The writings of Samuel Hahnemann

I admit to a certain curiosity about old homeopathy books. What do they contain? Is there any science in these books?  Exactly what did Samuel Hahnemann write that gained him such a dedicated following?

If you’re unfamiliar with Samuel Hahnemann, the founder of homeopathy, or the alternative medicine practice of homeopathy, you might like to read this introduction before reading any further with this post.

Generally, Hahnemann’s writings about homeopathy were translated into English not long after the publication of the original German versions. In all my reading about homeopathy, I’ve seen almost no comments taken from these translations of Samuel Hahnemann’s work.

My approach to this material will be: just because a book is old, that doesn’t mean I’ll ignore poor reasoning and throw away everything learnt in the last 200 years.  I’m looking for good evidence and logical reasoning to back up any claims.

Critics might suggest I’ve only looked into Hahnemann’s writings with the idea of cherry picking it and then dismissing it. Not so: if I find good science I’ll change my mind.  Hahnemann claimed to have done experiments.

I forbear indicating the great exertions, the innumerable and careful observations, the inquiries, reflections and various experiments by means of which I have succeeded…

[1]

I’m particularly interested in finding the details of those experiments.  How were they done?  What was the methodology? And of particular interest to me, did any placebo-controlled trials occur?

My source for original material about homeopathy is the Taubman Medical Library Homeopathy Collection; it’s really quite an amazing internet resource.  The closest and best medical academic library near me, at the University of Melbourne, has very few old homeopathy books. The few books that it does have are fragile due to age, and they’re kept in special old book collections requiring permission to see them.

In contrast, the Taubman collection is regarded as one of the world’s most complete collections on the subject of homeopathy; very conveniently, it’s all scanned and searchable via the internet.

There is a great deal of material in the Taubman collection.  The work I’ll be referring to here is The Nature of Chronic Diseases.  This is a large work published in five separate book volumes. Volume one was published in 1828. (Note: the English translation was published in 1845, with volumes one through four available.)

Yes, I know The Nature of Chronic Diseases isn’t Hahnemann’s first manuscript, nor his last.  It was written after his earlier better-known works Organon of the Healing Art (1810) and Materia Medica Pura (1811).  However Chronic Diseases combines elements of the two previous works.

If this post generates some interest, I may try to tackle Hahnemann’s Organon of the Healing Art in a later post.

With the introduction over, I now begin my review of Hahnemann’s Chronic Diseases volume one. Let’s delve in:

On the attack

One of the first things I noticed and was somewhat taken aback by, was the attacks on conventional medicine of the 1800’s.  Conventional medicine wasn’t very good or science-based at the time; it incorporated bloodletting and leeches, among many bizarre practices.  As an example of the poor state of medicine, in 1799, George Washington’s life was cut short by a throat infection and the use of bloodletting as a treatment. The French in the 1830’s imported about 40 million medicinal leeches a year.

If homeopathy was so much better than the medicine of the time, is it really necessary to attack it so much?

…that the artificial secretions consequent upon allceopathic drugs, inflict much greater losses upon the organism than natural evacuations do. So far from diminishing the primitive disease, the allceopathic practice, on the contrary, favours the universal ruin by its pretended dissolvants, purgatives, bloodletting, cupping, leeching, which is now in immoderate use, diaphoretics, blisters, setons, fontanels, issues, etc. God be praised, the homoeopathic physician has dispensed with the necessity of employing those barbarous and homicidal contrivances.

[2]

Note that “allceopathic drugs” is the derogatory name given to any non-homeopathic medicine in use at the time, and “organism” refers to patients.

Yes, the medicine of the time was terrible, no contest.  However, was homeopathy any better?

The faithfully practised precepts of the homoeopathic method of cure, as it is taught in my own writings and those of my disciples, have hitherto manifested to all men, and in a very striking and decisive manner, their natural advantage over the allceopathic method, both in regard to acute diseases as well as epidemics and sporadic fevers.

[3]

Another swipe at 1800’s medicine with a slight religious tone to it.

Science-based medicine was at its very beginnings in the early 1800’s. James Lind, in 1747, conducted what is regarded as the first scientific trial in an effort to try and rid the British Navy of debilitation and death from scurvy.  Although the results of the first trial were very slow to be adopted, the British Navy officially recommended the daily consumption of lemons or limes in 1795.

In 1796 Edward Jenner discovered the link between cowpox infection and immunity to smallpox, a discovery that eventually led to modern vaccines, although Louis Pasteur’s experiments confirming germ theory lay many years ahead (~1862).

Theoretically, Hahnemann could have learnt from Lind and Jenner. Hahnemann could have put homeopathy on a scientific foundation and shown it to be safer than the medicines of the day, but did he?

First, the treatment was satisfactory, then it became less favourable, and finally hopeless. Despite these failures, the doctrine itself has then been, and will ever be, founded upon the unshakeable pillars of truth.

[4]

Is it possible that Hahnemann is describing in broad terms the death of a patient treated with homeopathy?  Regardless, Hahnemann tries to put homeopathy beyond scientific testing: it’s “unshakeable”. So far it’s not looking good for reasoned argument.

Psora, Miasm and Itch

Many pages, (pages 26 to 61), of volume one of Chronic Diseases are short case histories of people who were treated for “itch” by the medicine of the time.  The repeating theme is: the symptoms went away, then a short time later they were struck down by some new ailment.

The point of this appears to be some kind of put-down of the medicine of the early 1800’s.

Hahnemann doesn’t properly characterise the “itch”, so it’s difficult to know exactly what he’s writing about.  I’ve read suggestions that Hahnemann is referring to all skin conditions.  Interestingly, scabies was quite a common skin condition in the early 1800’s.  Scabies was one of the earliest medical conditions to have an identifiable cause established.  Scabies mite was first described in 1687.

As the cause of scabies was known in Hahnemann’s time, his attempt to redefine it as “itch”, if that’s what he’s trying to do, is rather strange.

I may here observe that the great epidemic diseases, such as: small-pox, measles, purpura, scarlatina, hooping-cough, fall-dysentery, and other typhoid fevers, if they are improperly treated, and are permitted to complete their course, shake the organism so thoroughly, that the latent psoric miasm becomes roused in such patients and gives origin to cutaneous eruptions.  If these eruptions are numerous, authors call them scabies spontanea, (self-originating itch).

[5]

I’d guess that around 50% of the writing in the first half of Chronic Diseases is about attacking the medicine in use at the time, the early 1800’s.

The language used  by Hahnemann, even after translation into English, makes this book difficult to penetrate for its meaning.  Take, for example:

In the last three centuries, the psoric miasm, which now manifests itself in the shape of the common itch, has been losing this benign character.

[6]

There is a great deal of poorly argued writing in volume one about “psora”, “miasm” and “itch”. Certainly “psora” and “miasm” are no longer commonly used terms.  After a little more research I found that “miasma” is an old term used to describe a kind of unhealthy air or pollution, sometimes said to originate in swamps.

Hahnemann appears to be redefining psora and miasm such that they apply to all manner of conditions:

If the patient should then die in spite of all the drugs which the allceopathic physician gives him, the doctor declares that the patient has died of the effects of hooping-cough, measles, etc. These effects are nothing more than the visible consequences of the latent psoric miasm which may manifest itself in innumerable forms, and which never had been cured on account of its nature and mode of action having been unknown heretofore.

[7]

Below, another example of Hahnemann’s grand style of writing with poor reasoning:

Science has now revealed to us the nature of this internal enemy, and the means to conquer him; we know now that it is a deep-seated psora slumbering in the inmost recesses of the organism, and which the robustest constitution would have been insufficient to expel, unless aided by the efforts of art…

[8]

Well two hundred years later, science knows nothing of this “psora”, or what to do with it.

From theory to treatment

At page 110 of Chronic Diseases, Hahnemann stops expounding his ideas and begins to suggest treatment:

I shall now pass to the treatment of chronic diseases, the number of which is almost without end. Although I do not pretend to say that the fact of all chronic diseases having been traced by me to a three-fold origin, has made the treatment of those diseases an easy matter; yet I may say that the discovery of the remedies which are homoeopathically adapted to those different classes of diseases, has secured the possibility of their successful treatment.

The three-fold origin to which he refers consists of the ill-defined terms I mentioned above, “psora”, “miasm” and “itch”.

At this point in my reading through Chronic Diseases I wonder, “What, is that it?”

Hahnemann has his chance in this volume to re-state the evidence on which the treatment of homeopathy relies.  This book is one of Hahnemann’s later works; his views and his evidence should be well formed and argued by now.  So far the major themes have been an attack on the medicine practised in the early 1800’s and unclear, poorly argued thoughts about “psora”, “miasm” and “itch”.

I looked hard to find any evidence of what we would regard as simple science, i.e. formulate a hypothesis, then conduct experiments to confirm or refute it.  James Lind had already shown that the best method for testing potential new medicines on people was to use the controlled trial.

Hahnemann does write about one experiment he claims to have conducted – more on that later.

In my opinion Hahnemann hasn’t done nearly enough to establish his theories before progressing to suggesting treatment.  How is the “like cures like” idea established?  What about the idea that ultra dilutions will work as a treatment?  Surely, at the very least, some kind of dose-response testing should have been done to indicate that ultra dilutions work?  None of this is clear, nor in any way properly linked to Hahnemann’s three-fold origin idea. In any case, the three-fold idea is now largely forgotten by both science and the “modern” practice of homeopathy.

Without a knowledge of that three-fold origin and these homoeopathic remedies, the successful treatment of chronic diseases is absolutely impossible.

[9]

I wonder if any pharmacists today, anywhere in the world, selling homeopathy across the counter, know about Hahnemann’s “three-fold origin” of disease?

The treatment advice that Hahnemann suggests other homeopathic practitioners give to patients sounds rather bizarre at times:

Rich patients must walk more than they usually do. The physician may permit them moderate and proper dancing, rural entertainments, provided they do not conflict with the necessary dietetic precautions, conversation with friends; he may also permit them innocent music, and listening to amusing lectures; they may sometimes even go to the theatre, but they must never play cards.

…reading lewd novels, and superstitious or exciting books, are to be carefully avoided.

[10]

…patients of the higher classes must carefully abstain from perfumes, scented water, tooth powders, etc.

[11]

Coffee

Samuel Hahnemann doesn’t like tea and coffee.

Unfortunately coffee has become so necessary to the so-called civilized nations that, unless the homoeopathic physician interdicts the use of coffee once for ever during the treatment, he will find it just as difficult to abolish the use of that beverage as it is difficult to eradicate superstition and prejudice. Young people of twenty and even thirty years, may be deprived of it at once, without any injury. Persons of a more advanced age ought to be persuaded to abstain from the use of coffee little by little, taking a little less of it every day; most of them will be found willing to leave off the use of that beverage at once, and they do so without experiencing any disagreeable consequences, except perhaps for the first two or three days. Even as late as six years ago I was under the impression that coffee might be permitted, in a small quantity, to old people, in case they should find it difficult to give it up. But I am now convinced that the protracted use of coffee does not make it harmless, and that the physician who is bound to take care of the best interests of his patients, ought to insist upon their depriving themselves of coffee altogether.

And tea

The same criticism may be passed upon Chinese tea.

[12]

Disappointingly, Hahnemann doesn’t say here what negative health effects he believes he’s found in patients where there is long-term drinking of coffee.

Interestingly, Hahnemann wrote an earlier essay (1803) on the effects of coffee, in which he has a good old rant about it.  Many of the human diseases he attributes to the magical “psora” in Chronic Diseases, he previously blamed on coffee.  The quote above shows Hahnemann has significantly toned down his rhetoric against coffee, though not given it up.  Alternatively, this rant against coffee is an indication of an over-active imagination when it comes to finding something to blame for health conditions with an unknown cause.  There is certainly no indication that he’s tested the reasoning behind his assertion that everyone should stop drinking coffee.

Hahnemann’s earlier writings about coffee can be found by going to Google Books and searching for The Lesser Writings of Samuel Hahneman. Or try this link.

An experiment

Perhaps Samuel Hahnemann does understand a little of why critics of his ideas find the logic of ultra dilutions hard to swallow (pun intended).  To counter that criticism, he describes an actual experiment – the only one I could find in Chronic Diseases.

By way of introduction, the homeopathic thinking is: the more dilute the remedy, the more powerful it is. The practical criticism of that is: having used a mortar and pestle to grind your base ingredient for a homeopathic preparation, wouldn’t it be possible to create a very powerful remedy from remaining (highly dilute) particles inevitably left behind after cleaning?

Fears have also been entertained that, in triturating the medicinal substance in a porcelain mortar, particles might become detached from this latter, and that the triturating process might change them to powerfully active silicea. To ascertain whether such fears were founded, I caused one hundred grains of sugar of milk to be triturated with a new porcelain pestle in a porcelain mortar, the bottom of which had been recently polished; thirty-three grains were taken at a time. They underwent the process of trituration eighteen times, each trituration lasting six minutes. Every four minutes the mass was stirred up with a spatula. The object of this frequently repeated trituration, which lasted in all three hours, was to impart medicinal qualities, either to the sugar of milk, or, at any rate, to the particles of silicea which might have been separated from the mortar; but, from experiments which I have made upon highly susceptible subjects, I have been obliged to infer that the prepared sugar of milk is no more medicinal than the sugar in its raw state; its only quality is that of being nutritious.

[13]

Interestingly, Hahnemann has some idea that experiments conducted in a logical way can test a hypothesis.  He even claims the experiment is placebo-controlled by using “sugar in its raw state” for comparison.

If anyone is thinking of criticising my review of Chronic Diseases on the basis that Hahnemann was writing at a time when no one knew how to perform logical experiments, clearly that’s not the case.

Sadly, this experiment is all too brief in description; reasonable questions about it remain unanswered.

Was the experiment blinded, i.e. did Hahnemann know who had taken the placebo and who hadn’t?  How many took part in the experiment?  How long did the experiment last? How were the “highly susceptible subjects” selected?  Were the results objectively quantified?  I’d really like to know the details; they’re just not given, which is disappointing.  I think more writing space should have been devoted to detailing the experiment than to attacking conventional medicine.

And how are the results of this experiment to be interpreted?  Does Hahnemann’s own experiment contradict the idea that greater dilutions are more effective?

What I don’t understand, and which is very damaging to Hahnemann’s arguments, is why he didn’t apply placebo-controlled experiments, like the one above, to his homeopathic treatment as a whole?   Why just the one placebo-controlled experiment to narrowly dismiss one small criticism of his work?

The experiment is also important from the point of view of more recent testing of homeopathy.  When the suggestion is put to modern homeopaths that homeopathy should be put to fully blinded placebo-controlled testing, the response is often: “It’s a holistic medicine; it doesn’t work like that.” However, I suggest that if it’s good enough for Samuel Hahnemann to do placebo-controlled experiments, it should also be good enough for modern homeopaths.

The reality, as we now know, is that homeopathy fails to work whenever it’s subjected to good quality, scientifically rigorous clinical trials.  And by that I mean trials that are double-blinded, randomised, and that involve statistically large numbers of patients.

Ultra dilutions

I know readers of this post will be interested in the widely disputed idea of ultra dilutions.

The detail of how homeopathic preparations are made is detailed in Chronic Diseases from page 189 to page 196.  I recommend reading it for yourself; it’s too long to copy and paste here.

There is no indication that the dilution method was subjected to scientific scrutiny by Hahnemann.  There is also no indication as to how the method was developed; Hahnemann simply asserts, without argument, that this is how homeopathic dilutions are to be done.

Homeopathy being based upon a law of nature, it should avoid and exclude all uncertainties.

[14]

Interestingly, his method differs from modern descriptions of how to make homeopathic preparations.  Which method works, and how do you differentiate which one is best?

According to Hahnemann, you make the preparation potent by shaking it twice with your arm – not ten times – and there is no mention of banging it against a book.  The pills (Hahnemann calls them globules) are apparently made with powdered lactose (sugar of milk) and should be “flaxseed” in size.

That’s all for my review of volume one of Chronic Diseases by Samuel Hahnemann.  There are three more volumes available online.  A skim read shows that they consist largely of lists of symptoms and diseases that it’s claimed homeopathy can treat.  There are some quite extraordinary claims contained in those volumes.  Let me know if you want me to write about those, or if you have any other comments, feel free to post a comment below.

And of course, if you need medical treatment, see your local medical doctor.  Based on my reading of Hahnemann’s books, I won’t be going to a homeopath or purchasing homeopathy at my local pharmacy.

Mal.

With kind thanks to Rosemary for help correcting this post.


[1] THE NATURE OF CHRONIC DISEASES V1, Hahnemann, translated and edited by Charles J. Hempel 1845, page 136

[2] ibid, page 177

[3] ibid, page 13

[4] ibid, page 17

[5] ibid, page 170

[6] ibid, page 28

[7] ibid, page 170

[8] ibid, page 71

[9] ibid, page 110

[10] ibid, page 138

[11] ibid, page 139

[12] ibid, page 140

[13] ibid, page 165

[14] ibid, page 192

How to find the original pages in THE NATURE OF CHRONIC DISEASES.

Go to the Taubman Collection home page. Click the link to “browse the collection”. Click on C (for Chronic Diseases). There you will find the four English translation volumes listed, the lowermost one is volume one. Click on volume one and go to the relevant page.

4 Responses to The writings of Samuel Hahnemann

  1. Paul Gallagher says:

    Great post.

    I tend to see Toxins as doing the job of miasma’s these days.

  2. keng2 says:

    Yes, great post. To be fair, the idea of miasma – bad air – as the causative agent in disease WAS the majority orthodox view in Hahnemann’s time. It’s reflected in the word MALARIA, and it’s the reason that fires were lit during times of plague, and why the Great Fire of London in 1666 was widely seen to have been a neccessary divine intervention to end the plague of 1665.

    • malvickers says:

      Thanks Ken, I did look into this but only a little, I’m not much good with word etymology. “Miasm” and “Miasms” appear to be a words and a concepts introduced by Hahnemann, or possibly his English translators. Although I only consulted one reference prior to writing:

      http://en.wikipedia.org/wiki/Homeopathy

      See the “Miasms and Disease” section.

      I agree that “miasma” is a much older word and an older concept exactly as you describe.

      What the difference is between the two words (apart from the obvious extra “a”) I have no idea. There is certainly no clear distinction made in the English translations of Hahnemann’s work that I’ve read.

  3. terry kelly says:

    Unfortunately, most Pharmacists do seem to be selling this useless stuff. And displaying it prominently. And making money from it. They should know better…actually, I think they do.

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