The history of homeopathy in the Russian Empire
until World War I, as compared with other European countries and the USA: similarities and
by Alexander Kotok, M.D.
On-line version of the Ph.D. thesis improved and enlarged
due to a special grant of the Pierre Schmidt foundation.
1.9.4 United States of America
The history of the fast spread, flourishing and swift decline of homeopathy in the USA presents,
probably, the most interesting piece of the history of world homeopathy, and attracted the
attention of many scholars. The attempts to understand the reasons which led to the decline and
virtual disappearance of homeopathy in the USA, are not only purely historical, but are also
practical. At the present time, homeopathy in the USA, as in many other countries, is on the rise.
When trying to ascertain why homeopathy, whose future seemed to be so promising, completely
surrendered to allopathy within some 20-25 years, one can foresee the future of contemporary
The reasons, which caused the fast development of homeopathy in the USA, seem to be clear. The
level of the training at medical schools was then very low:
Even the most credulous of Americans had become skeptical of the physicians'
claims to the dignity of a learned profession. The requirements for graduation from medical school,
complained a Massachusetts physician, were purely nominal, the final examination a "mere
pretense". In Iowa, six months of reading medicine were sufficient to win the title of doctor.
The prospective healer then bought a "pound of calomel, an ounce of quinine, a drachma of
morphine," and considered himself ready to locate. [...]. More damaging to the medical
profession than either lack of education or of ethical standards was the practice of the average
physician. His ministrations provided neither cure nor the illusion of competence and consistency
Allopathic medicine, especially its indiscriminate bloodlettings and abusive use of mercury,
which were so widely spread in the New World, was the subject of hard criticism of the
The reasons for the early success of homoeopathy in the USA are not difficult to
understand in the context of the state of orthodox medicine at the time. American orthodox medicine
in the first half of the nineteenth century was comparable with European medicine but was if
anything more dangerous. Bleeding was of course a sovereign remedy and was taken to even greater
lengths than were fashionable in Europe... Bloodletting was the correct treatment for almost any
disease but especially for fever214.
Certainly, this made the way of homeopathy in the USA much easier. Moreover,
Homeopathy, the most widespread of the medical sects competing with the regular
profession, benefited as well from a rapidly increasing German immigration, which provided both
practitioners and patients. Like hydropathy, [...] homeopathy was comparatively inexpensive and at
worst harmless. At least homeopathic medicines would 'not make well men sick, nor keep sick men
from getting well'215.
The first American homeopaths, like in Russia, were immigrant physicians of German origin,
graduates of the prestigious German universities.
In the 1830s the new doctrine was carried both West and East by German immigrants
and German graduates of the 'Nordamerikanische Academie'. The first homeopath of Ohio, in
1839, was a German pupil of Hahnemann's, and he was joined by a German faculty member of the
Nordamerikanische Academy [created by C. Hering in Allentown, Pennsylvania; see the chapter
'Homeopathic facilities] [...]. Four of the first five homeopaths in Maryland were German
immigrants [...]. Throughout the century these German pioneers remained the leaders of the
While continuing to grow owing to the conversion of regular physicians, especially during the
epidemics for the treatment of which allopathy had nothing at all to offer, homeopathy soon became
the most powerful "heresy" within the American medical profession. Moreover, homeopathy,
as distinct from other irregular practices, like Indian medicine, Thomsonism or Grahamism, appealed
to the fast growing and developing classes:
Homeopathy [...] appealed primarily to those middle and upper class persons who
were seeking an alternative to regular medicine. It was able to do so for two major reasons. First,
unlike its competitors, homeopathy was extremely fashionable among the European nobility and upper
classes, whose tastes were often copied by affluent Americans. Second, the leaders of Thomsonism
and virtually all the other movements opposing regular medicine were often uneducated laymen.
Patients, who could afford to pay for the best in medical care, would hardly be attracted to any
movement with this kind of leadership. Homeopathy was devised by a physician and the early American
homeopaths were all well educated and cultured physicians [...]. Many of them were also
'persons of the highest respectability and moral worth', according to the editor of the
'Boston Medical and Surgical Journal' [...]217.
It was not immediately that the regular profession recognized that homeopathy was a real threat.
It the first years the attitude toward homeopathy was rather skeptical and neglecting.
Most regular physicians regarded their homeopathic colleagues first with
skepticism, then with incredulity, and finally with bitter hostility. They considered many
homeopaths to be opportunists who practiced both homeopathy and regular medicine, not from
conviction, but 'according to order, on the whims and caprice of their medical patrons'
[...]. This statement summarizes the regular physicians' two basic objections to homeopathy: 1.
That the doses prescribed by homeopaths were too small to have any physiological effect whatsoever;
and 2. that the cures which homeopaths attributed to their drugs were actually brought about by the
"recuperative efforts of nature". The most interesting aspect of the criticism of the
size of the dose was the almost complete absence of any reference to the law of similars on which
it was based [...]218.
In accordance with H. L. Coulter, I am inclined
to see this hostility not just as a resentment against the spread of an "unscientific
method", but as a demonstration of their unwillingness to share the income:
[...]. A second and related point was allopathic dismay at the high fees the
public was willing to pay homeopaths, especially in the early years after the doctrine's
introduction, when there were still few practitioners [...]219.
In the 1840s, the two different streams within medicine, parted entirely. Allopaths began either
to expel homeopaths from medical societies or to look for some other methods of parting:
[...] Early in the 1840's, some regular physicians took the first steps to
purge their ranks of homeopaths. In 1843, the Philadelphia Medical Society expelled all homeopathic
physicians, a position with which the influential Boston Medical and Surgical Journal agreed
[...] In New York City, regular physicians pursued a different course. Unable to throw the
homeopaths out of the county society because of the provisions of its act of incorporation, they
formed their own private medical society, the New York Academy of Medicine, in 1847. A leader of
the Academy asserted at one of its first meetings that the organization 'would not admit
irregular men... Any swerving from the path of professional rectitude will not be recognized by us
The American regular profession had to unite and work out a certain position against irregulars.
The founding of the American Medical Association (AMA) served this aim. The chief vehicle of
collaboration within the profession, i.e., consultations, were banned:
The problem of homeopathy was a major factor in the founding of the American
Medical Association and was one reason for its survival and success. [...] The major vehicle in the
AMA for dealing with homeopaths was the code of ethics established in 1847. This document devoted
several important sections to relations with "irregular practitioners" as homeopaths and
other non-regular were called by the regular profession. The most important section concerned
consultations, traditionally a major point of contention among physicians. By keeping irregular
practitioners out of all consultations, the regular physicians hoped to destroy public confidence
in them, deprive them of their clientele, and increase the gulf between them and the regular
In reply, homeopaths established in 1844 their own powerful institution, namely the American
Institute of Homeopathy [AIH]:
[It was] Resolved [at the first session in April, 1844], that it is deemed
expedient to establish a society entitled "The American Institute of homeopathy", and the
following are declared to be the essential purposes of said Institute:
1. The reformation and augmentation of the Materia medica;
2. The restraining of physicians from pretending to be competent to practice
homeopathy who have not studied in a careful and skilful manner...
At the second session of the Institute, in May 1845, it was resolved:
Not to admit as a member of this Institute any person who has not pursued a
regular course of medical studies according to the requirements of the existing medical
institutions of our country, and, in addition thereto, sustained an examination before the censors
of this Institute on the theory and practice of Homeopathy [...].
The later charges of the American Medical Association that homeopaths were
uneducated physicians, were politically motivated and had no foundation in fact. The founding of
the American Institute of Homeopathy meant the emergence of homeopathy as the spearhead of the
opposition to orthodox medicine222.
The AMA initiated the full breaking-off with homeopaths:
In 1856 the American Medical Association resolved that homeopathic works should
henceforth no longer be discussed or reviewed in allopathic periodicals. After this time there was
no formal communication whatever between the two branches of the profession [...]223.
As in other countries chosen for comparison, homeopathy was attacked by special anti-homeopathic
books and pamphlets:
While several anti-homeopathic works appeared in the 1830's, Oliver Wendell
Holmes's224 "Homeopathy and Its Kindred Delusions" (1842) was the first
serious counter-attack by orthodox medicine [...]. During the course of the nineteenth century
about seventy-five anti-homeopathic books and pamphlets were published in the United States and
The situation of homeopathy in the USA at the turn of the century seemed to be excellent and was
the subject of the pride of homeopaths everywhere in the world: American homeopaths possessed 22
homeopathic colleges, dozens of purely homeopathic hospitals, dozens of homeopathic periodicals;
the number of the graduates of homeopathic institutions counted by thousands (see the chapter
"Homeopathic facilities"). Nevertheless, already the
first decade of the 20th century showed a fast decline of homeopathy, first in the
number of colleges: by 1913, only 10 remained, whilst by 1919 only 5 were still alive. Together
with the disappearance of the colleges, homeopaths lost their control over hospitals (the latter
dropped their homeopathic image and became purely allopathic facilities), whilst the homeopathic
periodicals were gradually discontinued. By 1950, nearby nothing remained from the past glory of
the homeopathic doctrine in the USA.
So, what happened? This problem has been actively debated these last years. No doubt that the decline of homeopathy was
partially connected to the publication of so-called Flexner Report226 followed by the "misuse"
of the Carnegie and Rockefeller Funds, which enabled the regular profession to improve its
educational standards and to strengthen its economical positions.
Yet the Flexner Report did not change the general negative trend within American homeopathy:
The Flexner Report, published in 1910, had no bearing on the failure of homeopathy
in America. In the decade prior to the appearance of the Flexner Report seven homeopathic colleges
closed and enrollment in homeopathic colleges declined by half. In the decade following the
publication of the Flexner Report, eight homeopathic colleges closed. In other words, the decline
which had started before the appearance of the Flexner Report, continued unchanged after its
publication [...]. In fact it was more critical of homeopathic medical colleges than allopathic
ones, favoring the elimination of two-third of each type. It judged five homeopathic colleges
worthy to continue as medical colleges227.
Why did "the homeopathic movement" collapse? No answer is possible without previously
briefly analyzing of the internal processes which had occurred within American homeopathy during
the second part of the 19th century.
First of all, homeopathy in the USA had slowly changed to the bad. First it became evident in
The earliest students of homeopathy in this country [America] were extremely
serious and dedicated. They possessed not only the keenness of mind to consider this new system of
medicine, but also the discipline and perseverance to study it in a foreign language, since at that
time all the texts were in German [...]. The demands of the curriculum kept away all but the most
dedicated individuals. As a result, homeopathy was initially represented by men of great integrity
and commitment, who were thoroughly grounded in the fundamental texts and principles of homeopathy.
They had great success in their practice228.
Later the decline became evident also in the teaching of homeopathy as a complete doctrine:
Almost without exception, the twelve thousands physicians calling themselves
homeopaths in 1900, received no training in homeopathic doctrine, homeopathic method, or
homeopathic Materia medica. Between 1840—1890 a structured course on the subject of
homeopathic doctrine and principles was presented at only two homeopathic colleges! [...] The most
important textbook of homoeopathy, the Organon of Medicine by Samuel Hahnemann, sold only
about five hundreds copies during the entire era of the supposed golden age of homoeopathy in
America. Hahnemann's Chronic Diseases, an essential supplement to the Organon, sold even
fewer copies and was "long out of print" in 1889 [...]229.
This point of view is shared by most researchers:
The [American] Institute [of homeopathy] grew rapidly in number but the new
members lacked the proselytizing fervor of the old guard, whom they looked on as obscurantist old
German fuddy-duddies. The purists, for their part, regarded the new recruits as upstarts who were
ignorant of Materia medica, did not know to individualize their cases, and never read The
Organon, and did not even believe in the law of similars. [...] The low-potency group, which
had always greatly out-numbered its rivals, drew gradually closer and closer to orthodoxy.
Eventually, the distinction between homeopathy and allopathy became so slight that there seemed no
point in perpetuating it, and the vast majority of American homeopaths quietly switched their
Indeed, the German immigrants, who occupied the positions of those who taught and those who were
taught, gradually were replaced by poorly educated American graduates, mainly recent converts from
allopathy, who had no desire to deepen their knowledge of homeopathic principles, merely applying
homeopathic medicines instead of allopathic ones. One should not forget that homeopathy as a whole
doctrine is very difficult to be studied and applied (especially the need of individualizing each
case), as compared with rather primitive allopathic prescriptions of that time. Thus, many
pseudo-homeopathic colleges certainly preferred to teach uncomplicated allopathy instead of seeking
and further attracting talented homeopathic practitioners to be introduced into teaching staff in
order to provide the teaching of true homeopathy.
In 1870, the A.I.H. declared that pathological indications were more important
than the individualizing symptoms of the case in the selection of the remedy. In 1880 it did away
with the provision that mixtures should not be a part of homoeopathy, and mixtures were welcomed.
By 1882 it voted that a homeopath need not restrict himself to practicing according to the law of
similars, but could practice any kind of medicine he wanted and still be called a proper homeopath.
[...] The AIH by 1880 was so overwhelmingly eclectic that the real homeopaths among them formed a
separate association, the International Hahnemannian Association (IHA). Interest in real homeopathy
was so small that no more 150 people ever belonged to it, while the roster of AIH numbered over
Thus, American homeopathy, if we understand under "homeopathy" the complete system of
teaching and training of homeopathy, lost its homeopathic purity long before it began to loose
colleges, periodicals and hospitals. The process of the merging of homeopathy into allopathy which
began in the second half of the 19th century, was speeded up by the successes of
allopathy, essentially in the field of bacteriology.
One should also mention that the American regular profession, like the case of Britain, adopted
at the beginning of the 20th century a new approach toward homeopathy. Instead of open
hostility, which gave to homeopaths public sympathy and brought no appreciable fruits, allopaths
began to regard homeopathy as an important step in the steady development of medical science:
In the twentieth century the AMA and the allopathic profession adopted a different
interpretation of homeopathy - denial that it possessed therapeutic efficacy combined with
acceptance of its reforming role. This new policy was formulated by William Osler
(1849—1919)232, who liked to declare that 'no one individual had done more good for
the medical profession than Hahnemann' in showing that the natural tendency was toward recovery
— but insisted that homeopathy and allopathy had both been superseded by 'scientific
medicine' [...]. The conviction that the homeopathic medicines were nothing but placebos led
Osler to his doctrine of 'therapeutic nihilism'233.
When reviewing our brief study of the relationship between allopathy and homeopathy in the
countries selected to be compared with the Russian Empire, one may note that, in essence, the forms
and methods adopted by the regular profession in its struggle against homeopaths and their
"heresy" were similar in all countries. The homeopathic theory was labeled as
"absurd", "denial of science", "propaganda of ignorance".
Nevertheless, the appeals of homeopaths offering to prove the efficiency of homeopathy by
experiment and not on the ground of theoretical speculations, steadily remained unanswered.
Homeopaths were expelled from societies common with allopaths, marginalized and blackmailed in
the press as "quacks", "wizards", and "betrayers of science". In
order to prevent the further spread of homeopathy through personal contacts, enabling a comparison
of different methods of treatment, British and American regulars prohibited consultations with
homeopaths; although in Russia this ban did not exist officially, the anxiety before a moral
condemnation of "brethren" in the atmosphere of anti-homeopathic hysteria, was no less
powerful than a direct ban.
In fact, the struggle with homeopaths has been nothing else but a struggle for the market of
medical services. In the countries where the medical market was overcrowded with manpower (Britain
and the USA) the resistance to homeopathy was especially irreconcilable, as homeopaths not only
competed with allopaths, but also attracted the most solvent public. In the USA this attitude
changed at the beginning of the 20th century for by allopaths (William Osler in first) initiated
"reconciliation" within framework of "scientific", i.e. allopathic,
Homeopaths from the very beginning were divided into the camps of "purists" and
"homeo-allopaths"; each of these had its outstanding representatives. Yet the vast
majority was always represented by the "homeo-allopathic" camp. This derived probably
from the fact that the steadily happening conversions to homeopathy, provided an influx of doctors
who had no intention to break off with allopathy entirely. Contradictions of this kind increased
the tension within the homeopathic profession. This was true for all countries but Russia. The
"pure" homeopathy had never been practiced there. Like their "mixed" colleagues
in other countries, Russian homeopaths rejected the doctrine of potentisation. Both domestic
self-treatment books and manuals for doctors favored the use of mother tinctures or low potencies,
usually not higher than the 6th centesimal dilution; the book by Richard Hughes, one of
the most important representatives of this trend within homeopathy, was frequently republished,
whilst the books by J. T. Kent, as well as "The Chronic Diseases" by Hahnemann, were
In the countries selected for comparison there were various reasons which caused the decline of
homeopathy by the end of the 19th century, like overidentification with aristocracy in
Britain, anti-German dispositions and personal conflicts in France, rejecting the homeopathic
doctrine for allopathic theories in the USA, caused by the rapid scientific progress at the end of
the 19th century and by "allopathic predispositions" both of new converts and teaching
stuff at homeopathic colleges. Moreover it should be stressed that no country in Europe succeeded
to establish a firm system of homeopathic education as compared with that of allopaths. At the
emergence of homeopathy on the medical scene, all European countries had already a firmly
constituted system of allopathic training; no high-ranking support could introduce homeopathy into
it. On the contrary, the example of the USA where homeopaths succeeded to obtain equality of rights
with allopaths, also in the field of education, provided a large representation of homeopathy (or
what was called homeopathy) in that country.
Homeopathy in pre-WWI Russia had no clear-cut timing for its decline. The very difficult period
of Russian history, from the Russia-Japan war (1904) to the First World War (1914) explained in
part the stagnation of Russian homeopathy. The tight connection of Russian homeopaths with their
high-ranking lay supporters was, in fact, rather fragile, for these supporters (the nobility, the
clerical estate), were especially sensitive to the social shocks experienced by pre-Revolutionary
Russia. Except for St. Petersburg and, to some extent, Moscow, homeopathic societies everywhere in
the Russian Empire were based on very few (2-3) physicians hired to receive patients in the
dispensary of the society. Thus, homeopathy in Russia had mainly a lay-domestic character, and was
practiced by rural clergymen, by the old village nobility, by petty officials in provincial towns,
etc. Certainly, no competition with regular medicine was possible. Nevertheless, before a general
threat when allopaths turned to closing homeopathic pharmacies) Russian homeopaths proved to be
able to unite, to organize a common meeting and to work out a common position. If Russian
homeopathy would have had any future, in the absence of wars and revolutions, I suppose that it
would have had to rely mainly upon their lay supporters, as was the case of German homeopathy.
Copyright © Alexander Kotok 2001
Mise en page, illustrations Copyright © Sylvain Cazalet 2001