By Eric Vandenbroeck and co-workers
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.
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