Translated by Katja Schütt and Alan Schmukler
Keywords: Homeopathy, Organon, Enlightenment, Sapere aude, Vital force, Natura morborum medicatrix, Hippocratism
Homeopathy has its origin in the work of its founder, Samuel Hahnemann, and among its most important writings is the Organon, which was corrected and edited six times. Throughout the history of this discipline various interpretations of the main concepts have been made, which forces us today to return to Hahnemann and to deal with those interpretations. Mainly concepts such as the vital force, Natura morborum medicatrix are analyzed. Homeopathy is freed from any spiritual and philosophical aura to define it as what it is: a medical discipline with scientific foundations.
Hahnemann’s thought is unaffiliated with a particular philosophy or spiritual tradition. Its basics must be sought in the mindset of the Enlightenment which has characterized the scientific tradition to this day. Hahnemann was a thinker whose ideas were supported by the empirical scientific method. There is no naturism or Hippocratism in homeopathy‘s teaching. It is scientific reason that guides its healing methods. Today the return to Hahnemannian thinking is necessary, to deal with its interpreters, who in many cases have misunderstood or changed it.
It would seem to be an anachronism to return to the thoughts of the founder of homeopathy, at a time when for many it is obsolete to continue delving into concepts that emerged between the 18th and 19th centuries. Despite all this, anyone who intends to train in the field of homeopathy needs to introduce himself to Hahnemannian thought, because therein lies the keys to the practice of homeopathy.
Although it will be necessary to consider that much water has gone under the bridge, and in deference to that what those clinging to outworn orthodoxy opine, a true homoeopathic doctor will have to incorporate a Hahnemannian discipline, no matter how strict it is, and to the whole set of contributions from those who have looked into the thinking of the founder.
And in this sense we have to face a hermeneutic problem, that is, the interpretations that have been made of the writings that give rise to homeopathy, and this fact alone justifies and compels us to return to Hahnemann’s thought. Therefore, this is not about approaching the original phase of homeopathy, it is rather to get into the living thought of this clinical therapeutic method through the work of its founder, with all that this may imply.
To go in depth into the thought of Samuel Hahnemann we must place it in the context of its time, and consider how it emerged from the scientific and philosophical conditions of the time. Sometimes we must follow the spirit more than the letter of his concepts, without prejudices or dogmatism, and try to see his work as a product of a stage in the history of human thought that has reached to transcend our time. We should not modify or arbitrarily discard any of his work before studying it carefully.
With that intention I propose a return to his most original thinking, excluding his interpreters. This explanation, which is not exhaustive, only tries to be a first step to ascertain some foundations that are the starting point of his work in the epistemological sense, and will be supported by quotations from his own texts.
The Organon, a revolutionary document
In my opinion, the starting point should be the Organon of Medicine, the central work of homeopathic medicine published in 1810 for the first time, and which represents a milestone in the field of medicine, a revolution that breaks with the paradigms of the medical order which was so chaotically constituted at that time. The new medical method established by Hahnemann in this work seeks to establishe order in a field full of contradictory theories about the concepts of health, illness and healing.
Throughout the different editions of the Organon we find a lucid, highly self-critical thinker who was not satisfied with establishing a sufficiently effective and complete method that shed light on the central problems of medicine. It is a fact that he evolved it, even more than many of his disciples who felt they had already found a new form of healing that provided good results in practice. Thus, he made changes in each new edition of the Organon that lead him to perfect his method.
Let us think, for example, of his miasmatic theory that made a radical change in the way human pathology is treated and that represents not only an extension of his concept of illness, but a profound revision that implies giving different meaning to the concepts of health, illness and healing. It could be said that Hahneamann established a different anthropological approach.
As everyone knows, Hahnemann was a stubborn and authoritarian man, but not someone who was bemused by his own ideas and discoveries to the point that he was not self-criticalt enough to perfect his method. He was, above all, a scientist willing to renew himself and open to modifying his own concepts. His work, as we know it today, is the fruit of the development of his critical thinking, which was a genuine search and without fearing to change the aspects that were necessary to improve his method.
There is an epistemological development in his work that is especially committed to providing foundation and bases for medical practice, because the great problem of the medicine of his time was the lack of solid principles that would lead to safe therapeutic results.
On the other hand, it is illusory to think that homeopathy is a finished fruit, because all knowledge of scientific order is subject to change and historicity, and must be constantly renewed and expanded. Homeopathy is not something historical, it is not a dogma of faith that must remain untouched and placed as a cult object.
Homeopaths have placed Hahnemann and Homeopathy at a quite vulnerable point: we have put them on a plane that does not correspond to the plane of science; we have become the representatives of a dogma. The Organon is our Bible, and that explains our repetitive discourse and lack of creativity; it explains our endogamy and hermeticism towards everything that could submit homeopathy to a critical judgment. We feel to be the owner of an immovable truth and are more concerned to repeat faithfully what was written in Hahnemann’s work, than to investigate and verify everything said by him.
We have to insist that the Organon is not a philosophical work that intends to defend a way of thinking or a philosophical, spiritual or religious ideology. It is a medical book that develops a clinical-therapeutic method that is based on an epistemology that arises out of a scientific empiricism. The Organon is, undoubtedly, the work that sustains our practice, which gives meaning to our medical approach, and it is, therefore, a scientific work that has to be revised critically and freed of all closed and hermetic aura, that is, we have to place it where Hahnemann himself put it, as a work that can be the subject of criticism and renewal, as his six editions show, with the last being modified before his death and posthumously published.
On the other hand, homeopathy “does not need defense”, as our masters said. It is sufficiently solid to remain and be further developed, because it has principles that can be developed further without risk. Our best defense, more than the theory, is the clinical practice, that rests on firm bases which allows us to work in a predictive order and provides us a criteria for our treatment of the patient.
I choose as a starting point to analyze an aspect that, in my opinion, is the point of most controversy and the one that generates the greatest problems to understanding the Hahnemannian concept, and which, on the one hand has given rise to very important currents in the history of homeopathy and, on the other, to a fierce opposition. I believe that in most cases this happens because of a biased or decidedly equivocal reading. Its analysis will help us to clear the way. I refer to the concept of the vital force which is described in paragraph 9 and the following paragraphs of the Organon. The transcendental paragraph number 9 says:
In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence.
A superficial view of this paragraph may suggest that Hahnemann thereby introduced the notion of the spirit into the medical field, closely linked to his own religious beliefs, but I believe that this is only apparent, since the following paragraph, number 10, tells us:
The material organism, without the vital force, is capable of no sensation, no function, no self-preservation, it derives all sensation and performs all the functions of life solely by means of the immaterial being (the vital force) which animates the material organism in health and in disease.
The reading of both paragraphs together clarifies doubts always present in the discourse of homeopaths. In these paragraphs written by Hahnemann, we find the following:
- The organism is in absolute dependence on the vital force and its functioning is only possible by means of this vital energy.
- The vital force is of an immaterial nature.
- Life and the conservation of it depend on the vital force and its relationship with the organism.
- Health and illness – two states belonging to the human condition – are patrimony of the vital force, never of the spirit.
- The spirit, which resides in us, makes use of the dyad made up by the instruments of the vital force and the organism (in the best of cases in a state of health), for the higher purpose of existence (whatever this might be).
- The vital force, being an immaterial force and understood as a dynamism, is nevertheless not an indestructible force. On the contrary, it is susceptible to alteration and to be affected, since disease originates in its disequilibrium. It can not, therefore, be conceived as a simple substance, as Kent opines, since this would not admit alteration.
These points are confirmed in paragraph 11:
When a person falls ill, it is only this spiritual, self acting (automatic) vital force, everywhere present in his organism, that is primarily deranged by the dynamic1 influence upon it of a morbific agent inimical to life; it is only the vital force, deranged to such an abnormal state, that can furnish the organism with its disagreeable sensations, and incline it to the irregular processes which we call disease; for, as a power invisible in itself, and only cognizable by its effects on the organism, its morbid derangement only makes itself known by the manifestation of disease in the sensations and functions of those parts of the organism exposed to the senses of the observer and physician, that is, by morbid symptoms, and in no other way can it make itself known.
As can be seen, this paragraph describes more precisely what is related to disease and does not refer to the spirit. Therefore, we can clearly say, that the spiritual does not belong to the field of Hahnemannian medical thinking, and whoever believes so does not understand what he reads. That‘s why it cannot be said that “Homeopathy is a medicine of the body, soul and spirit. In Hahnemannian terms it must be said: Homeopathy is the medicine of the soul and, as a consequence, of the body.
The term soul must be understood as the vital force that animates the body. Therefore the spirit is an entity alien to the scientific field, it is not a field of study for science as in the case of the vital force, and which we reach to know by its expression through signs and symptoms in disease, and the manifestations which we are able to access through experience, and in the state of health by means of the manifestation of a harmonious operation.
The concept of the vital force is inherently problematic, but it becomes even more so when we interpret the text inappropriately. A return to Hahnemann implies from my point of view, in the first place, an adequate understanding of the concepts in their own context and, later, to place them in our historical moment.
Several questions arise in this order of ideas: Is it valid to continue talking about the vital force in the terms expressed by Hahnemann? How should we interpret the concept of the vital force at the present time?
In general, we know that the concept of the vital force has been constantly used in the medicine of the eighteenth and nineteenth centuries. The school of Montpellier was the absolute defender of this concept (Barthez, Bordeu and Bichat). The German doctor Georg Stahl, promoter of animism, had a fundamental influence at that time. Vitalism explains the impossibility of life of inorganic matter; it requires an animating principle of that matter that is capable of keeping it alive despite its natural tendency to decay.
The problem that we have to think about is still greater, because it is not only about explaining life, but human life in all its complexity. Human life poses major dilemmas that go beyond the idea of a genetic biology and the tendency to see instincts as the life’s conservative force. We have to consider the consciousness, the unconscious, and man’s whole relationship with others. How is a human being structured? In my opinion, it is a more complex issue that can‘t be answered only with the idea of the vital force and that takes us to other fields of knowledge to receive an answer.
What kind of thinker was Hahnemann?
Don’t let us forget the historical circumstances of Hahnemann’s time, the period during which the philosophy and science of his time existed, nor his firm religious beliefs that appear from time to time in his work, but never to explain scientific phenomena. He was, above all, a rational man, an exemplary scientist who opted for a methodological empiricism.
A first light to understand Hahnemannian thought is given by the Latin phrase: Sapere aude, as it still appears today and in the time of Hahnemann, at the frontispiece of the school of Saint Afra in Meissen, where he studied and was awarded a scholarship for being an extraordinary student. This Latin locution of Horacio has an enormous meaning, as the philosopher Emmanuel Kant points out in a work that is small but of great importance in the history of philosophy: What is enlightenment ?, published in 1784.
It is not a coincidence that the phrase appears at the beginning of the 4th and 5th edition of the Organon of the healing art. Sapere aude, “dare to know”, “have the courage to use your own reason”. This is the slogan of the Enlightenment.
Kant says: Have courage to use your own reason! Hahnemann was a man of the Enlightenment and his great concern was to introduce a true order of rationality into medicine. In the introduction of the Organon he says: No! the true healing art is that reflective work, the attribute of the higher powers of human intellect, of unfettered judgment and of reason.
Hahnemann was a thinker influenced by the renewing spirit of the Enlightenment. He was an observer of nature, an empirical researcher who did not try to theorize about the phenomena that medicine studies. First of all he adhered to the observable, to the facts. He was a tough researcher for his time and not pleased to follow formulas or beliefs, wherefore he abandoned medical practice temporarily, as it had deeply disappointed him.
In a paragraph of the writing Nota bene for my reviewers, written in 1817, he says: “This doctrine appeals not only chiefly, but solely to the verdict of experience“.
“Repeat the experiments,” he shouts, “repeat them carefully and accurately and you will find the doctrines confirmed at every step.” No other medical doctrine or therapeutic system did or could do this: To insist on being “judged by its results”.
There is a short text written by Hahnemann in 1808 and included in his Lesser Writings, called On the Value of the Speculative Systems of Medicine, which is of utmost importance to me, because it perfectly reveals his position in relation to science, and can be considered a fundamental antecedent for the Organon’s epistemological structure.
I quote some paragraphs:
“Which, indeed, of the ontological systems regarding the (undiscoverable) nature of the human soul promises to afford any aid to the teacher in the execution of his noble office?He might well lose himself in the interminable labyrinth of abstract speculations on the ego and the non-ego, on the essences of the soul, & c., which extravagant self-conceit has in all ages wrung from the racked brains of hosts of sophists; but no advantage that will reward his pains will he draw from these transcendental subtleties. It has not been given to mortal man to reason a priori on the nature of his own soul.”
Another one says:
“The wise teacher is aware of this; he spares himself this fruitless trouble, and, in aiming at as wide an acquaintance as possible with his subject-matter, confines himself to the a posteriori, to that which the mind’s own acts have revealed concerning itself, to empirical psychology. More on this subject in this stage of being he cannot, more he need not, know.”
He also aims:
“Just so is it with the physician. That which binds in so wonderful an organization the (may be originally chemical) constituents of the human frame in life – which causes them, inspite of these their original nature, to act in quite an unmechanical and unchemical manner – which excites and impels them, when thus combined, to such automatic performances (which do not obey any of the known laws of mechanics, and differ from every chemical process, and all physical phenomena); this fundamental force does not reveal itself as a distinct entity; it can only be dimly surmised from afar, and is for ever concealed from all inquiry and observation. No man is acquainted with the substratum of vitality, or the a priori hidden arrangement of the living organization – no mortal can ever dive into it, nor can human speech, either in prose or verse, even faintly shadow it forth: the attempt ends in fiction and sheer nonsense.”
Here, another one:
“All, therefore, that the physician can know regarding his subject-matter, vital organization, and all that concerns him to know, is summed up in that which the wisest among us, such as Haller, Blumenbach, Wrisberg, comprehended and taught under the term physiology, and which we might designate the empirical knowledge of vitality, viz.: what the appreciable phenomena are which occur in the healthy human body, and what their connexion is; the inscrutable how they occur, remaining entirely excluded.”
The reading of the Organon carried out from a position that tries to avoid intermediary interpretations is highly illustrative, since it puts into question the observations of our preceptors. Suddenly, when reading the fundamental texts of homeopathy written by Hahnemann, it seems to contradict his later interpreters. An example of this is the whole Hippocratic notion that has been imposed on his work. That‘s why I dare say, in opposition to what we have been taught, that in some aspects Hahnemann is decididly anti-Hippocratic.
An example of this is the whole discussion established in the introduction of the Organon related to the medical systems of the time. These systems, which call themselves “rational”, are deeply criticized by Hahnemann because of their supposed rationality and pretending to follow and stimulate the reactions of the vital force in illness, which is absurd and dangerous.
But the vital force, which of itself can only act according to the physical constitution of our organism, and is not guided by reason, knowledge and reflection, was not given to man to be regarded as the best possible curative agent to restore those lamentable deviations from health to the normal condition, and still less that physicians should slavishly imitate its imperfect morbid efforts (to free itself from disease), and that with operations incontestably more inappropriate and severe than its own, and thereby conveniently spare themselves the expenditure of reasoning, reflection and judgment requisite for the discovery and for the practice of the noblest of human arts – the true healing art – while they allege their bad copy of the spontaneous efforts of doubtful utility made by the crude natural force for its relief, to be the healing art, the rational healing art!“
“The vital force, which can not act by itself but in conformity with the organic disposition of our body, without intelligence, without reflection and without discernment, has not been given to us to see it as the best guide to be followed in the cure of diseases, and even less so that we imitate slavishly the incomplete and morbid efforts that she makes to return health, adding to them other acts more contrary to the object she intends to achieve; so that we can spare the necessary intelligence and reflection works to discover the art of healing, and finally, so that we place in the place of the noblest of the human arts a bad copy of the ineffective aids that nature administers, when he abandons her to his own strength. “
What rational man would want to imitate its conservative endeavors?
“These efforts are in reality the disease itself, and the morbidly affected vital force is the producer of the visible disease! It must, therefore, necessarily follow that all artificial imitation, and likewise the suppression of these efforts, must either increase the disease or render it dangerous by their suppression, and both of these allopathy does; these are its pernicious operations which it alleges to be the healing art, the rational healing art! “
Higinio G. Pérez offers a contrasting point of view in his improved and revised edition of the 5th edition of the Organon of 1910, as can be seen in his note to paragraph 28: “The teacher, in his eagerness to properly explain his discovered principle, could not escape from the influence of his century and its atmosphere of ergolistic metaphysics, and had to veer away from his clearly positive method“.
And there he establishes his Hippocratic notion of homeopathy, affirming that: “the principle of homeopathy is such a clear and evident corollary of the indebatable axiom Natura morborum medicatrix that is doesn’t need to be hypothesized. No one can deny that nature, in all branches of human knowledge, is the teacher par excellence. ”
Without discussing here the benefit or not of “hippocratizing” homeopathy, it is important to return to the work of Hahnemann and then to analyze the arguments of his exegetes. In this concrete case of the Natura morborum medicatrix, Hahnemann does not manifest a Hippocratic affiliation; rather, radically rejects this notion. For him, it is not nature that operates the healing process, it is human reasoning that, by making use of his knowledge, intervenes to modify the course of the disease.
Authors like Higinio G. Pérez, Proceso Sánchez Ortega and Tomás Pablo Paschero reintroduced the idea of Natura as a condition for a return to health, a concept that has become a flag of homeopathy and is taught without adhering properly to what has been said by Hahnemann.
Hahnemannian thought is rational, based on the experience that our senses provide us. It is, then, the work of a doctor emerged from the Enlightenment who searches in the investigation of observable facts, not in imagination or in metaphysical matters. Some later authors, such as James Tyler Kent, Henry Clay Allen, Nilmani Ghatak and later Alfonso Masi-Elizalde, have taken homeopathy to a biblical tradition to understand disease, linking it to the original sin. Nothing could be further from Hahnemann‘s ideas. It would be necessary to make a separation between the clinical Kent and the philosophical Kent, and in the same way we would have to proceed with Allen, Sánchez Ortega and Paschero, among others, who, in an effort to take our discipline to higher levels turn it into something different from science: a philosophical system, a spiritual medicine, and so on.
The trascendence of homeopathy lies in its clinical method, in its epistemic bases and in everything that informs the medical measures. It does not need to adhere to a philosophical conception or a particular doctrine. The foundations established by Hahnemann are the essence of our medicine, but our science does not end there, which is demonstrated by the development that has taken place over two centuries.
It is unthinkable that today our clinical practice is the same as in Hahnemann’s time, and to corroborate it, it is enough to see his clinical cases. We have incorporated more than 170 years of evolution since the death of the master, in the same line as unicist orthodoxy. Nevertheless, let us point out that in the face of constant new developments, it is essential to rethink the teachings that gave rise to homeopathy.
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@ The article has been puiblished at “La Homeopatia de Mexico”, no.702, May-June 2016