures as merely suppressions of symptoms that only engender first temporary relief, palliation, then relapse and ultimately no deep cure, but just new and more sinister ‘diseases’ breaking out in their train. That is a perfect description of what suppression means and it is precisely the same as the blistering critique of allopathy he launched with such passion at the start of his career.
Direction of Cure
This again is a largely empirical concept derived from close study of cases under homeopathic treatment. Such observations reveal that cures simply tend to move the site of disorder from the inside outwards and from above downwards, and from centre to the periphery. This is called the direction of cure or Hering’s Law. It is not really a law as such, but rather a vague principle that is often found to work out in practice. It also connects with the concept of suppression, of which it is the opposite. While suppression is uncurative and inward-moving, so direction of cure is curative and outward-moving.
Often called Hering’s Law or direction of cure, “cure takes place in a definite orderly manner and direction…normal vital processes, cellular, organic and systemic, begin at the center and proceed outwardly…life is a centrifugal force, radiating, externalizing, …’from above downward’. In the same sense disease is a centripetal force, opposing, obstructing, penetrating toward the center and tending to disorganization… the progression of all chronic diseases is from the surface toward the center; from less important to more important organs – ‘from below upward’. Curative medicine reinforces the life force, reverses the morbid process and annihilates disease. Symptoms disappear from above downwards, from within outward and in the reverse order of their appearance. When a patient with an obscure rheumatic endocarditis, for example, begins to have signs and symptoms of acute arthritis soon after taking the homeopathic remedy and is relieved of his chest sufferings, we know that cure has commenced.” [Close, 132]
The idea of direction of cure probably became also more precise at the time Hahnemann studied chronic disease more closely, because he observed that chronic diseases are more liable to stem from suppressions and the restoration involves a reverse process. In acute eruptive febrile and infectious disease (such as scarlet fever, measles, rubella, etc.) it is a well known fact that the stronger the exanthema, the less are the consequences and the faster is the convalescence. In chronic diseases, as long as the morbid manifestations are inflammatory, the progression towards affecting the deeper layers, inner organs and the immune systems is less grave.
The direction of cure presumes a hierarchy or layers of different degrees of importance on what regards the inner organisation of man. The core, the most important are deeper, higher and central. Deeper are not only the physical inner organs but also the genetic and inherited aspects. In chronic diseases, deepest are the miasmatic layers, the inherited or acquired miasms that manifest as morbid pre-dispositions. Higher and central are considered not merely in a physical sense but in a hierarchical order of importance for the definition of the individuality. Hence, psyche, or the mental symptoms are higher and more central to the physical ones; a disease that evolves with an amelioration of psyche even with the aggravation of some physical manifestation is therefore regarded as following a good direction of restoration.
From the practical point of view, without understanding the basic idea of restoration (Lat. restauratio = to rebuild, to give back, to repair), the directions of cure applied literally can represent a trap. For example, a lower back pain developing as a sciatic neuralgia with progression down towards the toes (from upward downwards) seems superficially to conform to this principle but in fact is an aggravation of the condition. The progression toward periphery or downwards in this case is usually a consequence of the progression of the disease from a simple contracture to an affectation, inflammation or protrusion of the intervertebral discs: so, in spite the disease have progressed from upward–downward, centre-periphery, it is an aggravation because the disease progressed towards deeper layers of physical and physiological organisation: the muscles are less deep and less important then the skeleton.
In chronic diseases, the restoration (or direction of cure) principle regards the successive layer of affections. The proper cure makes a reverse order development of symptoms, the most recent suppressed symptom can eventually manifest first and the more profound ones come later. Hence, this hierarchical underground order of the human being does not manifest itself only in space terms but also diachronically, in time. Deeper, higher, more central, are also older, inherited or closer to the individual definition.
The vital force in homeopathy plays the same role as the vis medicatrix naturae [the innate self-healing powers] of ancient medicine or archeus, or animus of Stahl or archeus of Paracelsus and van Helmont. He actually he denies this, by saying that the vis medicatrix alone is not capable of accomplishing the aim of cure and no cure without homeopathy is possible. It is a metaphysical concept designed to explain numerous observations of how the organism functions both in health and in sickness. It is necessarily conceived as an abstract, unproven, intangible entity that coordinates the body processes and directs bodily events. It is an immaterial entity that stands behind and beneath the chemistry or the cells and directs their activity invisibly just like the conductor of an orchestra. In health, it smoothly coordinates all activities of the organism. In sickness, it ever strives to correct imbalances. Even “Galen recognised, in agreement with Hippocrates, a natural healing power inherent in the body.” [Haehl, I, 283-4] Ancient physicians generally always took the view of medicine as one of “supporting the patient and trusting the healing power of nature,” [Porter, 260] This “life-force dominated all corporeal processes…[and was] a health-defending property,” [Porter, 208] often termed the innate self-healing powers or “natural healing powers of the body,” [Gevitz, 1637]
Hahnemann starts, “with the conception of Life as a real or substantial entitative power or principle…the Dynamis and the Life Force. This is Hahnemann’s greatest discovery, and the absolute bedrock of his system.” [Close, 30-31] Even Sir John Forbes [1787-1861], consulting physician to Queen Victoria, 1841-61, “accepted the homeopathic cures as the result of the Vis medicatrix naturae…the less the physician does, the better chance the patient has of recovering.” [Rothstein, 243] Such innate self-healing powers, “the self-rectifying powers of the vis medicatrix;” [Simpson, 82] the “natural sanative powers of the constitution,” [Simpson, 81] “the curative powers of nature,” [Simpson, 88] and “the vital dynamism,” [Simpson, 23] are valid forces at work in every one of us and the enhancement of those powers is the primary task of all natural healing.
The organism not a static but a truly dynamic structure permeated by, ruled over and coordinated by the nurturing and sustentative vital power: “the organism is indeed the material instrument of life, but it is not conceivable without the animation imparted to it by the instinctively perceiving and regulating vital force.” [Organon, Aph. 15] Hahnemann believed in the innate “self-healing energy in the patient,” [van Haselen, 123] what he called the “self-regulating vital force, the vis medicatrix naturae.” [van Haselen, 123] And for example, even a modern allopath has stated, “only that nerve energy that runs through you and controls every function and autonomic process of your being every second of your life is capable of healing you. No drugs of doctors can do that. We can only facilitate it,” [Foley] then he clearly echoes the vitalist views of homeopathy and acupuncture.
Hahnemann had essentially the same views on the natural healing powers as an illustrious band of physicians before him. According to Haehl, these include Hippocrates, Galen, Sydenham, Stahl, and the Montpellier School [Haehl, I, 282-6]. Although he believed in the vital force and built homeopathy very much around that concept, he regarded allopathy as using it only in a “crude, unseeing, unintelligent, unreasoned,” [Haehl, I, 287] way, whose methods were not truly enhancing of the vital powers, but in fact depleted them. “Hahnemann’s theory and ideas about vital force and natural healing power…place him close to others, e.g. the striking agreement of his views with Sydenham about natural healing power, with the basic ideas of Stahl’s animism, and with the thought processes of Bordeu and Barthez in their vitalism.” [Haehl, I, 289] They were clinicians prominent in the Montpellier School of France.
Barthez – Montpellier.
Hippocrates conceived of the vital force as “an inborn power regulating…the functions of the organs and the correct relative mixture of the humours.” [Haehl, I, 283] By the same token, “illness is a disturbance of the healthy equilibrium.” [Haehl, I, 283] Galen “agreed with Hippocrates on a natural healing power inherent in the body,” [Haehl, I, 283-4] but made many confusing remarks as well. Stahl’s view was that the symptoms of “diseases were simply the efforts of the organism…to restore the equilibrium of health.” [Haehl, I, 284] Even in the Montpellier school, illness was seen as “an affection of the life power and is expressed by disturbances…[it is] a reaction of the life power.” [Haehl, I, 285] It is roughly in keeping with the views of Hippocrates, Stahl and the Montpellier school, but not with those of Brown or Galen, Boerhaave or Hoffmann, where the effects of the vital force are not always highly regarded or assisted or regarded as curative, or in which therapy tends to run against the natural efforts of the vital force by use of contraries.
The vital force is a “spiritual principle…that rules with unbounded sway.” [Organon, Aph 9] or what might also be called “a spiritual medicinal power,” [Simpson, 141]“Hahnemann minimises the healing power of nature,” [Guttentag, 1175] but “he describes its effects as nowhere to be imitated and as rarely sufficient.” [Guttentag, 1175] Post-Hahnemannian homeopathy “still holds the same respectful view of the healing power of nature as in 1836.” [Guttentag, 1175] Most homeopaths have reiterated the view that the healing power of nature is supreme.
J. T. Kent.
Kent says that “there is no cell or tissue so small that it does not keep its soul and life force in it,” [Kent, 670] and he expresses the view that “the vital force dominates, rules and coordinates the human body.” [Kent, 677] Also, that the vital force “is again dominated by still another higher substance which is the Soul.” [Kent, 677] In his conception of the organism, “the vital force holds all in harmony, keeps everything in order when in health.” [Kent, 677] In this view, “that which we call disease is but a change in the vital force expressed by the totality of the symptoms.” [Kent, 661] Therefore, “the inner nature of the remedy corresponds with the inner nature of the disease.” [Kent, 685] Disease being a dynamic imbalance, so any “dynamic wrongs are corrected from the interior by dynamic agencies.” [Kent, 643] Thus, “Man cannot be cured or be made sick except by some substance as ethereal in quality as the vital force.” [Kent, 644] Kent wisely called the vital force the “vice-regent of the soul,” [Kent, 660] and it does seem to correspond to the concept of the unconscious or subconscious mind that regulates all the bodily processes through the involuntary nervous system, and the endocrine organs and keeps the breathing and blood going etc. Because of its immaterial nature, the vital force bonds with various other key concepts in homeopathy, such as the small doses and the miasms. Though it is an abstract and insubstantial entity, its reality and truth is confirmed through the powerful logic of its usefulness as a concept underpinning so many aspects of homeopathy.
The vital force stakes another primary claim for a unique status within the conceptual core of homeopathy in that the remedies of homeopathy do not directly impact upon or cure the alleged ‘disease,’ but impact primarily upon the vital force, the innate vital powers, the vital dynamism that controls the organism, and solely through whose dominion and sovereign powers sickness is either created or annulled. Therefore, sickness is removed indirectly rather than directly, not at the local level, but at the level of the whole organism. The sickness itself is conceived as under the control of the vital force, not of itself. It is conceived primarily as an internal matter, not an external one. Accesses to sickness is thus always indirect and only achieved via the holistic powers of the vital force itself, which pervades the entire organism.
Homeopathy treats “the person and not the disease.” [Shaw, 6] It truly is the ‘innate healing power’. We should always “remember that it is our duty to help nature as far as possible do her job.” [Bodman, 225] Medicine involves an attempt “to restore health…an attempt to restore balance,” [Wheeler, 1947, 1] for true “health is simply the balanced life.” [Wheeler, 1947, 4] Homeopathy “is no religion, no sect, no fad, no humbug…remedies do not act directly on disease; they merely stimulate the vital reactions of the patient, and this causes him to cure himself.” [Weir, 200-201] Regarding the remedy, we need to remember, “that the reaction it sets up in the organism is a reaction which goes on working to the ultimate dispersion of the infirmity.” [Cooper, Jan 1893; 14] Reliance upon the “natural healing power leads to interpretation of symptoms as signs of the body’s struggle against disease,” [Coulter, II, 456] and thus symptoms are seen “as beneficial—being the signs of the struggle of the vital force against disease.” [Coulter, II, 487]
He also condemns any medical system that searches out and respects only “the mechanical origin of diseases…[and] which derives diseases from the original form of the parts.” [Ameke, 95] However, Hahnemann—like Bach, Paracelsus and Bailey—regarded sickness as due to “a morbid derangement of the internal dynamis,” [Hahnemann, 1810, Aph. 12] and an affection of the “morbidly deranged spirit-like dynamis.” [Hahnemann, 1810, Aph.15] He regarded “symptoms…[as] the expression of the vital force untuned.” [Handley, 66] He also states that “diseases obviously are not and cannot be mechanical or chemical changes in the material substance of the body…but are an exclusively dynamic, spirit like untunement of life.” [Hahnemann, 1810, Aph.31] Hahnemann expresses his own sentiments in the Organon [Aphorisms 11 [9, 10], 15 and 16]: “let it be granted now…that no disease…is caused by any material substance, but that every one is only and always a peculiar, virtual, dynamic derangement of the health.” [Hahnemann, Organon, Aphorisms 11 [9, 10], 15 and 16] Such is certainly a view of disease as a “dynamic derangement of the life force.” [Close, 37-8, 74]
Remedies “contain a non-material healing energy.” [van Haselen, 123] They mobilise the “self-healing vital force,” [van Haselen, 123] which is recognised as the source of all natural healing. Homeopathic “remedies do not act directly on disease; they merely stimulate the vital reactions of the patient, and this causes him to cure himself.” [Weir, 200-201] They lead to “stimulation of a person’s self-healing strengths.” [Franz, 32] Homeopaths thus conceive that “homeopathic remedies and Bach essences act as a catalyst,” [Franz, 32] to stimulate innate self-healing processes, using “natural healing substances.” [Richardson, 174] Paracelsus believed that “attenuation would release from the crude matter the inner ‘arcanum,’ the essential curative virtue.” [Richardson, 174] They further held that “the overall archeus or vital force and the archeus of each organ could be healed by a corresponding archeus of a medicinally prepared plant or mineral.” [Richardson, 174]
Hahnemann “is in tune with Paracelsus’ and van Helmont’s concept of the archeus.” [Richardson, 176] According to them “the dynamis of the corresponding natural life form, medicinally activated by potentisation…restores the individual human dynamis to health…[and represents] the highest immaterial or spiritual extraction of medicines.” [Richardson, 176] Kent’s view that potentised remedies contain “purely energetic medicinal powers imprinted on the water/alcohol medium during preparation,” [Richardson, 176] is entirely consistent with the views of Hahnemann and Bach, and they would probably all further agree with him that such remedies resonate “profoundly with the soul, mind and will.” [Richardson, 176]
Again we see the strong connection to case totality [holism] and to the general inadequacy of the concept of a localised disease. In popular parlance, the remedy stimulates the vital force to cure the disease and the remedy merely stimulates the vital force, whose powers pervade the entire organism; it does not of itself cure ‘the disease’ directly, it stimulates the body to heal itself. The vital force can be seen to be a very cohesive and unifying principle that permeates the whole of homeopathy, linking together many otherwise disparate concepts. What we see then is a medicine “based more upon quality and not a quantity.” [Barnard, 301]
The miasm is a metaphysical concept to try and explain cumulative observations of case histories of sickness within families. As an idea it probably derives from Hahnemann’s studies of venereal diseases, most especially Syphilis, which does have this character of a miasm that is acquired, then goes dormant and then springs out later in various hideous forms as well as being passed on to children as predictable [patterned] inherited syndromes of sickness. When viewed more metaphysically the miasms are defects carried in the vital force that cause sickness by deviations from its perfect and harmonious control. Miasms might be termed ‘internalised relics’ or stains of big diseases that are left in the vital force and which steal its natural self-healing power.
From “frequent observations, Hahnemann had discovered that chronic maladies…had some connection with a previous outbreak of Psora.” [Haehl, I, 138] This ‘miasm theory’ stirred up great controversy among his followers, and seems to have instinctively elicited much more ridicule than it did praise. To Hahnemann, Psora was “a disease or disposition to disease, hereditary from generation to generation for thousands of years, and…the fostering soil for every possible diseased condition.” [Haehl, I, 144] The theory “did not receive unanimous support from his followers, even after Hahnemann’s death.” [Haehl, I, 150] The notion of Psora has many facets; for example, “seven-eighths of all the chronic maladies prevalent are ascribed by Hahnemann to Psora…” [Haehl, I, 142] He did not confine its meaning solely to Scabies; “Psora…was widely known in Hahnemann’s time, as the general term for a whole series of skin troubles of the most varied kinds…” [Haehl, I, 143]
Yet, the miasm theory undoubtedly is an attempt to reach into “the deeper fundamentals of disease.” [Haehl, I, 137] Many called psora, “this thousand-headed monster.” [Haehl, I, 145] Chronic symptoms are regarded by homeopaths as “symptoms of the underlying miasmatic malady.” [Haehl, I, 145] Hahnemann’s “idea of Psora coincides to a large extent with that of inherited predisposition to disease.” [Haehl, I, 151] The initial “starting point for the main ideas [of miasms]…was the observation that certain chronic diseases…could be alleviated by homeopathic remedies, but not completely cured.” [Haehl, I, 138] To Hahnemann, “psora is a disease or disposition, hereditary from generation to generation for thousands of years.” [Haehl, I, 144] It “can be observed in the most variable forms imaginable.” [Haehl, I, 145] Psora as a miasm, therefore, becomes “the fostering soil for every possible diseased condition.” [Haehl, I, 144] The miasm theory can be seen as the logical extension of the vital force concept, and as bringing the vital force to its ultimate point.
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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.
How confident should we be as practitioners? This is a question which worried me greatly when I started out. I felt uncertain (not surprisingly as I was entering the world of sickness and health armed with a copy of Kent’s repertory – a copy of which a colleague justly through out of a window in a different continent – and some basic core delusions about Sankaran’s teaching.). I was qualified, I had the grades, supervised clinical work and diploma to prove it. And after all that training, I did not feel confident.
It will come, some said. The more patients you work with, the more confidence you’ll feel. Until a cold voice cut through the general internet babble, as a colleague (armed with a handbag full of plumbum crude – if you’re reading this, you know who you are) said sharply “if you’re not confident in what you’re doing, you shouldn’t be practicing.”
I see my own inner debate of that time reflected in many forums, where some few honest souls admit to worry and lack of confidence. With hindsight and its freedom of constraint, I see that confidence, for a homeopath, actually relates to at least two separate issues.
We must feel confident in our tools. If we do not feel confident in the principles of homoeopathy – not a blind faith but a clear understanding of the rationale of our practice, if we only know how to parrot “like cures like” without understanding what that means and more specifically, what that demands of us – we really should not be practicing. If we do not grasp that there is a quirk and a default in nature, whereby a stronger similar disease can annihilate a weaker one and will always do so unless something else is standing in the way of cure, whether it is a maintaining cause or a deeper inherited miasmatic taint – if we don’t get that then we really should not be practicing. We’re not talking about confidence in our ability. Here this is the confidence that our tools work. That “like cures like” is a prescribing principle, not a holistic “airy-fairy” slogan.
Personal confidence is another thing altogether. We have to get used to working with patients, to eliciting the information we need for prescribing, to listening to our patients without interrupting, to allow the picture of the disease to take shape before our eyes. We have to keep studying Organon, materia medica, provings, Hahnemann and Boenninghausen’s writings and works of similar value to keep our abilities honed and our homoeopathic knowledge checked and re-checked. We have to gain confidence in prescribing, in case-management, in effective follow-up.
Personal confidence is something every practitioner gains in time – in any field. But without confidence in our tools, that personal confidence is worthless. It’s worthless in the sense that if we are genuinely trying to work according to principle and don’t understand it, our confidence is a thin shell, a shiny veneer covering a world of insecurity in practice.
However, the worst expression of the worthlessness of personal confidence without true professional conviction is that those bumping up their levels of such personal confidence to overcome the lack of professional conviction are drawn to the new and the shiny, to developing their own new and shiny theories to astound the world. As a result, they never investigate the tools properly, and learn to work faithfully and honestly to principle.
Something Hahnemann said in the Organon within a slightly different context seems an apt quote to close this post:
“A true homoeopathic physician, one who never acts without correct fundamental principles, never gambles with the life of the sick entrusted to him as in a lottery where the winner is in the ratio of 1 to 500 or 1000 (blanks here consisting of aggravation or death)…” (note to Aphorism 285).
By Vera Resnick
You may already be familiar with my penchant for tables. There’s a quote below which in usual unwieldy translation of originally unwieldy German is difficult to read. Here’s the information in table form, and then read the quote: Continue reading