Recently two
Homeopathic Anthroposophic doctors in France were banned from practicing
medicine due to the (unnecessary) death of two patients, and where similar
discussions have been ongoing following my last weeks case study about Acupuncture.
I now follow this up with a case study about the
little known background of Homeopathy.
In 1810, Samuel Hahnemann (1755-1843), a German
physician and translator of medical texts, declared his discovery of two new
medical 'laws'. The first of these principles-called 'the law of similars'
after Hahnemann's famous phrase 'similia similibus curantur' (like treats
like)-was, he asserted, based on his own careful observation and self-experimentation.
And as seen previously in the case of
Anthroposophic doctors who follow the doctrine of Rudolf Steiner who is
known as the creator of present day Waldorf Schools, there is indeed a
counterpoint of occultism running through homeopathy right from the beginning.
And besides its paralelling of Hermetic ideas, we can also look at the
resemblances that exist between Hahnemann's ideas and those of the
sixteenth-century physician Theophrastus von Hohenheim, commonly known as
Paracelsus, who came from the alchemical-hermetic tradition.
In fact there are three, major pillars of homeopathy:
the just mentioned law of 'similars', the potentization of remedies, the
working of the life force or dynamism.
All three of them find no basis in any known
scientific theory.
Homeopathy thus also should be seen in what is in fact
a hermetic context whose principles
are as follows:
1) principle of analogies
2) principle of polarity
3) principle of levels/layers of existence
4) principle of
unity
And how we find this mirrored in homeopathy:
1) analogy: as above so below – the law of
correspondence and resonance in micro- and macrocosm
- in
homoeopathy the law of 'similars'
2) polarity: in all the manifested world there is
duality; nothing exists without the simultaneous operation of its opposite
- in
homoeopathy the law of first and secondary reaction
3) levels of existence: beside the physical level
there is the level of the life force, the level of the psyche, of the rational
mind and the level of the spirit – to name the gross ones; and these levels
exist in micro- as well as in macrocosm
- in
homoeopathy the law of the working of the dynamism apart from the physical
body, which is called an instrument of the spirit, dwelling in it
- the
possibility of potencies is based on the possibility of separating these levels
from each other, i.e. to separate the spirit or entity of a remedy from its
physical form (this has been shown by alchemy many times)
4) unity: everything in the world is one on the
ultimate level of existence, everything is one and connected and related; and
to achieve that unity and relatedness is the higher purpose of our existence,
as seen by all mystics and religions.
- in
homoeopathy "the higher purpose of our existence."
In the perspective of the development of European
philosophical traditions, homoeopathy in fact is an heir of alchemy; though
Hahnemann didn't mention this and even tried to exclude this perspective, since
in his time it was not proper to discuss alchemy in decent circles.
- The idea
of potentization is clearly alchemical as a means of spiritualizing matter –
Hahnemann states this clearly enough. And nowhere else but in alchemy do we
find this idea.
- The idea
that there is a force inside matter that can be isolated and influenced and
that this force is the important part of any material entity given.
- The whole
background of thinking is the same as in alchemy, as shown above.
- Paracelsus
is seen as an important forerunner of Hahnemann by most historians.
- Leading
British homeopathist Kent’s idea of simple substance is what alchemy called prima materia – the substance before matter
which has no specification but is linked to the working of the life force
before it manifests. Kent picked this up from Swedenborg, a visionary whose
picture of the world reflects all the characteristics of an hermetic
"weltanschauung," as shown above. Kent’s system of potencies (30,
200, M, 10M) is also derived from Swedenborg‘s esoteric system of numbers.
Hahnemann nevertheless reported that those substances
which caused the symptoms of a particular disease in healthy person would
relieve those symptoms in their sufferers.
Essentially, Hahnemann (like many other physicians,
before and since) believed that disease sprang not .horn a simple breakdown in
the bodily mechanism which would demand similarly mechanical treatment: for
example, purges to vent impurities, or emetics to remove blockages-but from
disturbances of the body's ethereal vital force. Thus treatments needed to act
on the metaphysical, rather than the corporeal, level. This rationale was, of
course, not unlike that offered by mesmeric healers to explain that system's
more than physical effects. Hahnemann argued that the therapeutic potency of a
medicine in this metaphysical realm increased as the material medicinal
substance itself was mixed, diluted, and refined:
For its own special purpose and by its own special
procedure homeopathy develops the inner, spirit-like medicinal powers of crude
substance to a degree hitherto unheard of, and makes all of them exceedingly,
even immeasurably penetrating, active, and effective .... This remarkable
transformation of the properties of natural bodies through the mechanical
action of triturating and succession on their tiniest particles ... develops
the latent dynamic powers previously imperceptible and as it were lying hidden asleep
in them. These powers electively affect the vital principle of animallife.1
Hahnemann claimed to have derived his 'laws' and the
therapeutic system built around them through reasoned experiment, rather than
through either scholarly theorization or full-throttle speculative empiricism
alone. However, his 'new science' was clearly attuned to ongoing debates in the
medical community-debates with which his work as a translator of
eighteenth-century medical texts would certainly have made him familiar. Most
importantly, Hahnemann's system tapped into an increasingly widespread belief
among medical professionals and consumers alike in the vis medicatrix
naturae-the healing power of nature. In the Organon der rationellen Heilekund
(first published in 1810, translated rapidly and widely, and generally referred
to in English as the Organon if Rational Healing, or just the Organon), he
argued that within all living bodies resided an innate healing power: 'In the
state of health the spirit-like vital force (dynamis) animating the material
human organization reigns in supreme sovereignty. It maintains the sensations
and activities of all the parts of the living organism in a harmony that
obliges wonderment)'2 Similarly, emerging models of disease as 'self-limiting'
bolstered his system. These models proposed that diseases had a natural course
through which they would inevitably progress, ending in a 'crisis' during which
the patient's 'dynamis' or vital force would either be exhausted or be restored
to a state of healthy balance.3
In combination, these two ideas suggested that the
most effective therapeutic strategy was to strengthen the body for its
inevitable ordeal, and to assist nature in reaching the 'crisis' before the
body had been exhausted (a doctrine that would subsequently underpin the
mid-nineteenth-century orthodox reformers' turn towards therapeutic nihilism).
Hahnemann had no doubt that his method of treating like with like would surpass
and supersede orthodox methods, which he termed 'allopathy'-'treatment with
opposites'-and derided for opposing nature's own healing process and thus
depleting the body. But he intended to go beyond merely assisting 'diseased
nature' down her own 'very imperfect' path.4 Hahnemann reasoned that the
artificial diseases reliably and briefly induced by his 'proven'-experimentally
tested-medicines more powerfully engaged the patient's vital force. The strong
symptoms thus artificially induced 'extinguished' the weaker (but more
persistent) effects of the natural disease, then disappeared as the medicines
left the patient's system: 'By giving a remedy which resembles the disease the
instinctive vital force is compelled to increase its vital energy until it
becomes stronger than the disease which, in turn, is vanquished.'5
Another area of heated debate among Hahnemann's
medical contemporaries was the question of disease classification (or 'specific
disease'). Could physicians distinguish with certainty one disease from another
and treat it (in accordance with whatever explanation of its causation was then
current) or could they be sure only of the individual patient's set of
symptoms? In other words, did diseases exist as specific and knowable entities
separate from the bodies in which they were expressed, or was every patient's disease
experience unique and particular? The way in which a practitioner answered
these questions had ramifications for every aspect of medical practice. If a
practitioner believed in specific diseases, he (and in orthodox practice, it
was all but inevitably a he) would strive to identify and treat that disease in
increasingly standardized ways. However, practitioners dubious of specific
disease identifications and standard treatments would tailor their treatments
to individual patients and sets of symptoms. Men and women, adults and
children, rich and poor, city-dwellers and country folk, sickly and hale,
gluttonous and abstemious, pillars of virtue and slaves of the flesh-each would
need slightly or radically different therapies. Since Hahnemann was suspicious
of medical claims to be able to explain and identify diseases (although not
necessarily of the notion of specific disease), he hedged his bets. His new
medical system focused very closely on individual constellations of symptoms,
rather than on what he regarded as largely speculative disease entities.
Indeed, Hahnemann argued that the symptoms were the disease: 'Illness is the
sum of its symptoms.'6
Given this assumption, it was imperative that
homeopathic practitioners elicit from their patients a complete and detailed
description of their entire disease experience. However, for any given
constellation of circumstances and symptoms, homeopathy claimed that it could
produce a proven specific remedy. Thus although homeopathy was based on two
fairly straightforward principles, its practice depended on an elaborate
complex of factors:
We only require to know, on the one hand, the diseases
of the human frame accurately in their essential characteristics and their
accidental complications, and, on the other hand, the pure effect of drugs;
that is, the essential characteristics of the specific artificial disease they
usually excite, together with the accidental symptoms caused by difference of
dose, etc. and 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 obstinate diseases.7
Despite Hahnemann's blithe 'only', homeopathic
practice clearly demanded a substantial burden of prior knowledge, especially
as few known drugs had yet been tested on healthy individuals. In particular,
homeopathic treatment depended heavily on a detailed patient history, and on
precise patient-reporting of symptoms. Homeopathic practitioners could not rely
exclusively on their own reading of the patient's body, because it was the
patient's experienced illness (and personal circumstances) that determined the
appropriate remedy. A homeopathic physician might spend several hours on the
initial consultation, simply in taking the patient's history:
The patient details the history of his sufferings.
Those about him tell of what they have heard him complain, how he has behaved,
and what they have noticed in him. The physician sees, hears, and remarks by
all his other senses what there is of an altered and unusual character about
the patient. He writes down accurately all that the patients and his friends
have told him in the very expressions used by them ... When the narrator has
finished what he would say of his own accord, the physician then reverts to each
particular symptom and elicits more precise information.8
As with mesmerism, homeopathy's emphasis and
dependence upon patient testimony presented a sharp contrast to trends in
orthodox practice, where doctors were increasingly interested in uncoupling
diagnosis from the 'subjective' experience of illness. Through technology and
technique, regular medicine was struggling to declare independence from the
patient; homeopathy instead reinforced the role of the patient as a
partner-albeit often unwitting and in need of expert guidance--in the
diagnostic process. Hahnemann explicitly notes that the patient's' own account
of his sensations is most to be trusted' adding only the parenthetical caveat
'(unless he is feigning illness)'.9
Homeopathy was also dependent on physicians'
willingness to serve as their own experimental alembics (again, demonstrating a
degree of comfort with subjective evidence which was disappearing from
'regular' practice); on the thoroughness and precision of their reports when
'proving' drugs; and on the continuous pursuit of such experiments. In this
combination of attributes, homoeopathy united two already diverging strands of
medicine--the rationalist system-building of learned medicine with its balance
of universal 'laws' and individual experience; and the rising empiricism of'
scientific medicine' with its hypotheses and experiments. It is perhaps this
combination of familiarity and novelty that rendered homoeopathy so pernicious
in the eyes of orthodox medical professionals----and so very attractive to
medical consumers.
Like Hahnemann himself, medical consumers in the early
nineteenth century were far from satisfied with the therapeutic offerings of
the medical profession, and in particular with the prevailing fashion for
dangerously emphatic treatments. Not only were their testimonies increasingly
discounted, but their bodies-vulnerable sick bodies, at that-were subjected to
newly punishing measures in the search first of diagnosis, then of cure. 'A
disgust of medicine' was hardly surprising when that medicine might entail (as,
famously, in the case of George Washington's last illness):
two copious bleedings; a blister applied to the part
affected; two moderate doses of calomel [a mercury-based emetic]; an injection
... which operated on the lower intestine another bleeding, when about
thirty-two ounces of blood were drawn, vapors of vinegar and water ... ten
grains of calomel ... repeated doses of emetic tartar ... blisters applied to
the extremities and a cataplasm of bran and vinegar to the throat.'10
Patients were regularly bled to syncope
(unconsciousness), cupped,
and scarified. As well being bled through these general or local means,
they were puked, purged, and poisoned; in some common diseases (for example,
syphilis), patients were treated with mercury until their teeth loosened in
their jaws. Medicated enemata offered another route to rebalancing the body's
input and output, particularly in conditions such as hysteria, and disorders of
the menses. And of course, there were the leeches. One American patient, Emily
Mason, wrote to her sister of the treatment she was due to receive for facial
pain: 'Today, I am threatened with leeching-Don't you envy me having those
sweet little worms in my mouth?11
These harsh therapeutic tools formed the backbone of a
rising medical trend: 'heroic medicine'. Although all of these methods and
medications had long pedigrees in western medicine and were accepted by doctors
and patients alike, the first third of the nineteenth century saw their usage
taken to the very extremes of human endurance in search of medical 'activity'.
In assessing the rationale behind such apparently horrific treatments, it is
worth remembering that although orthodox doctors in this period knew
considerably more about the internal structures and workings of the body than
their predecessors, their new knowledge had not yet led to any novel therapies.
Even Jenner's much-lauded innovation of vaccinating with cowpox against the
much more deadly smallpox did not constitute a cure, merely a far safer and
often more effective preventive. So medical practitioners found themselves in
the invidious position of making greater claims to authority based on their
improved ability to describe the actions of disease upon the body, without
being any better at explaining the origins of, or actually treating, disease.
Moreover, their new knowledge, dependent as it was largely upon pathology, required
investments at both the personal and professional level. Not only did
individual practitioners have to spend both time and money acquiring
pathological training (and moreover to do so at the risk of their own health,
given the dangers of accidental self-contamination in the chamel house); but
the profession too had to invest its capital as a humane art in the distasteful
practices of human dissection (and while familiarity may have blunted our
distaste for dissection, the controversy which has, as recently as 2003,
greeted public exhibits of the dissected body-whether glossed as art or
education-suggests that it remains just beneath the surface). Homeopathy
represented an entirely different vision of medicine, then, in very fundamental
ways. It was deliberate and gentle; it did not aim for or produce instantaneous
or dramatic effects on the human body. It was, at least as framed by Hahnemann,
profoundly anti-materialistic, and rooted its model of disease not in ever-more
minute examinations of the physical body, but inattentive observations of the
experiential one. Like mesmeric physiology, homeopathic knowledge was self
declaredly rooted in the living body, not the dead--specifically the bodies of
all its 'proving' practitioners.
From its origins as a critique from within the
boundaries of elite German medicine, homeopathy spread rapidly to the rest of
Europe, and accompanied the waves of German immigrants to the United States. In
France and Britain, but especially in the United States, it found fertile soil,
well prepared by the therapeutic excesses and monopolistic ambitions of
orthodox medicine.12 Indeed, homeopathy-with its emphasis on mild, easily
self-administered, and highly portable drug therapies-was particularly well
suited to the exigencies of a geographically dispersed, necessarily
self-sufficient, and generally willful population. And Jacksonian American,
culturally and politically marked by a rejection of elitism and professional
claims to exclusive knowledge, was already shrugging off early attempts by its
nascent medical profession to regulate the practice of medicine, and make it a
preserve of the 'regularly trained'.
The chronology of medical regulation in America during
this period demonstrates both the surging but often thwarted ambitions of
medical practitioners, and the close relationship between culture, politics,
and medical pluralism. Before the 1830s, medicine in the United States largely
followed the professional model established in Britain. Medical societies were
founded (the first, in Boston, in 1736), as were medical schools (beginning
with the College of Philadelphia in 1765). Shortly thereafter, medical
societies began to promote binding codes of practice which discriminated
against 'irregulars' -lay and religious healers, itinerant practitioners,
proponents of non-canonical medical systems, and anyone else claiming to
practice medicine in the absence of training either through apprenticeship with
an established doctor or surgeon, or in a medical school. By 1830, the United States
had twenty-two medical schools, and thirteen states had passed laws which
allowed local medical societies to license medical practitioners. Although
these laws carried little force, they did raise the status of 'regulars' and
gave them the exclusive right to sue for the payment of their medical bills.
But these first steps towards an established orthodoxy were already being
undermined by Jacksonian skepticism, by the continued proliferation of other
medical systems-many rather better suited to the American context-and by the
burgeoning industry of medical certification. New York journalist Mordecai Noah
captured the changing mood of Jackson's America in 1830 when he stated bluntly:
'medicine like every useful science should be thrown open to the observation
and study of all.' Meanwhile, medical degrees were becoming accepted as
equivalent to the licenses issued by professional societies. This provoked a
boom in highly profitable proprietary medical schools-essentially 'diploma
mills', with low standards and even lower admissions requirements. Between 1830
and 1840 in the United States, 6800 new doctors graduated from such schools to
the disgust of their better-trained colleagues and medical consumers alike. As
one critic writing in a medical journal complained:
It is very well understood among college boys that
after a man has failed in scholarship, failed in writing, failed in speaking,
failed in every purpose for which he entered college; after he has been dropped
down from class to class, after he has been kicked out of college; there is ONE
unfailing city of refuge-the profession of medicine.13
'Regular medicine' soon found itself caught in the
proverbial cleft stick: on one hand, the mood of American society was staunchly
anti-elitist, and equally strongly in favor of the dissemination of all useful
knowledge and skills by every available means. On the other, the nascent
educational institutions and regulatory systems that were intended to justify
the privileges and authority claims of the medical profession were often
themselves manifestly corrupt. Medical deregulation swiftly followed. Between
1830 and 1850, all but two states repealed their laws restricting medical
practice to regularly qualified practitioners. Thus the United States came to
offer an untrammeled and unrestricted medical frontier to practitioners of all
therapeutic stripes, and consumers were left free to assess the merits of
competing systems and practitioners as they saw fit.
In 1847, elite US practitioners founded the American
Medical Association (AMA) explicitly to combat the 'irregulars', who were
rapidly gaining ground and establishing their own institutions and journals;
and equally explicitly, to eradicate, regardless of system, all those who, as
noted physician, Worthington Hooker, put it in 1849, practiced 'medicine as a
trade instead of a profession, and [studied] the science of patient-getting to
the neglect of the science of patient curing'. The AMA sought to restore the
credibility of the 'regular' profession partly by closing the wounds caused by
competition between orthodox practitioners. It regulated minimum fees, barred
consultation with irregulars, and banned grubby advertising. However, the
Association faced a long and uphill struggle. Its homeopathic opponents were often
'regularly' educated and better qualified-and they offered their well-heeled
clients a far more palatable therapeutic course (an American journalist in 1848
was inspired to verse: 'The homeopathic system, sir, just suits me to a title I
It proves of physic, anyhow, you cannot take too little').14 Meanwhile, for
their poorer or rural adherents, homeopathists established homeopathic
dispensaries and even mail-order homeopathy medicine chests-highly suitable for
life on a frontier chronically underserved by medical practitioners of any
system. These institutions and businesses alike persisted well into the
twentieth century, despite major challenges like the 1910 Report on Medical
Education in the United States and Canada, known universally as the Flexner Report
after its author Abraham Flexner (a noted educational reformer, but not a
doctor). Ostensibly Flexner's famous survey of American medical education
supported no system, but only 'modern' medicine: 'Prior to the placing of
medicine on a scientific basis, sectarianism was, of course, inevitable.
Everyone started with some sort of preconceived notion, and from a logical
point of view, one preconception was as good as another. ... Modern medicine
has as little sympathy for allopathy as for homeopathy.' However, his findings
set a new standard for medical education in which basic sciences, laboratory
training, and hands-on clinical education reigned supreme. Few of the
homeopathic medical schools (and indeed few 'regular' institutions) met this
standard or could raise the funds necessary to improve their facilities. Many
went under, but the last surviving homeopathic medical school (the Hahnemann
Medical College and Hospital of Pennsylvania) only finally severed its ties to
the homeopathic system in the 1950S after over a century of teaching.
In Europe too, homeopathy was no short-lived fad; it
was the system of choice for the British upper classes and gained royal
patronage amongst Victoria's many offspring (patronage that homeopathy still
retains today, with London's Homeopathic Hospital still operating under the
Queen's warrant). As regularly trained William Kingdon (1789-1863) reported in
an 1827 speech to his medical brethren, patient demand was essential to the
spread of homeopathy-and perhaps the most important force in the creation of
converts from within the medical profession itself.
My most profitable business is with gentlemen in the
city, whose object it is to have their maladies attended to, if possible,
without interference with their usual avocations-men whose minds are enlarged
by education and occupations,-whose habit is industry, and whose fortune is the
profitable occupation of their time, equally removed from the indolent and the
luxurious, who readily catch at novelty for amusement, and the ignorant and
unlettered, who are easily caught by any appearance of mysticism. Such men as
these have been requiring me, for the last eighteen months, to try, as they
call it 'Homeopathy,' at which I only smiled incredulously, and I fear,
contemptuously. The reiteration of such applications, however, and from men in
whose judgment and veracity I had confidence, seemed to demand from me some
investigation of the subject; and desirous to set about it in the fairest way,
I sought an introduction to Dr. Quin, of whom I had heard most honorable
report.15
Conversions, or even speculative dabbling like this,
were a blow to the heart of orthodoxy. Like the United States,
nineteenth-century Britain also suffered from proprietary medical schools, over
competition among medical practitioners, and popular contempt for large
portions of the orthodox profession. The luxuriant growth of British homeopathy
was therefore no less threatening and loathsome to its orthodox profession. The
pages of the Lancet and the British Medical Journal (BMJ) were filled with
bitter diatribes against homeopathists, and indeed against their
clientele-castigated as faddish, ignorant, deluded, self-indulgent, and of
course, those old favorites, hysterical and hypochondriacally. And in this furnace
of fear and loathing was the orthodox profession forged. The competition
offered by the homeopathic system drove 'regular' practitioners previously
absorbed by the internecine warfare between elite and general practitioners to
organize and identify as one profession. Moreover, homeopathy's commercial and
therapeutic successes also forced major changes in orthodox medical practice.
As the prominent and well-regarded physician SirJohn Forbes grudgingly noted in
1858:
The favorable practical results obtained by the
homoeopathists-or to speak more accurately, the wonderful powers possessed by
the natural restorative agencies of the living body, demonstrated under their
imaginary treatment-have led to several other practical results of value to the
practitioners of ordinary medicine.16
Despite scoffing at homeopathy's 'imaginary
treatment', Forbes carefully enumerated the beneficial effects of inter-system
competition:
[I]t has tended directly to improve their practice, by
augmenting their confidence in Nature's powers, and proportionately diminishing
their belief in the universal necessity of Art, thus checking that unnecessary
interference with the natural processes by the employment of heroic means,
always so prevalent and so injurious. It has thus been the means of lessening,
in a considerable degree, the monstrous polypharmacy which has always been the
disgrace of our Art-by at once diminishing the frequency of administration of
drugs and lessening their dose.17
Even as he argued that homeopathy merely took credit
for Nature's, own miracle cures, Forbes acknowledged the reciprocal weaknesses
of orthodox practice: 'unnecessary interference' and 'monstrous
polypharmacy'.18 Reviewers applauded Forbes's text, though few were as
forthright as Forbes himself about the impact of homeopathic successes on
regular practice.
Homeopathists themselves were only too aware of their
impact on orthodoxy. One homeopath observed allopathic borrowings with an air
of amused superiority:
[T]he 'sweeping over us' of homeopathic knowledge ...
made patients less tolerant of bloodletting, and so doctors had to give it up;
and as they found that diseases did better without it, they had to alter the
teachings of their textbooks accordingly, and they had to invent some other
reason for their altered practice, and the 'sweeping over us of cholera' or
'the change of type of disease' served to save their dignity ... 24
Others expressed indignation at the allopathic
pillaging of their pharmacopoeia and unacknowledged 'plagiarism' of their
practices of expectant medicine; and minute doses. Their hostility was only
strengthened by continued attacks on homeopathy from the allopathic camp.
Naming prominent 'regular' names with abandon, one homeopath wrote, 'Black,
Thorowgood and many others recommend bits of homeopathic practice without
mentioning the hated word. Wilks filches from us while he abuses us. '20
In Britain and Germany, as in the US, medical
professionals at the mid-century fought hard to re-establish a single orthodoxy
and to imbue it with social, legal, and moral standing. As in the US, their
efforts, beginning with organization (the British Medical Association was
founded in 1832, and was intended, like its US counterpart, to fight orthodox
corruption and quackery alike), self regulation and the raising of educational
standards, and building on the successes of the emerging 'germ theory' did meet
with considerable and growing success. However, homeopathy's powerful lay
constituency and its elite corps of well-educated, well-organized (the British
Homeopathy Society, for example, was founded in 1843, only a decade after the
orthodox British Medical Association), and upper-class practitioners, if unable
to resist some marginalization, nonetheless successfully prevented 'allopathy'
from being enshrined in law as exclusively synonymous with 'medicine'. Indeed,
homeopaths were able to force an amendment to the 1858 Medical Act (which
established a regulatory body to supervise 'regular' medical education, and the
annual publication of a Medical Register of qualified practitioners), which
prevented medical licensing bodies and medical schools from discriminating
against 'irregulars' so long as they were medically qualified. As in the US,
the British government had no stomach for restricting the free trade in medical
thought-or commodities.
Both homeopathy and mesmerism presented themselves
initially as radical innovations within established medicine. Only as they were
squeezed out by orthodox hostility did these systems reposition themselves as
'alternatives'-as challengers to the medical system they had intended to
reform. The two systems shared not only a belief in imponderable forces or
energies that could be turned to the task of curing; they also shared certain
aspects of practice. Both, of course, were highly time-consuming, homeopathy
because of its elaborate system of provings and detailed case histories,
mesmerism because of the need to condition the patient to respond to the
mesmerist's gaze and touch. Both also depended heavily on subjective,
experimental data, either from the mesmerized patient or from the
homeopathist's experience of proving. Perhaps worst of all in the eyes of the
orthodox profession, mesmerism and homeopathy both went around the medical
establishment, to address the patients themselves. One well-known medical
convert to mesmerism, James Esdaile bitterly protested the lack of a 'Free
Trade in medical knowledge', after a paper describing his mesmeric practice in
India, initially solicited by a respectable medical journal, was suddenly
rejected.26 Denied the freedom of the medical press, Esdaile stubbornly
published his article himself as a pamphlet. This fits well with his approach
in a book-length version, in which he urged patients themselves:
to exercise their common sense and sober judgment in
determining for the doctors the matter of fact; and if the community decides
that it is really a remedy of great efficacy, that there is no resisting the
proofs in support of it, that to know nothing about it is no recommendation to
a medical man; then Mesmerism will assume its proper rank as a remedial agent
... 22
Esdaile was himself regularly qualified, and far from
desiring a free medical marketplace; he wanted the practice of mesmerism to be
firmly 'lodged in the hands of those who alone should practice it': other
orthodox doctors and surgeons. 'Instead of doubting and dogmatizing about
Mesmerism, I/would earnestly entreat my medical brethren to put it to the test
by personal experiment.' What Esdaile in fact wanted was for consumer pressure
to force the medical profession to change its stance on mesmerism-to render it
orthodox. Unfortunately, although mesmerism could be smuggled into the private sickroom,
it was harder to dismember than homeopathy; consequently, it could not be
selectively (and by subterfuge) integrated with orthodoxy in the same way that
homeopathy's most consumer-friendly attributes and practices had been.
Despite their shared features, homeopathy and
mesmerism were far from similar in other ways, and produced quite different
effects on the medical profession. In Europe, mesmerism perpetuated sexual
hierarchies and in India, hierarchies of race, even as it challenged hierarchies
of class. Homeopathy, on the other hand, was instrumental in opening the
medical profession to women (and to a lesser degree, non-whites) particularly
in the United States. This openness was not entirely disinterested. Doctors had
long recognized that women were the family decision-makers in matters of
health. Noting 'the growing aversion to large doses of strong and disagreeable
medicine among the more liberal and progressive elements in society', one
contemporary commented that 'many intelligent women had become tinctured with
the heresy of Homeopathy and gave a preference to the physician who would
prescribe or administer their milder and pleasant remedies'.23 As this American
author (married to an early orthodox female physician) observed, this offered an
opportunity for women of either medical sect: 'conformity to the demands for
mild remedies gave the women doctors access to many families whose views were
in accord with the reform movements that recognized the growing interest in
enlarging the sphere of woman'.
JohnJames Garth Wilkinson's 1855 booklet War, Cholera
and the Ministry of Health, 24 promoting the use of homeopathy in the British
war effort in the Crimea, aptly illustrates the benefits that accrued to
homeopathy by its radical inclusion of women as professional colleagues. As he
argued for the special feminine suitability of the practice of medicine,
Wilkinson sounded themes that would have been very familiar to his audience:25
In all respects one half of medical practice belongs
to Homoeopathic woman. Only note her qualities. The first of these is
intuition, the bird's eye of her ever busy love .... Were this intuition fixed
and educated, it would readily pass into stable medical sight. Her fine sense
animated by this, might soon eclipse the corresponding organism in the man in
several fields of diagnosis ....26
Homeopathy had much to gain from recruiting women. For
example, as he recited these stereotypes of femininity and invited women into
the homeopathic profession, Wilkinson also claimed for homeopathy the purity
that had become a 'feminine' trait. And by likening allopathy to slavery, he
sought to harness the campaigning morality that had emerged as such a powerful
weapon in abolitionism:
Woman… is the pillar of Homeopathy; she first saw the
horrors of the old system in her own nursery among her loved ones; she has
first experienced the blessing of the new. It was she that emancipated the
slave: it will be she that ultimately rescues the Briton from the crooked and
venomous darts of physic. She will then enter upon one of her own callings from
which she has too long been excluded.27
In one area, the recruitment of women was in fact
necessary: homeopathy, having marketed itself in particular to women as a means
by which to spare themselves and their children from the horrors of heroic
medicine, needed female bodies on which to 'prove' new homeopathic drugs for
the treatment of 'female complaints'. By the standards of the profession, the
provers of drugs had themselves to be trained and skilful observers: ideally,
homeopathic doctors.28 Wilkinson also emphasized the status of homeopaths as
'an independent middle class' of healers, not a bad prediction of origins of
the women in his target audience.29 And like many others in this period, he
claimed for homeopathy the honor of effecting woman's emancipation from the
domestic sphere: 'Hahnemann, without having that end in view, has done more
than anyone else perhaps towards the emancipation of woman, by providing her
with a field of the most humane and artistic usefulness, in which her beautiful
powers can expand ... What then may we not augur for medicine when an entire
better half is added to it?'30 Women too benefited: through sectarian medicine,
particularly homeopathy, many of the first generations of female medical
practitioners gained access to the medical profession as a whole.
Despite the challenges of 'scientific medicine' and
the wholesale reform of the institutions and practices of orthodox medicine,
homeopathy entered the twentieth century in strength. In Britain, it continued
to have the support of the royal family and much of the social elite as well as
a large middle-class following. British homeopathy differed from its US
counterpart in its enduring reliance on medically qualified 'converts' as
practitioners, and on a well-to-do client base. But eight cities had their own
homeopathic hospitals, which treated charity patients as they trained
generations of medical students. And the working poor could choose, in 1900,
from thirty-five recognized homeopathic dispensaries, while homeopathic
remedies were even more widely available for self-medication.
Although the number of homeopathic doctors continued
to fall, their institutions survived and were indeed included first by the 1911
National Insurance Act (which insured all working men, and paid approved
institutions and practitioners for their care) and subsequently the National
Health Service (NHS).
The integration, finally, of homeopathy into orthodox
medicine, under the auspices of the NHS was not without controversy, pain, or
its own particular ironies. Many homeopathists were intensely skeptical of the
intentions and outcomes of integration; the Scottish branch of the British
Homeopathic Society adopted in 1941 a resolution expressing their anxiety about
the effects of state control, and calling for the national society to 'ensure
the right of medical men to independent judgment in matters of treatment'
(though it is only fair to note that many non-homeopathic doctors were
expressing exactly the same concerns about stat!: intervention in therapeutic
decisions).31 Others were convinced that exclusion from the NHS was a far
greater threat to the long-term survival of their beloved system. An editorial
in the British Homeopathic Journal in 1944 took an accommodating approach:
There is a tendency for all minority movements, be
they political or otherwise, to assume a self centeredness which is apt to
result in the obscuration of the highest aim of general endeavour ... the
homeopathic body one feels is not free from this taint .... [Some] wittingly or
unwittingly adopt the very attitude which it would seem can but antagonize even
those who are not unsympathetic to the homeopathic point of view ... The
discoveries of medicine are free to all. So should the homeopathic view be
preffered. Not with a superior air that this or that is 'the whole truth and
there is not other!', but with a gentler assurance that we found this or that
seems to give us better results and inviting inquiry and trial by experiment
... To shut one's eyes to the discoveries of chemotherapy ... is, one feels,
foolishness. The 'pure' homeopath so called is a crank living in his own little
cell. The complete physician is he who endeavors to know all, and knowing all,
to choose what is best for the patient.32
Another correspondent took a slightly different
approach to the process and goals of integration: 'I would view with regret any
tendency to segregate Homeopathy more than is necessary for the preservation of
our hospitals because that is not the way of progress. Rather let us infiltrate
into ordinary medical practice until Homeopathy (and I refer to the
"pure" brand) is understood and given its proper place in the healing
art.'33 The focus of homeopaths on the preservation of the remaining
homeopathic hospitals and the establishment of homeopathy as an independent
specialty was effective-as far as it went. But homeopathy in general practice
struggled from the outset to survive under the geographic limitation of patient
pools, and time-constraints imposed by NHS practice, and many homeopaths chose
to stay in their more lucrative and flexible private practices instead.34 In
1950, the Faculty of Homeopathy Act formally recognized homeopathic teaching,
research, and practices, but homeopathic training-the lifeblood of any
specialty-was denied public funding by the old enemy, the British Medical
Association (through its offshoot, the British Postgraduate Medical
Federation). In the end, neither the sponsors not the skeptics of homeopathy on
the NHS could have predicted the revival of homeopathy's fortunes and
popularity of the 1970s and 1980s in part due to changes in the funding of
entirely orthodox general practices. Not only was the system taken up eagerly
by consumers and lay practitioners rediscovering the Organon-it also became
once more the subject of clinical and scientific experimentation.
Medical consumers and providers often draw a strict
division between orthodox medicine-in the West, typically high-tech,
hospital-based, officially sanctioned and steeped in science-and 'alternative',
'complementary', or 'quack' therapies. But this distinction is fluid and
contingent: the boundary between 'orthodox' and 'heterodox' must be actively
policed by both lay and professional authorities if it is to remain stable. The
cases of mesmerism and homeopathy illustrate how that boundary was established
and sustained over time.
A few years ago BBC television took up the challenge
as part of its Horizon science documentary series, gathering together a team of
scientists to oversee the project. They examined the effect of homeopathically
diluted histamine on cells and compared this with the effect of pure water.
Histamine is associated with allergic responses in cells, but would it still
cause cells to react if it had been diluted to the extent that it was no longer
present? Professor Martin Bland of St George's Hospital Medical School
announced the final result: 'There's absolutely no evidence at all to say that
there is any difference between the solution that started off as pure water and
the solution that started off with the histamine.'
1. Samuel
Hahnemann, Organon if Medicine: A New Translation, trans. Jost Kunzu, Alain
Naude, and Peter Pendleton (London: Victor Gollancz, 1986), 188. Unless otherwise
noted, all quotations from Hahnemann are from this translation of Hahnemann's
sixth (and last) revised edition of his Organon, completed in 1842, just before
his death.
2. Ibid. IS.
3. e.g. the flu
might be said to progress through headaches, to swollen glands and body aches,
to fever and nausea, to the breaking of the fever, to recuperation.
4. Hahnemann,
Organon, 25.
5. Trans. Elizabeth Danciger, in The Emergence if
Homeopathy: Alchemy into Medicine (London: Century Paperbacks, 1987).
6. Trans. Edward Hamlyn, The Healing Art if Homeopathy
(Chicago: Keats Publishing, 1981), 19.
7. Trans.
Danciger, Emergence if Homeopathy.
8. Trans.
Hamlyn, Healing Art, 37-8.
9. Hahnemann,
Orgjnon, 86.
10. 'News. From "The Times." A newspaper
printed in Alexandria, dated in December', Medical Repository, 3 (1800),
3II-12, quoted in John Harley Warner and Janet Tighe, Major Problems in the
History of American Medicine and Public Health (New York: Houghton Mifflin,
2001), 57-8. For a full and gory description of the full extent of ' heroic
medicine' see Kaufinan, Homeopathy in America, esp. ch. I.
11. Emily Mason to Catherine Mason Rowland, 4 Nov.
1840, quoted in Martin Kaufman, Homeopathy in America: The Rise and Fall of a
Medical Heresy, 1971,12.
12. Homeopathy proved equally adaptable to the
political, cultural, and medical climate of colonial India/the Raj.
13. 'American vs. European Medical Science again',
Medical Record, 4 (1869), 183.
14. United States Magazine and Democratic Review, 22
(May 1848), 418, quoted in Kaufinan, Homeopathy in America, 30.
15. 'Mr. Kingdon on Homeopathy', Journal of the
Calcutta Medical and Physical Society, I (I July 1837), 404.
16. Sir John Forbes, Of Nature and Art in the Cure of
Disease, 2nd edn. (London: John Churchill, 1858), 162-3, cited in Nicholls,
Homoeopathy, 165.
17. Forbes, Of Nature and Art, 162-3, cited ibid.
165-6.
18. Forbes, Of Nature and Art, 162-3, cited ibid. 166.
19. Robert Ellis Dudgeon, Hahnemann, The Founder of
Scientific Therapeutics (London: E. Gould and Sons, 1882),23-4, cited ibid.
169.
20. Robert Ellis Dudgeon, The Influence of Homeopathy,
32-3 on General Medical Practice since the Death of Hahnemann (London: Turner
& Co., 1874), cited ibid.
21. James Esdaile, The Introduction of Mesmerism (with
the Sanction of the Government) into the Public Hospitals of India (London: W.
Kent and Co., 1856), 10.
22. This and immediately succeeding quotations from
James Esdaile, The Introduction of Mesmerism, as an Anaesthetic and Curative
Agent into the Hospitals of India (Perth: Dewar and Son, 1852),9.
23. Joseph Longshore, in a manuscript biography of his
physician wife, Hannah Longshore. Quoted in Regina Morantz-Sanchez, Sympathy
and Science: Women Physicians in American Medicine (New York: Oxford University
Press, 1985), 59.
24. James John Garth Wilkinson, War, Cholera, and the
Ministry of Health, and Appeal To Sir Benjamin Hall and the British People (New
York: William Radde, and Fowler & Wells, 1855). Wilkinson was a regular MD,
and author of another (rather curiously titled) work, The Human Body and its
Relation to Man.
25. Morantz Sanchez, in Sympathy and Science: Women
Physicians in American Medicine, 1985, 5 and passim, has discussed these themes
in great depth.
26. Wilkinson, War, 54.
27. Ibid, 53.
28. Anne Taylor Kirschmann, Adding Women to the Ranks,
1860-1890: A New View with a Homeopathic Lens' Bulletin of the History of
Medicine, 73 (1999), 429-446, at 434-5.
29. Wilkinson, War, 56. 35.
30. Ibid. 54.
31. Thomas Robertson, 'Homeopathy and Post-War
Reconstruction', British HomeopathicJoumal, 32 (1942), 117.
32. Editorial, British Homeopathic Journal, 34
(1944),157-210, at 157-8.
33. Correspondence, ibid. 186.
34. Dr Manasse, Homeopathy and General Practice,
British Homeopathic Journal, 39 (1949), 186-7.
35. William Buchan, Observations Concerning the
Prevention and Cure of Venereal Disease (London: Chapman, 1796), p. iv.