Hahnemann Revisited: Clinical Application of Organon in Modern Day Practise

Drs. Bipin and Anju Jethani show how far ahead Hahnemann was in his thinking.

Abstract: Often regarded just as an archaic piece of work, Organon of Medicine seems to have outlived its worth in face of modern literary advancements. This article attempts to underline the utmost significance of this masterpiece of Hahnemann’s Organon by correlating it with the principles of modern medicine. It also demonstrates the immense far-sightedness of a man whose thoughts were way ahead of his times. Most importantly, this article endeavors to portray the different concepts and modes of treatment which Hahnemann elucidated in and which are gradually being by modern medicine.

‘Hahnemann was so far ahead of his time that his teaching, in its higher phases, could not be fully understood until science in its slower advance had elucidated and corroborated the facts upon which he based it.’

…………Stuart Close – ‘The Genius of Homeopathy’1

 

This statement very aptly underscores the significance of Master Hahnemann’s contributions in the field of Modern Medicine, greatest amongst which stands The Organon Of The Art Of Healing[1].

The moot question often asked is ‘what significance can a work written 200 years ago have for modern medicine where a plethora of theories are making their way in and out of the medical literature. The following discussion attempts to illustrate the paramount ‘modern-ness’ of this so called ‘old work of Hahnemann’.

To begin with, let us look at this work from an etymological point of view.

The term ORGANON is etymologically derived from the Greek word ‘ORGANUM’ meaning “The instrument for a very specific purpose2. ‘Organum’ during the middle ages actually referred to a special kind of musical instrument, capable of producing, in certain specific style, polyphonic (many-voiced) Gregorian chants.

Precise as he was in his literary expressions, Christian Friedrich Samuel Hahnemann wanted to use a particular term as the title of his magnum opus that would best convey its essence. Hence, Hahnemann adopted the Aristotlean term ORGANON[2] so as to illustrate the importance of the specific instrument or the tool that each and every physician needs to employ for a specific purpose —to restore the sick to health.

We need to understand that Organon is not a mere compilation of theoretic medicine, but rather a guiding philosophy that has acted as an Oracle, giving us the rules and guiding principles that would lead us to our specific purpose. Secondly the word ‘Art’ conveys the practical approach – the bedside approach in medicine that Hahnemann believed in—- no theoretic medicine. As we find, Hahnemann clearly wrote in the Introduction: ‘Without disparaging the services which many physicians have rendered to the sciences auxiliary to medicine, to natural philosophy and chemistry, to natural history in its various branches, and to that of man in particular, to anthropology, physiology and anatomy, etc., I shall occupy myself here with the practical part of medicine only, with the healing art itself…………..’ 3

Lastly the word ‘healing’ (a derivative of Old English hælan meaning “to make whole, sound and well4) is derived from the word ‘whole’. It highlights Hahnemann’s philosophy of a holistic therapeutic system of medicine that perceives man as a whole, as opposed to the Cartesian approach that propagates a fragmentary, analytical view of man in health and disease. Hence, Hahnemann chose the word ‘heal’ that best encapsulated his Gestalt approach.[3]

Summarily speaking, Hahnemann’s The Organon of the Art of Healing is the instrument for application of principlesfor restoring the sick (patient as a whole) to health.

Delving further, we find that there are many concepts in Organon which are very similar to what modern medicine emphasizes today. Following are the concepts discussed by Dr Hahnemann which fall close to what is being discussed and said about disease causation, prevention and modes of treatment as of today:

 

EPIDEMIOLOGICAL CONCEPT OF DISEASE CAUSATION

The modern concept of disease causation reflects the fact that a concurrence of different “exposures” or conditions is required to induce disease, none of which is in itself necessary. For example, lung cancer can be induced by a causal web, including tobacco smoking and individual predisposition from CYP1A1 and other high-risk genotypes. 5 Thus modern medicine emphasizes a multi-factorial nature of disease causation – the interaction of environmental and genetic factors. Hahnemann too appreciated this fact when he wrote in §117 of Organon of Medicine (6th edition):

‘…………For as two things are required for the production of these as well as all other morbid alterations in the health of man – to wit, the inherent power of the influencing substance, and the capability of the vital force that animates the organism to be influenced by it…………….’

Thus Hahnemann understood the concept of causal web in the epidemiological study of diseases and strongly objected to the prevalent notion of single cause, a concept that has gradually been absorbed by conventional medicine.

 

PREVENTIVE ASPECT OF MEDICINE

In light of the modern onslaught of lifestyle disorders modern medicine has focused its attention to the PRIMARY AND PRIMAL LEVELS OF PREVENTION.

Primary prevention emphasizes general health promotion, risk factor reduction, and other health protective measures to foster healthier lifestyles and reduce the risk of disease incidence. On the same lines, Hahnemann gave due importance to lifestyle as can be deciphered in §4, 5, 208 and specially §77, where he stated that:

‘Those diseases are inappropriately named chronic, which persons incur who expose themselves continually to avoidable noxious influences, who are in the habit of indulging in injurious liquors or aliments,…………. , who are deprived of exercise or of open air, who ruin their health by overexertion of body or mind, who live in a constant state of worry, etc. These states of ill-health, which persons bring upon themselves, disappear spontaneously, provided no chronic miasm lurks in the body, under an improved mode of living, and they cannot be called chronic diseases’.

In addition, modern medicine has now given another level of prevention, PRIMAL PREVENTION, that has been used to describe all measures taken to ensure fetal well-being and prevent any long-term health consequences from gestational history and/or disease. The rationale for such efforts is the evidence demonstrating the link between fetal well-being, or “primal health,” and adult health. 6

Hahnemann gave the same concept in §284 footnote of sixth edition of Organon of Medicine wherein he elaborated that:

‘………But the case of mothers in their (first) pregnancy by means of a mild antipsoric treatment, especially with sulphur dynamizations prepared according to the directions in this edition (§ 270), is indispensable in order to destroy the psora – that producer of most chronic diseases – which is given them hereditarily; destroy it both within themselves and in the foetus, thereby protecting posterity in advance. This is true of pregnant women thus treated; they have given birth to children usually more healthy and stronger, to the astonishment of everybody.’

These words of Hahnemann in Organon justify the need to start homoeopathic treatment of an individual in during pregnany itself.

 

SCOPE OF EMERGENCY MEDICINE

‘Only in the most urgent cases, where danger to life and imminent death allow no time for the action of a homœopathic remedy – not hours, sometimes not even quarter-hours, and scarcely minutes – in sudden accidents occurring to previously healthy individuals – for example, ………. from lightening, from suffocation, freezing, drowning, etc. – is it admissible and judicious, at all events as a preliminary measure to stimulate the physical life with a palliative, as for instance, with gentle electrical shocks, with clysters of strong coffee, with a stimulating odor, gradual application of heat, etc ……..’

These words of Hahnemann as mentioned in §67 footnote of sixth edition seem to be the language of a modern textbook of emergency medicine. This shows that Hahnemann was not biased to the homoeopathic approach in all cases of diseases and appreciated the scope of antipathy in emergency care.

 

IMPORTANCE OF SURGERY

Hahnemann was well aware of the significance of mechanical intervention in treatment of pure surgical disorders and so he wrote in §186:

‘For in the case of injuries accruing to the body from without, if they be at all severe,…..the treatment of such diseases is relegated to surgery; …….. in so far as the affected parts require mechanical aid,……….. , may be removed by mechanical means, e.g., by the reduction of dislocations, by needles and bandages to bring together the lips of wounds, by mechanical pressure to still the flow of blood from open arteries, by the extraction of foreign bodies that have penetrated into the living parts, by making an opening into a cavity of the body in order to remove an irritating substance or to procure the evacuation of effusions or collections of fluids, by bringing into apposition the broken extremities of a fractured bone and retaining them in exact contact by an appropriate bandage,…..’

As in the above quote, Dr Hahnemann directs that a physician should be well versed with the subjects of anatomy and surgery to help him provide appropriate mechanical aid in the treatment of cases dependent on material, non-dynamic external causations.

 

APPRECIATION OF CONCEPT OF IMMUNIZATION

It is a remarkable fact of history that Jenner’s first experiments with Cowpox in Dorset in the summer of 1796, coincided with Hahnemann’s publication of his ‘Essay on a New Principle for ascertaining the curative powers of medicine’. As an astute and well observant physician, Hahnemann was very well aware of developments in the field of medicine. Ironic as it may seem, he was not only well versed with the Jenner’s concept of immunization but also endorsed his concept of immunization. In fact, Hahnemann perceived that it was on account of the similarity of manifestation and differing in kind nature of cowpox vaccination (cowpox and small pox are two different disease entities with differing infecting agents), that paved the way for the success of cowpox inoculation. He therefore appreciated Jenner’s Cow-pox vaccination as mentioned in the Footnote to §46 of sixth editionOrganon of Medicine as:

‘This seems to be the reason for this beneficial remarkable fact namely that since the general distribution of Jenner’s Cow-pox vaccination, human small-pox never again appeared as epidemically or virulently as 40-45 years before when one city visited lost at least one-half and often three-quarters of its children by death of this miserable pestilence.’

This again shows Hahnemann’s open minded rationalistic approach in medicine that allowed him to appreciate the works of his contemporaries.

 

VALIDATION OF PSCHO-IMMUNOLOGY & SIGNIFICANCE OF PSYCHOTHERAPY

Although modern medicine has barely begun to incorporate an understanding of the mind-body connectionHahnemann had delineated this concept nearly two centuries ago whereby he appreciated the importance of mind in the etiological perspective of diseases. He wrote in the footnote to §17 of the sixth edition:

A warning dream, a superstitious fancy, or a solemn prediction that death would occur at a certain day or at a certain hour, has not infrequently produced all the signs of commencing and increasing disease,…

Hahnemann was also one of the pioneers in promoting the humane treatment of the mentally ill and he was a strong proponent of psychotherapy in cases so demanding it. He stated in §226 of the sixth edition:

‘It is only such emotional diseases as these, which were first engendered and subsequently kept up by the mind itself, that, while they are yet recent and before they have made very great inroads on the corporeal state, may, by means of psychical remedies, such as a display of confidence, friendly exhortations, sensible advice, and often by a well-disguised deception, be rapidly changed into a healthy state of the mind (and with appropriate diet and regimen, seemingly into a healthy state of the body also.)’

It was precisely for this reason that Richard Haehl has very rightly remarked that Hahnemann “possessed an extraordinary understanding for the nervous and mental activities of his patients…and [possibly] considered psycho-therapy in certain cases to be more important, more applicable than the use of homeopathic medicines,7

 
CLINICAL CLUE TO PRESCRIBING

The Organon also contains certain significant prescribing clues which can often serve as a key to unlock a difficult case. A case is illustrated below to underscore this aspect:

A 6 yr. old child had low grade fever with malaise, lethargy and nasal discharge. As reported by the attendant, the child was talking continuously during the fever. He was constantly talking of the activities that he had performed in school and at home. Considering this significant concomitance of ‘loquacity (loquacious flow of talk) during fever’, Podophyllum 200 in water potencies was given but without much improvement. The child continued to suffer from low grade fever, complaining of tiredness but with no localising signs. The child gradually felt increasing lack of energy and yet there was no definite prescribing clue. It was here that a prescribing clue as given in footnote to § 183 of Organon of Medicine came to the rescue:

‘In cases where the patient (which, however, happens excessively seldom in chronic, but not infrequently in acute, diseases) feels very ill, although his symptoms are very indistinct, so that this state may be attributed more to the benumbed state of the nerves, which does not permit the patient’s pains and sufferings to be distinctly perceived, this torpor of the internal sensibility is removed by opium, and in its secondary action the symptoms of the disease become distinctly apparent.’

The child was prescribed Opium 30 with a remarkable result, as the fever came down within four hours of administration. The above discussion aptly demonstrates the prudence of Hahnemann to have delineated the approaches and concepts of modern medicine. The need of the hour is not to decry a work like Organon merely on account of its old age but rather attempt to perceive the pearls of wisdom hidden within. Let us learn from our allopathic brethren who having scoffed for long at the concept of infinitesimal quantities have with open arms embraced the significance of ‘nano’ in context of the role of vitamins and hormones in the human body – an approach towards Hahnemann’s ultra-dilutions.

What better salutation can be offered to this man of bedside medicine – Samuel Hahnemann, than by the remark of another epochal figure of medicine – Sir William Osler, regarded as the father of modern conventional medicine who once said that ‘No individual has done more good to the medical profession than Samuel Hahnemann.’

 

REFERENCES:

  1. Close Stuart. The Genius of Homeopathy: Lectures and Essays on Homoeopathic Philosophy.New Delhi: B. Jain Publishers (Pvt.) Ltd.
  2. Merriam Webster Online, Merriam Webster, March 2013
  3. Hahnemann, Samuel. Organon of Medicine, Introduction. Translated from 5th edition with an appendix by R.E. Dudgeon; with Additions & Alterations as per Sixth edition translated by William Boericke. New Delhi: B. Jain
  4. Collins English Dictionary – Complete and Unabridged, HarperCollins Publishers 2003.
  5. Vineis, Paolo and David Kriebel. Causal models in epidemiology: past inheritance and genetic future Environmental Health: A Global Access Science Source, 2006
  6. Gluckman, P.D. et al., Effect of In Utero and Early-Life Conditions on Adult Health and Disease, by New England Journal of Medicine. 359;1
  7. Haehl, Richard (1992). Samuel Hahnemann: His Life and Work – I,Reprint edition. New Delhi: B. Jain Publishers (Pvt.) Ltd, 272-3.
  8. This was the actual title given by Hahnemann from 2nd edition onwards tills his death and was changed to Organon of Medicine by R.E. Dudgeon.
  9. The word Organon was used for the first time by the eminent Greek philosopher Aristotle (384-312 BC). Under the common title of the ‘Organon’ the work of Aristotle was summed up on the logic treatise. This is a collection of six of his works on logic. Aristotle summed up all knowledge of Deductive logic (from general to particular) in Organon.

About the author

Bipin Jethani

Bipin Jethani

Dr. Bipin Jethani M.D. (Hom.) is working as Assistant Professor/Reader in the Dept. of Organon of Medicine at Nehru Homoeopathic Medical College and Hospital, Govt. of NCT of Delhi.

About the author

Anju Jethani

Dr. Anju Jethani M.D. (Hom.) is working as Senior Medical Officer (Homoeopathy) at Medical Center, High Court of Delhi, Dte. of ISM & Homoeopathy and as Senior Lecturer in the Dept. of Organon of Medicine at NHMC &H, Govt. of NCT of Delhi.

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