Homeopathy

HOMEOPATHY (from Greek homoios - similar, and pathos - suffering, disease), a peculiar therapeutic system that arose on the principle of treating diseases with drugs that cause in the body of a healthy person phenomena as similar as possible to the symptoms of the given disease. Homeopathy is associated with the name of the physician Samuel Hahnemann (see), to whom belongs the introduction of the terms both of homeopathy and "allopathy," or "alloeopathy" (Greek allos or alloios - other, opposite, and pathos - suffering, disease) to characterize the therapeutic methods of the dominant (official, "school") medicine, which, according to Hahnemann, strives for the treatment of diseases by causing symptoms opposite to the symptoms of the disease (contraria contrariis). The formulation of the new therapeutic "law" underwent a characteristic change in Hahnemann himself: at first this "law" read: "let the like be treated by the like" (similia similibus curentur), and in Hahnemann's main work "Organon" this "law" sounds already as a more indisputable axiom - "like is cured by like" (similia similibus curentur). Three main, fundamental tenets put forward by Hahnemann and generally recognized by modern homeopathy should be distinguished. The first and most important is the law of similars, which prescribes in the treatment of diseases the use in small doses of such drugs that cause in a healthy person phenomena as similar as possible to the symptoms of the given disease. The second tenet is the necessity of testing the action of medicinal substances on healthy people, which makes it possible to establish the symptoms, or "pathogenesis" (in the terminology of homeopaths) of the given drug and to apply this latter for the treatment of patients on the basis of the law of similars. The third tenet is the treatment with minimal doses ("high potencies") of medicinal substances, since more "massive" doses harm the body. In main features, Hahnemann expressed his new views on the therapy of diseases in one of his comparatively early works (1796). In this essay, Hahnemann reviews the various ways that practical medicine ordinarily used for applying therapeutic means in sufferings of the human body. "The first and highest way consists in the elimination of the basic causes of disease. But all the thoughts and efforts of the best practitioners have not succeeded in discovering the basic causes of all diseases - causes which for the most part will remain forever hidden from the human mind." "The second way consists in the aspiration to suppress existing symptoms with drugs that cause an opposite action." According to Hahnemann, in acute diseases, in which nature itself most often conquers, it will be correct and appropriate to resort to such "temporary" means. But if we fought with these means against chronic diseases and those that are only just passing into a chronic state, this way would prove harmful and disastrous, and the means would appear to be merely "palliative" (examples cited by Hahnemann: laxative salts and aloe for chronic constipation, bloodletting for chronic inflammations, opium for chronic pains). "Enlightened, reasonable, and conscientious physicians used," Hahnemann says further, "in chronic diseases methods directed not at all to the suppression of symptoms, but on the contrary, to radical cure; in a word, they used specific remedies." According to Hahnemann, every true drug causes in a person a sort of disease, all the more specific the more effective the drug. This direct, primary action is followed by an indirect, successive action, opposite in symptoms; it is into this state that one must strive to bring the patient. What path did Hahnemann choose in search of these specific remedies? He considered the help of botany and chemistry insufficient, since these sciences give a concept only of the general properties of substances. Experiments on animals, in his opinion, are too "crude" a research method. Besides, an animal cannot express its sensations in words. There remains the sole path - testing drugs on people. The impetus for the development of Hahnemann's views was his experiment on himself (1790). Hahnemann's experiment with cinchona bark on himself, evaluated by both old and new homeopaths as the most important starting point for the development of the entire homeopathic doctrine, has the following history. Translating Cullen's "Materia Medica" in 1790, Hahnemann pondered the question of how to explain the beneficial action of cinchona bark on intermittent fever known to medicine and to what to attribute the frequently observed cachexia of such patients treated with cinchona bark. Suffering himself earlier from intermittent fever and having been cured of it by cinchona bark, Hahnemann decided in the same year 1790 to test the action of a large dose (over the course of several days, twice a day, 4 quents (drams) each) of cinchona bark on himself as a healthy person. After each dose, a "paroxysm" set in and lasted for 2-3 hours. The symptoms of the cinchona disease paroxysm were: cooling of the legs, weakness, palpitation, tremor, pounding in the head, thirst, dulling of the senses. However, the symptoms typical for intermittent fever - chills, fever, and sweat - were not noted. Hahnemann's immediate task was the accumulation of as detailed pictures as possible of the action of individual drugs on a healthy person to establish the "pathogenesis" of drugs. To carry out the principle with full consistency, to prove the "law" of similia similibus, the use of large, "massive" doses of medicinal substances was required both on healthy people for the purpose of establishing "pathogenesis" and on patients for the purpose of treatment. Thus Hahnemann had to reckon in the full volume with the "direct" (see above) action of drugs, with pronounced deterioration of the morbid state (examples: opium in constipation, arsenic in diarrhea). Obviously, carrying out the principle in such a form proved impossible. Therefore, Hahnemann took a step towards reducing doses (1806). Along this path he went irresistibly further. Naturally, in this case the objective symptoms of the "drug disease" had more and more to give way to subjective sensations, mood changes, shades of these moods. Thus homeopathic pharmacology was enriched, the number of special specific signs of the "pathogenesis" of drugs grew. Hahnemann conditioned the transition to small and minimal doses by the development of the concept of "dynamization," "potentiation" of drugs. By dynamization he understood the manifestation of special, hidden therapeutic forces of medicinal substances ("physiological potentiation"). Going along this path, Hahnemann reached the 30th dilutions (he considered by the centesimal scale - see below) and even subsequently (by the end of his long life) began to recommend a single sniffing of the drug instead of internal administration. This doctrine of Hahnemann on the "dynamization," "potentiation" of drugs is connected with his concepts of disease in general. Over the years, Hahnemann drifted further and further away from the material, substantial basis of understanding the essence of diseases, attaching all strength and all significance to individual symptoms of disease. In him

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grew the conviction that the aggregate of symptoms is indeed the disease. In the heat of the fiercest polemic with representatives of "allopathic" medicine, he considered it possible to explain the changes found in organs during autopsies as the result of "the spoilage of human health caused by incorrect allopathic treatment." At the same time, having initially applied the principle of "similia similibus" to chronic diseases, Hahnemann gradually extended it to all diseases (except surgical ones). The concluding stage of the evolution of Hahnemann's views coincides with the concept of the "vital force" introduced by him into the 4th and 5th editions of his "Organon", a concept very vague, contradictory, and ideologically close to the views of his predecessors—founders of natural philosophical and medical systems (Stahl on the "soul", Brown on "irritability", Blumenbach on "vitalism"). The material organism, according to Hahnemann, without the vital force is incapable of self-preservation. Upon the onset of a disease, this spiritual vital force is initially affected by the dynamic influence of the pathogenic agent. By prescribing a homeopathic remedy to a patient, the physician subjects them to the influence of another dynamic force, which turns the natural disease into an artificial one that is very similar to the first and somewhat stronger than it. The natural disease ceases to exist. It is interesting to note that in connection with the theories just expounded, Hahnemann also put forward such requirements as: not prescribing mixtures of medicinal substances, not prescribing the next dose before the effect of the previous one has ended, strict adherence to diet, a most detailed anamnesis of the patient and determination of their constitution, detailed individualization of the disease in the given patient ("treat the patient, not the disease"). But these requirements do not essentially pertain to that doctrine of Hahnemann which formed the basis of homeopathy. The soil for the birth and spread of Hahnemann's therapeutic doctrine was favorable. In theoretical medicine, vague and contradictory views reigned; in practical medicine, methods of energetic intervention in the pathological process were practiced (frequent bloodletting, large doses of medicines, fontanelles, setons, most complex prescriptions, etc.). Thanks to this instability of views and dissatisfaction with therapeutic medicine as an art, Hahnemann acquired not a few like-minded people and followers. Hahnemann's extraordinary personal gifts, his enthusiasm, and his belief in his ideas contributed to this. However, for the majority of physicians contemporary to Hahnemann, his arguments to prove the principle of "similia similibus" were in any case insufficient. A fierce polemic flared up, and a sharp antagonism was created between homeopaths and "allopaths". Of the followers of homeopathy, one part went down the path of infatuation with the extremes of the Hahnemannian system, while another part did not recognize the reality of homeopathic remedies used in excessively high "potencies". At the congress of homeopaths in 1836, the majority resolved to adhere to lower dilutions (D6 is rarely transgressed by many contemporary homeopaths), recognized the generality of individual pathological forms based on data from pathological anatomy, physical and chemical diagnostics, and recognized experimentation on animals as a legitimate and important research method. However, the fundamental principle remained unshakable: diseases are cured by small doses of such medicines which in large doses cause a symptom complex analogous to the symptom complex of the given disease. From the data characterizing the state of homeopathy in our time, one can point out: in Leningrad, a Society of Homeopathic Physicians has existed since 1868. In the Society's clinic in 1922, there were over 12,000 visits. In 1913, the First All-Russian Congress of Followers of Homeopathy took place. In America, already by 1913, there were 13 special homeopathic institutions (of the type of medical faculties), a therapeutic establishment in every large city; homeopathic physicians number in the thousands. Among them, there are mixed types—eclectics, who do not always apply solely the principle of "similia similibus" for treatment purposes. Compared with America, homeopathy is less widespread in England and Western Europe; however, there are enough therapeutic establishments, pharmacies, and pharmaceutical plants serving homeopathy. For more than 20 years, chairs of homeopathy have existed at universities in Madrid, London, Paris; most recently, a similar chair has been established at the University of Berlin. The revival of the question of homeopathy and small doses on the pages of the medical press occurred mainly since 1925 and is associated with major scientific names: Bier and his school, physical chemist Traube, and others. Among Russian works, material for judging homeopathy and small doses is provided by the works of Kravkov, Skvortsov, Gurevich, Shervinsky, Gramenitsky, Nikitin, and others. In all these works one can find extensive material—physicochemical, experimental, and clinical—evaluated differently by the authors, on the questions of the reality of small and even minimal quantities of substances; on the dissimilarity and even opposition of the action of large and small doses; on the dependence of the strength of action of substances on the degree of their grinding, i.e., on the degree of increase of their surface area; on the negative and positive phases of the action of drugs; on cases of treating diseases according to the principle of "similia similibus"; on the "biological law" of Arndt-Schultz. All homeopathic remedies are applied per os. Many of them are either not applied at all in "allopathic" medicine (e.g., Sepia—cuttlefish, Lachesis—snake venom, Apis—bee venom, etc.) or are almost never applied, e.g., Thuja, Arnica, Crocus, and many others. "High potencies", or dilutions of medicinal substances, correspond to smaller doses; "low" ones correspond to larger doses. According to the decimal scale, each subsequent dilution differs by 10 times in concentration from the neighboring one; thus, D1 = concentration of 1/10, D2 = 1/100, D4 = 1/10,000, and so on; according to the centesimal scale, the difference is 100 times. Where "D" does not stand, the centesimal scale is understood. Sometimes "D" is replaced by the sign x. For example, Aconit. 10 = Aconit. D20, Aconit. 30 = Aconit. D60. Forms of medicinal substances: liquid—alcoholic tinctures (tinctura, guttae); solid—powders (pulv.) or pellets (granulae), the base of which is milk sugar. Both old and new homeopathic pharmacopeias impose high requirements on the purity of wine alcohol, milk sugar, and glassware. The initial, first dilution (1st potency—"Urtinctur") is obtained by adding an equal part of alcohol to an equal part of freshly squeezed plant juice; after filtering, it is diluted with alcohol to a drug concentration of 1:10. To obtain D2, it is diluted (with energetic shaking) 10 times with alcohol; to obtain 2 centesimal, 100 times, and so on. To obtain alcoholic tinctures from insoluble substances, energetic and prolonged trituration with milk sugar is prescribed. The physical properties of substances in this case, in the opinion of homeopaths, change so that substances, even those that are especially difficult to dissolve, starting from D5-D6, can be obtained in the form of tinctures. Besides Homeopathy

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Moreover, according to homeopaths, it is during these procedures of succussion, shaking, and trituration that special, hidden, as if dormant forces of medicinal substances emerge. These procedures, which previously required the application of strenuous physical labor, are now widely and completely mechanized. Homeopathic medicines, when properly stoppered, can be preserved for an indefinitely long time. As a rule, in chronic diseases, higher potencies are more commonly used, whereas in acute diseases, the reverse is true. Making a general critical evaluation of the homeopathic doctrine from the standpoint of scientific medicine, we conclude: 1. Homeopathy cannot be contrasted with scientific medicine, since the development of the latter was and is based on objective research methods, on firmly established, provable facts, and is in the closest connection with the successes of physical, chemical, and biological disciplines in all their individual branches. Homeopathy, on the other hand, developed almost entirely detached from this scientific base, utilized a subjective research method, and in the hands of its creator Hahnemann turned out to be transformed into a closed scholastic doctrine proceeding from vague, often contradictory, difficult-to-prove mental speculations. 2. If homeopathy is considered merely as a practical therapeutic method, then, as Hahnemann himself pointed out (see above), the principle of similia similibus was not alien to the medicine of his time and is not alien to our modern medicine either (examples: the exacerbation of chronic inflammations by chemical and physical means, the "provocation" of focal and general reactions in "irritation therapy," and others), but only as one of many other methods of treatment, and not as the sole one. Therefore, the term "allopathy" is essentially incorrect. 3. The principle of small doses (not fundamental in the modern homeopathic doctrine) is not alien, especially to modern scientific medicine (the therapeutic optimum of many potent agents corresponds to D4, D5, and even D6 of the homeopathic scale). But in other cases, the therapeutic reputation of large, "massive" doses of very many drugs remains unshakable. Experimental and biochemical data, especially of recent years, prove the possibility of the physiological action of very small quantities (resp. concentrations) of substances; however, it is impossible ex principio to comprehend, without losing material ground under one's feet, any action whatsoever of substances taken in potencies above D24, since at this dilution in 1 cubic centimeter there is for many substances less than a single molecule [experimental proofs (Kravkov, König) of the effectiveness of D30 and even D32 are scientifically shaky and are not confirmed]. 4. The method of testing drugs on humans is not denied alongside many other methods by our contemporary scientific medicine either (Kant and Krapf), but Hahnemannian homeopathy recognized it as the only one. 5. Of Hahnemann's propositions, as they were formulated in their original form (see above) and when they did not yet bear the stamp of extreme infatuation and even confusion, the following are valuable: a) the similia similibus principle itself as applied to the treatment of certain forms of chronic diseases; b) the concept of "specific" remedies (closest of all to our organospecific or pharmacologically specific ones); c) the indication of the importance of the surface area in the action of drugs; d) the indication of the "phases" of drug action.

M. Graninitsky.

Homeopathic pharmacy, an institution for the preparation of medicines according to Hahnemann's method. Its activity was regulated by the Medical Statute (appendix to article 25), according to which it was permitted to establish central homeopathic pharmacies in Petersburg and Moscow to supply all provincial homeopathic pharmacies and all homeopathic physicians. Homeopathic physicians were permitted to prepare and dispense medicines themselves, as well as to prescribe homeopathic medicines from ordinary pharmacies. The opening and management of homeopathic pharmacies was permitted only to graduated pharmacists. Homeopath