Dr Subhas Singh
In the 17 18 and 19 century Empirical physicians accepted the principle of the immediacy of therapeutic experience and sought ways to structure it intrinsically- ordering the phenomenon without doing them violence. It sought its rules & principles outside the living body, oscillating pack & forth among Chemistry, Physics, Mathematics & Mechanics- finally settling on Physiology. Though apparently this is a better selection than basing the medical science solely on Pathology but the principal defect of ancient Empiricism was absence of a precise relationship between the medicine and the morbific process, which attempted to cure.
The Philosophy of all the scientific advancements and researches was and has still been that of materialism. Though the subject matter of medicine is Man ho combines in himself the mental, vital and physical aspects, modern scientific men have always tried to understand him from the Chemico-Physical and mechanical points of view, based on the methodology of physical sciences. Here Hahnemann appears and the discovery o Homoeopathy cuts across the general evolutionary trend of modern medical sciences.
The history of medicine shows that the medical profession has been willing to adopt even the most outlandish therapeutic theories when these theories simplified the physician:
Intellectual and physical work. The doctrines of John Brown (1735-1788), Benjamin Rush (1745-1813) and F.J. V. Broussais (1772-1838), all contemporaries of Hahnemann, were taken up readily enough by the practitioners of the time because they promised to alleviate the physician’s burden. If Hahnemann had promised the same, if homoeopathy had been simplified therapeutic doctrine, one can be sure that it would soon enough have become medical orthodoxy.
In a new and original interpretation of pharmacology Hahnemann found the key which Empirical thinkers had been seeking for centuries, one which brought all elements Empirical doctrine in a new crystallization and gave them a new focus. It was this, which has enabled the homoeopathic system to outline all its competitors and in fact to survive and flourish to the present day.
Following the Cullen’s translation, Hahnemann, like Hippocrates, was continua searching for pure testimony to support his contentions, and he, like Hippocrates WI directed his observations towards clinical medicine was an ardent and constant supporter the truth. That we can claim for his infallibility is not reasonable. That we can claim for hi, clearer, freethinking is honest and just.
From the years 1790 to 1805, his new system of treatment was slowly coming birth. We have a first slight intimation of its arrival in 1790; in 1796, we see the first define form in the fight against the mixing of drugs in use at the time; in the following year5 unfolded itself further, and attained its first complete form in the “Organon” in the year 18
“Organon” is Hahnemann’s exposition and vindication of his therapeutic method. In Organon, Hahnemann had given a finished picture of his doctrines. It has been preceded by a number of essays in Hufeland’s Journal, which was the leading medical journal of the time in Germany. Hahnemann designed his principles and methods in Organon as one that should be a medical logic, an instrument that the physician should use for the discovery of the best remedies for diseases.
It is worth noting that being a versatile and voracious reader that he was Hahnemann consciously or unconsciously was guided and inspired by some of the great writers and philosophers of his time. We can find the stamp of some of the great works of the time in Hahnemann’s work and methodology as it developed and evolved with passage of time.
Hahnemann was raised on the principles as developed into a pedagogical system byJ.B. Basedow (1723-1790) which combined the natural development with that of utility.
Basedow concern for utility, the real and practical is central to homoeopathy which sets itself the goal of making all pharmacological knowledge useful to the practitioner immediately and without the intervention of theory.
Basedow’s “appeal to perception”, of course, figures ir Hahnemann’s exclusive stress on symptoms as the source of medical knowledge.
Like Bacon (whose work ‘Novum Organum’ inspired Hahnemann to name his book), Hahnemann sought to recall men from the spinning of the thought – cobwebs to the patient investigation of facts. On the line of Bacon, he further set up the practical – which in his case is the healing of the disease – as the proper aim of medical philosophy, not seeking in knowledge a terrace, for a wandering and variable mind to walk up and down with a fair prospect “but rather accounting it a rich store-house, for the glory of the Creator, and the relief of man’s estate”. In true Baconian style, Hahnemann devoted his strength to the exposition and perfecting of his proposed method of further progress towards this end, leaving to the future the carrying it into effect.
Emanuel Kant was one of the writers and philosopher who was much read and acclaimed during Hahnemann’s time. Like Kant, Hahnemann set himself in his field to task of delaminating the boundaries of possible experience, beyond which the scientist of experience and the physician have r to seek. What Kant took upon himself to accomplish for philosophy, Hahnemann would have completed for medicine – “a medicine within the border of pure experience”. For, these reasons, Tischner call Hahnemann the “Kant of Medicine”. Hahnemann no doubt was influenced by the critical philosophy of Kant (and perhaps of Lambert too). Hahnemann in a letter to Mr. Von Villers, dated 3Oth,Januaryl8ll, praised Kant. He wrote “I admire Kant very much, particularly because he draws the line of philosophy, and of all human knowledge, where experience ends”.
At the end of the seventeenth and at the beginning of the eighteenth century, Ernst George Stahl’s view prevailed in the medical world. In place of natural healing power he set a domination of the soul (anima) over the body. Every natural and every morbid symptom of the body was stated be originated from the soul. Stahl is also emphatic in asserting that the efforts of the anima do not always adequately correspond to the purposes of life and to if maintenance of the body. Therefore, the professional skill of the physician is necessary. Aphorism 10 and 15 of the “Organon” Hahnemann uses phrases, which might be Stahl’ own and expresses his, conception.
Organon of Medicine has run through Six editions indicating the continuous effort towards self-improvement and perfection, which Hahnemann always sought. In these editions though the fundamentals remains unchanged but the subsequent refinement in the application of the Law of Similars is very much evident.
In the growth of a complex thing as a new system of medicine, it was inevitable the there should be considerable alterations and improvements effected in the course of fort eight years. The time occupied by Hahnemann in the elaboration of his novel doctrine an practice. The idea of the homoeopathic rule of practice occurred to him while translating Cullen’s Materia Medica in 1790. The “Essay on New Principle… .“, in which he put forward the homoeopathic therapeutic rule, as yet understood by him to be of only partial application i.e. to some chronic diseases, was published in 1796. In 1806, ten years after this, “Medicine of Experience” he enunciated the rule with no such limitations to its applicability.
Hahnemann first called his work “Organon der Rationellen Heilkunde” or “Organon of the Rational Art of Healing” but from the Second Edition onwards the title was changed’ “Organon der Heilkunst” or Organon of the Healing Art. The ‘Rational being here and in other places dropped. This elimination of the term “rational’ has been supposed by those who criticize him to “imply that his followers were required to accept his doctrine as though they were the revelations of a new Gospel, to be received as such, and not to be subject to rational criticism”. But Hughes is of opinion that the reason of this change lies in the fact that He was seeking, not consistency of a theory, but the success of a practical to him’ It mattered little whether a thing commanded itself or not to the speculative reason his only concern was that it should be true.
Christian Gellert’s (1715-1769) poem on the title page of the First Edition replaced in the subsequent editions by the words “Aude Sapere” which denote the profound conviction and motive inspiration of Hahnemann’s mind. It was the similar thought that he expressed in “Medicine of Experience” – “As the wise and beneficent Creator has permit those innumerable states of the human body differing from health, which we term disease He must at the same time have revealed to us a distinct mode whereby we may obtain knowledge of diseases that shall suffice to enable us to employ the remedies capable subduing them; He must have shown to us an equally distinct mode whereby we may discover in medicine those properties that render them suitable for the use of diseases He did not mean to leave his children helpless, or to require of them what was beyond their power. This art, so indispensable to suffering humanity, can not therefore remain concealed in the unfathomable depths of obscure speculation, or be diffused through the boundless void of conjecture; it must be accessible, readily accessible to us within the sphere of external and internal perceptive faculties”.
Hahnemann believed in the illimitable possibilities of medicine. Hahnemann wrote Preface for each editions of his work. The Preface to the Second Edition deserves special notice. It is a full statement in brief giving the author’s view on the existing state of medicine.
Nowhere does Bacon speak more clearly through Hahnemann than in his emphatic statements here regarding the relation of reason to experience in the study of the subject.
In 1807, the “Indications of the Homoeopathic employment of medicines in Ordinary Practice” was published. This essay appeared in Hufeland’s Journal and it formed three years later the basis of the “Introduction” to the “Organon” and was prefaced also to the Second and Third Editions but the beginning and end of the essay are different from the corresponding portions of the Introduction and the collection of examples in the middle of it, as well as the reference to doctors and writers is greatly extended in the “Organon”.
‘Introduction’ forms a considerable proportion of the whole book. It has altered very much between its earliest and the latest appearance. In the first three editions, ‘Introduction’ consists of a series of unintentional Homoeopathic cures taken from medical literature, with few explanatory, preparatory and concluding remarks. In the Second and Third editions, Hahnemann introduced into the body of the work a long section of destructive criticism on existing theories and modes of treatment. This finds a more appropriate place’ in the Introduction under the title “Survey of the Allopathy of the hitherto – prevailing School of Medicine”. From Fifth Edition onwards, the instances of Homoeopathic cure disappeared altogether, being merely referred to in a note. The Introduction became a continuous essay, its subject being the author contemporaries and predecessors.
On going through Hahnemann’s literary works especially those related to medicine in general and Homoeopathy in particular, it can be deduced that simplicity of Hahnemann’s conception lies in its entire freedom from hypothesis and completeness within itself. All other medical systems had been based upon certain doctrine of life and disease but Hahnemann’s method was utterly independent of them. His whole argument might be conducted as it is in the first three editions of his work, without any discussion of Physiological and Pathological questions. But at the same time, his art, indeed like all others, has its associated sciences. Physiology and Pathology are to it what Chemistry is to Agriculture and Astronomy to Navigation. So far they bring real knowledge, the more versed the physicians is in them better for himself and for those in whose aid he works.
The content of the Organon may be arranged under four divisions though they do not occur in the order in which they are given here. But if one goes through the whole of Organon then, he finds that the subject consists of -
- Discoveries – experimental propositions or the result of actual experiment.
- Directions or Instructions.
- Theoretical and Philosophical illustrations.
- Defenses and accusations.
1. Discoveries & Propositions
In “Organon” experience is not referred for the purpose of lauding any individual remedy, far more, it has relation to an entire method of cure. Every doctrine is evolved on the basis of experience to make this science complete. Homoeopathy is a science – a science that treats of the effect of a diversity of substances upon the human frame.
Many discoveries and propositions like Classification of diseases, Drug proving treatment and cure of chronic diseases, one sided diseases, Mental diseases, Intermittent diseases, Drug dynamizations etc. are mentioned in Organon, which are the result of experiments and observations. It is worth noting that the fact that most of these discoveries and propositions have modified which speaks for itself. Alterations and modifications hay been incorporated wherever the necessity was felt or where never observations an inferences demanded.
The Doctrine that dilutions or potencies are capable of curing diseases according to the law, “Similia Similibus Curantur”, is a proposition which belongs to biology, and then finds its confirmation, it likewise or only be investigated by experiment, and cannot be estimated without it.
2. Directions or Instructions
Under this heading can be enumerated directions for examination of the sick, for the preparation of medicines for trying then on the healthy subject, for the selection of the remedies, dietetics and directions for the psychical treatment.
Hahnemann has appended certain theories to the laws of nature discovered by him by which these laws are illustrated and brought into unison with other laws already acknowledged, or with other theories received as true. Hahnemann has supported his Lay and Doctrines with many illustrations drawn from nature and from various journals and books. He quotes extensively, from ancient as well as his contemporary medical mythological and other authors in support of his views. He proceeds further to elaborate the system in details and the principles of treatment as well as the remedies to cure the natural diseases. It is one of the best and most logical approaches to make one’s statement more comprehensive and acceptable.
4. Defenses & Accusations
The storm of anger and opposition that broke over Hahnemann and Homoeopathy was the very worst atmosphere for the calm and dispassionate enquiry, which he eagerly desired. In such situations Hahnemann has defended himself and Homoeopathy at various places in Organon and has also criticized and accused the wrongful methods used at that time for treatment. Out, the entire polemical part may be stricken out, without in the slight degree changing the principal matters or without having any influence either to ratify invalidate the doctrine itself.
In first four editions, Hahnemann had in several places spoken rather slightingly of the vital force and its influences on the production and cure of disease, but the expressions are greatly modified in the fifth edition. In last two editions “Vital Force’— “Vital Principle” occupies quite a different and a much more important position in regard to disease, its causes and cure. The doctrine of drug-dynamization of medicines by processes peculiar to homoeopathy, which had only been hinted at in previous editions, is in the fifth edition distinctly stated. The directions for repetitions of doses are also different from those in previous editions.
Medicines were to be administered o healthy individuals & a record should be maintained of the symptoms, which they produced. A given substance was then to be cured to treat the patient whose symptoms were identical with the symptom-pattern developed in the proving of this substance. This interpretation of the traditional Empirical principle of “cure through similars” was called by Hahnemann the “Law of similars” and was thenceforth the basis of Homoeopathic practice.
The Therapeutic Law of Nature as stated in Aphorism 26 (in the 5 and 6 edition) can be traced back to 1796, when in his ‘Essay on a New Principle “ Hahmnemann stated-“We should imitate the nature which sometimes cures a chronic disease by super adding another and, employ in the (especially chronic) disease we wish to cure, that medicine which is able to produce another very similar artificial disease and the former will. be cured.”
This also shows how the idea of Modus Operandi of Homoeopathic cure developed in his later works. In the same ‘Essay…” we can see the birth of this conception of Primary and Secondary Actions of Medicine. He says- “Most medicine has more than one action – the first a direct action which gradually changes into the second (which I called the indirect secondary action). The latter in generally a state exactly the opposite of the former. It may be almost considered an axiom that the symptom of the secondary action are the exact opposite of those of the direct action.”
Hahnemann’s object in attenuating medicines was not the same in the early and middle part of his life as it was in his declining years. In the later year, he had in view, the transference of the properties of medicine from the medicinal substance to the alcohol, or the sugar of milk, the separation of the quantities of matter from the substance in which they inhered, or, to use his own words, “The spiritualization of the dynamic properties”, the unveiling and vivifying of the medicinal spirit, the increase and exaltation of the strength of the medicine, in order that might cause in the healthy and cure the sick, when undynamised medicines would fail for want of power.
Hahnemann’s conception of doses and diminution of quantities, as seen in Organon was expressed for the first time in ‘What are Poisons? What are Medicines?’- An essay, published in 1806. Here he observes that poisons differ from medicines only in quantity. A substance such as table salt, innocuous and even healthy in small amounts, can become poisonous if consumed in larger quantities. And a substance such as arsenic is toxic even in small doses, loses its toxicity and reveals. medicinal qualities if taken in an infinitesimal dose. The strongest poisons, in Hahnemann’s view, make the best remedies precisely for their inherent ability to exert an effect on the Organism.
From the earliest days and throughout the whole of his medical career, Hahnemann paid the great attention to the question of using cold water in cases of illness. This fact needs more emphasis, since the water healing process has fallen into strong disfavor, when Hahnemann appeared and had only a few supporters amongst the physicians of that time.From the “Directions for curing old sores “ in 1784, it can be seen what extensive use he made of the different methods of applying water. In his later life and to the end of his medical career he esteemed very highly the effect of water. In the Sixth edition of the “Organon” he describes it as a valuable “homoeopathic auxiliary remedy’ in the treatment of the sick and convalescent.
Hahnemann never ceased to observe and to test and the later editions of the Organon. It contain a good deal of additional matter embodying his later experience but nothing that conflicts with the essential principles laid down in first editions. Especially he came to develop views concerning the origin of chronic diseases and the best method of treating them homeopathically which modify some of the paragraphs here set forth and added a good deal of fresh material.
“Organon” exhibits a passionate desire for exact and clear statements. Indeed Hahnemann’s desire for clarity leads him into repetition. But throughout it is clear in thought, arduously painstaking and full of conviction yet moderate and argumentative. No unprejudiced person can rise from its perusal without a respect for Hahnemann and to what is true of Organon in this respect.
Although, in Organon, the fundamental principles appear to have been laid out with an exhortative epistemological rigor in 294 aphorisms (in 5 edition), homoeopaths themselves always an independent lot – have come to this door from as many different directions as there are homoeopaths. This is intrinsic to the art of medicine. Every homoeopath brings varieties and irregularities of real-life and actual clinical situations in individual capacities that would be impossible to impose or teach them in a general way. Every homoeopath, every day thus adds many more aphorisms to the pageless book of homoeopathy of course not in the sense of amended theory but of added experience.
In his ‘Essay on a new Principle for Ascertaining the Curative Powers of Drugs. .‘, he had merely shown the external framework, or the corner stone of his convictions. In his Fragmenta de viribus ….‘, he had collated a number of experimental provings of medicines. In his ‘Medicine of Experience’ and in the smaller and larger other treatises he had carried his investigations further. But in the ‘ Organon’, his methodically constructed work on ‘rational healing’ or on the ‘healing art’ in general; he brought all this to completion.
The Organon may in time be widely recognized as one of the most important books in the entire history of medicine because it introduces in the long story of man’s struggle against disease, a successful system of medicinal therapy that contrasts radically with everything previously taught and practiced.