Heilkunst: An Overview

Heilkunst: An Overview

Preface

In 1810, a German doctor, Samuel Christian Friedrich Hahnemann, issued a formal explanation of a radical new system of healthcare. This work, Organon der Heilkunst, went through six editions between 1810 and his death in 1843.

Dr. Hahnemann has since become famous worldwide for creating a treatment approach called homeopathy. And yet, homeopathic treatment is only one part of a much more complex and comprehensive approach to healthcare bequeathed by the genius of Dr. Hahnemann. The rest of the story of Hahnemann’s complete system, Heilkunst, has yet to be told. Reducing Dr. Hahnemann’s complex system to homeopathic treatment is akin to reducing the entire system of Chinese medicine to acupuncture.

While such a reduction is understandable historically, due to past ignorance and faulty translations, it is demonstrably false. Modern research has now revealed the rest of the system hitherto unseen or ignored, and there remains no impediment to its rightful acknowledgment.

The purpose of this edition of the E-Zine is to set out the nature and extent of Dr. Hahnemann’s complete system of healthcare, and also to place that system and Hahnemann within a broader context. Heilkunst is not an isolated or erratic boulder on the landscape of Western science and philosophy, but an integral part of a stream within Western thought that provides a clear, rational foundation for Dr. Hahnemann’s ideas and connects them with other important thinkers and scientists both prior to and after Hahnemann’s time.

Introduction

Heilkunst refers to the comprehensive system of healthcare principles developed by the German medical reformer, Dr. Samuel Christian Friedrich Hahnemann (1755-1843), more commonly known for having founded homeopathy, the best-known part of his system. “Heilkunst” is from the German word meaning, literally, “the art (kunst) of making whole (heilen).”

Hahnemann’s system of healthcare is based on the understanding of disease as dynamic (energetic) in nature and origin, rather than material or physical.

Heilkunst encompasses three realms:

1.      therapeutic regimen (the restoration of balance – homeostasis),

2.      internal medicine proper (the removal of disease – palingenesis), and

3.      therapeutic education (the establishment of a healthy mind through means other than regimenal measures or medicines).

Heilkunst contains a complex disease classification (nosology), a systematic method of preparation of medicines (pharmacopeia), and a comprehensive database of remedial substances (materia medica).

The epistemological foundation of Heilkunst derives from a significant stream of Western thought going back to Greek thought, mostly the pre-Socratic thinkers, but starts more formally in modern times with Sir Francis Bacon. It then picks up various contributors to German Idealism, such as Schelling and Hegel as well as the approach to the investigation of nature developed by Goethe. On the English side, we have the works of Drs. Hunter, Brown and Saumarez, and the extensive and intensive mind of Samuel Taylor Coleridge.

More recently, expansions of the original contributions to Heilkunst have been made by the medical teachings of Dr. Rudolf Steiner, the founder of anthroposophical medicine, and Dr. Wilhelm Reich, founder of orgonomic medicine (orgonomy).

In essence, Heilkunst, as conceived by its founder, constitutes a structured method for the evaluation (anamnesis), understanding (diagnosis), treatment (therapeutics) and management of disease and illness in a given individual, at all levels – body, mind, soul and spirit.

Heilkunst and Homeopathy

Until recently, Dr. Hahnemann’s teachings had been restricted to only one aspect, homeopathy. Because of this, the term homeopathy has come to have two meanings: one, to refer specifically to the use of a medicine based on a match between the symptoms of a disease in a patient and similar symptoms produced by the medicine in a healthy person (known as “provings”); and, two, to refer generally to Hahnemann’s works and teachings as a whole.

Homeopathy is the specific approach developed by Dr. Hahnemann to deal with a certain type of disease, a “pathic” disease. In this approach, the physician takes the symptoms of a given disease in a patient as constituting the image of the disease itself, and then seeks to find a medicine that has been shown to produce a similar disease image (called an “artificial disease”) in a healthy person. Hence he coined the term, from the two Greek words, “homoios” (similar) and “pathos” (suffering or symptoms).

Dr. Hahnemann’s work and treatment approaches, however, went beyond homeopathy. When he formally presented the set of principles for his radical revision of Western medicine, he entitled the treatise, Organon der Heilkunst. It encompasses diet, nutrition, psychotherapy, energy manipulation and detoxification, as well as several approaches to treating disease, including, but not limited to, homeopathic prescribing. His first work after his abandonment of the prevailing medical approach, A Friend of Health, covered hygiene, diet and nutrition, and mental health. His next significant work, a long essay in 1796, laid down the basic principles of Heilkunst, included in which, but not restricted to, was the homeopathic approach.

The term Organon has Greek and Latin roots and means “a set of principles for use in scientific or philosophical investigation.” It goes back to the Greek philosopher, Aristotle (used by his students to refer to the full set of his works on logic) and Sir Francis Bacon (Novum Organum), who wrote in Latin.

The term Heilkunst is a German term that is difficult to translate. There is no direct equivalent in English. It literally means “the art of rendering a being whole,” derived from the two German words “heil” and “kunst.” “Heil” has a dual meaning in German, one related to health (compare the Old English, hale, as in “hale and hearty”), and one involving a greeting (as in the English “hail fellow, well met”), although both are related, not to mention heil as in heil-ig (holy) and Heil-and (savior).

In its health context, it includes two concepts rendered separately in English – cure and healing. Thus, while it is often translated as “medicine,” this does not really capture the richness of the German term. “Kunst” is also often rendered as “art,” but the concept of art in German is somewhat different from that in English. It encompasses the idea of a rational approach to knowledge that is grounded in, but goes beyond the sense-based world, and uses a form of knowing that goes beyond intellectual knowing (“wissen” in German, hence the German term for science in English is “wissenschaft”), to a deeper knowing involving more intuitive capacities (“kennen” in German). Again, English has only one word, know, where German has the two. English can only capture the distinction in the inflection and context of the word: “Do you know that man?” “Yes, I’ve known him for several years, but I don’t really feel that I know him.”

The term “Heilkunst” then is properly used to refer to the complete system of medicine developed by Dr. Hahnemann, and the term “homeopathy” refers more narrowly to one of the uses of medicines according to the law of similars, done on the basis of matching the symptoms of a disease in a patient to a similar symptom picture produced by a medicine in a healthy person (known as a “proving”), mentioned above.

The Discovery of Heilkunst

Although the elements of Heilkunst are derived largely from the writings and teachings of Dr. Samuel Hahnemann, their discovery and elaboration had to wait for more recent times. Part of the reason was the necessary emphasis that Dr. Hahnemann himself placed on homeopathy in his writings. It was a new, yet complicated approach to the application of the ancient law of cure known as the law of similars, one that required significant elaboration, so it is perhaps not surprising that this element received the most attention in quantitative terms in his works and from his followers. Part of the problem can be laid at the door of poor translations, so that until recently, there was significant distortion in English translations, and many of the foundational concepts were effectively eliminated or obscured.

German and English form a certain polarity; where German has one term, such as heilen, English has two (cure and healing), and where English has only one, such as knowing, German has two (wissen and kennen). Also, where Dr. Hahnemann used various precise terms in German to refer to a key element of his approach to medicine, namely the concept of a living power at the root of life, health and disease, this concept and its epistemological basis was little understood, if at all, by translators.

Thus, the various terms in German involving this living power (Lebensprincip, Lebenskraft, (and its polarization into Erhaltungskraft and Erzeugungskraft) Lebensenergie, Dynamis, Kraftwesen) were conflated into one English term – “vital force” – on the mistaken notion that all of this referred in some way to the theory prevalent in the 19th Century of a vital force that directed the activities of the physical body (vitalism). This conflation hid deeper insights to be found in Dr. Hahnemann’s works.

However, translation problems cannot be the problem when it comes to German-speakers working with the original German writings. The deeper and more important reason lay in the fact that until recently, no one had understood the broader philosophical context within which Hahnemann was working and writing. This context is critical to being able to understand the complexity of his system and its driving principles.

What is unique to Hahnemann is not the law of similars. This concept had been known to medicine for centuries prior. It is not the idea of testing medicines on healthy persons (provings), as this had been suggested earlier, though not carried out as systematically as by Dr. Hahnemann. It is in the understanding of the polar nature of life, and in particular in the understanding of the supersensible forces in sense objects as well as of the independent life of the mind above nature.

These are the ideas that came to life in the cultural and philosophical developments of Europe known as Romanticism, German Idealism and aspects of English Associational Psychology, what Samuel Taylor Coleridge, a prime figure in this cultural development, termed “the Dynamic System of Thought.” Hahnemann, though practically oriented, worked within and was an integral part of this system. The key to unlocking the other aspects of Hahnemann’s system, and also placing homeopathy properly within that system, lay in the understanding of this broader philosophical and theoretical context.

It was not until recently that a scholar who had dedicated his life to studying this system of thought applied himself to Hahnemann’s works. The result was the first translation of Hahnemann’s main works, the Organon of Heilkunst and the Chronic Diseases, that revealed what lay in his system beyond homeopathy. Steven Decker, of Santa Barbara, California, also created the first translation wherein the reader can follow the thought process of the translator word by word to the final rendition, but also one in electronic form that allows the researcher to search on the same term in English and its various German counterparts, or to see how the same German term can be variously translated into English.

The Principles of Heilkunst

At the very start of the Organon of Heilkunst, Hahnemann states that any valid medical system needs to be founded on “clearly realizable principles,” (Aphorism 2) that is, on principles grounded both in nature and reason. Immediately thereafter, in Aphorism 3, he states that such a system must provide three things:

1. the basis for an accurate identification of disease or imbalance (diagnosis based on a clear categorization of disease, or nosology);

2. a comprehensive classification of remedial agents, identifying the potential therapeutic action of each (materia medica, or pharmacopeia); and

3. the basis for matching the diagnosis with the curative agent (therapeutics).

Writings

The foundational writings of Heilkunst are the following main works: Organon der Heilkunst, Chronische Krankheiten (Chronic Diseases), and a collection of articles, Gesammelte kleine Schriften (Collected Smaller Writings, very misleadingly translated in English as The Lesser Writings).

The Organon der Heilkunst is the formal treatise created by Hahnemann to expound his discoveries, but it is supported by and linked to his other significant works, both initially and throughout his life. It is also the most difficult title to translate into English (see above).

Philosophical Context of Heilkunst

The fundamental basis of Heilkunst is found in its “dynamic” view of disease, which places it in what Samuel Taylor Coleridge termed “the Dynamic System of Thought” in Western philosophy.

This system or stream of thought in Western philosophy is not well known. It’s origins can be seen in Bacon’s efforts to rid the mind of various “idols” or delusions to which it was prey in order that it could be used as a fit and proper scientific instrument for a systematic and methodical inquiry into nature, both mother nature and human nature; not just the outer appearances (natura naturata), but also the inner, living content (natura naturans) (see in particular the Novum Organon included in Bacon’s Great Instauration).

It is next to be found in the stream of German philosophy termed German Idealism, which sought to penetrate the veil between nature’s outer form and inner content using those aspects of mind beyond the intellect (Verstand). Where English has only one word for the concepts mind and thinking, German has several, reflecting that the act of thinking and consciousness involve the whole of man, not just the brain (see for example, modern research on the second “brain,” the extensive neural system found in the gut).

The main figures in German Idealism are Fichte, Schelling, and Hegel, followed by I.M. Fichte, Troxler, Deinhardt, Scchlege, Planck, Preuss, Grimm and Hamerling, to name a few. Later figures, and ones that came after Hahnemann’s time are those involved in the development of phenomenology, such as Brentano, Husserl, Heidegger, Wittgenstein and Gadamer.

The significant scientific writings of Wolfang von Goethe from 1780 to 1830 set the basis for an inquiry into natural phenomena that was based on a form of cognitive participation using other aspects of mind than the intellect. These efforts, and those of the German Idealists and Romanticists, to get at the “Spirit and the Wesen in nature” (the supersensible aspects of matter) were expanded on and developed further by Rudolf Steiner, the founder of anthroposophical medicine, which he saw as an extension of Heilkunst. At the same time, the work of Dr Wilhelm Reich into the dynamics of sexuality led him to a deeper understanding of the nature of the generative power discovered by Dr. Hahnemann, and provided a means of understanding the sub-sensible or elemental aspects of nature.

All of this has been advanced in terms of insights and better integration by a lifelong student of this Dynamic System of Thought, Steven Decker. As noted above, his studies allowed him to translate the Organon and the Chronic Diseases and to reveal aspects of Hahnemann’s discoveries that had been previously hidden by misunderstanding and ignorance about the context within which Hahnemann lived and worked, and about his predecessors and also his heirs.

Foundational Concepts and Principles

Dynamic Nature of Disease

Dr. Hahnemann’s research led him to reject the prevailing notion of his day, and still a dominant one to this day, that disease is something material, that is, that science and medical science must concern itself with sense-data. This is based in the Western philosophical tradition from Descartes, Hume, and Hartley to the influential works of Immanuel Kant in the 18th Century. Thus, in this view, if there is a skin lesion, then the problem is to be found in the skin itself or in some chemical imbalance, or hormonal dysfunction or blood disorder, for example. Treatment is then directed at the offending material cause (materia peccans).

At the same time, Hahnemann rejected the vitalist tradition that derived its idea from medieval medicine, such as the works of Paracelsus and Von Helmont, positing an abstract notion of some “vital force” not grounded in any natural observed reality that was above the material realm and directing it. Disease was seen here as an imbalance in a person’s life that could be corrected by natural measures or spiritual means, an approach that is at the base of much of the natural health field today.

Hahnemann’s research led him to the conclusion that health and disease involve an interaction between the dynamic element of a human being, which suffuses, but is not identical with, the physical body, and the inner essence of various external factors, whether nutritional or inimical, traumatic (physical or emotional) or microbial, psychical or somatic. He concluded that this “living principle” or “living power” (Lebensprincip or Dynamis) is the key to understanding and treating disease and sickness. Since the Dynamis mobilizes the physical body, the physical body cannot become sick unless the Dynamis is first disturbed. The symptoms of abnormal function at the level of the psyche and soma are then the result of this disturbance.

Thus, the cause of sickness must be sought beyond the material or sense-world. Sickness ultimately is supersensible in nature, or to borrow from Aristotle’s students, metaphysical (beyond the material or sense-based realm). The physical body simply reflects the derangements at the supersensible or dynamic level.

Also, while Hahnemann understood the role of infectious agents (well before modern microbiology), the real agent of disease was not, in his view, the physical carrier (microbe), but the energetic or dynamic element in that agent that was able to act on the living or dynamic element of the human organism.

Hahnemann was convinced that he had placed his new system of medicine on the firm foundation of natural law and principle. This then provided for the rational ordering of therapeutics, on a basis which is empirical, but not materialistic, because it is grounded in nature and in principles derived from natural law. Without this foundation, any system of medicine for Hahnemann was without principle (allopathic) and had the potential to cause great harm because it relieved by suppressing symptoms, but did not remove the underlying cause. For example, if a person has a headache and takes an anti-inflammatory, the pain may be reduced or even removed, but the cause of the headache is not addressed. For Hahnemann, the result of a disease process (inflammation) can never be the cause of itself, a basic principle of logic. Anti-inflammatory drugs are then suppressive of the symptom, not curative.

Dual Nature of Disease

Hahnemann further discovered a distinction between disease and disorders due to imbalance. This is based on his discovery of the dual nature of the living principle or Dynamis. Disease he considered to be a dynamic impingement on the generative side of the Dynamis; imbalance is a disturbance of the sustentive power (what traditionally was termed the vis medicatrix naturae or inner healer). The generative power (Erzeugungskraft) is that power responsible for cell division, fertilization of the egg, and the creation of new ideas. Proper generative function is palingenesis. The sustentive power (Erhaltungskraft) is the power that maintains homeostasis, keeping things in balance.

Because of this dual nature of the Dynamis, there is a distinction in the disease process between the initial action (Erstwirkung) of the disease agent, which involves an impingement on the generative power of the Dynamis, and the reaction or counteraction (Gegenwirkung, Nachwirkung) of the sustentive side, much as in physics where each action produces a counter-action.

Thus, the initial action of disease is seldom felt, much like the initial moment of conception, as we can see in the initial infection of typical infectious diseases (e.g., chickenpox). This is followed by a prodromal period wherein the sustentive power readies to react and restore balance due to the initial action of the disease agent. The counteraction of the sustentive power produces the various symptoms we associate with disease (fever, rash, discharges, etc.).

Dual Nature of the Remedial Process

The dual nature of the disease process has a counterpart in the dual nature of the remedial (Heil) process, also as between the initial action of the medicine, which destroys the disease lodged in the generative power, and the counter action of the sustentive power to restore balance again, which now succeeds as the disease has been destroyed.

This polarity also provides a distinction between the concepts of cure and healing. Cure involves the removal of disease (curative action or lysis) by use of the right medicine acting on the generative power of the Dynamis (all medicines being such by virtue of their power to so act). Healing is the restoration of balance (homeostasis) by the sustentive power side of the Dynamis following the removal of disease, and also often involves various symptoms known as the healing reaction or crisis.

The Two Laws of Treatment

Hahnemann’s research and experiments had led him to rediscover the ancient principle of cure, called the “law of similars” (similia similibus). This law, known to the Egyptians and Greeks, stated that a disease could only be cured by a medicine that could cause that same disease in a healthy person. The problem in the past had been one of dose; crude doses used according to the law of similars were dangerous, and because of that this method had been largely abandoned by Hahnemann’s day in favor of the law of opposites (contraria contrarius), or for simply using regimenal measures to support the natural healing power.

If the principle of similars, which Hahnemann concluded was grounded in natural law, is curative, then using medicines on the basis of the law of opposites is suppressive.

Heilkunst does include the application of the law of opposites, but within the proper jurisdiction which involves the healing function of the sustentive power in diet, nutrition, lifestyle, energy work, psychotherapy, drainage, detoxification, etc.

There are several applications of the law of similar resonance, one of which is based on the overt symptom picture (totality of characteristic symptoms) of the patient, which is matched to the symptom picture or image produced by a given medical agent in a healthy person, to which Hahnemann gave the name homeopathy. Another is to make a remedy from the causal disease agent, either through a characteristic discharge, such as tubercular sputum (Tuberculinum), known as a nosode, or by isolating the disease agent itself, such as by using a dynamized and potentized form of cortisone to remove an iatrogenic disease caused by that drug. This is known as an isode.

Practitioners in Hahnemann’s time developed the use of nosodes, which are homeopathic dilutions of the disease agent made from an excretion of a person suffering the disease in question, of which Hahnemann approved. Rabies nosode, for example, is made by potentizing the saliva of a rabid dog. This provides a ready and effective means of finding a curative medicine for a new disease not yet identified.

The appropriate substance to treat a disease is one which induces a similar disease state in a healthy person. Heilkunst uses a vast range of isodes, that is, those made from all manner of disease agents (drugs, poisons, chemicals, vaccinations, etc.,) related to the pathogenic and iatrogenic disease jurisdictions.

Degrees of Similitude

What symptoms are associated with various substances is determined by provings, in which the researcher imbibes the remedy and records all physical, mental, emotional and modal symptoms experienced. A homeopathic repertory is a listing of remedies by symptom, used to determine the most appropriate medicine for a given disease. The appropriate application of a medicine can also be determined from clinical experience based on the knowledge of the applicable principle governing a disease jurisdiction.

Disease Classification

Since the cause of disease is not material, but lies in a disturbance of the dynamic or energetic level of our being, the diagnosis must address itself to this level. Hahnemann developed an extensive classification of disease.

First, he distinguished between those diseases that are idiopathic, that is, self-standing, autonomous and not dependent on other diseases, and those that are secondary and derivative of a prior disease. The self-standing or idiopathic diseases have a constant nature, that is, they always show up the same, such as the classic infectious diseases (measles, typhoid, cholera, yellow fever, etc.) and are termed “tonic” (Stimm-based disease in German) diseases in Heilkunst. They are addressed by means of the homotonic principle, that is, by means of remedies that are specific to a given disease. An example would be Apis mellifica for the homogenic disease from a bee sting.

The secondary, derivative diseases are variable in nature. That is, it depends on the nature of the interaction between the tonic disease and the patient as to which new diseases are spun off. These Hahnemann termed “pathic” diseases. They are addressed by means of the homeopathic principle.

Second, Hahnemann distinguished disease according to temporality. There were diseases that were acute and those that were of long duration (distinction by quantity of time) and diseases that were of a self-limiting nature versus those of a chronic nature (distinction by quality of time). Thus, measles would be an acute disease of a self-limiting nature, whereas malaria would fall in the category of a chronic disease, but if the person just contracted it and was suffering symptoms, it would be acute, and if the patient had been suffering for several years from periodic flare-ups, it would be of long-duration.

He also distinguished between the various layers of pathic diseases and the different jurisdictions of the tonic diseases. Within the tonic disease realm, he identified several: those based on a certain disease “irritation,” such as mental, emotional and physical traumas (homogenic); on improperly prescribed medicines (iatrogenic); infectious agents (pathogenic); and finally diseases caused by various false beliefs that cause us to act in ways against our overall health (ideogenic).

Hahnemann’s nosology also encompasses the spirit, soul, mind and body of man, providing a basis for assessing the impact of disease on the various levels of our being. It further includes the different elements of disease, from symptoms that are pluralized (plurific) in nature (changes in feelings, functions and sensations that the patient reports) and those that are unific in nature and require the participation and discernment of the practitioner, such as “the Feeling,” (das Gefühl) or “the Impression” (das Eindruck) of the disease.

In the area of acute diseases, Hahnemann distinguished those that were simply flare-ups of underlying chronic diseases, from true acutes, and here he distinguished between epidemic and sporadic on the one hand, and acute versus chronic miasms on the other. A miasm is a disease of constant nature, the term meaning “a noxious influence” in the medical terminology of his time.

Hahnemann wrote a separate book on his discoveries of the chronic miasms, and therein also distinguished these from the chronic diseases that were spun-off from these chronic miasms. The chronic miasms are tonic diseases, and the chronic diseases are pathic in nature.

Posology

From the very beginning of his new system, Hahnemann came to the conclusion that medicines, to the extent that they can affect the human being, must be able to act dynamically and that their power to act as medicine lay in this dynamic effect. He also was conscious of the serious negative effects of the crude drugs of his day and finally of the problem in using crude doses and the law of similars. All of this motivated him to seek to dilute the crude nature of medicines and to seek that level at which the negative effects of the medicine was minimal or nil, while still preserving a therapeutic (positive, curative) effect.

About the author

Rudi Verspoor

Rudi Verspoor

Rudi Verspoor is Dean and Chair Department of Philosophy Hahnemann College for Heilkunst, Ottawa. He was Director of the British Institute of Homeopathy Canada from 1993 to early 2001.

Part of his time is spent advising the Canadian government on health-care policy and in working for greater acceptance of and access to homeopathy. His publications include:
Homeopathy Renewed, A Sequential Approach to the Treatment of Chronic Illness (with Patty Smith);
A Time for Healing; Homeopathy Re-examined: Beyond the Classical Paradigm (with Steven Decker);
The Dynamic Legacy: Hahnemann from Homeopathy to Heilkunst (with Steven Decker).
Visit Rudi Verspoor at the Center for Romantic Science
http://www.romantichealthcare.com/

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