The history of homeopathy in the Russian Empire
until World War I, as compared with other European countries and the USA: similarities and discrepancies

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.

3. 6 The Zemtsvo and homeopathy

Leningrad Hospital

Almost immediately after the zemstvo system had been introduced, practising homeopaths and their supporters started issuing books and brochures urging the zemstvos to turn to homeopathy as the most reliable and safe system of medical treatment. Till the homeopathic societies were established, those publications were due to the pens of isolated propagandists for homeopathy. Since the 1880s, the issuing of such literature (for which the societies were assigning resources), became systematic. The societies, beginning with the St. Petersburg Society of the Followers of Homeopathy, issued and distributed this literature free of charge to the zemstvos. In fact, the main character of the propaganda was left unchanged until the World War I. These publications referred to events and statistics taken from current allopathic medical documents of the zemstvos as instances to be analysed and compared with the presumably "benefitable homeopathic method of treatment" (cheaper, reliabler, safer etc.). Homeopaths and their lay supporters pointed out that zemstvo medicine was: 1. expensive 2. hardly available for the population, careless and indifferent, and 3. unsafe because of use of dangerous substances, including poisons. It is also important to mention that in homeopathic publications there were rarely direct mentions of the Zemstvo. The societies used to have in the headings or subheadings of their publications such sentences like "First aid with homeopathic drugs", "On the cheaper and accessible medical help though homeopathy", "On the safe first help within the rural population", and so on. General reports, protocols of the opening of homeopathic societies and price-lists of the large homeopathic pharmacies, were delivered to the zemstvo authorities. Often these mailings were accompanied by covering letters of the chairmen of the societies; these letters contained proposals for taking advantage of homeopathy or just invitations to pay more attention to homeopathy. Although extremely rare, there were a few examples of even zemstvo physicians proposing the introduction of homeopathy into the Zemstvo. The reaction of their allopathic colleagues was predictable:

There is a physician in the Novouzensk zemstvo [...] [of the Saratov province] who said at the Meeting of physicians that he had excellent results treating cholera with homeopathic drugs. In order to save money, he proposed to the Meeting the idea of replacing scientific treatment with homeopathic drugs, the zemstvo would save thus more than 20,000 rubles yearly. While taking his age into consideration, the Meeting had heard his report till the end, but then suggested to him that he either deal with homeopathy privately or leave the zemstvo service54.

It seems that the fate of those feldshers who tried to use homeopathy, was not any easier:

Midwife and feldsher Ekaterina Zhelominskaia serving at the Kromakha (the Orel province) zemstvo, after having subscribed to homeopathy had started to treat patients with it during the last year. She became soon convinced of its success and superiority [to allopathy]. When the local physician Vil'chinsky had knowledge of it, he forbade her in rage to use homeopathic drugs [...]. Zhelominskaia remarked: 'I was forbidden to treat with homeopathy, as this method of treatment is not accepted in our zemstvo. They know nothing about it and do not want to know. They forbid it, not because they are convinced that this method is harmful or does not bring any benefit; on the contrary, they see that [homeopathy] treats with success many diseases, but they just forbid it. I had no other choice but to leave [...]. Even if I shall have to suffer more for homeopathy, I shall continue to use it as I have been convinced a hundred times over, that this is a much better method of treatment'"55.

I have found one example belonging to the first years (1877) of the zemstvo system, when a zemstvo physician and the zemstvo authorities decided together to try homeopathy.

The Trubchev zemstvo [the Orel province] decided: 1. to order medicines for homeopathic experiments for 50 rubles, whilst the physician Salov proposed his free service to make these experiments [...]56.

This report appears to be single of this kind. I have not been able to find any other mention of this zemstvo in neither homeopathic nor allopathic periodicals. Thus, one may conclude that, most probably, Dr. Salov had not been satisfied with the results obtained from his "homeopathic experiments" and the zemstvo did not assign means for homeopathy any further.

I suppose that usually those zemstvos which wanted to introduce homeopathy, turned to laymen for help, in the absence or in spite of resistance of physicians. Doubtless, even from the most enthusiastic laymen one cannot expect a sense of responsibility comparable with that of physicians. "Vrach", most probably in the face of its editor Prof. Manassein, commented on that, referring to the Kiev newspaper "Kievlianin" (The Kievan), N 265 of 1887:

In 1885, the Ostersk [of the Voronezh province] zemstvo meeting decided: 'to introduce treatment with homeopathy in the district as an experiment'. Accordingly, in 1886, three homeopathic kits and manuals were ordered and then delivered among 'the persons being popular in the district' [...]. About a year has passed from then; probably, the zemstvo became ashamed of its ignorance. At least, it did not publish any report on the activity of 'popular persons'. This is to be regretted. We could have gotten a very instructive document for the future historian of our mental development [sic!]57.

No unbiased reader may understand what "ignorance" should the zemstvo become ashamed of and why this, probably unsuccessful, experience would be serve as "instructive document for the future historian of our mental development". I guess, that in the opinion of the editorialist of "Vrach", i.e., Manassein himself, only mentally handicapped persons might decide to examine homeopathy...

Nevertheless, homeopaths and their supporters were absolutely right when they only expected from the zemstvo authorities their permission for doing what needed in order to introduce in some way homeopathy. The experience of the Belev zemstvo which supported homeopathy during 25 years according to the decision of its authorities58, may be seen as a proof of it. Yet homeopathic ideas could not find a rich soil for their growth in the 1880s, when the homeopathic propaganda, as I mentioned above, became more or less systematic. In my opinion, there are explanations for the relative weakness of the efforts made to spread homeopathy throughout the zemstvos. First of all, by the 1880s, allopathic zemstvo medicine was already rooted in the Zemstvo. Zemstvo physicians, who were considered to be specialists in their fields, bitterly resisted the penetration of homeopathy into the Zemstvo (see examples above). Zemstvo officials could not ignore the opinion of physicians and their threats to leave the zemstvo service if homeopathy would be either financed together with regular practice or was even allowed to be practiced by an invited homeopathic physician. Later we shall also see some examples of this opposition. On the other hand, the educational level of the zemstvo meetings had been constantly improving since the introduction of the zemstvo system. It will be demonstrated in the chapter "Homeopathy and the clergy" that the deputies of the Belev zemstvo meeting approved the proposal made by its chairman who was a nobleman, to introduce homeopathy, without any discussion. Yet from the 1880s onwards, homeopathy could not have been introduced without an exchange of views and without discussions.

'Zemsky vrach' [Zemstvo physician] of April 30, reports that the chairman of the Kobeliaki district [Poltava province] zemstvo board V. V. Gan agitates actively for introducing homeopathy into zemstvo medicine. He sent recently to all the province and district deputies an elegant folder containing a brochure by Dr. Brazol against smallpox vaccination, 5-6 other brochures of homeopaths, a January issue of "Vrach-gomeopat" and the price-list of the Flemming [homeopathic] pharmacy in St. Petersburg. To the folder was attached a circular letter of Mr. Gan in which he requested that attention be given to 'the problem of making zemstvo medicine cheaper and putting it in good order'. As if 'making cheaper' might be achieved by embracing homeopathy. To Mr. Gan's great disappointment, his effort came to grief. Some deputies sent the folders back, whilst others, who had earlier been indifferent toward the discussion initiated by homeopaths, now, on having read the folders delivered, 'understood that this polemic is ridiculous'. But what about zemstvo physicians of the Kobeliaki district, forced to be managed by such a person like Mr. Gan?!59

So, when zemstvo deputies refused some expensive proposals of zemstvo physicians, those deputies were regarded as "profane", "dark" and "ignorant". Nevertheless, now zemstvo deputies seemed to the editor of "Vrach" Manassein sufficiently educated to understand such a primitive matter like homeopathic doctrine, and thus to conclude that polemic between allopaths and homeopaths is "ridiculous"!

It goes without saying that the single efforts of individuals not supported at the zemstvo meetings, could not influence the situation.

At the Pereiaslavl' [the Riazan' province] zemstvo meeting a deputy named Artem'ev (unfortunately, neither his title nor his educational rate is mentioned) proposed to abolish zemstvo schools and zemstvo medicine for creating a zemstvo fund. [Zemstvo schools] may be replaced with church-parish schools, while [zemstvo medicine] would be replaced by homeopathic treatment! Thus, instead of 37,000 rubles only 5,000 [rubles] would be needed. To the honor of the zemstvo meeting, the overwhelming majority [of the deputies] approved the budget of zemstvo medicine and education proposed by the Board, against Mr. Artem'ev's attacks ('Kievskoe slovo', October 26, 1893). It is characteristic that a defender of homeopathy appealed also against zemstvo schools60.

What was "characteristic" in the fact that a deputy proposed two absolutely different ideas? Nothing for any unbiased observer. It could have been indeed "characteristic" only for the readers of "Vrach" who considered the main physician's calling to be rather educator and enlightener within the rural population than a treating doctor. Accordingly, "unscientific" homeopathy and the denial of the benefit brought by zemstvo schools, were in the opinion of zemstvo physicians and their supporters from "Vrach", the matters of the same "reactionary", or at least "conservative", root.

It seems that often the general press, especially the provincial periodicals, together with zemstvo physicians, condemned the efforts of homeopaths and their supporters. The allopathic periodicals readily cited these anti-homeopathic views:

'Yuzhny Kur'er' [South Courier] from Simferopol' was informed that some charitable society had proposed to the provincial zemstvo to organize homeopathic treatment throughout the villages. Reporting on that, the newspaper on its side mentions that 'more wild a proposal has hardly been received by the Tavria zemstvo during its whole existence. That a councilor or a captain with missing legs and with shooting pains in all his body, may be treated by a homeopath, this may find some justification. But proposing to leave hundreds of thousands of peasants for ridiculous homeopathic experiments, this does not generate fun but indignation'. To what extent can the blindness of the people reach, while deciding to propose sweet grains instead of rational medical support! Do they really believe indeed that instead of obstetric forceps or surgical knife, those ill-fated grains might also have been proposed? Fiat homeopathia pereat mundus61.

I guess that what was indeed proposed by "some charitable society", is to examine homeopathy, nothing more.

Although the difficulties of introducing homeopathy were more than evident, there were other factors which concurred in making the starting positions of homeopathy in the early stages of the zemstvo system promising enough. Due to landlords and their wives who were responsible (at least before their own conscience) for the health of their serfs, as well as owing to the enthusiasts from among rural clergymen and teachers, homeopathy became known even in the most provincial villages. I refer again to Prof. Engelhardt writing in 1873, from some god-forsaken village in the Smolensk province where he had been exiled:

There is a mistress here who treats with homeopathic grains, with occasional success. Siddor [a peasant] and other peasants are persuaded that this mistress 'knows' and conjures on the grains. Many times I have tried to convince him that they [the grains] are simply homeopathic medicines which can be bought and given when somebody becomes ill and that everybody treats with homeopathy because it is not difficult, and requires no specific knowledge, but he has refused to change his mind. [In his opinion]: what kind of medicine is that? There is no taste or smell, [the medicine] being hardly felt in mouth — no, this is no medicine. No doubt, she 'conjures' on the grains. A feldsher gives medicines, either bitter or sour. This is a drug, and that one [giving by the mistress] is the 'conjuring'62.

Two things attract attention in this quotation. First of all, at a relatively long time before regular homeopathic propaganda started in the 1880s with the establishment of the St. Petersburg Society of the Followers of Homeopathy, Engelhardt states that "everybody treats with homeopathy". Although we do not know what that "everybody" means, we may guess that Engelhardt had been a witness of many homeopathic experiences made in the locality where he was living. Secondly, Engelhardt's conviction that to treat with homeopathy is "not difficult, and requires no specific knowledge" testifies that his own knowledge on homeopathy was obviously superficial. He seemingly based his statement mainly on his experience of seeing laypeople, treating exclusively with homeopathy.

As to the opposition of zemstvo physicians to the introduction of homeopathy, this may be considered as part of their opposition to any initiative of the Zemstvo not approved by them.

Reflecting on an established view in the Soviet historiography of "brave and progressive" zemstvo physicians opposed to zemstvo deputies and officials who resisted the "right" development of Russian society, Zhuk substantiates the position of zemstvo physicians:

The attempts of some zemstvo boards that had been made from the beginning of their activity, which aimed at replacing physicians by feldshers, introducing homeopathy, ignoring the problem of the organization of medical help for the peasantry, caused the resistance of physicians not only because this contradicted their professional interests but also because two different views crossed on this [zemstvo] soil. One view is that a peasant [muzhik] has simple diseases and the help of a physician is a blatant luxury for him. Moreover, physicians thought it was inappropriate to lower the scientific level of medical help for the mass of the peasants63.

Zemstvo physicians expressed and supported their own views on the development of zemstvo medicine, science, etc., as they had been taught in universities. As we shall see further, homeopaths never succeeded to provide zemstvo medicine even with one single homeopathic doctor. Generally, there was not the slightest reason for zemstvo physicians to be afraid of any kind of rivalry with homeopaths in the countryside during all the zemstvo period. Zemstvo physicians resisted homeopathy in the same way and for the same reasons as they resisted "feldsherism", hydrotherapy or sorcery. Those were "unscientific" methods, produced chiefly by non-physicians or by single representatives of physicians' community, and thus those methods could not be accepted by the "specialists".

It is interesting to add here that in Russia many strange things were considered in the medical circles to be "scientific" in the second half of the 19th century. For example, the treatment with koumiss (horses' milk) of different diseases, including cholera and tuberculosis, was the subject of numerous research projects and was considered doubtless "scientific". This was also true for the treatment of cholera with juices made of wild beers,gymnastics, Russian baths64, etc.,and the reports on the investigations made, were considered worthy to be published in the main Russian medical periodicals.

Although in the large cities there was not less hostility of allopathic physicians toward homeopathy than in the countryside, the social urban environment was considerably preferable for homeopaths. The representatives of the intelligentsia and the nobility supported homeopathy in the urban zemstvos. Thus, in 1900 the large Khar'kov district zemstvo meeting, answering the request of the local homeopathic Society, decided to support the Society with a contribution of 100 rubles. It is remarkable that a year earlier, in 1899, the Society had turned to the Khar'kov district zemstvo with the same request attaching a brochure of Dr. Diukov "Homeopathy as a problem of zemstvo-community medicine"65; but the zemstvo board passed the request to the district medical council. The council decided that homeopathy cannot be viewed as an acceptable method, thus the proposal was rejected. In 1900, the Society asked again for zemstvo's support and the zemstvo board passed again the inquiry to the same medical council. The latter informed that there is no reason to reconsider the decision accepted before. Then the zemstvo board applied directly to the zemstvo meeting, leaving aside the opinion of the local zemstvo physicians.

The members of the board decided:

'The board has to recognize that the intent of homeopaths striving to cheapen the cost of medicine, deserves attention and thus, with the support on the side of the zemstvo, the board is asking the meeting to support the Society with an adequate donation'. The meeting discussed this intercession of the board, whilst those deputies outspoken for homeopathy pointed out that leaving apart the essence of the conflict between allopaths and homeopaths, there is no doubt that some patients benefit from homeopathy. Therefore, because of a possible financial profit for the zemstvo, the latter has all the reasons not to close the door before the homeopaths; on the contrary, they should be given the opportunity to prove the practical value of their method of treatment66.

Most probably the similar positive decision made in 1898 and 1899, by the Khar'kov municipality (Duma) to support the Society with a donation of 200 and 300 rubles respectively, was not an accidental coincidence. Yet it is to be surmised that in the following years neither the city Duma nor the district zemstvo supported homeopathy any more. I may conclude this because the periodical "Vestnik gomeopaticheskoi meditsiny", edited by Diukov and issued till 1903 in Khar'kov, which was especially sensitive to the situation of homeopathy within Russian society, never again mentioned that Khar'kov homeopaths were helped in some way by the local authorities. Thus, this "Khar'kov success" of 1898—1900 appears have been single and not leading to promising results.

Another important topic has to be elucidated here. I discussed above the conflicts between physicians and feldshers within zemstvos. Even if they recognized feldshers to be an "evil" of zemstvo medicine, zemstvo physicians did not really imagine day-to-day work without them. I cannot say that homeopaths had never considered feldshers as a possible vehicle supporting the introduction of homeopathy into the Zemstvo. Nevertheless, as it was usual for Russian homeopaths, they were unable to establish even one single institution which could provide minimal homeopathic education. In vain did the lay readers of homeopathic periodicals in villages appeal for more widely attracting feldshers to homeopathy67. The editor of "Vestnik gomeopaticheskoi meditsiny" Dr. Ivan Lutsenko wrote, while informing that the St. Petersburg Society of the Followers of Homeopathy proposed training zemstvo feldshers to homeopathy: "But it is clear enough that feldshers cannot play a chief role in zemstvo medicine"68. It is to be pointed out, that the editor came to this thoughtful conclusion in the editorial in which he also reported to the readers about the inability of Russian homeopaths to provide the Zemstvo with even one single homeopathic physician!69

In 1912, in the same periodical, an article entitled "Homeopathy and the feldshers' problem" and signed "Reader", the issue of teaching homeopathy to feldshers was again roused.

Physicians have tried to depreciate and discredit the role of feldshers, whilst [physicians themselves] readily use their services. [Physicians] treat the more intelligent patients, while the common people has been left at the disposal of feldshers. I think that if homeopathy has spread relatively slowly, this is due to the fact that it has not had such an assisting staff as allopathy has in the person of [...] feldshers"70.

Moreover, the "Reader" offered a concrete proposal: to establish a 4-years homeopathic course for feldshers at the Emperor Alexander II Homeopathic hospital. No discussion whatever followed this offer.

Summarizing this chapter, I would like to argue that though the problem of a possible introducing of homeopathy had been arisen indeed in many Russian zemstvos, nothing, in fact, resulted from it. The reasons for that will be analyzed in more detail in the Summary.

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Copyright © Alexander Kotok 2001
Mise en page, illustrations Copyright © Sylvain Cazalet 2001