This talk is intended to give you an understanding of homeopathic medicine. To adequately grasp it one needs to realize that homeopathy is based on a fundamental discovery in the use of medicines, a discovery that solved an age-old problem in therapeutics.
We will look at the history of medicine up to the time of Samuel Hahnemann, see why he was dissatisfied with the medicine of the time and how he came to have a breakthrough conceptually — this leading to the establishment of a new system of therapeutics.
From this initial discovery we will see how the conceptual framework of homeopathy developed, leading to deep insights into the nature of both disease and healing.
Medicine before Hahnemann
For almost all cultures, disease was seen as the effect of non-material influences. Usually we hear this described as “evil spirits” or the acts of the gods. From our contemporary position it is easy for us to think this simple and superstitious, yet it can be better understood if put like this: There are influences that we cannot see, that seem arbitrary or without obvious cause. Since we can’t see them, they must be invisible, not physical and visible like is a wasp or a bear. If both invisible and harmful then we can say they are “spirits”, e.g., not physical beings and harmful to us, thus evil. In essence not different to our ascribing harmful influences to bacteria, viruses, or factors of pollution that we cannot see.
Some cultures also thought that harm could come from the ancestors, the influence of them continuing on past the grave. Considering what we know about genetic defects and mutations, that’s not so different from what we think now.
In any case, the attempt to control these invisible influences involved primarily exorcisms, use of magic, purification rituals, incantations and charms. Today we can understand by our own behavior how not knowing why things happen, we try to act in a way that will protect us or prevent our susceptibility. At those times it was perhaps wearing an amulet, today we would receive a vaccine, the modern amulet. Medicine of that time was well developed — at least conceptually. One record describes over 6,000 demons that can be responsible for health problems.
Other ways of attempted control of the health situations involved the use of soothsayers that would predict the outcome of disease. Most often it involved observing signs in nature, for example, looking for omens or reading the signs in the liver of sacrificed animals. This latter, examining the liver, was a form of “solicited omen” in which one posed a question to be answered, selected an animal to be the repository of that question, had it go through a purification ceremony, sacrificed it and then read the answer in the internal organs. Same idea as using Tarot cards or reading tea leaves — or a pendulum.
There was the use of some herbs and treatments like massage and simple surgery. In pharmacies of the time hundreds of plants and their uses were known. Animal parts were also used in medicine, esp. from poisonous snakes or animals, even the dung from animals. Over 150 minerals were also known and used, some of them quite poisonous.
The medicine of the Greeks is the primary source for the medicine that is contemporary to our culture. There were two primary schools of thought, not compatible with each other, that have continued down to the present day and are best represented in allopathic medicine, or what we refer to as contemporary or orthodox medicine and homeopathic medicine.
A major difference for the Greeks was the view that diseases had natural causes rather than supernatural ones and they looked for explanations in the natural happenings around them. Both schools of thought started from that basis.
The primary concept was that the body was made up of “humors”, the blending of which was responsible for optimal health. When one of the humors became too prominent, thus out of balance, then disease would appear. The major humors were (1) blood, (2) phlegm, (3) yellow bile, and (4) black bile. There were other humors than these, many more subtle ones were described, though there was not a systemization of them so that we could put them into a hierarchy.
An additional element was “pneuma” or “air” which through the balance of the humors allowed there to be consciousness, thought and perception.
Disease arose because of an improper processing of the humors. It went like this. The humor was first “crude” or “raw” and had to be made palatable to the being. It went through a process somewhat like cooking, e.g., the body or vital heat was involved in taking it into the proper form. This cooking was called coction.
When there is illness the raw unprocessed humor is discharged and so we can see the nature of the illness from closely observing the discharges from the patient. The body recovers from the illness by either discharging the offensive humor or “cooking” it.
It was not thought that disease was radically different from health, but they existed on a continuum. Some influence that could cause disease would result in a struggle for supremacy — the disease or the strength of the body would prevail.
The Empirical School
This view of health and disease was what we would call “holistic”. Though this term can have different meanings depending on one’s perspective today, at that time it meant that it was the organism’s own reactive powers that were the first line of defense against disease. There was always only one disease and that affected the entire patient even when symptoms seemed localized.
Proper treatment was to assist the process of coction by using something similar to the symptom condition. Thus fever was treated by bathing the patient with hot water. If the body was cold and stiff, cold water was applied to produce heat. I know, it sounds backward — but read on.
Other observed natural processes were imitated to bring about discharge and resolution, thus the use of emetics, purgatives, clysters and purgatives.
Sometimes another disease was deliberately established that would take precedence, as this second disease could be more easily cured than what was there originally.
There was emphasis on prognosis rather than diagnosis and disease was considered to be individual, such that patients always had treatment suitable for their specific condition.
The Rationalist School
The other way of understanding disease used the principle of contraries. Symptoms were to be treated with measures that would oppose them, fever with cold water, cooling medicines, etc. There was not reliance on the patient’s defenses — rather the physician took over those functions and treated the patient based on the theory of medicine adhered to by that school of medicine. It was an approach based on intervention, the defenses of the body not considered significant. The doctor substituted his knowledge and activity for that of the organism.
The emphasis was on removing what was considered to be harmful material from the body — bad blood, impure humor, unwelcome discharges. Thus there was more surgical intervention, drainage of pus or fluids.
Philosophically, this approach premised a special knowledge. Whereas the empirical doctor used common language and relied on what was observable, the Rationalist claimed that only the specially educated could understand what was happening and this set them apart from the general population because of this special knowledge. It also had the advantage of faster practice. Rather than individualizing patients, they were grouped together under diagnostic categories based on the theory that was current, and all treated the same way if it was assumed they suffered that disease common to all — for example, marsh fever, cholera, rheumatism, etc.
Medicine at the time of Hahnemann
Hahnemann was trained in medicine but frustrated at the lack of efficacy, the many theories of how to treat disease, and the lack of knowledge of the action of medicines.
The chief ways in which patients were treated were:
- Very complex mixtures of herbs and animal material, sometimes having up to 100 ingredients.
- Bleeding patients to remove what was considered to be “bad blood”.
- Purging with emetics and purgatives.
- Infecting patients with other diseases.
- Use of mercury (or other poisonous metals), a substance that was used for almost every disease much as we use antibiotics today. It resulted in serious poisoning of most patients.
Syphilis and the use of mercury
Mercury was found to treat the symptoms of syphilis, a disease that had been brought to Europe with Columbus — a little gift from the New World. It swept through the population as an epidemic killing many and maiming those it left behind. In desperation people were treated with mercury to the point of toxicity, the idea being that the disease caused by mercury was preferable to that of syphilis — much as we consider using chemotherapy and radiation to treat cancer today.
The issue of “specific medicines”
It had been observed that certain medicines seemed to have an unusual action. Rather than cause much upset in the patient, they would just result in symptoms going away and the patient feeling much better. Most medicines did not do this, but an occasional one did. One of these was Cinchona or “Jesuit’s bark” that was found to be specific to the treatment of malaria. It was a “problem” in medicine in that it did not fit into the models of how medicine would act. Why was this medicine different? What was the basis for such a wonderful action?
Hahnemann was aware of this and in translating a contemporary medical text, came to think about this problem and what it could mean. The theory proposed (in the authoritative text) was that Cinchona acted by being very bitter and therefore affecting the stomach in a way that would stop the fever. Hahnemann reasoned that other substances, even more bitter, should do the same — but they did not. So, there must be some other action to specifics. After considerable thought he came to the idea of trying the medicine on himself to see what it could do. On doing this, he observed the duplication of fever symptoms in himself and he thought that the reason a medicine could be specific, was because of its ability to duplicate the symptoms of the disease that it was treating. This insight was tested and confirmed and became the basis for the homeopathic system of therapeutics.
Extension of the theory: provings
Hahnemann continued to work with this idea and began a series of tests to see if other medicines could produce symptoms in the healthy person, symptoms that could then be used as a guide for the specific use of that medicine. After doing this with a larger number of medicines and confirming their usefulness, he published his findings in the first book that described in detail the accurate effects of drugs, the Materia Medica Pura, published in 1811.
These medicines then became the basis of a new therapeutics. A guiding principle established at that time was that only medicines whose actions were determined through prior testing were to be used in treatment. Speculation as to use of unknown drugs was established to be both inaccurate and harmful to the patient and so this ethical stance became an important part of homeopathy from the very beginning.
Application of the discovery
One of the first medicines that Hahnemann studied was Belladonna, from the poisonous nightshade plant. He found that the symptoms produced by it virtually duplicated scarlet fever of children, a serious illness causing death in many. He was able to apply this understanding to its treatment with success, which then greatly encouraged the direction he was going with this new method.
As new medicines were studied and the homeopathic practitioners became more skillful in using them, many impressive cures followed and these resulted in the establishment of homeopathy within the medical community itself. Several of the eventual leaders of the homeopathic movement started as skeptics, who themselves were cured or saw cures in their patients and were then convinced of the usefulness of the new method.
An example is cholera, a frightening and serious disease that spread as an epidemic through populations, often killing people in a few hours. The public was terrified of it. In 1849 a terrible epidemic hit Cincinnati and after the dust had cleared it was seen that the allopathic hospitals had mortality rates of 48—60% while the homeopathic hospitals had only 3% (1,116 patients). Homeopathy was still a relatively new method, the first US doctor being Hahns Burch Gram who began practice in New York in 1825. Yet the tremendous success of those Dr. Gram had taught brought homeopathy into a firm footing in the Northeast.
A case of Dr. Hahnemann’s is an example of how homeopathy differed in its approach to treatment from the other forms of medicine used at the time:
Case: The Washerwoman
S., a washerwoman, somewhere about 40 years old, had been more than three weeks unable to earn her bread, when she consulted me on the 1st September, 1815.
1. On any movement, especially at every step, and worst on making a false step, she has a (shooting pain) in the pit of the stomach, that comes, as she avers, every time from the left side.
2. When she lies she feels quite well, then she has no pain anywhere, neither in the side nor in the pit of the stomach.
3. She cannot sleep after three o’clock in the morning.
4. She relishes her food, but when she has eaten a little she feels sick.
5. Then the water collects in her mouth and runs out of it, like the water-brash.
6. She has frequent empty eructations after every meal.
7. Her temper is passionate, disposed to anger.
8. When the pain is severe she is covered with perspiration.
9. The catamenia were quite regular a fortnight since.
In other respects her health is good.
Now, as regards Symptom 1, Belladonna, China, and Rhus toxicodendron cause shootings in the pit of the stomach, but none of them only on movement, as is the case here.
Pulsatilla (see Symp. 387) certainly causes shooting in the pit of the stomach on making a false step, but only as a rare alternating action, and has neither the same digestive derangements as occur here at 4 compared with 5 and 6, nor the same state of the disposition.
Bryonia alone has among its chief alternating actions, as the whole list of its symptoms demonstrates, pains from movement and especially shooting pains, as also stitches beneath the sternum (in the pit of the stomach) on raising the arm (448), and on making a false step it occasions shooting in other parts (520, 600).
The negative Symptom 2 met here answers especially to Bryonia (638); few medicines (with the exception, perhaps, of Nux vomica and Rhus toxicodendron in their alternating action — neither of which, however, is suitable for the other symptoms) show a complete relief to pains during rest and when lying; Bryonia does, however, in an especial manner (638, and many other bryonia—symptoms).
Symptom 3 is met with in several medicines, and also in Bryonia (694).
Symptom 4 is certainly, as far as regards “sickness after eating,” met with in several other medicines (Ignatia, Nux vomica, Mercurius, Ferrum, Belladonna, Pulsatilla, Cantharis), but neither so constantly and usually, nor with relish for food, as in Bryonia (279).
As regards Symptom 5 several medicines certainly cause a flow of saliva like water-brash, just as well as Bryonia (282); the others, however, do not produce symptoms similar to the remaining ones. Hence Bryonia is to be preferred to them in this part of the ailment.
Empty eructation (of wind only) after eating (Symptom 6) is found in few medicines, and in none so constantly, so usually, and to such a great degree, as in Bryonia (253, 259).
To 7. — One of the chief symptoms in diseases is the “state of the disposition,” and as Bryonia (772) causes this symptom also in an exactly similar manner — Bryonia is for all these reasons to be preferred in this case to all other medicines as the homeopathic remedy.
Now, as this woman was very robust, and the force of the disease must consequently have been very considerable to prevent her by its pain from doing any work, and as her vital forces, as has been observed were not impaired, I gave her one of the strongest homeopathic doses, a full drop of the undiluted juice of bryonia root, to be taken immediately, and bade her come to me again in 48 hours. I told my friend E., who was present, that within that time the woman would assuredly be quite cured, but he, being but half converted to homeopathy, expressed his doubts about it.
Two days afterwards he came again to ascertain the result, but the woman did not return then, and, in fact, never came back again. I could only allay the impatience of my friend by telling him her name and that of the village where she lived, about a mile and a half off, and advising him to seek her out and ascertain for himself how she was. This he did, and her answer was:
“What was the use of my going back? The very next day I was quite well, and could again go to my washing, and the day following I was as well as I am still. I am extremely obliged to the doctor, but the like of us have no time to leave off our work; and for three weeks previously my illness prevented me earning anything.”
What is the medicine doing when similar?
In the almost 50 years of clinical practice and research that Dr. Hahnemann was able to do in his life, he worked out the details of the homeopathic mechanism. He found that when a medicine was able to produce changes similar in nature and expression to that of the natural disease in the patient, it stimulated a response. This response was the natural one the body used in curing itself. The remedy was able to stimulate this to happen in spite of obstacles or sluggishness of the system. The essential factor was the similarity in effect, which was absolutely necessary.
Reactions: aggravation, counter-action
The reaction that ensued was often seen as a two part change. First there was a temporary aggravation of one or more of the symptoms and second, a resolution of the problem as the system re-balanced itself. Symptoms disappeared and health was regained. With continued experience with patients, other signs were recognized that this process, which he called “cure” was happening.
Return of old symptoms (chronological reversal)
Symptoms that had been suppressed before by other treatments would come back to be resolved. The sequence was of a chronological reversal — the more recent ones first, then older ones appearing in the reverse order of how they arose in the first place.
Externalizing of lesions
There was also the movement of the focus of the disease from the inside of the body to the exterior, often as a skin eruption. So as the internal organs improved the skin would become more noticeably affected. It was essential that this skin condition not be suppressed.
Movement of focus downwards
Over time the lesions would move downward in the sense of towards the rear legs and feet and away from the head.
Discharge was very often a part of recovery. This could sometimes be in the form of pus, or changed secretions from the bladder, bowels, skin, ears, vagina or other mucous membrane lined tissues.
Enhancement of inflammation
Common to all these processes was an inflammatory process that allowed true healing to occur, a healing that should have occurred long ago. The inflammatory process was not a negative development but the primary way in which altered tissues and damaged organs were brought back to normality.
The meaning of symptoms
In all of this came a new understanding of what symptoms were. Instead of the stance that symptoms were the disease, something to get rid of, they were seen as an integral aspect of the process of defense the body was using to fight the influence of the disease. Practitioners were brought to the understanding that symptoms were essential to the healing response. It was found, for example, that the patient that exhibited few or weak symptoms did not have much vitality and it was this lack of vitality which resulted in the inability to have a final healing. Also, those individuals that had much prior suppressive treatment would come to a state of minimal symptom expression and this because of the ensuing weakness.
Symptoms as part of a healing response
Symptoms came to be seen as part of healing. Thus they were to be assisted by the remedy and never blocked or altered in any way. Homeopathy came to be a method of assisting the body’s own tendencies, working with it to accomplish the intended end.
What are medicines doing when not similar?
Once a method of using medicines to bring about the recovery of health in a reliable manner was worked out, this provided a context for further exploration of the action of drugs used in other ways. That is, what happens when drugs are not used on the basis of similarity? Symptoms certainly change; is this the same or an alternative way of using them? Within this context Dr. Hahnemann was able to learn a great deal about the use of medicines.
Elucidation of cure vs. palliation & suppression
Two other effects were elucidated. When drugs are not similar to the patient’s state then they can either palliate or suppress symptoms. This was a new understanding and an essential part of clarifying the use of medicines.
Palliation is using a drug to maximize its first influence on the body. That is, rather than the reaction or counter-action that will follow, the immediate, often physiological, effects are the ones desired. Drugs used in this way are intended to modify or block some function of the body. For example, use of an anti-inflammatory to block inflammation or an anti-histamine to block the action of released histamine. It is necessary to continue using the drug to maintain the effect. As it “wears off” then the drug is given again. So there are three aspects seen with palliative treatment:
- The drug must be repeated on a regular schedule.
- The effect of the medicine is quick, almost immediate.
- As time goes on, larger and larger doses are needed to maintain the same influence.
Suppressive therapy is similar but different to this degree. A symptom or group of symptoms is made to disappear — either for a long time or permanently. This is not a curative effect. The patient is not better overall and, in fact, may be more ill as time goes on — but with different symptoms.
- The drug is used for a while, until symptoms subside.
- The patient does not improve overall.
- Often there will be changes in the emotional state that follow — anxiety, irritability, etc. that come up as the physical symptoms disappear.
These two alternative methods of using drugs were found to result in gradual deterioration of a patient’s condition when this practice was continued over a long period of time. It is not immediately obvious it will happen this way, but as homeopaths worked curatively with patients it was observed that palliative and suppressive treatment were never helpful treatments — in fact they were often the reasons why disease got as bad as it did.
Clarification of principles
Other discoveries were made as well. Certain “rules” were established as necessary for success with curative treatment. Besides using medicines inappropriately, in a way that was palliative or suppressive, there can be other obstacles to bringing a patient to full recovery. Some are obvious — like continued physical deprivation. Others were not understood until practice experience was accumulated.
One remedy at a time
A basic one is that the best results are obtained in using one remedy at a time. Mixing remedies or giving them alternately resulted in palliation or suppression or just confusion of the case. It was found to be necessary to let one medicine, that was similar to the patient in his entirety, to act without the interference of other medicines, even those that have some degree of similarity as well.
No external treatment
Treatment of external lesions, like skin eruptions or growths like warts or tumors, also interfered with curative treatment and it was found necessary to proceed with just internal homeopathic treatment to have success. In fact, the external lesions became a very useful guide. As the internal treatment continued, the external would gradually disappear and thus provide a way of evaluating progress.
No surgical removal of lesions
The most profound technique of suppressing symptoms (or lesions) was the use of surgery. Removing the effects of disease threw the patient dynamic into disarray and greatly delayed a curative response or, in some cases, made the patient incurable. Thus surgery is not used as much in homeopathy — usually at the end of treatment to remove the remnants of disease in a cured case.
Hierarchy of symptoms
If we are to be guided by symptoms in choosing a medicine, are all symptoms of equal importance? Experience has enabled homeopathic practitioners to classify symptoms as to their usefulness in prescribing. They are broken down as:
- General symptoms, affecting the whole patient.
- Particular symptoms affecting a part.
- Mental or emotional symptoms as the primary focus.
- Modalities, conditions that alter a symptom for better or worse.
- Concomitants, symptoms that appear along with the chief complaint.
All of these are important but numbers (1), (4) & (5) are especially so.
Diagnosis as a misleading concept
The idea of grouping patients by the most common symptoms, that is those symptoms that are not specific to that individual, is the diagnostic method with which we are familiar. It is assumed that it is the common expression of named conditions that categorize the patient into a diagnostic group and, on this basis, a standard treatment is determined. This idea runs counter to the discoveries in homeopathy — that disease is individual and requiring specific individual treatment and also that the common symptoms are of least value. So, the idea of diagnosis is rejected as unsound and inaccurate as a basis for treatment.
Animals were treated early on, even in the time of Hahnemann. He saw no reason why animals could not be treated by homeopathy on the same basis as human beings.
Clemens von Boenninghausen (1785–1864) was one of the first practitioners to treat animals as a regular practice. He was originally a lawyer who was saved from death by tuberculosis by homeopathic treatment. He became one of the most dedicated disciples of Hahnemann and contributed much to the early homeopathic literature. Von Boenninghausen thought that treating animals was particularly interesting because it avoided the criticism of placebo effect. Many of his published cases involved treated horse and cattle.
Homeopathy continued to be used on animals, becoming a method used all over the world. The very first successful treatment of canine distemper was by a veterinarian using homeopathy (before vaccines were developed). Dr. Jervis describes the exciting success of using nosodes for both prevention and treatment.