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Hughes, Hahnemann and the half-homœopaths
Hughes, Hahnemann and the half-homoeopaths G.R.
MITCHELL,
L . R . C . P . & S . , L . R . F . P . & S . , F.F.
HOM.
To be invited to give the Richard Hughes Memorial Lecture is a very high privilege indeed and one for which I am most grateful. That pleasant task, however, carries with it a very high responsibility. I t either should provide some original, useful, clinical material, or else open up some new aspect of especial interest to all homceopaths. My first impulse therefore was regretfully to turn the honour down--as Dr. Priestman very nearly did. Like her, however, I had second thoughts. My doubts, you must understand, were concerned with the fact that for over fifteen years I have been completely divorced from all active medical practice. That circumstance combined with a failing memory meant that it would be quite presumptuous for me to try to offer any clinical advice. Before reaching a definite decision, however, I started to re-read Hughes's Principles and Practice of Hom~eopathy. I had no sooner turned over the first page of Dr. Dudgeon's Foreword than I came upon an arresting paragraph. The lines that caught m y interest were referring to Hughes's medical writings. They ran as follows: "Their strenuous advocacy of pure and unadulterated homceopathy mark him as by far the greatest, ablest and most faithful exponent of the great therapeutic truth revealed by Hahnemann . . . that some who are not distinguished for their strict adhesion to the teaching of Hahnemann should insinuate doubts as to the value of Dr. Hughes's colossal and disinterested work and in the sincerity of his zeal for homceopathy reminds us of Juvenal's sneer at the Gracchi for complaining of sedition." Now, Dudgeon's exuberant, but well-deserved tribute had till this occasion made no great impact upon me. As a follower of Kent I had regarded Hughes and his fellow-travellers as an undoubtedly sincere but sadly mistaken group who believed--as Frank Bodman has told u s - - t h a t the opposing faction was only a small minority that would soon become extinct. But now, oil re-reading the passage, I recalled that Hughes and his following represented the vast majority of the British homceopaths of that time and they therefore were entitled to regard themselves as being the proper representatives and the authoritative mouthpiece of British Homceopathy. Today we Kentians have taken over that role. We are now the official voice of British Homceopathy, and, like the Hughes's faction, we sincerely believe ourselves to be the chosen people who are correctly interpreting Hahnemann's teaching. I felt, therefore, that it might be interesting and even, perhaps, clinically useful, to explore the beliefs and practises of Hughes, noting all the pro's and con's as revealed in his writings and after that to ask the question Richard Hughes Memorial Lecture read te the Faculty of Hemceepathy on 25 March 1976
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whether he--or, for that matter, we ourselves--might perhaps deserve Hahnemann's scornful dismissal for being "Half-Homceopaths". Hughes, as we know, was a devoted and fervent follower of Hahnemann. But, for all his deep devotion to his Master, he was by no means a blind, unthinking hero-worshipper. He disagreed with m a n y of H a h n e m a n n ' s theoretical views and, in one single instance, on a point of fact. Such free-thinking is, I hope, acceptable to all of us, and we can agree with Hughes when he wrote: "We are homceopathists not H a h n e m a n n i a n s . . . Homceopathy is a vital thing, growing as the years go on, and legitimately influenced b y its environment. I t is in our hands somewhat different from what it was when it dropped from Hahnemann's; but it is H a h n e m a n n ' s still. All study, exposition, practice of it must start from him; and the result it achieves must be accounted a monument reared to his honour." To his opponents, the most heretical deviation of Hughes was his use of pathology as a guide to the similimum--a usage which led him on to the practice of organ prescribing. Hughes, well aware of H a h n e m a n n ' s attitude towards such measures, defended his own standpoint by reminding us t h a t in Hahnemann's time pathological knowledge was almost non-existent, and the little t h a t was then known was not enough for H a h n e m a n n to let it influence homceopathic treatment. To clarify his own position Hughes analysed all knowledge into firstly, Phenomena, secondly, the Laws governing phenomena and, thirdly, the Factors causing phenomena. I n medicine the Phenomena are the patient's symptoms, while the Laws and Causes are the concerns respectively of physiology and pathology. He affirms that in homceo-therapy the total s y m p t o m picture must be the final guide to the similimum. But, "Causes", he writes, "enable us to form groups of remedies associated with them, instead of having to wander through the whole Materia Medica for each prescription." H e thus makes it clear that he is using the name of the disease--i.e, pathology--as we use a repertory rubric from which to select the similimum. Hughes's method of pathological prescribing is the one t h a t we followers of Kent use at the bedside of acute illnesses. Having diagnosed the nature of the illness we automatically think of a group of remedies that experience has taught us to be commonly associated with such a ease. And, to be fair to Hughes, we must notice t h a t he keeps emphasizing t h a t the totality of symptoms must be paramount when finally choosing the remedy, as, for example, where he writes: "We thus come back to the phenomena as our mainstay in practice; for therapeutic purposes the totality of symptoms constitutes the disease." With his habitual perspicacity Hughes points out that Hahnemann, himself, used this pathological method when he selected Ms Psoric group of remedies. And, although Hughes does not mention it, we m a y remember also Hahnemann's pathologically chosen prescription, Aconite, Hepar, Spongia for croup. So far then, Hughes has a strong measure of support for his pathological approach. And later on, in that section of his book devoted to the clinical application of Homeeopathy, it still seems t h a t all is well. For there Hughes writes: " . . . these cases of which I speak consist ordinarily of a good m a n y symptoms. Your aim must be to 'cover' as m a n y as possible of these with the corresponding medicine, no simile merely, but a similimum to the morbid state before you." And, a little later, "If there is anything very distinctive about the case before you, and you find similar peculiarities to have been produced b y a drug, you will do well to t r y that drug, even though it has not produced the lesion present in the patient."
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Good for Hughes! He seems now to be emphasizing t h a t peculiar symptoms a r e of greater importance than the name of the disease. Here surely speaks a faithful follower of Kent! But, alas! in the very next paragraph he begins to give himself away. "There are some of our American brethren", he writes, "who would make such a practice the rule instead of the exception; who would banish nosology pathology altogether from our minds when the question of medical treatment comes up, using our knowledge about them solely for purposes of prognosis and general management . . . I cannot agree with this doctrine." He continues, " I maintain t h a t our knowledge of morbid species should be used for therapeutic purposes also, and for this end would strive to raise pharmacodynamics to the level of pathology." Here he still has some reason, for, as we know, K e n t teaches t h a t all symptoms, pathological as well as those peculiar to the sick person, have their place in the total picture. Hughes agrees, but he then continues, "Are we not on surer ground when we oppose to a pneumonia a drug capable of causing pneumonia than when we choose the remedy on the ground merely of the resemblance of the effects to certain outward symptoms present? The latter comparison m a y err; the former cannot." We follow Hughes's logic, but doubts are growing stronger and we await his next profession with some trepidation. " O f course", he continues, "to make our simile a similimum we should endcayour, if possible, to cover these outward symptoms also." That final word, "also", uncovers the gulf that separates Hughes from K e n t and from ourselves. For whilst both of our separate schools accept the Totality of Symptoms, we insist that the outward, generals are the first essentials, whereas to Hughes they are merely used to confirm his all-important pathological picture. Hughes must have known t h a t H a h n e m a n n had stressed the over-riding importance of the patient's general symptoms. As we have seen, however, he took refuge in the primitive state of past pathology, and, in this way, justified his perfectly honest belief that he was expressing what would have been Hahncmann's view had he enjoyed the privilege of living at the end of the 19th century. Hughes was intrinsically honest, and when he differed from H a h n e m a n n he always did so in an open and frank manner. The fifth edition of the Organon was a target for some of his most candid criticisms. He delightedly accepted the theory of Psora, but felt that H a h n e m a n n was at fault in limiting its cause to scabies. He most strongly opposed the inclusion of speculative theories in what, he thought, should have been purely a textbook of homceopathic Principles. He felt that the proper places for unproven material were the medical journals or pamphlets. The one, and, I think, the only time when Hughes differed from Hahnemann on points of fact was when he was translating H a h n e m a n n ' s Cyclopaedia of Drug Pathogenesy. Wherever in that work he found a proving to be completely unverifiable--and he spent tremendous time and trouble on this research--he omitted that proving altogether. Symptoms with only slight support he included, but marked them with a letter from the alphabet, thus warning readers to accept them with caution. Hughes also scorned H a h n e m a n n ' s visualization of a "Vital Force", and likewise his conception t h a t potentization awakened "The Spirit of the Drug". Such philosophical imagery was wasted on the very much down-to-earth Hughes. We must remember, however, that he was hampered b y the scientific view then prevailing t h a t the a t o m was the final, indivisible unit of matter. H a d he known, as we know today, t h a t matter is a product of electrical energy, he might have realized that Hahnemarm's picturesque vision of dynamization
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unleashing a spirit came nearer to the truth than did his own matter-of-fact conceptions. As we know, Hughes was a confirmed low potency prescriber. The highest potency he used was the 30th centesimal, and that only very rarely. But be admitted that other doctors seemed to have verified activity in higher attenuations, and he appears to have accepted that there was activity in the 200th. He was, however, adamant t h a t neither it nor the 30th should be used for provings. In his own practice he kept within the very lowest centesimals and decimals. That m a y well have been his salvation, for experience has shown that the lower ranges demand less accurate matching than do the higher ones, and so his pathological approach m a y well have been aided to some extent by that fact. I t must be noted that he had some understandable justification for regarding the 1M series with profound suspicion. Having calculated the tremendous amount of diluent required and the astronomical time it would take to carry out the process by serial dilution and succussion, he got in touch with the American pharmacists and asked for details of their manufacture. The replies he received were far from reassuring. M a n y pursued a policy of secrecy and refused to cooperate. And from those who were frank and open on the subject he learned t h a t some of their ideas were of very doubtful efficacy, whilst others were obviously useless. The first pharmacist to attempt Hering's 1M scale was Jenichen. He reckoned t h a t succussion of an ordinary centesimal dilution with very occasional further dilutions would, if carried out long enough, solve the problem. He imagined t h a t so m a n y shakes would raise a potency by one step higher in the scale. He gave no explanation how he knew, nor did he reveal the requisite number of shakes needed, nor how he came to calculate these. Fincke tackled the problem by means of "fluxion". B y this process a stream of water is allowed to flow in an out of a vessel holding a fixed quantity of diluent--presumably starting with a one thousandth dilution of the drug. The potency was believed to rise according either to the quantity of liquid passed, or --which came to the same t h i n g - - t h e time for a fixed amount to flow. The process of fluxion was applied also b y the pharmacist Swan, who made a reasonable modification b y forcing the diluent through tiny perforations in an otherwise closed tube. The added force thus imparted to the jets would tend to increase any potentizing effect the fluxion method might produce. Hughes rightly questioned whether the fluxion process of continuous dilution combined with succussion would raise the potency to the same degree as does Hahnemann's serial dilution and succussion. Moreover he made calculations which showed that Swan had confused multiplication with addition so that his millionth came to equal H a h n e m a n n ' s tenth! His justified opinion on these unusual potencies is well expressed in a passage dealing with the best way for an enquirer to test the validity of Homceopathy. He advises the beginner to experiment with, I quote, " . . . infinitesimal quantities. I do not mean", he continues, "such 'airy nothings' as the hundredth, thousandth and millionth dilutions employed (or supposed to be employed) by the extreme left of our school. I do not mean 'fluxion potencies' of anyone's manufacture. I am speaking of Hahnemann's scale carried to any reasonable height the experimenter m a y choose." At this point, forgive me if I leave Hughes for a m o m e n t and speak, in parenthesis, of the processes used in the manufacture of our present day 1M range of potencies. Mr. Ainsworth tells me t h a t Nelson & Co., shortly after he joined the firm, set about with commendable zeal, and succeeded in achieving
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a true 1M potency. Using one thousand separate vials and the correctly measured dilutions for the thousand stages, they eventually reached their goal. All potencies above the 1M, however, have still to be imported from the U.S.A. These are being reached by means of the fluxion process as modified by Dr. Skinner. Many of us, from our successful use of the 10M and CM can attest to their reliability, but we cannot and do not know whether they have really risen to the heights denoted by their appellations. Dr. Skinner believed that he had corrected the errors of Fincke and Swan, but confessed that he found no difference between the efficacy of his attentuations and those of the American pharmacists. True to type, the cynical Hughes commented, "The inference is obvious"! And now, let us return to our chosen task of deciding whether Hughes's defections--or our own--might have aroused Hahnemann's wrath and brought down upon us the shameful title, "Half-Homceopaths". But first, let us recall the circumstances that led him to coin that derogatory term. Those circumstances are of more than passing interest, for Hahnemann's sudden dramatic explosion and the means he adopted to bring it about shocked all his contemporaries and caused a schism amongst his followers which widened, and eventually brought about the closure of his beloved Leipzig Hospital. I t is not a long story, and is well worth telling in some detail. I n the June of 1821 Hahnemann, driven forth by the triumphant Decree in favour of the apothecaries, left Leipzig, and settled in Coethen. Before he left the city, Homceopathy had been enjoying a period of encouraging popularity. But his departure brought about a depression, and for a time Homceopathy languished there. A little later, however, some miraculous cures created a new demand for it. I n consequence some of the Leipzig physicians became converted, and adopted the new teaching. I n addition, doctors from the surrounding coUntry--many of them already homceopathists--were tempted to move into this new and fertile field. But the rapid growth of the number of homceopaths in the city swung the pendulum the other way. There were now too many homceopaths looking after too few patients. Such a situation inevitably bred jealously and contention amongst the homceopathic community of doctors, and they split into two parties, one of which claimed that pure Homceopathy was self-sufficient, whilst the opposing faction preached that some virtue could still be found in traditional medicine, and that a judicious blending of the two schools was the rational solution. Hahnemann in Coethen kept in touch with his Leipzig following, siding, naturally, with the purists. When he had news of a defaulter he wrote to him in kindly but firm reproach. I n 1830 the two factions called a truce in order to celebrate Hahnemann's Jubilee. When the rejoicings were over, the truce was maintained and a Society was organized--The Leipzig Central Association of Homceopathic Physicians. I t published a Journal, and Hahnemanu now sent his critical comments to this--as well as to the rebels themselves. Hahnemann had good reason to play things softly, for plans were afoot to endow a new Homceopathic Hospital in Leipzig, and he knew that any serious division amongst the doctors might ruin that plan. Thus he wrote to Stapf, one of his loyal informers, " . . . ungratefulness recoils upon the guilty . . . Do not let them know of your displeasure, so that the enemies cannot make a schism of it, as this would hurt our cause." Then, one year before the Hospital was due to be opened, Hahneman suddenly let himself go in a blistering, vituperative denunciation of the rebels which
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eventually brought about the very schism he had for so long been trying to avoid. I t appeared, not in a private letter; not in the homceopathic journal; but i n - - o f all places the public press! " I have heard for a long time", he wrote, " t h a t some in Leipzig, who pretend to be homceopaths, allow their patients to choose whether they shall be treated homceopathically or allopathically . . . let them, at any rate, not require of me that I should recognize them as m y true disciples." He then gave a long list of misdeeds, all of which dealt with various uses of allopathic measures alongside Homceopathy. Then he continued, "They swagger in the cradle of homceopathic science . . . where its founder first stepped forward as a teacher. But behold! I have never acknowledged you; away from me ye medical - - - - ! " (censored by the newspaper's editor). And three paragraphs later he earns once again the censor's blue pencil: " B u t if ye will still persist in t h a t behaviour, then m a y - be meted out to you alone." Two paragraphs further on he cries: "Hence I most solemnly protest against the employment of such a bastard-homceopath." The censorious letter appeared in the Leipzig Tageblattunder the title given it b y Hahnemann, "A Word to the Half-Homceopaths of Leipzig". And there we find the first recorded instance of Hahnemann's use of t h a t expression. Two days after that letter had appeared the same paper printed a comment from the Leipzig Homceopathic Association. I t was brief, restrained and dignified. I t declared that the Leipzig Association "does not recognize any absolute authority in science. However highly all members of this association esteem the homceopathic theory of healing yet the principle must remain established, that every scientific physician in the practice of the healing art must be guided entirely by his own convictions. Science, as the offspring of untrammelled reason, can never be determined by personal anathemas." A longer, but equally restrained letter was sent to Hahnemann. I t maintained the rights of complete freedom in scientific thought. I t also categorically denied t h a t any homceopathic doctor in Leipzig had ever left it to his patients to to choose between Homceopathy and allopathy. The letter ended on a kindly note: " . . . the board of directors now invites you in deep respect to accept the title as President of the Association." H a h n e m a n n turned the offer down. When the time came for the hospital to be opened, however, he graced the function with his presence, and although for some years he showed no further interest in it, his coolness eventually thawed somewhat and he deigned to take some notice of its affairs. For ten years, torn with continuing dissension and strife amongst the staff, it managed to struggle along. At one period a completely bogus homceopath was appointed Chief Physician! He held t h a t post for over six months before being discovered, and then left boasting that he had mugged up a smattering of H a h n e m a n n ' s principles in order to spy out the defects and futility of Homceopathy. He bore the somewhat appropriate name of Fickel. I n 1842 the hospital finally closed down. H a h n e m a n n wrote to Boenninghausen, "These gentlemen have brought it to that. There you can see the excellence of Noack and Trinks. The latter especially has almost sacrificed himself to destroy all that was good." Seven months later the old m a n died, never, apapparently, having realized that he himself had been the first to make the hospital's degeneration and death inevitable. The cause of H a h n e m a n n ' s extraordinary outburst was a visit from a Dr. Schubert, a nasty character, disliked by all in Leipzig. I t was he who brought a tale to Hahnemann, the tale of how Moritz Mfiller had treated a dying girl by
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applying leeches. Although he admitted having been a p a r t y to the "crime", he slanted the story so as to make Mfiller, who was his senior, seem to be the chief culprit. He m a y have known that H a h n e m a n n had for some time mistrusted Miiller. After the damaging newspaper article had appeared, H a h n e m a n n received a letter from the Leipzig publisher, Reelam, telling the true story of his daughter's death. He wrote: "According to information received, Dr. Schubert has communicated an altogether wrong rendering of m y beloved daughter's d e a t h - - w h a t e v e r his purpose, m a y God forgive him." The letter went on to explain t h a t Dr. Hornburg, hearing of the girl's symptoms, had advised Aconitum. Schubert had disagreed. The patient continued to decline, so Schubert called in Moritz Miiller who gave Aconitum, to which the lassie responded well. Schubert, however, took off Aconitum and gave her Pulsatilla and other remedies. The patient went rapidly downhill. When she was obviously dying Schubert sent once more for Miiller who, realizing she was moribund, tried, as a last resort, the application of a leech. Seeking an explanation f o r H a h n e m a n n ' s incredible gullibility and also for his disastrous action in publicizing Homceopathy's domestic strife to the world, we find Haehl and Hughes e a c h providing us with an identical cause. Haehl wrote: "A further evil, making itself gradually more apparent, was great susceptibility to tale-bearing and uncritical attention to dubious informatory whisperings. With extraordinary credulity Hahnemann, particularly in the seclusion of the KSthen period, listened to calumnies against the "Half-Homceopaths", especially if they were embellished w i t h . . , assurances of devotions to his person . . . I n the retirement of his fifteen years' sojourn in KSthen this onesidedness increased more and more." Hughes independently recorded: "Almost everything in Hahnemarm's work during the first quarter of this century is of enduring worth; it is positive, experimental, sound. But from this time onwards we see a change. The active and public life he led in Leipzig, with the free breath of the world blowing through his thoughts, had been exchanged, since his exile in Coethen in 1821, for solitude, isolation, narrowness." That extract from Hughes was written by him in relation to Hahnemann's final stabilization of potencies. Hughes says: "In the year 1829 he . . . unfortunately determined to secure uniformity in homoeopathie usage b y having one dilution for all medicines, and this in the deeillionth the 30th of the centesimal scale. Our present Organon" (i.e. the 5th, G.R.M.) "represents this view; but the first four editions make no such determination, and are entirely moderate and reasonable in the principle of posology they lay down." I t must be pointed out that Hughes here was not concerned over H a h n e m a n n ' s abandoning of the high potencies. Hughes was all for that! W h a t he was regretting was t h a t Hahnem a n n in this instance had stopped at a point t h a t was much too high. For, although Hughes had accepted the 30th and had used it in his own practice, he much preferred the lowest centesimal and decimal ranges... So now, having learned of the more important foibles of Hughes and of Hahnemann's whims and fancies, we are in a position to consider how the latter might have reacted towards his adoring, but wayward disciple. I t is clear that Hughes was completely innocent of Mfiller's drastic deviation. There is no evidence to be found t h a t he ever mixed allopathic measures with his homceopathic treatment, unless indeed his ancillary regime can be called allopathic. This consisted of hydrotherapy, electricity, gymnastics and massage. H a h n e m a n n was always in favour of commonsense, natural adjuncts; as, for
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example, fresh air and simple diets. No! I think on that score Hughes would have been commended rather t h a n condemned. Hughes's criticizing of H a h n e m a n n for limiting the cause of Psora to scabies would have touched the Master on a tender spot. But, although H a h n e m a n n cherished and maintained his theory, I have not been able to find any evidence that he ever strongly condemned those who discounted it. But the one deviation that would without any doubt have stirred Hahnem a n n to the depths was, of course, the deliberate policy of Hughes in making the pathological picture the chief pivot around which to seek the similimum. T h a t defection was not perhaps so serious a fault as the detestable heresy that had detonated the Leipzig explosion, but nevertheless it was a grave departure from H a h n e m a n n ' s teaching, and one that could not be lightly glossed over. H a h n e m a n a had already condemned it in a letter to Stapf, in which he described H a r t m a n n as, " A man who would like to turn us all into allopaths, who wants to tell the laity to take remedies blindly according to the names of diseases . . . let every honourable m a n ignore this ignorant babbler." There is condemnation indeed! I t seems almost certain then that on this account Hughes would indeed have been cast into the outer darkness, a pariah to be despised by all decent, honourable homceopaths! Hughes's argument that, having admittedly founded his rubric on pathology, he still faithfully observed the Law of the Totality of Symptoms and did not altogether disregard the generals, would not have made much impact on Hahnemann. But one wonders how he would have reacted to the reminder that he himself had used the pathological approach when he listed the anti-psoric remedies! That might have tended to soften his displeasure, particularly when he reflected on Hughes's obvious sincerity and the fact that his works had aroused much interest amongst the allopaths, and had enabled Homoeopathy to survive the a p a t h y of those bleak years. And now, how would w e have fared under H a h n e m a n n ' s searchingly critical eye? Secure in the knowledge t h a t through Kent's philosophy we had successfully restored pure Hahnemannian Homceopathy, we would doubtless sit back and await in smug content the praise and appreciation of the Master. I t would come therefore as an unexpected blow to find that our case was immeasurably worse than that of Hughes. H a h n e m a n n would soon enlighten us. He would point out that we have replaced the comparatively mild heresy of Hughes for the unforgivable apostasy of Miiller and other Leipzig offenders. Like them we seek virtue in traditional medicine, and have come to believe that a judicious blending of our two schools is a rational solution. We believe this when we supply hormones for deficiency diseases, and again when occasionally we prescribe an antibiotic alongside Homoeopathy in dangerously fulminating illnesses. Picture H a h n e m a n n ' s horror and despair as he realized that this time he was facing, not a small handful of Leipzig sinners but the whole British Faculty of Homceopathy! We can surely hear his anguished cry, "Eheu! Eheu! Inutilis vixi!"--"Alas! Alas! I have lived in vain!" Hughes and ourselves, however, can find comfort in the assurance that Hahnemann, had he really lived through our two eras, must assuredly have realized the tremendous advance of science both between his and Hughes's day, and from Hughes's day to ours, so that, although much of the old allopathy still persists, a significant part of it has now become, like Homceopathy, a truly rational treatment. And that is what Hughes had in mind when he wrote--as I quoted earlier--"Homceopathy is a vital thing, growing as the years go on,
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and legitimately influenced b y its environment; it is in our hands different from what it was when it dropped form Hahnemann's; but it is H a h n e m a n n ' s still and the result it achieves must be accounted a monument reared to his honour." Hughes had sufficient faith, or scientific insight, never to despair even when the science of his own day seemed to belie the trust he put in Hahnemann. Probing for an explanation of the infinitesimals he concluded that, since the atom w a s - - a s the science of those days held--indivisible, he could find no satisfactory answer. He wrote, " H a h n e m a n n ' s dynamization in the light of later science must be untenable." But then it is as if he realizes that advancing science might in the future find the key. For he adds a footnote from an essay by Dr. Gatehell in which the writer proposed that an explanation might lie in the established fact that compound salts in solution become broken down into electrically charged ions. Dr. Gatchell could see the limitations inherent to his hypothesis. ~ts interest to us today, however, lies in its foreshadowing of a new concept visualized by the late G. O. Barnard, 1, 2, a sub-atomic physicist attached to our own Government. Barnard has shown t h a t our present-day conceptions of the way water and electrolytes interact could result in the healing qualities of a drug being transferred to parts of the chain-groups which are formed by water molecules, so that when the last atom of drug has disappeared its qualities could be preserved indefinitely by those same molecular groups passing on their information to the fresh groups in each dilution. From Hughes's practice there is one lesson to be learned. I was trained in the pure Kentian tradition b y those old stalwarts J o h n Weir, Margaret Tyler, Douglas Borland and Charles Wheeler. B y them I became imbued with the nigh unshakable belief t h a t the lowest useful potency was the 30th centesimal. But Wheeler told me that he personally was quite insensitive to the high dilutions and when ill he had to revert to the lower decimals. Soaked in m y Kentian creed I assumed t h a t Wheeler was an exception so freakish and rare as to be ignored from the practical point of view. Years later, when the new Oxford Road Clinic was due to be opened, a young assistant of mine was invited to move to Manchester, run the Clinic and take over the very low potency practice of the recently deceased Dr. Reginald Jones. The name of that volatile youth was Dr. Inn McKinley Burns. He had been well grounded in high potency work b y Dr. Henderson Patrick of Glasgow. Some of you m a y remember that a few years before his sad and sudden death, Inn gave us an astonishing lecture on some remarkable successes he had achieved using the lowest decimal dilutions, the efficacy of which he had learned from Reginald Jones's records. I a n had b y no means lost faith in the high potencies which he still employed, but he recounted some astonishingly successful selected cases using the 3x and even lower potencies. Long years ago I gave a lecture titled, "Some Failures in Homceopathio Practice". After listening to Inn's paper I wondered whether perhaps some of those failures might have been due to m y clinging too blindly to K e n t and his high jinks, and that some of those failures might have been steered to success by low potency treatment. I most seriously suggest to you that in resistant cases especially if they belong to the categories specified by I n n - - y o u should consider those despised dilutions. Remember it was they that convinced H a h n e m a n n of Homoeopathy's effectiveness in his early experimental ventures. On this same subject an interesting example had been noticed by Hughes. I n the passage I have in mind he reported t h a t a Dr. Sten had been puzzled b y 9
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the case of a patient who was suffering from a disturbingly troublesome cough which called unmistakably for Bryonia. That remedy had been given in various potencies some high, some low, without the slightest effect. In desperation one evening he gave her a single dose of Bryonia MOTHE~ TI~CTUaE. On waking the following morning she found her cough had vanished. I t never returned! As a somewhat light-hearted epilogue to this lecture let me draw your attention to an extraordinary lapse on the part of Hughes's close friend and colleague, Dr. Dudgeon. He, according to Hughes, had been responsbile for persuading British Homceopathy to drop the then accepted motto, Similia similibus curantur in favour of Hahnemann's correct version, Similia similibus curentur. When Hughes dropped dead in Dublin with his Principles and Practice of Homoeopathy unpublished, Dudgeon took over the task of getting the book into print. And on the black, hard cover he displayed a gilt profile of I-Iahnemann surrounded by the words, Similia similibus--Yes! You've guessed i t ! - curantur! REFERENCES
1 Barnard, G. O. (1965) Microdose Paradox--A New Concept. Journal of the American Institute of Homeopathy, 58, Nos. 7-8. Barnard, G. O. & Henderson, James H. (1967) A New Biophysical Concept. Journal of the American Institute of Homwopathy, 60.
FROM THE ARCHIVES
The mysterium of prescribing KARL
K ~ ) N I G , M.D.
In opening this lecture may I express my grateful thanks to the Faculty of Homceopathy for giving me again the opportunity of addressing the Faculty and for the permission to speak on the "Mysterium of Prescribing". This title has caused some of you to wonder what might be the content of m y discourse. For many years I have occupied myself with the questions: What actually lies behind the mental process in man that, at times, enables us as physicians to find the true and proper remedy for some of our patients? How is it possible that by certain conscious and sub-conscious processes the proper remedy appears before our mental eye? What kind of inner answer can solve the complex question which a diseased person asks the doctor by way of the symptoms which he exhibits? For all the symptoms are to the doctor a question, and the remedy which he prescribes is the answer to this question. What, now, is really the mental process A paper read to the Faculty of Homceopathy at the Ninth Meeting of the Seventh Session. Reprinted from The British Homvsopathie Journal, 41, 31-37. January 1951
MITCHELL,
L . R . C . P . & S . , L . R . F . P . & S . , F.F.
HOM.
To be invited to give the Richard Hughes Memorial Lecture is a very high privilege indeed and one for which I am most grateful. That pleasant task, however, carries with it a very high responsibility. I t either should provide some original, useful, clinical material, or else open up some new aspect of especial interest to all homceopaths. My first impulse therefore was regretfully to turn the honour down--as Dr. Priestman very nearly did. Like her, however, I had second thoughts. My doubts, you must understand, were concerned with the fact that for over fifteen years I have been completely divorced from all active medical practice. That circumstance combined with a failing memory meant that it would be quite presumptuous for me to try to offer any clinical advice. Before reaching a definite decision, however, I started to re-read Hughes's Principles and Practice of Hom~eopathy. I had no sooner turned over the first page of Dr. Dudgeon's Foreword than I came upon an arresting paragraph. The lines that caught m y interest were referring to Hughes's medical writings. They ran as follows: "Their strenuous advocacy of pure and unadulterated homceopathy mark him as by far the greatest, ablest and most faithful exponent of the great therapeutic truth revealed by Hahnemann . . . that some who are not distinguished for their strict adhesion to the teaching of Hahnemann should insinuate doubts as to the value of Dr. Hughes's colossal and disinterested work and in the sincerity of his zeal for homceopathy reminds us of Juvenal's sneer at the Gracchi for complaining of sedition." Now, Dudgeon's exuberant, but well-deserved tribute had till this occasion made no great impact upon me. As a follower of Kent I had regarded Hughes and his fellow-travellers as an undoubtedly sincere but sadly mistaken group who believed--as Frank Bodman has told u s - - t h a t the opposing faction was only a small minority that would soon become extinct. But now, oil re-reading the passage, I recalled that Hughes and his following represented the vast majority of the British homceopaths of that time and they therefore were entitled to regard themselves as being the proper representatives and the authoritative mouthpiece of British Homceopathy. Today we Kentians have taken over that role. We are now the official voice of British Homceopathy, and, like the Hughes's faction, we sincerely believe ourselves to be the chosen people who are correctly interpreting Hahnemann's teaching. I felt, therefore, that it might be interesting and even, perhaps, clinically useful, to explore the beliefs and practises of Hughes, noting all the pro's and con's as revealed in his writings and after that to ask the question Richard Hughes Memorial Lecture read te the Faculty of Hemceepathy on 25 March 1976
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whether he--or, for that matter, we ourselves--might perhaps deserve Hahnemann's scornful dismissal for being "Half-Homceopaths". Hughes, as we know, was a devoted and fervent follower of Hahnemann. But, for all his deep devotion to his Master, he was by no means a blind, unthinking hero-worshipper. He disagreed with m a n y of H a h n e m a n n ' s theoretical views and, in one single instance, on a point of fact. Such free-thinking is, I hope, acceptable to all of us, and we can agree with Hughes when he wrote: "We are homceopathists not H a h n e m a n n i a n s . . . Homceopathy is a vital thing, growing as the years go on, and legitimately influenced b y its environment. I t is in our hands somewhat different from what it was when it dropped from Hahnemann's; but it is H a h n e m a n n ' s still. All study, exposition, practice of it must start from him; and the result it achieves must be accounted a monument reared to his honour." To his opponents, the most heretical deviation of Hughes was his use of pathology as a guide to the similimum--a usage which led him on to the practice of organ prescribing. Hughes, well aware of H a h n e m a n n ' s attitude towards such measures, defended his own standpoint by reminding us t h a t in Hahnemann's time pathological knowledge was almost non-existent, and the little t h a t was then known was not enough for H a h n e m a n n to let it influence homceopathic treatment. To clarify his own position Hughes analysed all knowledge into firstly, Phenomena, secondly, the Laws governing phenomena and, thirdly, the Factors causing phenomena. I n medicine the Phenomena are the patient's symptoms, while the Laws and Causes are the concerns respectively of physiology and pathology. He affirms that in homceo-therapy the total s y m p t o m picture must be the final guide to the similimum. But, "Causes", he writes, "enable us to form groups of remedies associated with them, instead of having to wander through the whole Materia Medica for each prescription." H e thus makes it clear that he is using the name of the disease--i.e, pathology--as we use a repertory rubric from which to select the similimum. Hughes's method of pathological prescribing is the one t h a t we followers of Kent use at the bedside of acute illnesses. Having diagnosed the nature of the illness we automatically think of a group of remedies that experience has taught us to be commonly associated with such a ease. And, to be fair to Hughes, we must notice t h a t he keeps emphasizing t h a t the totality of symptoms must be paramount when finally choosing the remedy, as, for example, where he writes: "We thus come back to the phenomena as our mainstay in practice; for therapeutic purposes the totality of symptoms constitutes the disease." With his habitual perspicacity Hughes points out that Hahnemann, himself, used this pathological method when he selected Ms Psoric group of remedies. And, although Hughes does not mention it, we m a y remember also Hahnemann's pathologically chosen prescription, Aconite, Hepar, Spongia for croup. So far then, Hughes has a strong measure of support for his pathological approach. And later on, in that section of his book devoted to the clinical application of Homeeopathy, it still seems t h a t all is well. For there Hughes writes: " . . . these cases of which I speak consist ordinarily of a good m a n y symptoms. Your aim must be to 'cover' as m a n y as possible of these with the corresponding medicine, no simile merely, but a similimum to the morbid state before you." And, a little later, "If there is anything very distinctive about the case before you, and you find similar peculiarities to have been produced b y a drug, you will do well to t r y that drug, even though it has not produced the lesion present in the patient."
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Good for Hughes! He seems now to be emphasizing t h a t peculiar symptoms a r e of greater importance than the name of the disease. Here surely speaks a faithful follower of Kent! But, alas! in the very next paragraph he begins to give himself away. "There are some of our American brethren", he writes, "who would make such a practice the rule instead of the exception; who would banish nosology pathology altogether from our minds when the question of medical treatment comes up, using our knowledge about them solely for purposes of prognosis and general management . . . I cannot agree with this doctrine." He continues, " I maintain t h a t our knowledge of morbid species should be used for therapeutic purposes also, and for this end would strive to raise pharmacodynamics to the level of pathology." Here he still has some reason, for, as we know, K e n t teaches t h a t all symptoms, pathological as well as those peculiar to the sick person, have their place in the total picture. Hughes agrees, but he then continues, "Are we not on surer ground when we oppose to a pneumonia a drug capable of causing pneumonia than when we choose the remedy on the ground merely of the resemblance of the effects to certain outward symptoms present? The latter comparison m a y err; the former cannot." We follow Hughes's logic, but doubts are growing stronger and we await his next profession with some trepidation. " O f course", he continues, "to make our simile a similimum we should endcayour, if possible, to cover these outward symptoms also." That final word, "also", uncovers the gulf that separates Hughes from K e n t and from ourselves. For whilst both of our separate schools accept the Totality of Symptoms, we insist that the outward, generals are the first essentials, whereas to Hughes they are merely used to confirm his all-important pathological picture. Hughes must have known t h a t H a h n e m a n n had stressed the over-riding importance of the patient's general symptoms. As we have seen, however, he took refuge in the primitive state of past pathology, and, in this way, justified his perfectly honest belief that he was expressing what would have been Hahncmann's view had he enjoyed the privilege of living at the end of the 19th century. Hughes was intrinsically honest, and when he differed from H a h n e m a n n he always did so in an open and frank manner. The fifth edition of the Organon was a target for some of his most candid criticisms. He delightedly accepted the theory of Psora, but felt that H a h n e m a n n was at fault in limiting its cause to scabies. He most strongly opposed the inclusion of speculative theories in what, he thought, should have been purely a textbook of homceopathic Principles. He felt that the proper places for unproven material were the medical journals or pamphlets. The one, and, I think, the only time when Hughes differed from Hahnemann on points of fact was when he was translating H a h n e m a n n ' s Cyclopaedia of Drug Pathogenesy. Wherever in that work he found a proving to be completely unverifiable--and he spent tremendous time and trouble on this research--he omitted that proving altogether. Symptoms with only slight support he included, but marked them with a letter from the alphabet, thus warning readers to accept them with caution. Hughes also scorned H a h n e m a n n ' s visualization of a "Vital Force", and likewise his conception t h a t potentization awakened "The Spirit of the Drug". Such philosophical imagery was wasted on the very much down-to-earth Hughes. We must remember, however, that he was hampered b y the scientific view then prevailing t h a t the a t o m was the final, indivisible unit of matter. H a d he known, as we know today, t h a t matter is a product of electrical energy, he might have realized that Hahnemarm's picturesque vision of dynamization
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unleashing a spirit came nearer to the truth than did his own matter-of-fact conceptions. As we know, Hughes was a confirmed low potency prescriber. The highest potency he used was the 30th centesimal, and that only very rarely. But be admitted that other doctors seemed to have verified activity in higher attenuations, and he appears to have accepted that there was activity in the 200th. He was, however, adamant t h a t neither it nor the 30th should be used for provings. In his own practice he kept within the very lowest centesimals and decimals. That m a y well have been his salvation, for experience has shown that the lower ranges demand less accurate matching than do the higher ones, and so his pathological approach m a y well have been aided to some extent by that fact. I t must be noted that he had some understandable justification for regarding the 1M series with profound suspicion. Having calculated the tremendous amount of diluent required and the astronomical time it would take to carry out the process by serial dilution and succussion, he got in touch with the American pharmacists and asked for details of their manufacture. The replies he received were far from reassuring. M a n y pursued a policy of secrecy and refused to cooperate. And from those who were frank and open on the subject he learned t h a t some of their ideas were of very doubtful efficacy, whilst others were obviously useless. The first pharmacist to attempt Hering's 1M scale was Jenichen. He reckoned t h a t succussion of an ordinary centesimal dilution with very occasional further dilutions would, if carried out long enough, solve the problem. He imagined t h a t so m a n y shakes would raise a potency by one step higher in the scale. He gave no explanation how he knew, nor did he reveal the requisite number of shakes needed, nor how he came to calculate these. Fincke tackled the problem by means of "fluxion". B y this process a stream of water is allowed to flow in an out of a vessel holding a fixed quantity of diluent--presumably starting with a one thousandth dilution of the drug. The potency was believed to rise according either to the quantity of liquid passed, or --which came to the same t h i n g - - t h e time for a fixed amount to flow. The process of fluxion was applied also b y the pharmacist Swan, who made a reasonable modification b y forcing the diluent through tiny perforations in an otherwise closed tube. The added force thus imparted to the jets would tend to increase any potentizing effect the fluxion method might produce. Hughes rightly questioned whether the fluxion process of continuous dilution combined with succussion would raise the potency to the same degree as does Hahnemann's serial dilution and succussion. Moreover he made calculations which showed that Swan had confused multiplication with addition so that his millionth came to equal H a h n e m a n n ' s tenth! His justified opinion on these unusual potencies is well expressed in a passage dealing with the best way for an enquirer to test the validity of Homceopathy. He advises the beginner to experiment with, I quote, " . . . infinitesimal quantities. I do not mean", he continues, "such 'airy nothings' as the hundredth, thousandth and millionth dilutions employed (or supposed to be employed) by the extreme left of our school. I do not mean 'fluxion potencies' of anyone's manufacture. I am speaking of Hahnemann's scale carried to any reasonable height the experimenter m a y choose." At this point, forgive me if I leave Hughes for a m o m e n t and speak, in parenthesis, of the processes used in the manufacture of our present day 1M range of potencies. Mr. Ainsworth tells me t h a t Nelson & Co., shortly after he joined the firm, set about with commendable zeal, and succeeded in achieving
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a true 1M potency. Using one thousand separate vials and the correctly measured dilutions for the thousand stages, they eventually reached their goal. All potencies above the 1M, however, have still to be imported from the U.S.A. These are being reached by means of the fluxion process as modified by Dr. Skinner. Many of us, from our successful use of the 10M and CM can attest to their reliability, but we cannot and do not know whether they have really risen to the heights denoted by their appellations. Dr. Skinner believed that he had corrected the errors of Fincke and Swan, but confessed that he found no difference between the efficacy of his attentuations and those of the American pharmacists. True to type, the cynical Hughes commented, "The inference is obvious"! And now, let us return to our chosen task of deciding whether Hughes's defections--or our own--might have aroused Hahnemann's wrath and brought down upon us the shameful title, "Half-Homceopaths". But first, let us recall the circumstances that led him to coin that derogatory term. Those circumstances are of more than passing interest, for Hahnemann's sudden dramatic explosion and the means he adopted to bring it about shocked all his contemporaries and caused a schism amongst his followers which widened, and eventually brought about the closure of his beloved Leipzig Hospital. I t is not a long story, and is well worth telling in some detail. I n the June of 1821 Hahnemann, driven forth by the triumphant Decree in favour of the apothecaries, left Leipzig, and settled in Coethen. Before he left the city, Homceopathy had been enjoying a period of encouraging popularity. But his departure brought about a depression, and for a time Homceopathy languished there. A little later, however, some miraculous cures created a new demand for it. I n consequence some of the Leipzig physicians became converted, and adopted the new teaching. I n addition, doctors from the surrounding coUntry--many of them already homceopathists--were tempted to move into this new and fertile field. But the rapid growth of the number of homceopaths in the city swung the pendulum the other way. There were now too many homceopaths looking after too few patients. Such a situation inevitably bred jealously and contention amongst the homceopathic community of doctors, and they split into two parties, one of which claimed that pure Homceopathy was self-sufficient, whilst the opposing faction preached that some virtue could still be found in traditional medicine, and that a judicious blending of the two schools was the rational solution. Hahnemann in Coethen kept in touch with his Leipzig following, siding, naturally, with the purists. When he had news of a defaulter he wrote to him in kindly but firm reproach. I n 1830 the two factions called a truce in order to celebrate Hahnemann's Jubilee. When the rejoicings were over, the truce was maintained and a Society was organized--The Leipzig Central Association of Homceopathic Physicians. I t published a Journal, and Hahnemanu now sent his critical comments to this--as well as to the rebels themselves. Hahnemann had good reason to play things softly, for plans were afoot to endow a new Homceopathic Hospital in Leipzig, and he knew that any serious division amongst the doctors might ruin that plan. Thus he wrote to Stapf, one of his loyal informers, " . . . ungratefulness recoils upon the guilty . . . Do not let them know of your displeasure, so that the enemies cannot make a schism of it, as this would hurt our cause." Then, one year before the Hospital was due to be opened, Hahneman suddenly let himself go in a blistering, vituperative denunciation of the rebels which
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eventually brought about the very schism he had for so long been trying to avoid. I t appeared, not in a private letter; not in the homceopathic journal; but i n - - o f all places the public press! " I have heard for a long time", he wrote, " t h a t some in Leipzig, who pretend to be homceopaths, allow their patients to choose whether they shall be treated homceopathically or allopathically . . . let them, at any rate, not require of me that I should recognize them as m y true disciples." He then gave a long list of misdeeds, all of which dealt with various uses of allopathic measures alongside Homceopathy. Then he continued, "They swagger in the cradle of homceopathic science . . . where its founder first stepped forward as a teacher. But behold! I have never acknowledged you; away from me ye medical - - - - ! " (censored by the newspaper's editor). And three paragraphs later he earns once again the censor's blue pencil: " B u t if ye will still persist in t h a t behaviour, then m a y - be meted out to you alone." Two paragraphs further on he cries: "Hence I most solemnly protest against the employment of such a bastard-homceopath." The censorious letter appeared in the Leipzig Tageblattunder the title given it b y Hahnemann, "A Word to the Half-Homceopaths of Leipzig". And there we find the first recorded instance of Hahnemann's use of t h a t expression. Two days after that letter had appeared the same paper printed a comment from the Leipzig Homceopathic Association. I t was brief, restrained and dignified. I t declared that the Leipzig Association "does not recognize any absolute authority in science. However highly all members of this association esteem the homceopathic theory of healing yet the principle must remain established, that every scientific physician in the practice of the healing art must be guided entirely by his own convictions. Science, as the offspring of untrammelled reason, can never be determined by personal anathemas." A longer, but equally restrained letter was sent to Hahnemann. I t maintained the rights of complete freedom in scientific thought. I t also categorically denied t h a t any homceopathic doctor in Leipzig had ever left it to his patients to to choose between Homceopathy and allopathy. The letter ended on a kindly note: " . . . the board of directors now invites you in deep respect to accept the title as President of the Association." H a h n e m a n n turned the offer down. When the time came for the hospital to be opened, however, he graced the function with his presence, and although for some years he showed no further interest in it, his coolness eventually thawed somewhat and he deigned to take some notice of its affairs. For ten years, torn with continuing dissension and strife amongst the staff, it managed to struggle along. At one period a completely bogus homceopath was appointed Chief Physician! He held t h a t post for over six months before being discovered, and then left boasting that he had mugged up a smattering of H a h n e m a n n ' s principles in order to spy out the defects and futility of Homceopathy. He bore the somewhat appropriate name of Fickel. I n 1842 the hospital finally closed down. H a h n e m a n n wrote to Boenninghausen, "These gentlemen have brought it to that. There you can see the excellence of Noack and Trinks. The latter especially has almost sacrificed himself to destroy all that was good." Seven months later the old m a n died, never, apapparently, having realized that he himself had been the first to make the hospital's degeneration and death inevitable. The cause of H a h n e m a n n ' s extraordinary outburst was a visit from a Dr. Schubert, a nasty character, disliked by all in Leipzig. I t was he who brought a tale to Hahnemann, the tale of how Moritz Mfiller had treated a dying girl by
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applying leeches. Although he admitted having been a p a r t y to the "crime", he slanted the story so as to make Mfiller, who was his senior, seem to be the chief culprit. He m a y have known that H a h n e m a n n had for some time mistrusted Miiller. After the damaging newspaper article had appeared, H a h n e m a n n received a letter from the Leipzig publisher, Reelam, telling the true story of his daughter's death. He wrote: "According to information received, Dr. Schubert has communicated an altogether wrong rendering of m y beloved daughter's d e a t h - - w h a t e v e r his purpose, m a y God forgive him." The letter went on to explain t h a t Dr. Hornburg, hearing of the girl's symptoms, had advised Aconitum. Schubert had disagreed. The patient continued to decline, so Schubert called in Moritz Miiller who gave Aconitum, to which the lassie responded well. Schubert, however, took off Aconitum and gave her Pulsatilla and other remedies. The patient went rapidly downhill. When she was obviously dying Schubert sent once more for Miiller who, realizing she was moribund, tried, as a last resort, the application of a leech. Seeking an explanation f o r H a h n e m a n n ' s incredible gullibility and also for his disastrous action in publicizing Homceopathy's domestic strife to the world, we find Haehl and Hughes e a c h providing us with an identical cause. Haehl wrote: "A further evil, making itself gradually more apparent, was great susceptibility to tale-bearing and uncritical attention to dubious informatory whisperings. With extraordinary credulity Hahnemann, particularly in the seclusion of the KSthen period, listened to calumnies against the "Half-Homceopaths", especially if they were embellished w i t h . . , assurances of devotions to his person . . . I n the retirement of his fifteen years' sojourn in KSthen this onesidedness increased more and more." Hughes independently recorded: "Almost everything in Hahnemarm's work during the first quarter of this century is of enduring worth; it is positive, experimental, sound. But from this time onwards we see a change. The active and public life he led in Leipzig, with the free breath of the world blowing through his thoughts, had been exchanged, since his exile in Coethen in 1821, for solitude, isolation, narrowness." That extract from Hughes was written by him in relation to Hahnemann's final stabilization of potencies. Hughes says: "In the year 1829 he . . . unfortunately determined to secure uniformity in homoeopathie usage b y having one dilution for all medicines, and this in the deeillionth the 30th of the centesimal scale. Our present Organon" (i.e. the 5th, G.R.M.) "represents this view; but the first four editions make no such determination, and are entirely moderate and reasonable in the principle of posology they lay down." I t must be pointed out that Hughes here was not concerned over H a h n e m a n n ' s abandoning of the high potencies. Hughes was all for that! W h a t he was regretting was t h a t Hahnem a n n in this instance had stopped at a point t h a t was much too high. For, although Hughes had accepted the 30th and had used it in his own practice, he much preferred the lowest centesimal and decimal ranges... So now, having learned of the more important foibles of Hughes and of Hahnemann's whims and fancies, we are in a position to consider how the latter might have reacted towards his adoring, but wayward disciple. I t is clear that Hughes was completely innocent of Mfiller's drastic deviation. There is no evidence to be found t h a t he ever mixed allopathic measures with his homceopathic treatment, unless indeed his ancillary regime can be called allopathic. This consisted of hydrotherapy, electricity, gymnastics and massage. H a h n e m a n n was always in favour of commonsense, natural adjuncts; as, for
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example, fresh air and simple diets. No! I think on that score Hughes would have been commended rather t h a n condemned. Hughes's criticizing of H a h n e m a n n for limiting the cause of Psora to scabies would have touched the Master on a tender spot. But, although H a h n e m a n n cherished and maintained his theory, I have not been able to find any evidence that he ever strongly condemned those who discounted it. But the one deviation that would without any doubt have stirred Hahnem a n n to the depths was, of course, the deliberate policy of Hughes in making the pathological picture the chief pivot around which to seek the similimum. T h a t defection was not perhaps so serious a fault as the detestable heresy that had detonated the Leipzig explosion, but nevertheless it was a grave departure from H a h n e m a n n ' s teaching, and one that could not be lightly glossed over. H a h n e m a n a had already condemned it in a letter to Stapf, in which he described H a r t m a n n as, " A man who would like to turn us all into allopaths, who wants to tell the laity to take remedies blindly according to the names of diseases . . . let every honourable m a n ignore this ignorant babbler." There is condemnation indeed! I t seems almost certain then that on this account Hughes would indeed have been cast into the outer darkness, a pariah to be despised by all decent, honourable homceopaths! Hughes's argument that, having admittedly founded his rubric on pathology, he still faithfully observed the Law of the Totality of Symptoms and did not altogether disregard the generals, would not have made much impact on Hahnemann. But one wonders how he would have reacted to the reminder that he himself had used the pathological approach when he listed the anti-psoric remedies! That might have tended to soften his displeasure, particularly when he reflected on Hughes's obvious sincerity and the fact that his works had aroused much interest amongst the allopaths, and had enabled Homoeopathy to survive the a p a t h y of those bleak years. And now, how would w e have fared under H a h n e m a n n ' s searchingly critical eye? Secure in the knowledge t h a t through Kent's philosophy we had successfully restored pure Hahnemannian Homceopathy, we would doubtless sit back and await in smug content the praise and appreciation of the Master. I t would come therefore as an unexpected blow to find that our case was immeasurably worse than that of Hughes. H a h n e m a n n would soon enlighten us. He would point out that we have replaced the comparatively mild heresy of Hughes for the unforgivable apostasy of Miiller and other Leipzig offenders. Like them we seek virtue in traditional medicine, and have come to believe that a judicious blending of our two schools is a rational solution. We believe this when we supply hormones for deficiency diseases, and again when occasionally we prescribe an antibiotic alongside Homoeopathy in dangerously fulminating illnesses. Picture H a h n e m a n n ' s horror and despair as he realized that this time he was facing, not a small handful of Leipzig sinners but the whole British Faculty of Homceopathy! We can surely hear his anguished cry, "Eheu! Eheu! Inutilis vixi!"--"Alas! Alas! I have lived in vain!" Hughes and ourselves, however, can find comfort in the assurance that Hahnemann, had he really lived through our two eras, must assuredly have realized the tremendous advance of science both between his and Hughes's day, and from Hughes's day to ours, so that, although much of the old allopathy still persists, a significant part of it has now become, like Homceopathy, a truly rational treatment. And that is what Hughes had in mind when he wrote--as I quoted earlier--"Homceopathy is a vital thing, growing as the years go on,
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and legitimately influenced b y its environment; it is in our hands different from what it was when it dropped form Hahnemann's; but it is H a h n e m a n n ' s still and the result it achieves must be accounted a monument reared to his honour." Hughes had sufficient faith, or scientific insight, never to despair even when the science of his own day seemed to belie the trust he put in Hahnemann. Probing for an explanation of the infinitesimals he concluded that, since the atom w a s - - a s the science of those days held--indivisible, he could find no satisfactory answer. He wrote, " H a h n e m a n n ' s dynamization in the light of later science must be untenable." But then it is as if he realizes that advancing science might in the future find the key. For he adds a footnote from an essay by Dr. Gatehell in which the writer proposed that an explanation might lie in the established fact that compound salts in solution become broken down into electrically charged ions. Dr. Gatchell could see the limitations inherent to his hypothesis. ~ts interest to us today, however, lies in its foreshadowing of a new concept visualized by the late G. O. Barnard, 1, 2, a sub-atomic physicist attached to our own Government. Barnard has shown t h a t our present-day conceptions of the way water and electrolytes interact could result in the healing qualities of a drug being transferred to parts of the chain-groups which are formed by water molecules, so that when the last atom of drug has disappeared its qualities could be preserved indefinitely by those same molecular groups passing on their information to the fresh groups in each dilution. From Hughes's practice there is one lesson to be learned. I was trained in the pure Kentian tradition b y those old stalwarts J o h n Weir, Margaret Tyler, Douglas Borland and Charles Wheeler. B y them I became imbued with the nigh unshakable belief t h a t the lowest useful potency was the 30th centesimal. But Wheeler told me that he personally was quite insensitive to the high dilutions and when ill he had to revert to the lower decimals. Soaked in m y Kentian creed I assumed t h a t Wheeler was an exception so freakish and rare as to be ignored from the practical point of view. Years later, when the new Oxford Road Clinic was due to be opened, a young assistant of mine was invited to move to Manchester, run the Clinic and take over the very low potency practice of the recently deceased Dr. Reginald Jones. The name of that volatile youth was Dr. Inn McKinley Burns. He had been well grounded in high potency work b y Dr. Henderson Patrick of Glasgow. Some of you m a y remember that a few years before his sad and sudden death, Inn gave us an astonishing lecture on some remarkable successes he had achieved using the lowest decimal dilutions, the efficacy of which he had learned from Reginald Jones's records. I a n had b y no means lost faith in the high potencies which he still employed, but he recounted some astonishingly successful selected cases using the 3x and even lower potencies. Long years ago I gave a lecture titled, "Some Failures in Homceopathio Practice". After listening to Inn's paper I wondered whether perhaps some of those failures might have been due to m y clinging too blindly to K e n t and his high jinks, and that some of those failures might have been steered to success by low potency treatment. I most seriously suggest to you that in resistant cases especially if they belong to the categories specified by I n n - - y o u should consider those despised dilutions. Remember it was they that convinced H a h n e m a n n of Homoeopathy's effectiveness in his early experimental ventures. On this same subject an interesting example had been noticed by Hughes. I n the passage I have in mind he reported t h a t a Dr. Sten had been puzzled b y 9
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THE BRITISH HOM(EOPATHIC JOURNAL
the case of a patient who was suffering from a disturbingly troublesome cough which called unmistakably for Bryonia. That remedy had been given in various potencies some high, some low, without the slightest effect. In desperation one evening he gave her a single dose of Bryonia MOTHE~ TI~CTUaE. On waking the following morning she found her cough had vanished. I t never returned! As a somewhat light-hearted epilogue to this lecture let me draw your attention to an extraordinary lapse on the part of Hughes's close friend and colleague, Dr. Dudgeon. He, according to Hughes, had been responsbile for persuading British Homceopathy to drop the then accepted motto, Similia similibus curantur in favour of Hahnemann's correct version, Similia similibus curentur. When Hughes dropped dead in Dublin with his Principles and Practice of Homoeopathy unpublished, Dudgeon took over the task of getting the book into print. And on the black, hard cover he displayed a gilt profile of I-Iahnemann surrounded by the words, Similia similibus--Yes! You've guessed i t ! - curantur! REFERENCES
1 Barnard, G. O. (1965) Microdose Paradox--A New Concept. Journal of the American Institute of Homeopathy, 58, Nos. 7-8. Barnard, G. O. & Henderson, James H. (1967) A New Biophysical Concept. Journal of the American Institute of Homwopathy, 60.
FROM THE ARCHIVES
The mysterium of prescribing KARL
K ~ ) N I G , M.D.
In opening this lecture may I express my grateful thanks to the Faculty of Homceopathy for giving me again the opportunity of addressing the Faculty and for the permission to speak on the "Mysterium of Prescribing". This title has caused some of you to wonder what might be the content of m y discourse. For many years I have occupied myself with the questions: What actually lies behind the mental process in man that, at times, enables us as physicians to find the true and proper remedy for some of our patients? How is it possible that by certain conscious and sub-conscious processes the proper remedy appears before our mental eye? What kind of inner answer can solve the complex question which a diseased person asks the doctor by way of the symptoms which he exhibits? For all the symptoms are to the doctor a question, and the remedy which he prescribes is the answer to this question. What, now, is really the mental process A paper read to the Faculty of Homceopathy at the Ninth Meeting of the Seventh Session. Reprinted from The British Homvsopathie Journal, 41, 31-37. January 1951