- Email: [email protected]
Against tendentious interpretations of Hahnemann's writings
British Hom~eopathic Journal July 1989. Vol. 78. pp. 123-126
For debate
Against tendentious interpretations of Hahnemann's writings DR J A C Q U E S J O U A N N Y
How strange it is to see that among homoeopaths, 150 years after the death of Hahnemann, those who consider themselves the most faithful disciples of the Master and who call themselves the representatives of 'pure homoeopathy' are precisely those who misinterpret the fundamental precepts that he defined. Stranger still, these 'purists' seek to base their point of view on truncated or misconstrued quotations from the writings of the founder of the method. Far be it from me to want to hold as gospel truth all that Hahnemann wrote at the dawn of a scientific era in which everything was open to discovery. However, I believe that it is worthwhile to draw attention to the tendentious interpretations made by certain individuals who seek pseudo-justifications of doctrines whose applications do nothing but harm the crediblity of homceopathy--this same hom0eopathy which its founder wanted to be objective, clinical and
experimental. In this vein, I came upon an article by Robert Bachelerie entitled 'Introduction A l'Hom6opathie pure et ~ la technique de Boenninghausen--Les maladies chroniques selon Hahnemann' (introduction to pure hom0eopathy and to the Boenninghausen m e t h o d - chronic diseases according to Hahnemann; in Medecin Homeopathe, periodical of the Syndicate of French Homeeopathic Physicians). This provides a good analysis of certain parts of Hahnemann's Chronic Diseases, but Bachelerie completely eclipses the three main characteristics of the work. He has doubtlessly done so to justify by means of partial quotations and convoluted interpretations the esoteric philosophical theses and the reputedly homeeopathic practices of the spiritualistic schools of Kent, Ortega, Paschero and other visionaries. Let us therefore examine briefly
- - w h a t Hahnemann really wrote, and - - w h a t certain individuals are trying to eclipse for doctrinal reasons. What Hahnemann wrote
In the Chronic Diseases, Hahnemann wrote that in 1816, after twenty years of practice, he observed that the purely symptomatic methods for determining homeeopathic medicines that he had initially advocated gave good results in acute diseases but repeatedly led to failure in chronic cases. In 1828, after twelve more years of questioning and observation and 32 years of clinical practice, he believed he had discovered the origin of all chronic pathology and suggested new methods of treatment: - - a l l chronic pathology was, like syphilis, miasmatic, that is, due to material agents of contamination, of which there were three in all; - - t r e a t m e n t should be pluri-medicational and include anti-miasmatic specifics; - - t h e prescription should be determined by a medical, clinical and intellectual approach, taking into account the aetiology of the disease and the individual constitution of the patient. This goes beyond a purely symptomatic analysis. Hahnemann warned against the use of repertories which some of his contemporaries were already developing. What certain individuals are trying to eclipse
It is unfortunate that this concept and these methods of treatment, clearly expressed by Hahnemann in the language of his time, have been studied so little by homeeopaths. Some of them might then be less attracted by the fantasies of some visionary currents whose doctrines are based on the following tripod: psychic origin of 'miasms' 123
124 single drug, rarely a d m i n i s t e r e d d r u g diagnosis m a d e with r e f e r e n c e to repertory T h e s e postulates force t h e s e individuals to eclipse t h e w o r k of H a h n e m a n n w h o insisted o n the physical, m a t e r i a l n a t u r e of m i a s m s t h e r a p e u t i c pluralism criticism of r e p e r t o r i e s a n d thus to ' t o r t u r e ' the writings of t h e f o u n d e r of h o m o e o p a t h y in o r d e r to justify themselves. The physical, substantial nature o f m i a s m s It is easy to show t h a t to H a h n e m a n n ' s way of t h i n k i n g t h e r e were n o d o u b t s o n this point. F o r discerning linguists w h o k n e w the definitions of t h e w o r d s t h a t h e used, the dictionaries of t h a t time gave the following definition of ' m i a s m ' ;
deleterious corpuscles, insensible, scattered in the air or rising up from sulphur mines, cloacas and marshes. ' I n s e n s i b l e ' was defined as that which escapes the senses, and 'cloaca' as a place where rubbish is discarded. E l s e w h e r e H a h n e m a n n w r o t e of 'micro-organisms' t h a t were responsible, for e x a m p l e , for c h o l e r a epidemics, p r o v i n g t h a t h e a n t i c i p a t e d w h a t would l a t e r b e c o m e bacteriology. W h a t is m o r e , the t h r e e chronic diseases t h a t h e t h o u g h t he h a d identified did, according to h i m , c o m e from a c o n c r e t e physical agent, c o n t a g i o n being - - d i r e c t l y genital, in the case of syphilis a n d sycosis ---directly or indirectly c u t a n e o u s (dirty clothing, for e x a m p l e ) in the case of psora. This m e a n s t h a t o n e has to b e p r o m p t e d by ulterior m o t i v e s in trying to i m p u t e a loose definition to the t e r m ' m i a s m ' , leaving a d o u b t hanging o v e r possible immateriality in o r d e r to a d v a n c e a m o r e or less esoteric i n t e r p r e t a t i o n of the facts. Therapeutic p l u r a l i s m In a c c o r d a n c e with the intellectual dictatorship of the so-called spiritualistic schools, B a c h e l e r i e surreptitiously speaks of using a 'single medicine', thus o m i t t i n g to e m p h a s i z e t h e fact that, t h r o u g h o u t his e n t i r e b o o k , H a h n e m a n n o f t e n used t h e plural a n d w r o t e of the medicines which are necessary for t r e a t i n g chronic diseases, a n d which are to b e t a k e n repeatedly: The cure of an old psora that has been deprived of its eruption, whether it may be latent and quiescent, or already broken out into chronic diseases, can never be accomplished with sulphur alone . . . .
British Homteopathic Journal
The psora that is still latent within, as well as the psora that has developed into one of the innumerable chronic diseases springing from it, is very seldom cured by any single anti-psoric remedy, but requires the use of several of these remedies---in the worst cases the use of quite a number of them---one after the other, for its perfect cure . . . . It is, therefore, not strange, that one single and only medicine is insufficient to heal the entire psora and all its forms and that it requires several medicines in order to respond . . . . In such a case sulphur alone (as little as any other single antipsoric remedy) is usually no longer sufficient to produce a complete cure, and the other antipsoric remedies, one or another according to the remaining symptoms, must be called upon to give their homceopathic aid . . . . The hom~eopathic medical treatment of the countless chronic diseases (non-venereal and therefore of psoric origin) agrees essentially in its general features with the hom0eopathic treatment of human disease as taught in the Organon of the Art of Healing. 2 (Italics are Hahnemann's). In inveterate chronic diseases, I have been in the habit of giving a tablespoonful of such a solution every day, sometimes every two days. 3 W e are forced to n o t e t h a t H a h n e m a n n h a d laid h e r e t h e p r i m a r y c o r n e r - s t o n e s of pluralist techn i q u e s by successively prescribing several single medicines. H a h n e m a n n was n o t a unicist b u t a single prescriber. T h e r e a d e r will also note t h a t H a h n e m a n n uses the t e r m antipsoric, which b e c o m e s , u n d e r B a c h e l e r i e ' s pen, 'hom0eopsoric' to c o n f o r m to the translation----often quite slanted----of Pierre Schmidt. We also r e a d of t h e o r i e s of ' s u p p r e s s i o n ' a n d ' r e c u r r e n c e s of old s y m p t o m s ' w h i c h are so d e a r to Kentists as if they h a d b e e n f o r m u l a t e d by H a h n e m a n n himself. T h e y are in fact i m p r o p e r e x t r a p o l a t i o n s of words t h a t m e r e l y describe t h e p h e n o m e n a of m o r b i d a l t e r n a t i o n . A s far as I k n o w H a h n e m a n n n e v e r stated that the r e a p p e a r a n c e of the c h a n c r e in syphilis or t h e r e a p p e a r a n c e of a discharge in g o n o r r h o e a were signs t h a t foretell a cure. Criticism o f the repertories H a h n e m a n n t o o k a very clear position concerning t h e m e t h o d s of drug diagnosis in chronic pathology. T h e physician must study - - t h e progressive s y m p t o m a t o l o g y of t h e p a t i e n t , taking into account the 'entire condition of t h e p a t i e n t ' ; - - h e m u s t c o n c e r n himself with the aetiology of the d i s o r d e r to b e t r e a t e d , q u e s t i o n i n g t h e p a t i e n t o n his p e r s o n a l a n d h e r e d i t a r y antecedents, o n t h e onset a n d d u r a t i o n of t h e dis-
Volume 78, Number 3 July 1989 order, on his professional or personal dayto-day conditions of hygiene; - - h e must also concern himself with the patient's sensitivity to different factors, 'studying his character, his mentality, his constitution'. H e should then consult the experimental data of pure materia medica, where 'the action of the drugs themselves' is investigated, but he should beware of the 'vague indications given in the repertories'. The relevant passage is the following: The homeeopath, if he would act in a manner worthy of his calling, should investigate first the whole state of the patient, the internal cause as far as it is remembered, and the cause of the continuance of the ailment, his mode of life, his quality as to mind, soul and body, together with all his symptoms (see directions in Organon) and then he should carefully find out in the work on Chronic Diseases as well as in the work on Materia Medica Pura a remedy covering in similarity, as far as possible, all the moments, or at least the most striking and peculiar ones, with its own peculiar symptoms; and for this purpose he should not be satisfied with any of the existing repertories--a carelessness only too frequent; for these books are only intended to give light hints as to one or another remedy that might be selected, but they can never dispense him from making the research at the first fountain heads. He who does not take the trouble of treading this path in all critical and complicated diseases and, indeed, with all patience and intelligence, but contents himself with the vague hints of the repertories in the choice of a remedy, and who thus quickly dispatches one patient after the other, does not deserve the honourable title of a genuine hom0eopath. 4 A f t e r this, the physician will research, both in the Chronic Diseases itself and in the Materia Medica Pura and elsewhere, the medicine whose own action has the closest resemblance, if not with all the particularities of the present case, at least with the most striking details. For this he will not be satisfied with resorting to repertories, which are only suitable for hinting that such or such a substance might be chosen, but which can never substitute from resort to the origins themselves. If a physician exercises neither the precaution nor the patience to follow this procedure in critical and complicated cases, if he only relates to the vague indications of the repertories, and if he rushes from one patient to the next, he does not merit the honourable n a m e of homoeopath. Nevertheless, in the translation of the Chronic Diseases by Schmidt and Kunzli--unconditional repertorialists--many sour notes have been placed.
125 We should also point out that, in not one of the six editions of the Organon, did H a h n e m a n n ever r e c o m m e n d the use of repertories which, however, were already being controlled by some of his contemporaries. H e opposed their use, since they deal with purely symptomatic techniques, excluding nosology, something which had already led him to setbacks in chronic pathology. It was in order to avoid such 'setbacks' that he had advised Boenninghausen to edit a repertory that would include the characteristic symptoms of drugs in relation to their anatomical location and to the diagnosis of the disorder to be treated. Today this repertory is only of historical interest, its nosology having become obsolete. Other repertories have of course been written since H a h n e m a n n ' s time. The best-known of these is Kent's Repertory. H o w e v e r , compared to H a h n e m a n n ' s homeeopathic methods, which were somato-psychic, those of Kent are psychos o m a t i c - - i n accord with the author's phil o s o p h y - - a n d detached from nosology. Strictly speaking, Kent's Repertory therefore is not ' H a h n e m a n n i a n ' . W h a t is more, most of the symptoms listed in that work are not entirely trustworthy, as they have not been induced by the pharmacodynamics of the substances in question. To o v e r c o m e these major criticisms, some individuals try and hide behind that m o d e r n shield of incompetence, the computer! However, trying to use computer technology to help one or the other of the repertories will not help to r e m o v e their basic drawbacks. H o w can an automatic office machine based on binary responses, with a data input that is at best uncertain, be used for diagnostic purposes with biological p h e n o m e n a that do not correspond to mathematical laws? Nevertheless we hear various authors praising their own particular software without even realizing that by promoting such equipment these individuals are being more systematic, more automatic, and more materialistic than the classical therapeutic practitioners w h o m they never tire of reviling.
Conclusion The medical community must know that H a h n e m a n n founded hom0eopathy on the basis of clinical observation and experimentation. In keeping with the learning of his time, he advanced pathogenic hypotheses, just as Jahr, Grauvogl, Nevel, Fortier-Bernoville, Bernard and others would do after him. H o w e v e r , even if
126 pletely correct (nor entirely false), the clinical descriptions on which they are based remain true. On the other hand, other authors advanced pathogenic hypotheses based on philosophical, esoteric, religious or psychoanalytical ideas that generally ended up in a verbal or conceptual delirium for which those authors sought selfjustification in the muddy waters of an extreme psychiatrization of hom0eopathy or in the technological automation they advocated (repertory, then computer). Readers who consider this to be a harsh conclusion should re-read, in an objective translation, Hahnemann's C h r o n i c Diseases. That is the only way of -----exactly determining what Hahnemann wrote; --judging the modifications made by subsequent generations of hom0eopaths and seeing how far they derive from the scientific knowledge of the day (which would be normal) or from philosphical or esoteric alternatives (which would be dangerous); --determining what can and should be maintained in the light of present medical knowledge. We must not, on the pretence of fidelity to Hahnemann, take as 'gospel truth' texts that are 150 years old, with parts of them contradicted by other findings. Nor is it logical, on the pretence of fidelity to an esoteric alternative, to convolute these texts in order to prop up such an alternative. Nor is it correct, on the pretence of modernity, to include obsolete data in computers, playing on their keyboards with a satisfied and magical air. You cannot put a 'formula 1' chassis on a
Address for correspondence
Dr J. Jouanny La Combe de Riu Champes 07440 Albouffere France
British Homaeopathic Journal
Cugnot machine--however revolutionary the mechanism may have been for its t i m e- - an d hope to modernize this precursor of automobiles. The approach to homoeopathic methodology is a medical one. It is a form of medical endeavour that is non-automatic and continually changing. The phenomenon of similitude, the basis of homceopathy, mistakenly called the 'law of similars', is a phenomenon of general biology that does not govern all of biology and does not have unequivocal physiopathological support. In its therapeutic application, there must also exist, behind the similitude of symptoms, a physiopathological similitude that no repertory has included up to the present day and time. As to the pharmacology of the infinitesimal, a secondary element in the field of homoeopathy, this is still far from being clarified. For this reason no repertory or computer software can or should be offered to practitioners at the present time, not as a clinical tool, and even less as a diagnostic tool. Just like any other practitioner, a quality homoeopathic physician cannot be replaced by a dictionary or a machine. He must be first and foremost a good clinician who bases his work on an objective analysis of symptoms and on a trustworthy materia medica. References
1 BacheliereR. Introduction ~ l'Homropathie pure et ~ la technique de Beonninghausen--Les maladies chroniques selon Hahnemann. Medicin homeopathe 198; 2 Hahnemann S. Chronic Diseases 1838, pp. 105~5. Translated by L. H. Tafel. New Delhi: B. Jain 1985. 3 Hahnemann S. Chronic Diseases 1838, vol. 3, p. ii. Translated by C. J. Hempel. London: H. Balliere1846. 4 HahnemannS. Chronic Diseases 1838, p. 121. Translatedby L. H. Tafel. New Delhi: B. Jain 1985.
For debate
Against tendentious interpretations of Hahnemann's writings DR J A C Q U E S J O U A N N Y
How strange it is to see that among homoeopaths, 150 years after the death of Hahnemann, those who consider themselves the most faithful disciples of the Master and who call themselves the representatives of 'pure homoeopathy' are precisely those who misinterpret the fundamental precepts that he defined. Stranger still, these 'purists' seek to base their point of view on truncated or misconstrued quotations from the writings of the founder of the method. Far be it from me to want to hold as gospel truth all that Hahnemann wrote at the dawn of a scientific era in which everything was open to discovery. However, I believe that it is worthwhile to draw attention to the tendentious interpretations made by certain individuals who seek pseudo-justifications of doctrines whose applications do nothing but harm the crediblity of homceopathy--this same hom0eopathy which its founder wanted to be objective, clinical and
experimental. In this vein, I came upon an article by Robert Bachelerie entitled 'Introduction A l'Hom6opathie pure et ~ la technique de Boenninghausen--Les maladies chroniques selon Hahnemann' (introduction to pure hom0eopathy and to the Boenninghausen m e t h o d - chronic diseases according to Hahnemann; in Medecin Homeopathe, periodical of the Syndicate of French Homeeopathic Physicians). This provides a good analysis of certain parts of Hahnemann's Chronic Diseases, but Bachelerie completely eclipses the three main characteristics of the work. He has doubtlessly done so to justify by means of partial quotations and convoluted interpretations the esoteric philosophical theses and the reputedly homeeopathic practices of the spiritualistic schools of Kent, Ortega, Paschero and other visionaries. Let us therefore examine briefly
- - w h a t Hahnemann really wrote, and - - w h a t certain individuals are trying to eclipse for doctrinal reasons. What Hahnemann wrote
In the Chronic Diseases, Hahnemann wrote that in 1816, after twenty years of practice, he observed that the purely symptomatic methods for determining homeeopathic medicines that he had initially advocated gave good results in acute diseases but repeatedly led to failure in chronic cases. In 1828, after twelve more years of questioning and observation and 32 years of clinical practice, he believed he had discovered the origin of all chronic pathology and suggested new methods of treatment: - - a l l chronic pathology was, like syphilis, miasmatic, that is, due to material agents of contamination, of which there were three in all; - - t r e a t m e n t should be pluri-medicational and include anti-miasmatic specifics; - - t h e prescription should be determined by a medical, clinical and intellectual approach, taking into account the aetiology of the disease and the individual constitution of the patient. This goes beyond a purely symptomatic analysis. Hahnemann warned against the use of repertories which some of his contemporaries were already developing. What certain individuals are trying to eclipse
It is unfortunate that this concept and these methods of treatment, clearly expressed by Hahnemann in the language of his time, have been studied so little by homeeopaths. Some of them might then be less attracted by the fantasies of some visionary currents whose doctrines are based on the following tripod: psychic origin of 'miasms' 123
124 single drug, rarely a d m i n i s t e r e d d r u g diagnosis m a d e with r e f e r e n c e to repertory T h e s e postulates force t h e s e individuals to eclipse t h e w o r k of H a h n e m a n n w h o insisted o n the physical, m a t e r i a l n a t u r e of m i a s m s t h e r a p e u t i c pluralism criticism of r e p e r t o r i e s a n d thus to ' t o r t u r e ' the writings of t h e f o u n d e r of h o m o e o p a t h y in o r d e r to justify themselves. The physical, substantial nature o f m i a s m s It is easy to show t h a t to H a h n e m a n n ' s way of t h i n k i n g t h e r e were n o d o u b t s o n this point. F o r discerning linguists w h o k n e w the definitions of t h e w o r d s t h a t h e used, the dictionaries of t h a t time gave the following definition of ' m i a s m ' ;
deleterious corpuscles, insensible, scattered in the air or rising up from sulphur mines, cloacas and marshes. ' I n s e n s i b l e ' was defined as that which escapes the senses, and 'cloaca' as a place where rubbish is discarded. E l s e w h e r e H a h n e m a n n w r o t e of 'micro-organisms' t h a t were responsible, for e x a m p l e , for c h o l e r a epidemics, p r o v i n g t h a t h e a n t i c i p a t e d w h a t would l a t e r b e c o m e bacteriology. W h a t is m o r e , the t h r e e chronic diseases t h a t h e t h o u g h t he h a d identified did, according to h i m , c o m e from a c o n c r e t e physical agent, c o n t a g i o n being - - d i r e c t l y genital, in the case of syphilis a n d sycosis ---directly or indirectly c u t a n e o u s (dirty clothing, for e x a m p l e ) in the case of psora. This m e a n s t h a t o n e has to b e p r o m p t e d by ulterior m o t i v e s in trying to i m p u t e a loose definition to the t e r m ' m i a s m ' , leaving a d o u b t hanging o v e r possible immateriality in o r d e r to a d v a n c e a m o r e or less esoteric i n t e r p r e t a t i o n of the facts. Therapeutic p l u r a l i s m In a c c o r d a n c e with the intellectual dictatorship of the so-called spiritualistic schools, B a c h e l e r i e surreptitiously speaks of using a 'single medicine', thus o m i t t i n g to e m p h a s i z e t h e fact that, t h r o u g h o u t his e n t i r e b o o k , H a h n e m a n n o f t e n used t h e plural a n d w r o t e of the medicines which are necessary for t r e a t i n g chronic diseases, a n d which are to b e t a k e n repeatedly: The cure of an old psora that has been deprived of its eruption, whether it may be latent and quiescent, or already broken out into chronic diseases, can never be accomplished with sulphur alone . . . .
British Homteopathic Journal
The psora that is still latent within, as well as the psora that has developed into one of the innumerable chronic diseases springing from it, is very seldom cured by any single anti-psoric remedy, but requires the use of several of these remedies---in the worst cases the use of quite a number of them---one after the other, for its perfect cure . . . . It is, therefore, not strange, that one single and only medicine is insufficient to heal the entire psora and all its forms and that it requires several medicines in order to respond . . . . In such a case sulphur alone (as little as any other single antipsoric remedy) is usually no longer sufficient to produce a complete cure, and the other antipsoric remedies, one or another according to the remaining symptoms, must be called upon to give their homceopathic aid . . . . The hom~eopathic medical treatment of the countless chronic diseases (non-venereal and therefore of psoric origin) agrees essentially in its general features with the hom0eopathic treatment of human disease as taught in the Organon of the Art of Healing. 2 (Italics are Hahnemann's). In inveterate chronic diseases, I have been in the habit of giving a tablespoonful of such a solution every day, sometimes every two days. 3 W e are forced to n o t e t h a t H a h n e m a n n h a d laid h e r e t h e p r i m a r y c o r n e r - s t o n e s of pluralist techn i q u e s by successively prescribing several single medicines. H a h n e m a n n was n o t a unicist b u t a single prescriber. T h e r e a d e r will also note t h a t H a h n e m a n n uses the t e r m antipsoric, which b e c o m e s , u n d e r B a c h e l e r i e ' s pen, 'hom0eopsoric' to c o n f o r m to the translation----often quite slanted----of Pierre Schmidt. We also r e a d of t h e o r i e s of ' s u p p r e s s i o n ' a n d ' r e c u r r e n c e s of old s y m p t o m s ' w h i c h are so d e a r to Kentists as if they h a d b e e n f o r m u l a t e d by H a h n e m a n n himself. T h e y are in fact i m p r o p e r e x t r a p o l a t i o n s of words t h a t m e r e l y describe t h e p h e n o m e n a of m o r b i d a l t e r n a t i o n . A s far as I k n o w H a h n e m a n n n e v e r stated that the r e a p p e a r a n c e of the c h a n c r e in syphilis or t h e r e a p p e a r a n c e of a discharge in g o n o r r h o e a were signs t h a t foretell a cure. Criticism o f the repertories H a h n e m a n n t o o k a very clear position concerning t h e m e t h o d s of drug diagnosis in chronic pathology. T h e physician must study - - t h e progressive s y m p t o m a t o l o g y of t h e p a t i e n t , taking into account the 'entire condition of t h e p a t i e n t ' ; - - h e m u s t c o n c e r n himself with the aetiology of the d i s o r d e r to b e t r e a t e d , q u e s t i o n i n g t h e p a t i e n t o n his p e r s o n a l a n d h e r e d i t a r y antecedents, o n t h e onset a n d d u r a t i o n of t h e dis-
Volume 78, Number 3 July 1989 order, on his professional or personal dayto-day conditions of hygiene; - - h e must also concern himself with the patient's sensitivity to different factors, 'studying his character, his mentality, his constitution'. H e should then consult the experimental data of pure materia medica, where 'the action of the drugs themselves' is investigated, but he should beware of the 'vague indications given in the repertories'. The relevant passage is the following: The homeeopath, if he would act in a manner worthy of his calling, should investigate first the whole state of the patient, the internal cause as far as it is remembered, and the cause of the continuance of the ailment, his mode of life, his quality as to mind, soul and body, together with all his symptoms (see directions in Organon) and then he should carefully find out in the work on Chronic Diseases as well as in the work on Materia Medica Pura a remedy covering in similarity, as far as possible, all the moments, or at least the most striking and peculiar ones, with its own peculiar symptoms; and for this purpose he should not be satisfied with any of the existing repertories--a carelessness only too frequent; for these books are only intended to give light hints as to one or another remedy that might be selected, but they can never dispense him from making the research at the first fountain heads. He who does not take the trouble of treading this path in all critical and complicated diseases and, indeed, with all patience and intelligence, but contents himself with the vague hints of the repertories in the choice of a remedy, and who thus quickly dispatches one patient after the other, does not deserve the honourable title of a genuine hom0eopath. 4 A f t e r this, the physician will research, both in the Chronic Diseases itself and in the Materia Medica Pura and elsewhere, the medicine whose own action has the closest resemblance, if not with all the particularities of the present case, at least with the most striking details. For this he will not be satisfied with resorting to repertories, which are only suitable for hinting that such or such a substance might be chosen, but which can never substitute from resort to the origins themselves. If a physician exercises neither the precaution nor the patience to follow this procedure in critical and complicated cases, if he only relates to the vague indications of the repertories, and if he rushes from one patient to the next, he does not merit the honourable n a m e of homoeopath. Nevertheless, in the translation of the Chronic Diseases by Schmidt and Kunzli--unconditional repertorialists--many sour notes have been placed.
125 We should also point out that, in not one of the six editions of the Organon, did H a h n e m a n n ever r e c o m m e n d the use of repertories which, however, were already being controlled by some of his contemporaries. H e opposed their use, since they deal with purely symptomatic techniques, excluding nosology, something which had already led him to setbacks in chronic pathology. It was in order to avoid such 'setbacks' that he had advised Boenninghausen to edit a repertory that would include the characteristic symptoms of drugs in relation to their anatomical location and to the diagnosis of the disorder to be treated. Today this repertory is only of historical interest, its nosology having become obsolete. Other repertories have of course been written since H a h n e m a n n ' s time. The best-known of these is Kent's Repertory. H o w e v e r , compared to H a h n e m a n n ' s homeeopathic methods, which were somato-psychic, those of Kent are psychos o m a t i c - - i n accord with the author's phil o s o p h y - - a n d detached from nosology. Strictly speaking, Kent's Repertory therefore is not ' H a h n e m a n n i a n ' . W h a t is more, most of the symptoms listed in that work are not entirely trustworthy, as they have not been induced by the pharmacodynamics of the substances in question. To o v e r c o m e these major criticisms, some individuals try and hide behind that m o d e r n shield of incompetence, the computer! However, trying to use computer technology to help one or the other of the repertories will not help to r e m o v e their basic drawbacks. H o w can an automatic office machine based on binary responses, with a data input that is at best uncertain, be used for diagnostic purposes with biological p h e n o m e n a that do not correspond to mathematical laws? Nevertheless we hear various authors praising their own particular software without even realizing that by promoting such equipment these individuals are being more systematic, more automatic, and more materialistic than the classical therapeutic practitioners w h o m they never tire of reviling.
Conclusion The medical community must know that H a h n e m a n n founded hom0eopathy on the basis of clinical observation and experimentation. In keeping with the learning of his time, he advanced pathogenic hypotheses, just as Jahr, Grauvogl, Nevel, Fortier-Bernoville, Bernard and others would do after him. H o w e v e r , even if
126 pletely correct (nor entirely false), the clinical descriptions on which they are based remain true. On the other hand, other authors advanced pathogenic hypotheses based on philosophical, esoteric, religious or psychoanalytical ideas that generally ended up in a verbal or conceptual delirium for which those authors sought selfjustification in the muddy waters of an extreme psychiatrization of hom0eopathy or in the technological automation they advocated (repertory, then computer). Readers who consider this to be a harsh conclusion should re-read, in an objective translation, Hahnemann's C h r o n i c Diseases. That is the only way of -----exactly determining what Hahnemann wrote; --judging the modifications made by subsequent generations of hom0eopaths and seeing how far they derive from the scientific knowledge of the day (which would be normal) or from philosphical or esoteric alternatives (which would be dangerous); --determining what can and should be maintained in the light of present medical knowledge. We must not, on the pretence of fidelity to Hahnemann, take as 'gospel truth' texts that are 150 years old, with parts of them contradicted by other findings. Nor is it logical, on the pretence of fidelity to an esoteric alternative, to convolute these texts in order to prop up such an alternative. Nor is it correct, on the pretence of modernity, to include obsolete data in computers, playing on their keyboards with a satisfied and magical air. You cannot put a 'formula 1' chassis on a
Address for correspondence
Dr J. Jouanny La Combe de Riu Champes 07440 Albouffere France
British Homaeopathic Journal
Cugnot machine--however revolutionary the mechanism may have been for its t i m e- - an d hope to modernize this precursor of automobiles. The approach to homoeopathic methodology is a medical one. It is a form of medical endeavour that is non-automatic and continually changing. The phenomenon of similitude, the basis of homceopathy, mistakenly called the 'law of similars', is a phenomenon of general biology that does not govern all of biology and does not have unequivocal physiopathological support. In its therapeutic application, there must also exist, behind the similitude of symptoms, a physiopathological similitude that no repertory has included up to the present day and time. As to the pharmacology of the infinitesimal, a secondary element in the field of homoeopathy, this is still far from being clarified. For this reason no repertory or computer software can or should be offered to practitioners at the present time, not as a clinical tool, and even less as a diagnostic tool. Just like any other practitioner, a quality homoeopathic physician cannot be replaced by a dictionary or a machine. He must be first and foremost a good clinician who bases his work on an objective analysis of symptoms and on a trustworthy materia medica. References
1 BacheliereR. Introduction ~ l'Homropathie pure et ~ la technique de Beonninghausen--Les maladies chroniques selon Hahnemann. Medicin homeopathe 198; 2 Hahnemann S. Chronic Diseases 1838, pp. 105~5. Translated by L. H. Tafel. New Delhi: B. Jain 1985. 3 Hahnemann S. Chronic Diseases 1838, vol. 3, p. ii. Translated by C. J. Hempel. London: H. Balliere1846. 4 HahnemannS. Chronic Diseases 1838, p. 121. Translatedby L. H. Tafel. New Delhi: B. Jain 1985.