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 as a method of treatment based on similars, single drug, "provings", small doses, potentized remedies and the miasmatic theory, was developed by the German Dr. Samuel Hahnemann in the 1790s onwards. The theory and main principles of homeopathic practice were represented by Hahnemann in his books "Organon" (1810) and "Chronic Diseases" (1828), whilst the pharmacological armamentum of homeopathy was provided in his large work "Materia Medica Pura" (1811—1819) and further developed by both Hahnemann himself and his followers.

Russia was among the countries usually described as the representatives of the so-called first phase of homeopathic Diaspora (1810—1830), which included also Belgium, Holland, Austria, Hungary, Poland, USA, Britain, Italy, France and Switzerland.

The first chapter of my research, entitled "Allopathy vs. Homeopathy", deals mainly with the allopathic opposition policies which homeopathy had met in the Russian Empire throughout the period under study.

Homeopathy entered the frontier areas of the Russian Empire with physicians of foreign, mostly German, origin and very fast, as soon as in 1827—28, attracted the interest of the higher circles in St. Petersburg, including the Tsar's family. Although the first reaction of the Russian professional medical press toward homeopathy was rather benevolent, the regular profession soon became convinced that homeopathy might represent a real threat to its foundation. Since 1829, when Dr. Herrmann had been entrusted by the Tsar with testing homeopathy in a military hospital, until World War I Russian allopaths demonstrated clear intolerance and even keen hostility toward their homeopathic counterparts. In fact, this was not special for Russia. In all countries chosen for comparison, the regular profession adopted similar approaches. Homeopaths were excluded from allopathic medical societies, stigmatized and blackmailed as "betrayers of scientific medicine", charlatans and quacks, whilst joint consultations with homeopaths were strictly forbidden. Allopathic periodicals were impenetrable to publications by homeopaths. Moreover, Russian editors of the scientific press, "emended" also foreign publications suspected for their benevolent attitude toward homeopathy: "wrong" articles in foreign books were replaced with "right" anti-homeopathic ones. Although the Russian regular profession had no such institutions like the American Medical Association in the USA or the Royal College of Physicians in Britain, which could establish a certain policy toward irregulars, such Russian facilities like the weekly journal "Vrach" and the Pirogov Society of Russian Physicians fulfilled successfully the functions of control in professional issues.

The second chapter of the research, "Homeopathic facilities" describes hospitals, pharmacies and periodicals. The number of all these in Russia was rather insignificant. Russian homeopaths managed only one real homeopathic in-patients facility, namely Alexander II Homeopathic Hospital in St. Petersburg, from 1898 to 1918. Other "hospitals" were rather in-patient dispensaries with 10-15 beds, located in some private accommodations. The hospitals which were opened in the 1840s owing to the support of Minister of Interior Count Perovsky, proved to be short-lived. It should be stressed that the fast closing of homeopathic hospitals was not caused by the shortcomings of homeopathy, but by the lack of support, both financial and political. Until the late 1860s homeopathy was practiced in Russia by German doctors, who remained alien both to the common people and to the most influential potential supporters, like the Orthodox clergymen and the old Russian nobility.

The number of homeopathic pharmacies in the Russian Empire reached the number of 32 at the turn of the centuries, whilst during the last five years of the 19th century it jumped from 17 to 32. This number could even have been larger, but the opening of new homeopathic pharmacies had been restricted by the small number of homeopathic doctors: Russia never counted more than about 100 homeopathic physicians.

There were altogether some 20-25 homeopathic societies in Russia, which mostly were established during the 1890s, the most fruitful period of Russian homeopathy. Nevertheless, the activity of almost all of them, with the exception of the St. Petersburg Society of the Followers of Homeopathy, was of little significance. Many societies virtually disappeared after their first meetings took place. The experience of the establishment of a professional homeopathic society in St. Petersburg in 1868 on the model of the British Homeopathic Association, proved to be unsuccessful. In the conditions of Russia homeopathy constantly retained a strongly pronounced character of domestic medicine, therefore laymen preferred not to support a few doctors and their "scientific" interests, but rather to establish lay organizations aimed at providing homeopathic treatment to the sick. Although the professional society, namely the St. Petersburg Society of Homeopathic Physicians, existed until WWI, its activity can by no means be compared with that of its above mentioned lay counterpart. This pronounced lay character of homeopathic societies resembled German homeopathic societies in the 1880s onwards. Nevertheless, the German societies counted thousands of members, whilst Russian ones usually had only 50-100 members.

The number of homeopathic periodicals also remained rather insignificant. During the whole period under study, 6 homeopathic journals were published in the Russian Empire, 5 in Russian and 1 in Polish. The two first journals were short-lived (2 and 4 years respectively) as they were supposed to be read by a "scientifically prepared public" and could not secure the minimally needed number of subscribers. In fact, the number of homeopathic societies, dispensaries, pharmacies and periodicals in Russia at their peak can be compared with that in Britain and France in the period of decline of homeopathy.

The third chapter, "Homeopathy and zemstvo medicine" deals with an original Russian facility called Zemtsvo (local government) and efforts of homeopaths and their lay supporters to introduce homeopathy into it. The analysis of the history of the relationship between the Zemstvo and the homeopaths clearly demonstrates that the organizational weakness of Russian homeopathy, and primarily the lack of professional practitioners, did not allow homeopaths to reach their goals.

The fourth chapter entitled "Homeopathy and the clergy" concerns the relationship between Russian homeopaths and the Russian Orthodox clergy. Although in all countries selected for comparison clergymen did not stay aloof of homeopathic matters, a large support was provided by the Russian Orthodox Church on all its levels. As Russian Orthodox clerics for centuries were the only educated persons living in villages, who had been asked by the peasants to provide some medical support, they met homeopathy with great enthusiasm. Usually the rural priests did not obtain any reward for their treatment, but the peasants anyway were the persons who secured the priests' income. The health of their parishioners was in itself a sufficient reward for the clerics' efforts. One may assume that thousands of rural priests treated with homeopathy. Many of them ordered domestic manuals, which remained until WWI the bestsellers within the Russian homeopathic press. While observing such an active involvement in homeopathic matters "from below", the high Church authorities encouraged it and took part in the activity of homeopathic societies themselves. By their participation in those societies' activity, the high-ranking clergymen enlarged their influence within Russian society. Homeopaths succeeded to obtain the support of such a distinguished clergyman as Father Ioann of Cronstadt, whose influence in the late 1880s onwards was comparable with that of the Tsar himself.

As a matter of fact, homeopathy had a rather large social basis within Russian society. Nevertheless, these supporters (clergy, nobility, high military staff) mainly were the representatives of "old" conservative Russia, whilst representatives of the intelligentsia were much less involved. Homeopathy, together with the "Old Russian world" at large, was completely destroyed by the Bolsheviks. It is especially important to realize that the period of flourishing of Russian homeopathy coincided with the period of decline of homeopathy in other European countries. This may be explained with the belated socio-economical development of the Russian Empire in the 19th century. The 1890s demonstrated that Russian homeopathy had a potential for further development, based on the large involvement of laypeople in the spread of homeopathy throughout the Empire. Yet the organizational weakness of Russian homeopathy, as well as the numerous shocks experienced by the Russian Empire at the beginning of the 20th century did not allow Russian homeopaths and their lay supporters to forward a deeper rooting of homeopathy in Russia society.

Around mid-19th century allopathy had little to offer. It often harmed more than it helped. Homeopathy, on the other hand, was innocuous, relatively easy to master, and ' last but not least ' inexpensive.

According to Squires, "Nineteenth-century medicine generally, and therapeutics in particular, could hardly be regarded as 'scientific' throughout the nineteenth century. It may have used some of the tools and rhetoric of science but that does not and did not make it theoretically and empirically powerful, comprehensive, systematic, experimentally testable and predictive knowledge. [...]. Some programmatic statements of what 'scientific medicine' should look like were made by practitioners like François Broussais, John Brown, Elisha Bartlett, John Forbes and others. Except for a few therapies like vaccination, quinine and diet; some surgical advances such an anesthesia and aseptics; and improvement in public sanitation and quarantine, little in regular therapeutics could be considered really effective and minimally iatrogenic. Whether homeopathic therapy was (or is) more effective has never really been put to rigorous, experimental, clinical test"1.

For example, the so-called Avogadro number was calculated by the physicist Josef Loschmidt only in 1865. This made it possible to evaluate whether in homeopathic medicines there was or not any drug in the solution and after how many dilutions. The answer is that only after the 24th decimal (or 12th centesimal) dilution no molecule of the substance dissolved may be found. I have to mention here that the overwhelming part of the homeopaths, especially in the 19th century, has applied lower potencies, sometimes very significantly, than the Avogadro number. Nevertheless, since the establishing of homeopathy, allopaths had asserted that homeopaths were using "incredible minimal, hundred-fold diluted" medicines, where no substance is present; therefore, the effects of such medicines ought to be recognized as psychical only.

There have been throughout the history of homeopathy several traditional objections against homeopathy, which I shall briefly mention together with their refutation.

1. Small homeopathic doses cannot have any effect. In fact, the use of minimal doses came to homeopathy a dozen years after Hahnemann and his followers began to treat in accordance to the law "similia similibus curentur" and only as a consequence of their practice, not as a starting principle for it. This was caused by the aggravations, sometime rather severe ones, in patients' conditions before their recovery.

2. Homeopathic medicines are dangerous substances. This contradicts the previous objection. Nobody has ever succeeded to prove that homeopathic medicines have represented any danger to patients, whilst either toxic or iatrogenic effects of allopathic medicines are well known.

3. Not homeopathy heals but an inherited tendency of the body toward natural recovery. In that case, there is here a statement which may be accepted by both homeopathy and allopathy.

4. Homeopathy uses the same medicines for all diseases. Firstly, homeopathic Materia medica currently contains at least 1,500 "proven" remedies. Secondly, the same medicines may be used for different diseases only in case they have similar manifestations in the patient. This is a corner-stone of the homeopathic approach to symptomatology and treatment.

5. Homeopathy treats by faith. As long as homeopathy exists, it treats as well as children and animals that cannot be suspected of being subject to suggestion.

6. Homeopathy cannot be applied in acute cases. The main success of homeopathy in the 19th century, i.e., the successful treatment of cholera, was indeed an application of homeopathy in acute, sometimes urgent conditions.

7. Many people have been treated without being cured by homeopathy. No medical system was, is or ever will be able to cure all conditions and diseases as this contradicts the principles of Nature. Homeopaths assert that they have excellent results in the treatment of most common diseases but never declared that they are able to treat all diseases.

It goes without saying that in view of the lack of any common point in theoretical conceptions and practical approaches, the only possible way to prove whether homeopathic medicines have a real effect was to test homeopathy in hospitals under the mutual control of allopaths and homeopaths. Such an experiment might have been of a special interest for, as I showed in my research, all the results obtained in the Russian Empire in homeopathic departments were, according to reports of the homeopaths in charge, beneficial. However, there were no controlled investigations but simply observations. This is the central point. It seems that when proclaiming the "absurdity" of homeopathy allopaths made all efforts both to prevent such a trial on the one hand, and to close any homeopathic facilities on the other hand. Because my thesis is dedicated mainly to the history of Russian homeopathy, I refer to Russian examples. When Dr. Herrmann was charged by the Tsar with homeopathic treatment in St. Petersburg military hospital in 1829, and reportedly obtained results at least not worse than those of allopaths, the Medical Council announced that the diseases successfully treated by him were either of the "easy" kind and could not be taken into consideration or not fit for comparison. The endeavor of Dr. Cherminsky who had met with success in his treatment of cholera with homeopathy in Zhitomir was rejected without any logical explanation at all2. Profs. Zdekauer and Kozlov3 proposed in 1867 to test homeopathy but while staying on purely allopathic ground, which was impossible to be accepted by homeopaths, who offered in turn opening a homeopathic facility where this experiment under mutual control might have been performed. No further discussion followed. Very similar to the story of cholera was the story of the epidemic of diphtheria in 18824. Again, there were then neither understanding of the disease, nor any reliable treatment for it in the hands of regulars. Homeopaths, who some years earlier developed Mercurius cyanantus as a reportedly powerful remedy for diphtheria, asked the Tsar in the presence of Dr. von Dittman to establish a homeopathic department where homeopathic treatment of the disease might have been provided. In spite of strong resistance of allopaths, such a facility was established. However, allopathic practitioners did not refer patients to the hospital and it had to be closed. In 1887, when Dr. Brazol was delivering a lecture on the theory of homeopathy at the St. Petersburg Pedagogical Museum in 1887, he was offered by the chemist G. Goldstein, a member of the Board of the Museum, to test homeopathy at some large hospital. Yet after Dr. Brazol readily agreed, Goldstein remained silent and never turned to him any more to develop further the affair5.

Allopaths have always asserted that because the theoretical basis of homeopathy was either "uncertain, hardly believable" or could not be proven with contemporary scientific methods, therefore homeopathy was nothing but "fraud, quackery, absurdity" or "placebo" in the best case. The allopaths refused to believe that such small doses had any possible therapeutic effect. Thus, only those who went beyond this axiom "it cannot be because it is impossible" and beyond the psychological barrier caused by that and tried the medicines, actually began to change their minds. The examples have been numerous although the number of the converts has always remained limited. The above mentioned Dr. Lev Brazol who had begun his carrier as a young very promising allopathic practitioner and converted to homeopathy after some successful experiences with homeopathic medicines, compared ironically the refusal of homeopaths to test small doses with that of a professor of the Padova university to look in telescope at Jupiter's satellites discovered by Galileo for "it cannot be". Thus, according to his words, "one ought to have the moral courage to look in the telescope in order to see Jupiter's satellites, i.e., to test homeopathy according to the laws of science"6. After having surveyed many homeopathic and anti-homeopathic publications of different kinds, I have never met a refutation made on the following basis: "I tried homeopathy carefully according to... and I found it does not work". Additionally, I found no example of the conversion to allopathy of a homeopath, while the history of homeopathy has been the history of conversion of allopaths to homeopathy. Naturally, most of those conversions were made exclusively on the ground of personal experience and not of theoretical ideas.

Toward the end of the century, when bacteriology due to the labor of Koch and Pasteur had brought a new understanding of disease based on the germ theory, allopathy gained strength although its therapeutic achievements still remained rather limited as long as certain technical and methodological advances and improvements (like X-ray discovery and antiseptics like sulfamides) had not yet come into practice. This is true for developed countries like France, Germany and Great Britain, but much less so far Russia where scientific achievements were adopted years later.

Thus, it is possible to assert that when more really scientific regular medicine had appeared in the late 19th century, homeopathy was gradually falling into decline due at least in part to its internal inability to build and maintain effectively its own system of education and training. This happened both in European countries and in the USA where the conditions for homeopathy had been incomparably more positive throughout all the period under study. Another problem is that homeopathy remained in confinement and declined to progress or to take into account any scientific advance. Homeopaths ignored as long as they could microscopes, stethoscopes and other medical instruments. This gave the appearance of lagging behind and reinforced the impression of being unscientific. Thus people were attracted towards science after 1860 or so. The decline of homeopathy can be explained along those lines.

When, nearly one century later, the therapeutic equipment became impressive, but with negative side effects such as iatro-pathology and lack of physician-patient relationship, homeopathy (together with other alternative methods of healing) came back to the fore. This partly explains a renewed interest in its historical development, to which this study aims at adding a new aspect, i.e., the story of Russian pre-WWI homeopathy.

Notes and references

1 Roy James Squires, "Marginality, Stigma and Conversion in the Context of Medical Knowledge, Professional Practices and Occupational Interests. A Case Study of Professional Homeopathy in Nineteenth Century Britain and the United States" Ph.D. Thesis, University of Leeds, 1985, p. 4

2 See the section "The Cholera years" of the chapter "Allopathy vs. Homeopathy".

3 See the section "Discussion which never took place" of the chapter "Allopathy vs. Homeopathy".

4 See the section "The Medical Council vs. Homeopathy: 50 years later" of the chapter "Allopathy vs. Homeopathy".

5 "Publichnye lektsii o gomeopatii L. E. Brazolia" (Public Lectures on Homeopathy of Dr. Brazol), St. Petersburg, 1889, p. 48

6 Ibid., pp. 128 and 131

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