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.