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.

3.8 The Novgorod-Seversk zemstvo experience

Although I have to admit that I have not been able to find all the details related to this story (I do not know how it began nor how it exactly ended) it cannot be omitted. In analysing the example of the Novgorod-Seversk (Chernigov province, Ukraine) zemstvo which considered the possibility of embracing homeopathy in its zemstvo medical system, we will be able to better evaluate the allopathic-homeopathic relationships in the late 1880s.

After having studied different materials published in connection with the homeopathic experience of the Novgorod-Seversk zemstvo, it appears that the latter decided in the spring or in summer of 1886, to seriously discuss the problem of introducing homeopathy. It was Nicholas Fedorovsky who offered to the zemstvo to examine homeopathy as a preferable medical system. For this purpose the zemstvo turned to allopaths of the highest rank amongst medical faculties to obtain their point of view. Neither homeopathic nor allopathic periodicals wrote about this inquiry until the reply from the Kiev University was published. I cannot be sure that the zemstvo received replies from other universities, although we bring a reference to an answer of the Khar'kov University. The official periodical of the St. Vladimir University in Kiev, "Universitetskie izvestiia" (University News), in its December issue of 1886, published the response written by three professors from the Kiev medical faculty:

At the request of the direction of the Medical faculty (November 25, 1886), we were asked to discuss the inquiry of the Novgorod-Seversk district zemstvo authority about the value of homeopathic treatment. As a result of the Faculty' request, we have the honour to present the following opinion:

The teaching of Dr. Hahnemann, the founder of homeopathy, who practised in the end of the previous and in the beginning of this century in Leipzig, is different from the accepted teachings in the medical science. The main difference consists in the point that, in Hahnemann's opinion, every medicine acts more effectively when it has been diluted and a very small quantity of the medicine is taken. [...]91.

After having devoted several lines to describing the methods of preparing homeopathic dilutions, the professors continued:

If homeopathic drugs would be used in such a diluted form, they would at least be harmless. Homeopathic treatment would bring indirect harm only to those patients who were seriously ill and who needed the right treatment from the beginning. Nevertheless, as these patients have undertaken no measures against the disease by the time they turn to homeopaths, the disease will have developed and reached the point when even the most effective therapy would prove unsuccessful. Yet homeopaths do not always prescribe their medicines in such tiny quantities, sometimes they step back from Hahnemann's doctrine and prescribe hard-acting drugs, like arsenic in the doses which have obvious influence upon the diseased organism. If all homeopaths would have been physicians, i.e., would have received special medical education [...] at least in individual cases, homeopaths could be useful for the sick. But because for the most part they are not physicians, and because those medicines are prescribed for a long time and in unsuitable cases, they can cause harm; for example, treatment leading to chronic poisoning with arsenic. Furthermore, [...] some homeopaths and even non-physicians, do reach positive results, one could explain that many diseases end with recovery in a short time without any treatment. If such a patient turns to a homeopath, the patient will attribute his recovery to homeopathy and become an adherent of homeopathy. Homeopaths enjoy especial success in those strata of society where the people on the one hand have significant financial means and on the other hand, have no serious occupation. Thus, they spend the larger part of their time for their health and tend to resort to the help of physicians at the slightest illness. If occasionally a person with a serious disease turns to a homeopath, the latter, fearing an unfavourable result, will reject this patient because homeopathy is not yet able to offer the needed medicine. It is also understandable that homeopaths had no success with opening dispensaries or hospitals, as those who would turn to them would be sick people with more serious diseases. Not having at their disposal effective drugs, in such cases they would not be able to achieve satisfactory results. [...]. Naturally, nobody may be forbidden to use the advice of homeopaths [...]. But the Zemstvo as a State institute obliged to care for public interest, should, on the grounds mentioned above, neither open homeopathic dispensaries nor assign means for homeopathy, and they should not encourage in any way the adherents of homeopathy.

Signed: Professors: F. Lesh, I. Sikorsky and E. Heibel92.

Naturally, the periodical "Vrach" could not pass over this story in silence. Speaking of the answer of the three professors, the editorialist wrote:

It goes without saying that all the faculties, in general, gave similar answers. It is interesting, that the zemstvo authority, also sent its inquiries to the Society of homeopaths, just as they had sent to the medical faculties! The Novgorod-Severs zemstvo's official opinion was probably that this Society is of a similar competence than that of the medical faculties!

Unfortunately, the response of the professors [...] is written too briefly. We guess that it would have been better not to reply at all, or they could have explained in a detailed way to the zemstvo officials that their positive thoughts about homeopathy were actually unfounded93.

It is most probably that here "Vrach" was in error when speaking of a parallel inquiry made among homeopaths, because "Gomeopatichesky vestnik" devoted not even one line to this event in 1886. Apart from this, in the discussion that followed the response of the professors, homeopaths never mentioned that they had been invited to reply to the inquiry like the allopaths had been. I tend to speculate that the inquiry we have discussed was made in response to homeopathic propaganda.

The professors' answer was also published in the city newspapers "Kievlianin" (The Kievan) and "Kievskoe slovo" (The Word of Kiev), at the very beginning of 1887. A reaction of homeopaths to the professors was published three months later, also in "Kievlianin", in an article entitled "The Answer of the Saint-Petersburg Society of Homeopathic Physicians to the article published in No 9 of 'Kievlianin' [...].:

The representatives of the medical faculty [...] professors Lesh, Heibel and Sikorsky base their judgment on the homeopathic method of treatment mainly upon the following principal propositions:

1. That most of those treating the sick with homeopathic medicines are not physicians and do not have the scientific training needed for professional medical practice.
2. That homeopathic drugs are so diluted that they cannot have any healing effect.
3. That doses of medicines sometimes used by homeopaths are far too high and may poison the sick person.

One should mention regarding the first point that in Russia [...] the license for medical practice is granted exclusively to those people who have graduated from a medical course at a university and have a certificate. If there are many [laymen] who provide the sick people with homeopathic medicines free of charge, there is, no doubt, a much higher number of those [laymen] providing allopathic medicines. As the number of the persons who have received a medical education is absolutely insufficient, this laypractice will be an inescapable phenomenon for a long time. Which one of these two schools, homeopathic or allopathic, will be more useful and less harmful in the hands of lay practitioners, is understandable for anybody examining the matter [...].

Secondly, the professors allege that the small doses of homeopathic medicines are not effective. We assert that this problem may be solved experimentally only. Any pure theoretical doctrine alleging a priori the inefficacy of minimal doses cannot be viewed seriously in view of evidence proving the opposite. We assert that no physician and no professor has the right to reject the effectiveness of homeopathic medicines; this can only be done after practical observations are carried out thoroughly and honestly.

Thirdly, the professors blame homeopaths that the latter sometimes poison their patients. This accusation, so contradictory to the previous one, leads us to wonder, from where do the professors draw their information about homeopathy [...].

Homeopathy is practiced currently all over the five parts of the world by thousands scientifically trained and morally irreproachable doctors, enjoying the confidence of millions of intelligent patients. We are entitled to demand far more serious and more competent deliberations on this matter [...].

President - Dr. med. V. von Ditman. [...]. Secretary — Dr. med. L. Brazol94.

"Vrach" reacted immediately to this publication:

In 'Kievlianin' (March 21) there was published an answer of the [St.] Petersburg homeopaths to the article published by the professors [...]. As we did not publish in toto the opinion of our respectful colleagues, we are not obliged to publish the answer to this opinion, especially because in a newspaper published exclusively for physicians, there is no need to hold discussions with homeopaths [...]95.

In fact, the involvement of official allopathy in this story was limited to the response of the three professors and to the commentaries on the incident by the tireless "Vrach". On the other hand, homeopaths and their lay supporters treated this promising precedent with far more attention. According to the mark of allowance made by the censor (January 30, 1887), I guess that in February-March approximately, the pamphlet of Nicholas Fedorovsky "For a common inquiry! A response to the Kiev medical faculty on its opinion regarding homeopathic methods of treatment" was published96. In his brochure Fedorovsky severely criticized the response of the professors, asserting that the zemstvo did not receive an adequate answer to its inquiry. First of all, in his opinion, the professors avoided serious discussion, while writing their alleged reply in especially simplified, even primitive, style.

We have heard from the defenders of that alleged collective response that the faculty mainly described a population that focused upon the poorly educated, the inexperienced in medicine, the society and the Zemstvo. Is this a justification [for rejecting homeopathy]? Beyond the Novgorod-Severs zemstvo there is the Zemstvo as a whole, the whole of Russia. In Russia, we believe, there are enough people with knowledge, who are sound of mind and with a good conscience, and those are the people that the faculty should speak to, even in Latin, being unafraid that the representatives of Russia will not understand it [...]'97.

Secondly, Fedorovsky pointed out that neither the professors nor anybody else have a sensible idea about the way of providing medical support in the countryside, which might be improved when millions of peasants are lacking any qualified help. As an illustration of the absolute alienation of physicians from real life, he brought the example of the proposal made at a meeting of physicians in St. Petersburg, of cleaning Russia (because all the diseases are rooted in the dirt), whilst such a procedure would require some 300 million rubles per year and the proposal was accepted "as almost genial"98. While bringing many examples demonstrating the spread of homeopathy in other European countries and the USA, Fedorovsky concluded similarly to the conclusion of "Vrach", that the medical faculty should either have refused to participate in the discussion or should have treated the affair more seriously.

Another brochure issued by homeopaths was an enlarged "Answer of the St. Petersburg Society of Homeopathic Physicians..." to which separate objections of Drs. L. Brazol, Soliansky and E. Gabrilovich were attached99. Referring again to the mark of allowance of the censor (made on May 30, 1887) I suppose that the brochure left the press in June-July of 1887. The most interesting remark, which allows us to follow the development of some trends within Russian homeopathy, was made by Dr. Brazol. Discussing the charge against homeopaths for treating with such small doses which have no effect whatsoever, Dr. Brazol wrote that homeopathic dynamisation of medicines 'has nothing to do with the virtual and experimental side of homeopathic therapy'100. This topic as well as other views offered by Brazol' in the brochure were discussed in the section "Typology of Russian homeopathy" in the chapter "Allopathy vs. Homeopathy".

Further, Brazol stressed that poisoning could hardly be attributed to homeopathy at all, whilst allopaths, who produced numberless '-isms' (bromism, mercurialism, morphinism, etc.) must be charged for that straightforwardly. He also did not agree with the professors regarding the 'inability' of homeopathy to treat serious illnesses. He also rejected the idea that patients were 'unwilling' to be treated with homeopathy. Concluding his objections, Brazol expressed the hope that the university would condemn the professors for their superficial and negligent attitude to the affair as well as for spreading false information among the public101.

As for the objections of Dr. Soliansky and Dr. E. Gabrilovich, they mainly repeated the usual arguments of Russian homeopaths against their allopathic counterparts (widely spread success of homeopathy in Europe and especially in the USA; success of homeopathy in the treatment of infectious diseases, especially of cholera; they urged the use of homeopathic medicines because allopathic drugs, wide-spread also among the laymen, are incomparably more dangerous), whilst Gabrilovich added:

The Zemstvo, as a State institution, being obliged to care for the public interest, should [...] just open homeopathic out-patient clinics to become convinced from experience, which one of the different ways [i.e., homeopathic or allopathic] is able to lead to the goal more directly, more quickly, and in a pleasanter and cheaper from than the other102.

"Gomeopatichesky vestnik" edited by the same Brazol, in the first half of 1887 published all the data I have cited above. The readers also took a part in the discussion. One of them wrote:

It is very regrettable that the Novgorod-Seversk zemstvo which was close to introducing homeopathic treatment, now can become confused, if it seriously believes Lesh, Sikorsky, Heibel and Co, that 'the zemstvo being obliged as a State institute to care about public interests, should neither open homeopathic out-patients clinics nor assign resources for homeopathy' [...]. We are very surprised! How could the Novgorod-Seversk zemstvo officials be so naive to inquire of allopaths about the reputation and the reliability of homeopathy? [...]. Despite the opinion of the professors of the medical faculty at the Kiev University, we, those who are living in villages with the people, continue to hold that with the actual lack of physicians in the provinces, the introduction of homeopathy is the only way to deal with the terrible health conditions of the people.

Signed: A. K., from the village of Kapustino, the Serpukhov district103.

But what about the Novgorod-Severs zemstvo itself? After such an intense exchange of ideas and views, what did it decide? A partial answer may be found in "Vrach".

The Novgorod zemstvo meeting appointed a special committee to analyze the basis of the organization of zemstvo medicine in the district. The committee also engaged in a discussion on the topic of homeopathy. At its meeting on July 27, the committee decided to inquire of the St. Petersburg Society of the Followers of Homeopathy about a possibility of getting a homeopathic physician (where and for what price?) as in principle the committee does not reject homeopathy! There are probably, ardent adherents of homeopathy among the members of the committee. Nobody can explain this decision, taking into account that the zemstvo colleagues [i.e., zemstvo physicians] who were invited members of the committee (Vasilevsky, Vladykov, Zhidkevich, Kotliarov and Solodsky) strongly resisted homeopathy in zemstvo medicine. Additionally, the zemstvo has received the replies of the Kiev and Khar'kov medical faculties. One should seriously pity the unhappy Novgorod-Severs zemstvo, and their introduction of homeopathy due to the ignorance of some persons! [...]. Thus, different landowners [bary i baryni] become ardent advocates of homeopathy, especially because they need not spend many years to study it. It is only painful, that these landowners represent the power that is able to force the unhappy peasant to be treated with homeopathy...104

The fact that the zemstvo indeed appointed a committee in order to make decisions regarding the further steps, appears in the protocol of the 7th Meeting of the St. Petersburg Society of the Followers of Homeopathy held on April 19, 1887105.

Yet there is no mention of any inquiry submitted to the Society in the protocol of the 8th and 9th Meetings held in 1888 and 1889 consequently. Thus, it seems that either the decision to turn to the Society was not implemented or the Society, while having nothing to propose, preferred not to return to this topic any more. The zemstvo and its interest for homeopathy disappeared from the pages of homeopathic periodicals in the second half of 1887. I guess that the Society of the Followers of Homeopathy, of which Nicholas Fedorovsky was a member, had actually nothing to offer. It hired two physicians and was in search for more. In fact, as soon as the discussion went from the field of propaganda to the hard soil of reality, Russian homeopaths have proved their inability to provide the Zemstvo neither with homeopathic doctors nor with teachers of homeopathy.

Thus, the story of Novgorod-Severs zemstvo ended, most probably, with nothing. Neither in the further publications of St. Petersburg Society of the Followers of Homeopathy, nor in "Gomeopatichesky vestnik" could I find any continuation of this experience. Homeopaths proved to be good in discussions, but absolutely impotent in practical life.

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