The following review refers to the work of Thomas Faltin Homeopathy in the Hospital – The History of Homeopathy at the Robert-Bosch Hospital from 1940 to 1973; ISBN 3-8304-7153X; Karl F. Haug publishing house at the MVS Medical publishing Houses Stuttgart; Publisher: Institute for the History of Medicine (IGM) of the Robert Bosch Foundation. Language: German
Starting with a summary describing the significance of homeopathic hospitals and the general history of homeopathic hospitals in Germany, Mr. Faltin finally gets to the homeopathic hospitals in Stuttgart, dealing especially with the Robert-Bosch-Hospital (RBH). In great detail he investigates and describes the milieu and structures with the original idea for a new hospital; the planning and the building history, the employees, the medical wards, the nursing and the hospital pharmacy.
The industrialist and donor Robert Bosch formulated guidelines, with the intention that “apart from relief from all sorts of need, (the hospital was) to work chiefly for the improvement of the moral, health-related and spiritual forces of the people. […] It shall be promoted: health, education, culture, assistance to gifted students, international reconciliation and the like.” The main purpose of his foundation was to be the “public health care, under special consideration of homeopathy, its scientific research, its teaching, practical application and its spread, especially by the running of the RBH in Stuttgart by the society. […]” Exclusively important to him was, that homeopathy would be promoted, because it was economically of highest importance. The supreme goal of the RBH for Robert Bosch was to carry through the value of the homeopathic healing method to the health market.
Bosch imagined this venture to be such that the treatment of patients in this hospital would clearly follow the (trade)mark of homeopathy to a decisive degree. The clinic was given the additional task, through research with trials and clinical treatment, to develop the homeopathic art of healing to its highest level. This included an analysis and evaluation of the discoveries achieved through teachings and literature. Further, to hand it down to fellow homeopaths and future generations for further education.
With admirable exactness and precision, Mr. Faltin’s investigation describes what is still preserved in recordings and in literature, and how the ideal formulated by Robert Bosch, had (not) been implemented in reality. Unfortunately homeopathy has not been practiced in the RBH since 1973. In a main section of his book, Thomas Faltin explores the problems contributing to the failure of homeopathy at the RBH. He doesn’t restrict himself to internal matters of homeopathy, but rather tries to investigate the reasons given by the persons and decision-makers involved. He explains how the change of times such as the successes of conventional medicine, at least in the clinical field, put more and more doubts on homeopathy. With this influence, new goals were set that could not be achieved. In the end the question about the scientific rigour of homeopathy was a hurdle that could not be overcome until today. The question arose, could homeopathy ever prove its effectiveness within its principles, for example using a single remedy? Are these principles reliable beyond any doubt, to produce cure and therefore be taken seriously?
Our readers who would like to learn more details need to study this book. How far the ideals of homeopathic therapeutics were from the reality that was practiced become obvious with the example of the RBH. We need to be aware that where ever there are initiatives for establishing a new homeopathic hospital one will be confronted with the same circumstances and mistakes in the ‘case’ of the RBH. It is possible these mistakes will be repeated again causing hurdles that result in greater difficultly than ever before.
Today, there are only very few hospitals in Germany that could be called “homeopathic”. The reason is that were mistakes and compromises were frequently made that undermined the homeopathic principles in the Organon. These made it more difficult to ensure the long-lasting sustenance of the homeopathic clinics, finally leading to their disappearance.
The Robert-Bosch-Hospital in Stuttgart was the largest homeopathic hospital in Germany ever, which again and again, received large amounts of money from the industrialist Robert Bosch, so that it was extraordinarily well equipped and could employ some of the most renowned homeopaths. Very soon it got the honour, together with the “Homeopathic Hospital of Stuttgart”, to be the “Mecca of Homeopathy” in Germany and in the world for practice, research and teaching.
Given this kind of support, it is sad indeed that such a hospital where homeopathy could clearly have become a dominating healing method, instead was watered down to a purely orthodox-medical clinic. Finally, the result was that alternative therapies of healing hardly played any role in its function!
The municipal and the state authorities were well disposed towards the early homeopathic hospitals in Stuttgart. This improved in the years 1933-1945, because with the “New German Medicine”, a synthesis was reached between conventional medicine and alternative medicine. Homeopathy, and also the hospital, as the central place of the health system, played an essential role in this synthesis by that time. Therefore, great importance was granted to the RBH within the government’s promotions of the concept of health.
By the way, homeopathy was part of the education at the Nursing school of the RBH as well. However the sources do not state how extensive and profound the education was. By 1956, this additional communication of knowledge was discontinued, so that the nursing school did not anymore differ from any other school.
On the basis of the fundamental guidelines of Robert Bosch, a kind of homeopathy was taught and applied, which felt committed to the “scientific-critical” orientation [see Moritz Müller around 1820, who, as the first homeopathic physician, pleaded for continuously developing homeopathy further by scientific findings and also to integrate elements of “allopathy” to the therapy]. This was the cause for discussions (dissensions?) at the RBH.
With this orientation to the prevalent scientific principles of comprehension and verifiability, it was hardly possible to include certain homeopathic schools of thought or other alternative courses of treatment. One was the question of potencies in research. The “scientific” decision resulted in favour of using low potencies.: “In what is materially demonstrable we have to start to research with and to build a firm base on.” (Waltz)
In this way, the scientific fusion of homeopathy was given highest priority at the RBH. Conventional diagnosis was compulsory at the RBH. Also, the physicians always used orthodox medicine when homeopathy was not promising. Low potencies, up to 30 D at most, were applied, because one could explain some scientific action mechanism on a biochemical basis. The RBH preferred an ‘organopathologic orientation’ in remedy selection. Whereas Samuel Hahnemann and many of his successors considered the total personality and symptom picture of the patient (subjective and objective symptoms, modalities etc.) in remedy selection, at the RBH the organospecific symptom complex was decisive.
For the clinical therapy in the department of medicine, the scientific orientation dominated, which was mainly expressed by the preference of low potencies and in a symbiosis of homeopathic and conventional medical treatment. From a report of the year 1955: “To sum up, one could consider homeopathy as adjuvant therapy to allopathy in severe cases. A homeopathic therapy of obstipation (constipation) and in conditions of pain apparently was unsuccessful. After the decrease of severe pathological states through allopathic medicines, often a homeopathic and balneological (balneology: science of baths) treatment follows. In mixed therapies, in 45 % in average, the effects of homeopathic remedies – although not easy to assess – are described as effective.” The report establishes: “Hence, exclusively homeopathically treated patients hardly exist in the Robert Bosch Hospital at present.”
Interestingly enough, even until the beginning of the 1960s, it did not get around among many non-local physicians and patients, that in the in-patient department of the RBH hardly any homeopathic treatments existed. This seems in contradition to how records appeared. The reputation of the RBH as the “Mecca of Homeopathy” still had been pretty strong.
The rate of homeopathic treatments in the outpatients’ clinic of the RBH is higher. An analysis for a period from 1957 to 1973 shows, that the rate of exclusive or mixed homeopathic treatments was very high: around 75 %. So, as much as possible, patients were homeopathically treated, this is to say, that in the year 1966/1967 for 169 patients 911 homeopathic and 396 conventional medicines were prescribed (a ratio of 2,3 to 1 in favour of homeopathic remedies). Conspicuously, in average, every patient received 5,4 homeopathic and additionally 2,3 conventional prescriptions. About 58 % of the patients were treated exclusively homeopathically.
The directing physician Ritter came to the conclusion “that in the outpatients’ department, a pretty large part is treated homeopathically”, though, he made a significant restriction: the homeopathically treated patients “also could just as well or even better” be treated with orthodox medicine; but many respond better to homeopathic remedies.
Under the directing physician Ritter (1957-1968), the existing practice of homeopathy in the outpatients’ department for reasons of scientific rigour, tried to follow a clear, scientifically verifiable line. Ritter exclusively used low potencies, as for him which could only be decided according to one’s experience at the hospital bed as to which dose would be appropriate in a specific case.
The spectrum of potencies mainly was in the narrow range between undiluted and 6 D. The problem with this practice was that a number of remedies were administered at the same time. Basically, Ritter tried to administer only one remedy in order to be able to observe its effects well. But on the basis of the “multimorbidity” of many patients, it frequently just remained to be a “pious hope” to prescribe a single remedy. Besides, the picture of the symptoms often has been so diversified in form that it was impossible to cover the picture of the disease with just one remedy alone. Then he prescribed several remedies “to, as it were, pepper with shot instead to shoot with a bullet”. Obviously concerning remedy selection, Ritter was oriented closely towards orthodox medicine: indeed, he included subjective symptoms in his anamnesis, nevertheless, finally he treated mainly according to an organotropic point of view.: “We did already hint to the fact that we do not attach as much significance to individualization in homeopathy as is likely to be promulgated.”
Ritter also seemed to concede: â€ž… that our today’s medical science (modern medicine) is the unalterable basis not only in diagnostic, but also in therapeutic respect.” Homeopathy merely would be of “additional value”, but would be able to partly compensate deficiencies of orthodox medicine. (It can be seen how much “scientific” modern medicine thought over-ruled the homeopathic approach to healing!) Ritter finally completely rejected homeopathy even at the hospital bed.
Ritter’s successor, Konrad Hoetzer, wanted to combine the scientific-critical way with classical homeopathy. His goal was to use homeopathy not just as an organotropic pharmaco-therapy but also to use it in a personotropic way. Along with the inclusion of subjective characteristics, homeopathy and depth psychology would have the same goals, so that a fruitful combination should be possible. Unfortunately Hoetzer was accused of being too much of a ‘classical homeopath’, and his activities with naturopathy and psychotherapy were disliked by some administrative persons/physicians at the Robert Bosch Hospital. Finally in 1973 a separation was unavoidable.
In his guidelines, Robert Bosch had attached great value to homeopathic research. The effectiveness of this art of healing should be proven scientifically and its treasure of remedies should be improved. Therefore, one expected scientific activities from every chairing physician of the RBH.
The difficult proof, that the homeopathic simile-principle is valid, could have given a great lift to homeopathy. However, even on the empirical level, this proof could not be attained. The homeopathic physician applied homeopathic remedies in patients according to the law of simila and he also had successes with it: whether these successes were based on the simila-principle, a placebo-effect, and a suggestive effect, or possibly was based on a totally different principle of healing, was not detectable.
Therefore, in consequence of the pressure of scientific norms, many homeopaths were ready to doubt the absolute validity of the similia principle, both at the RBH and also in the Central Society of Homeopathic Physicians – the simillimum merely was a “working hypothesis” to many of them. Therefore, only a few trials were conducted in this direction. In 1966, one agreed not to want to prove homeopathy as a whole but to merely prove the effectiveness of individual homeopathic remedies scientifically.
At the RBH, there were remedy provings as well with healthy and with diseased human beings and records are available. So it could be examined, whether the remedies really cured those diseases, diagnosed by the empirical method, through information already available in remedy provings in the Materia Medica or in the repertories. The effects of remedies were also observed with animal experiments. The remedy provings on healthy persons at the RBH were done in cooperation with the homeopathic training courses in the hospital’s school.
The goals of these provings were proof of the effectiveness of the principle of similia at least for the individual remedy. In addition the proving of new substances were added to the treasure of remedies. It aided the re-check of already proven remedies to help clear the repertories from false or unnecessary symptoms. However only ten remedy provings at the RBH can be traced back, though there may have been some more.
Until 1956, remedy provings with sick persons were performed at the hospital bed as well as with the outpatients at the outpatients’ department. After 1956, it was done only in the outpatients’ department. Hans Ritter had proven the effectiveness of around 50 homeopathic remedies in such a way, carefully analyzing the medical records of homeopathically treated persons afterwards. He had a box for each remedy, in which the records of the patients were filed according to the remedy they received. So, until 1958, there was an extensive collection of cases; for example, Ritter has collected 400 records of treatments with Nux vomica. But he did not analyse and publish all of his remedy collections.
As a third kind of remedy proving were the animal experiments.
The potentiation of homeopathic remedies was another area of research work. Otto Leeser was interested in proving the effectiveness of high potencies. Together with Leeser, started the period of doing basic research at the RBH. Leeser even brought in a physicist of the Institute of Technology in Stuttgart to bring forward homeopathic basic research.
In his days at the RBH, Rudolf Pirtkien occupied himself with systematizing of homeopathic knowledge. His very interest in the still very new computer technology in those days, lead to attempts to save and analyse medical records electronically. In this way, a new repertory could be compiled in which the physician could find the correct remedy quickly and correctly with the help of the electronic medium. However, in working towards this end, Pirtkien partly deviated from the homeopathic nature of the task.
As a final field of research we need to mention the history of homeopathy at RBH. It was established at the RBH by Heinz Henne in 1967. It continues to be of significance until the present day.
With this, the topic of homeopathy at the RBH is described superficially and in an extremely sketchy manner. The problems faced and the failures of homeopathy at the Robert-Bosch-Hospital cannot be dealt with at this place. Homeopathic hospitals and the kind of homeopathy practiced within them have always experienced a hard time preserving its identity when pressured by a dominating scientific medicine. Loss of identity seems to run like a thread through the history of other former homeopathic hospitals as well.
By his meticulous studies, Thomas Faltin has created a work which has no equal. In order to obtain sources of information, he searched in the archives of numerous institutions, including private archives of directing physicians of the RBH and 766 printed sources and literature.
The result of his investigation includes the environment and the structures around the RBH, therapy, research and theory and finally the problems and the failures of homeopathy at the Robert-Bosch-Hospital. For all those who are interested not only in the homeopathic teachings but also in its historical development and existence in a scientifically oriented world, this book is a ‘must have’.
Thanks for this intriguing article and book review. It is disturbing that there was so much possible with this promising venture of RBH, but result was a disappointing reversion to solely allopathy. I hope the book is now available in English as I would like to study this important ‘case history’ and where and how things went wrong. How much was cultural forces of the times and how these have or have not changed? We need to learn these lessons, as the author points out, so the same mistakes are not repeated.
Thank you again! C. Smith, MS, MDiv, CCH (cand)