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.

Homeopathy and its founder

Samuel Hahnemann(1755—1843)

Samuel Hahnemann was born in 1755 in Meissen (Saxony, Germany) in the family of a porcelain painter. He was fostered on a scholarship in the prestigious Prince's School in Meissen. At the age of twenty, Hahnemann attended the University of Leipzig, where he studied medicine during one year. Being dissatisfied with the lack of hospitals and of courses in clinical medicine, he left Leipzig for Vienna, where he received a basic clinical training under the supervision of Baron Dr. Joseph von Quarin (1733—1814), the famous physician-in-ordinary to the Empress Maria Theresa and the Director of the Medical School at the University of Vienna. Dr. Quarin supported Hahnemann when the latter found himself in dire financial straits, and obtained for him a place of librarian to the Governor of Transylvania, Baron von Bruckenthal, in Hermannstadt. There, he was also able to practice medicine to some extent, as no medical license was required in that city. After having served during two years as a librarian, Hahnemann returned to Germany and graduated from the University of Erlangen in 1779 (M.D.). Gradually he became bitterly disappointed with contemporary medicine, especially with the lack of understanding of medicines' action. Consequently, he stopped his practice, supporting his family (Hahnemann married the daughter of an apothecary in 1782) by translating books on various subjects.

Dr Joseph Von QUARIN (1733—1814)

In 1790, when translating William Cullen's Materia Medica, Hahnemann noted that the Peruvian bark (Quinine) used against malaria, was also able to produce in healthy individuals a fever similar to the fever observed in malaria. In order to verify that this is true, he took the bark himself until a characteristic fever appeared. That time Hahnemann did not recognize that he had discovered some universal law. Nevertheless, the numberless experiments he performed during the years 1790—96, convinced him that there is the basic principle upon which further experiments and the discovery of new medicines could be based.

The year 1796 has been officially recognized as the year when homeopathy was born. In that year Hahnemann published in Hufeland's Journal his paper called "Essay on a New Principle for Ascertaining the Curative Powers of Drugs, and Some Examination of the Previous Principles". In this writing Hahnemann pointed out the way to find and test new medicines. It should be done

[...] By administering such substances to healthy individuals in small quantities for days or weeks until they manifest the set of symptoms peculiar (or "specific") to that substance. The procedure was called by him the "proving" (from German Prüfung, meaning "test" or "trial"), and the homeopathic medical literature consists, in its essence, of lengthy lists of symptoms from proving remedies on healthy persons (the lists themselves are also called "provings"). [...] The discovery of the provings was a crucial event in the history of world medicine. Although the idea itself is simple enough and could have been revealed to millions of others, that honor fell to Samuel Hahnemann1.

In the "Essay", Hahnemann stated the main principle, on which later he built theory and practice:

One should apply in the disease to be healed [...] that remedy which is able to stimulate another artificially produced disease, as similar as possible; and the former will be healed - similia similibus - likes with likes2.

It took him as much as 14 years to formulate the main principles of the new medical theory, which was called by him homeopathy (or homoeopathy) - a term composed of the Greek words, homoios ("like") and p?thos ("accident", "condition", hence disease).

Hahnemann's final departure from the ranks of the orthodox came with the appearance of his book entitled "Organon of the Rational System of Medicine" (1810). For the first time Hahnemann defined the creed, method and role of homeopathic medicine:

1. The physician's high and only mission is to cure.
2. Diseases cannot be recognized by the change they effect in the interior, but they are clearly distinguishable by their symptoms.
3. The totality of the symptoms is the only authoritative guide in the selection of the medicine.
4. Only the homeopathic method of healing based on the fundamental law of 'similia similibus curentur' proves itself to be thoroughly efficacious in the long run.
5. Only one single and simple medicine is to be given to the patient at a time3.

In 1812 Hahnemann was accepted at the University of Leipzig, after he had submitted the dissertation required from those intending to deliver lectures. Yet the audience was small, there was opposition from professors, and Hahnemann had to discontinue his course.

Mélanie ďHervilly

The local pharmacists were not ready to comply with Hahnemann's violation of their exclusive rights of dispensing medicines, for Hahnemann prepared and dispensed medicines himself. As the court indeed prohibited Hahnemann from doing this, he decided to leave Leipzig for the tiny ducal capital of Anhalt-Koethen, where he was patronized by the Duke, his former patient. Hahnemann remained in Koethen from 1821 to 1835. In 1835, Hahnemann married (his first wife died in 1830) Mélanie ďHervilly, a thirty-five year old Frenchwoman. In the same year the married couple moved to Paris, where Hahnemann developed a large practice and had many disciples. He lived in Paris until his death (July, 1843).

The literary output he left contains 103 original dissertations, essays, books and scientific articles, dozens of translations (on topics related to chemistry, pharmacy and medicine) from the English, French, Italian and Latin, and more than 200 scholarly letters concerning homeopathy which have been preserved.

Generally, there are six cardinal principles upon which Hahnemannian homeopathy is based:

1. The Teaching of Similars
2. The Single Remedy
3. "Proven", According to Hahnemann's Definition, Remedies
4. The Minimal Dose
5. The Potentized Remedy
6. The Chronic Miasms' Doctrine

These main principles ought to be explained.

(1) As mentioned above, the Teaching of Similars means that a therapeutic treatment has to be based on the law "similia similibus curentur", according to him the only true therapeutic approach.

(2) The Single Remedy principle means that only one medicine can ever be truly homeopathic to the presenting illness at any one time. Thus, only single medicine should be administered to the patient at a given time. Although this principle seems to have been unquestionable to homeopaths for only one single homeopathic remedy has ever been "proved" according to the 3rd principle (see above), there has always been, since the appearance of homeopathy, a group of practitioners who have prescribed several remedies in combination and reported good results. Currently this certainly "non-homeopathic" practice is actively supported by producers of homeopathic medicines all over the world. These complex medicines are intended to protect from or treat at early stages, such widely spread diseases like cold, hemorrhoids, different skin eruptions, etc.

Albrecht von Haller (1708—1777)

(3) The "Proven" Remedies principle is Hahnemann's method of testing the effects of medicines on healthy volunteers, although Hahnemann himself credited Albrecht von Haller (1708—1777) with the honor to have suggested to test medicines on the healthy. Only healthy and reasonable people (the provers), according to Hahnemann, are considered capable of describing what they feel after having taken the remedy, and should therefore be chosen for the experiments. All signs and symptoms caused by the remedy are noted by the provers in their diaries (changes in temperament or in intellectual acuity, irritation, fatiguability, pains, etc.). This information is confronted to known toxic effects of that medicine. The most frequently noted signs and symptoms are elected and considered to be specific for the medicine "proven". This Hahnemannian method has not changed, except that additional placebo control groups have become customary in the second half of the 19th century4. The account of the first Hahnemann's provings was published in Latin in 1803 as an essay entitled "Fragmenta de viribus medicamentorum positivus". The essay reflected Hahnemann's thirteen years long labor; it resulted in the proving of twenty-seven medicines, whilst the number of symptoms recorded by him for each remedy ranged from twelve (for Copaifera balsamum) to 280 (for Pulsatilla).

"The provings of homeopathic remedies is the essential core of homeopathic Materia medica. The tradition of provings and clinical confirmation [i.e. the efficiency of the treatment according to the law of similars — A.K.] is a balanced approach to the development of a pure Materia medica"5.

(4) The Minimal (or Minimum) Dose principle has been developed by Hahnemann since 1798 after he had faced severe aggravation in the patients' conditions after administering "similar" drugs. This led him to reduce gradually doses up-to extremely minimal ones. In fact, not only for lay public, but also for rather educated people, homeopathy is very often identified with the conception of so-called minimal doses, although material doses have always been applied as well. The main difficulty in adopting this principle lays in the confusion of physiologic and therapeutic effects characteristic for those who are not familiar with this aspect of the problem. According to Hahnemann, physiologic or usual material doses may influence healthy tissues in the human body, whilst diseased tissues have another, incomparably higher degree of sensitivity and should thus be subjected to medicines whose "material" effects are not present any longer but whose "dynamic" effects (see below) are in their full power. The "minimality" of doses has thus to be adopted to the grade of the patient's sensitivity. By the issue of the 5th edition of the "Organon" (1833) Hahnemann had concluded his experiments by considering the 30th centesimal dilution as the highest possible. I guess that a few words on the homeopathic dilutions (potencies) process making according to Hahnemann are here in place.

To make potencies of any substance, the exact number of empty phials (or small bottles) is first selected which will be required in accordance with the number of the potency to be made. Each phial is marked with the name of the substance and numbered, and then placed in numerical order. Ninety-one drops of dilute alcohol are introduced into each phial. One drop of the mother tincture (solution) is added to the phial No. 1, it is succussed and allowed to rest for about three minutes. Then one drop from phial No. 1 is added to the phial No. 2, succussed, and allowed to rest as the previously described. This process is repeated up to the envisaged potency, always ensuring that the drop taken out of the phial is instilled into the very next higher number and into no other. A separate sterilized dropper is used for each dynamization [centesimal dilution]6.

In the very same order decimal dilutions are made. The difference is that not ninety-nine but only nine drops are being taken to prepare a decimal dilution.

(5) The "Potentized Remedy" is directly related to the principle of the dilution method,

…Imparting (along serial dilutions) the pharmacological message of the original substance (i.e. creating a template of the active principle) by means of trituration or succussion. It describes the process of modification of medicines as invented by Hahnemann. It is characterized by the following four distinguishing features.

It is purely mechanic and mathematico-physical process.
The procedure involves neither uncertain, unreliable nor immeasurable factors.
The resultant product is stable and can readily be maintained that way.
The process is theoretically illimitable, though it becomes laboriously time-consuming in the higher range of potencies…7

During the process of potentization medicines undergo, according to homeopathy, the following important changes:

A. Quantitative (chemical) reduction linked to quantitative increment of therapeutic (reactive) property.

B. Physical solubility (even of medicines, like metals, believed to have been insoluble)…

C. Physiological assimilability and bioavailability.

Altered therapeutic activity (suppression of primary [direct], and enhancement of secondary [reactive] effect of drugs8.

(6) The Chronic Miasms doctrine has represented the most difficult and controversial doctrine of homeopathy. The miasmathic theory, a new original conception of Hahnemann, was developed by him in his second in importance theoretical writing (after the "Organon"), called "The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Treatment", published in 1828—30.

Though now generally accepted by most homeopaths without question, at the time, the theory was generally greeted with disbelief and derision from all but the most devoted followers [...]. The word miasm means a cloud or fog in the being. The theory suggests that if 100% of diseases are miasmatic, then 85% are due to the primary and atavistic miasm Hahnemann called psora. The remaining 15% of all diseases he held to be either syphilitic or sycotic, being derived from suppressed Syphilis or suppressed Gonorrhea9.

It has been understood under the word miasma "a condition which may be acquired or inherited underlying chronic or recurrent disease effects"10. After having successfully treated at the very beginning many patients, Hahnemann became soon convinced that a number of diseases though treated, came back, destroying all the previously reached successes. This led him to seek explanation of the phenomena and he found it in the theory of chronic miasms. When applying "miasmatic" remedies, specific for each kind of miasms, to the treatment of chronic conditions, Hahnemann was able to improve the results of treatment obtained.

For 11 years Samuel Hahnemann carried out his research on the fundamental causes of chronic degenerative diseases. As Hahnemann collected the symptoms of his failed cases, he began to realize that there was a definite pattern to what he was observing. Why was this? The Hofrath [Hahnemann - A.K.] began proving new mineral, plant and animal remedies with the idea of finding similars to these unknown chronic syndromes. This led Hahnemann to the discovering of the chronic epidemic miasms, psora, pseudo psora, sycosis and syphilis11.

The six principles described above are considered by contemporary homeopaths to be firm and unchangeable. Nevertheless, the homeopathic community of the period under study was rather skeptical toward some of them and flexible in their applying. Thus, the miasmatic theory was rejected by the majority. The minimal doses were very often material; many homeopaths used only decimal potencies. The Hahnemannian theory of freeing dynamic forces as the remedy is diluted was certainly disapproved by many doctors for being "too mystical". Generally speaking, the later Hahnemann, since 1825 onwards, with all his revolutionary ideas, found little sympathy and understanding. Until his last days Hahnemann continued experimenting with new techniques, potencies and doses, trying to find the most appropriate solution to theoretical and practical problems he was meeting during the treatment he provided.

Baron Clemens M. F. Boenninghausen (1785—1864) J. T. Kent

The post-Hahnemannian development of homeopathy deserves a few words. Although there were no significant theoretical discoveries, Hahnemann himself succeeded to be a witness to the emergence of some ideas and experiments which developed later into complete trends. The first most important step was done by the closest Hahnemann's disciple Baron Clemens Maria Franz von Boenninghausen (1785—1864) who proposed and further developed the idea of repertorisation of symptoms met in patients. Boenninghause's repertory was first issued in 1845 and remained the dominant repertory until the late 1870s. It had been obvious that the total complex of symptoms met in a given individual may include several dozens of those, each of which may be managed by a certain medicine. Thus, the process of analyzing the case and prescribing the remedy would have become a matter of a highly subjective approach, let alone the necessity to remember thousands of symptoms relating to various remedies of fast-growing homeopathic Materia medica. The technique of repertorisation (analyzing and choosing the most important symptoms) and repertories (reference books that schematically index the symptoms sought to be located in Materia medica) have represented the guideline supporting the right choice of the remedy made by homeopathic practitioner. Since then, Repertories have been changed and improved in accordance both to the growing clinical experience and to constantly updated Materia medica; they have become very popular within the homeopathic community. The most reliable and widely used repertories are: "Clinical repertory to the dictionary of Materia medica" by John Henry Clarke first issued in 1904, "Repertory of homeopathic Materia medica" by James Tyler Kent first issued in 1877, "Clinical repertory and therapeutic index of homeopathic Materia medica" by Oscar Boericke, first issued in 1906 and "Synoptic key and repertory of Materia medica" by Cyrus Boger first issued in 1915.

J. H. Clarke O. Boericke

The second step in importance was the introduction of homeopathic nosodes. In fact, it was an idea of one of Hahnemann's pupils, Dr. Constantine Hering. After having read Hahnemann's "Chronic diseases" he proposed to use morbid secretions (watery excrements of cholera, the black vomit of yellow fever, discharges of various eruptions, etc.) as potentized homeopathic remedies for the treatment and prevention of diseases. Hahnemann first treated this idea with disbelief considering such a method to be non-homeopathic but rather isopathic (i.e., treating according to the principle "equalia equalibus curantur"), but soon he changed his mind. The use of nosodes in homeopathy has experienced rises and declines. Currently, some of nosodes (especially bowel nosodes) have rather limited use, whereas some nosodes are known to every homeopathic practitioner and more widely used.

The use of high and extremely high potencies has traditionally been the privilege of a small group of prominent homeopathic masters and their disciples, although lastly it is becoming increasingly popular all over the world. The first who turned to high potencies was the above mentioned Baron von Boenninghausen. By the end of the 19th century the high potencies were used almost exclusively by the American homeopath James Tyler Kent and his closest followers.

C. M. Boger Constantine HERING (1800—1880)

Throughout all the period under study homeopathic Materia medica had been constantly enriched. Constantine Hering only added several new categories of potentized remedies, often proved on himself (poisons taken from insects, snakes and other venomous creatures; nosodes; auto-nosodes, i.e. secretion taken from the patient's body; sarcodes, i.e. tissues and secretions of homologous organs; homeoprophylactic nosodes). Such important and powerful homeopathic medicines like Actea racemosa, Arum triphillum, Argentum nitricum, Baptisia, Bromium, Ferrum phosphoricum, Phosphorus, Podophyllum, Kalium bichromicum, Magnesium phosphoricum, Melilotus, Selenium and many others were introduced by various homeopathic physicians. Usually results of the provings were first published in homeopathic periodicals, then tried by doctors and after that introduced into Materia medica. The introduction of potentized poisons into homeopathy has been regarded as the breakdown which allowed homeopaths to treat some septic conditions which had been considered incurable before. Unfortunately, the history of homeopathic Materia medica has not yet been fully documented.

Together with the positive development of homeopathic theory and practice in the second part of the 19th century, it became evident that homeopathy had its own methodological difficulties impeding the adoption of the doctrine by large circles of practitioners. It is most probable that the disputes within the homeopathic community about subtle points of theory, doses and miasms, were no less significant as compared to the actual use of the therapy in practice. As soon as pure Hahnemannian homeopathy became corrupted by attempts to take short-cuts with the therapeutic method, it started to decline. This topic will be briefly analyzed in my thesis.

Notes and references

1 Harris L. Coulter, "Divided Legacy. A History of the Schism in Medical Thought", Berkeley, 1994, v. IV, pp. 246-47

2 Richard Hael, "Samuel Hahnemann. His Life and Works. Based on Recently Discovered State Papers, Documents, Letters, etc.", London, 1922, v. 1, p. 66

3 Robert Jütte, "The Professionalisation of Homoeopathy in the Nineteenth Century" In: John Woodward and Robert Jütte (Eds.): "Coping with Sickness. Historical Aspects of Health Care in a European Perspective", Sheffield, 1995, p. 46

4 "Thorsons Encyclopedic Dictionary of Homeopathy. Edited by H. Gaier", London, 1991, pp. 390-91 As to the grade of dilution (potentisation), homeopathic medicines are classified by their potencies as following: low (from a pure substance up-to 6th centesimal dilution, 6C), middle (up-to 30th centesimal dilution, 30C) and high (higher than 30th centesimal dilution). The use of high and super-hight dilutions (up-to 50M, i.e. 50,000C) was developed and applied by relatively small group of American homeopaths headed by J. T. Kent. In the 19th century also the use of nosodes (homeopathically prepared remedies from disease products with their own distinct drug picture) was gradually introduced.

5 David Little "The Principles of Hahnemannian Homeopathy: The Principles in Practice". A paper published at http://www.simillimum.com

6 "Thorsons…", see note 4, pp. 455-56

7 Ibid., p. 441

8 Ibid., p. 445

9 Peter Morrell, "Hahnemann's Miasm Theory and Miasm Remedies". Paper published at http://homeoint.org/morrell/articles/pm_miasm.htm

10 "Thorsons…", see note 4, p. 342

11 David Little "The Principles of Hahnemannian Homeopathy: The Chronic Diseases". Paper published on http://www.simillimum.com

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