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Was Kent a Hahnemannian?
British Homeopathic Journal (1999) 89, 78±83 ß 1999 Stockton Press All rights reserved 0307±0565/99 $12.00 http://www.stockton-press.co.uk/bhj
EDUCATION AND DEBATE
Was Kent a Hahnemannian? A Cassam1* 1
14 Westpoint, 49 Putney Hill, London, SW15 6RU, UK. This article voices concern at the trend among an in¯uential section of homeopaths the world over, to jettison Hahnemann's similimum principle and replace it with Kent's almost exclusive concentration on mental and psychic symptoms. This concern raises the question whether Kent was a true Hahnemannian. In order to discuss this question, two schools of thoughts are investigated. The ®rst argues that Hahnemann's theories were scienti®c whereas Kent's were metaphysical. The second criticises Kent's more severely for being metaphysical. At the same time, it accuses Hahnemann himself of increasingly losing his way, with increasing age, into metaphysical homeopathy. The author believes there was no break in Hahnemann's thinking as alleged, but a gradual development with increasing experience, together with judicious use of rational insight, when scienti®c explanation was not yet available. The yardstick used to accuse Hahnemann of being metaphysical is crudely empirical and long outdated. Keywords: rational insight; metaphysics; irrationalism; psychic symptoms
Introduction Was Kent a Hahnemannian? This question has exercised the minds of many thinking homeopaths since Kent was alive and practising. As recently as the April 1998 issue of the British Homoeopathic Journal, Joseph Schmidt wrote, `Kent's esoteric philosophy will seem utterly plausible to anyone who considers Hahnemann the greatest physician of all times, Kent a true Hahnemannian (my emphasis) and the law of similars a God-given revelation . . . .'.1 On the other hand, there have been many who have thought otherwise. Over the years, there have been two distinct trends of thought in this controversy. One critical school argued that Hahnemann's theories were scienti®c, by which they probably meant that his views were based on the laws of nature. On the other hand, this critical school believed that Kent's views were `metaphysical'. Presumably, Schmidt (quoted above) meant the same thing when he referred to `Kent's esoteric philosophy'. The second school of criticism accused Hahnemann himself of being metaphysical, but with the caveat that this applied to only Hahnemann in his later years. This school held that Hahnemann increasingly lost his way into metaphysical homeopathy as he grew older. *Correspondence author. A Cassam, 14 Westpoint, 49 Putney Hill, London, SW15 6RU, UK.
The most recent such critique was by Anthony Campbell in his book Two Faces of Homoeopathy published in 1985.2 Campbell's second thesis was that Kent was a follower of this later Hahnemann but went much further incorporating into homeopathy many of the mystical concepts of Swedenborg whose mystical philosophy he espoused wholeheartedly. In order to discuss these two schools of thought, I propose to investigate the three fundamental aspects of Hahnemann's theory. These are vitalism, dynamization or potentization and the theory of miasms. Campbell condemned all these three theories as metaphysical and, as remarked earlier, claimed they belonged to Hahnemann's later period starting in about 1821 when he was forced to move to the tiny principality of Kothen. In order to de®ne what he meant by `metaphysics', Campbell followed Karl Popper, according to whom all theories or concepts which were inherently in capable of objective falsi®cation by the established `scienti®c' methods were necessarily `metaphysical' At the same time, Campbell enlisted a mechanistic 18th century criterion for his de®nition. `By de®nition', he wrote, `the vital force cannot be seen or weighed; it cannot be detected by the senses or with instruments. It remains a mere theoretical construct and is no more accessible to scienti®c investigation than is the soul or the ether'.3 It is interesting to read what Nietzsche had to say about such a way of looking at the world. Nietzsche, who was a naturalist Ð meaning the way of under-
Was Kent a Hahnemannian? A Cassam
standing the nature through the universal laws and rules of nature Ð was nevertheless a ®erce opponent of the type of materialism advocated by Campbell. He asserted that such a mechanistic interpretation `that permits counting, calculating, weighing, seeing and touching, and nothing more, is a crudity and naivete, assuming that it is not a mental illness or idiocy'.4 Moreover, in enlisting the help of the 18th and part of the 19th century mechanistic and deterministic view of the world, Campbell was perhaps not aware that Hahnemann was following the ideas of Leibniz and Wolff, thinkers of impeccable philosophical credentials. According to Fernando Risquez, in his book Psychiatry and Homeopathy,5 the signi®cance of Leibniz's monadology in medicine was as follows: a Substance is the living force. b Everything that exists is made up of in®nite and eternal substances Ð the monads. c These monads may be classi®ed into: i. Monads of an inactive inorganic nature. ii. Monads of active but unconscious vegetable nature. iii. Monads of sensible animal nature. iv. Monads of rational human nature. According to Leibniz, therefore, the world is fully alive with beings animated by live forces of these four kinds of monads. Hahnemann used this concept of Leibniz and others to develop his theory of vitalism in homeopathic medicine.
Hahnemann's theory of vitalism For the purposes of our present discussion, vitalism and dynamization are being considered together because it was the process of dynamization, which, according to Hahnemann, released the spirit-like vital force. It is important to notice that Hahnemann arrived at the theory of vitalism not as a result of any preconceived predilection for such a concept. He came to it as his way of explaining the results of his experiments with smaller and smaller doses of medicines he was using for his patients. He experimented with smaller and smaller doses of medicines in order to reduce the toxic side effects or aggravations caused by these medicines when given in more concentrated form. He soon noticed that greater bene®ts were obtained when the indicated medicine was used in a diluted form, along with the reduction in aggravations. It was only after Hahnemann had observed this enhanced therapeutic effect with increasing dilution and succussion that the connection between dynamization and vitalism began to take shape in his mind. This in effect, reversed his previous assessment. This changed started early as 1814, only four years after the publication of the ®rst edition of Organon;6 although as late as 1824, he had not fully adopted the concept and even after that, `it was only as a probable explanation'.7 According to Ann Clover, in 1822±1827, Hahnemann started to use gradually increasing dilutions of medicines of up to 30 c.
Indeed, well before that, in the 2nd volume of his Materia Medica Pure in 1816, Hahnemann recommended the use of Arsenicum album in the 30th centesimal dilution.6 But he was against the use of any higher potencies beyond 30 c until 1833. In a letter written before 1833 to his Austrian and Russian colleagues, he expressed `his disapproval of potencies higher than 30th centesimal'.6 However, since there is not a single molecule of medicine left after 12c, we were already in the realm of Campbell's `metaphysics' as early as 1814±16 rather than 1821 as claimed by him. Moreover it also showed that there was no break in Hahnemann's, but a gradual evolution of his thinking, based on practice and experience. It has to be said that it is not clear on reading Campbell, whether he regarded the introduction of 30 c, or only the use of much higher potencies, as `metaphysical'. If the latter, his claim that by 1828, Hahnemann was well into his `metaphysical' period, cannot be sustained for, even at the time of the publication of his Chronic Diseases in 1828, and indeed as late as 1833, Hahnemann was not in favour of the use of potencies above 30 c.6 As far as vitalism was concerned, it was in the Preface of the 5th volume of Chronic Diseases that Hahnemann drew a distinction between dilution and dynamization with succussion. The latter was a process of preparation `by which the medicinal properties which are latent in natural substances while in their crude state, become aroused, and then become enabled to act in an almost spiritual manner on our life'.6 Hahnemann then went on to suggest that every human organism, whatever its state of health, was ruled by its vital force. A similar vital force was lying dormant in each natural substance, which was then released by the process of dilution and succussion. When the released vital force of the medicine was applied to the cause of the disease in the prescribed manner, healing resulted. The concept of spirit-like vital force even in an inanimate substance being released by dynamization that is by serial dilution and succussion, was a far cry from the religious or esoteric concept of spiritualism. It was the crude empiricism of critics like Campbell, which rejected everything which could not be seen or weighed or measured or detected by senses as `metaphysical', which was in fact out of line with the advancing knowledge. The idea of solid entities or irreducible atoms had long since been exploded. Campbell's idea was an inheritance from the crude empiricist world-view which, when applied to medicine, insisted on denying that a disease was a `real' one unless it revealed gross physical signs supported by clinical data and laboratory ®ndings. The absence of such corroboration meant that there was no `real' cause to be found and therefore the disease did not exist. Long before the advent of psychology and psychiatry, Hahnemann coined the word `vitalism' to refer to those factors. In to-day's language these would be considered psychological factors. Long before Freud and Jung, Hahneman realised that `Since the physical body is a
79
Was Kent a Hahnemannian? A Cassam
80
dynamic form, it follows logically that the energies of thought and feeling are in continuous kinetic interaction with the apparently physical aspects of being'.8 He realised over years of practice and experience that factors initiating a disease were dynamic and were not always capable of being recognised or diagnosed by physical, chemical or laboratory analysis. If this was metaphysics then Freud and his followers were metaphysicians par excellence. It is true that within last few decades, Freudian psychoanalytic theories and the method itself have come under severe critical onslaught, some of which, I believe, is deserved. But the point I am making is in no way affected by this controversy. What remains a fact is that Freud's theories were accepted by the establishment of the time and helped to bring into general acceptance the role of psychosomatic factors in the development and progress of the disease. This was precisely what Hahnemann contended in the only vocabulary that was available to him at the time.
Kent's theory of vitalism This leads us directly to Kent and his role. Hering, but especially Kent, who brought the seminal formulations of Hahnemann into disrepute by turning his `vital force' into god-like spiritual force. For Hahnemann, the vital force was an unconscious force without the capacity for re¯ection and moreover, it was present in both animate and inanimate things. The resemblance between Hahnemann's `vital force' to the concept of `Qi' (Chi) in traditional Chinese medical philosophy, is extremely close.9 The Qi, like the vital force is believed to be present both in animate and inanimate substances. The Qi itself consisted of `Yin' and `Yang' and was the source of all change. Chinese Taoist philosophy did not postulate any divine creator, but this was the predominant concern of Kent and played a crucial role in his homoeopathic thinking. Kent moved away from this Hahnemannian concept of the vital force and the Taoist concept of Qi. He substituted his own concept of `simple substance' and then proceeded to turn this into an explicitly religious concept. For him, the simple substance was endowed with formative intelligence. In this, and in re-interpreting a number of other seminal Hahnemannian concepts, he followed the Swedish mystic, Emanuel Swedenborg. For Swedenborg, the idea that there was a mystical correspondence between the spirit world and our own, was fundamental. He also believed that the form and the function of man was modelled on and re¯ected that of heaven. Whatever happened in the spirit world must have its correspondence here on earth. It was natural for a Swedenborgian like Kent to regard this correspondence as divinely ordained Law of Nature. In his Lectures on Homoeopathic Philosophy he stated, `We must begin by having respect for law . . . .
Let us acknowledge the (its) authority.' (p.19); `It is necessary that the exact and proper position of experience should be realised . . . . Experience has only con®rmatory place. It can only con®rm that which has been discovered through principle. (That is Law) . . . . Experience leads to no discoveries . . . . One who has no doctrines imagines he discovers by experience.' (p.43). This meant that, for Kent, the process of discovery and advance in knowledge in any ®eld of human endeavour through research and experiment was irrelevant. What one needed was the knowledge of the Divine Laws and this was for him the foundation of homeopathy.
Contrasts between two views highlighted There could be no greater contrast between these views of Kent and those of his supposed mentor. For Hahnemann, `The true healing art is in its nature a pure science of experience . . . '; . . . 'the complete true healing art . . . (is) only to be discovered by due attention to nature by means of our senses, by careful honest observations and experiments conducted with all possible purity and in no other way'.10 This of course did not mean that empiricism should be the only guide. Another legitimate guide might be rational insight. Christopher Peacocke, reviewing the book entitled In Defense of Pure Reason by Laurence Bonjour in the Times Literary Supplement wrote, `there must, he (the author) argues, also be a priori principles, which ensure that we are epistemically justi®ed in having beliefs about matters beyond our immediate experience'.11 Hahnemann himself, I would contend, made full use of this rational insight in trying to interpret the results of his experiments with medicines. However, this is a diametrically opposite position to that of Kent who would have absolutely nothing to do with facts discovered by due attention to nature by means of our senses, by careful honest observations and `experiment' or the achievement of a new insight with the help of pure reason. It is interesting to read Nietzsche in Beyond Good and Evil where he wrote about man who `is hardened in the discipline of science, he stands before the rest of nature, with intrepid Oedipus eyes and sealed Odysseus ear, deaf to the siren songs of old metaphysical bird catchers, who have been piping at him all too long, `You are more, you are higher, you are of a different origin!' ` (my emphasis).12 Spinoza said the same thing. `So the way to understanding nature of anything, of whatever kind, must always be the same, viz through the universal laws and rules of nature'.12 This was exactly what Hahnemann believed. He wrote in another context, ` I demand no faith at all, and do not demand that anybody should comprehend it; it is enough that it is a
Was Kent a Hahnemannian? A Cassam
fact and nothing else. Experience alone declares it and I believe more in experience than in my own intelligence'.10
Hahnemann's theory of miasm The third ground on which Campbell accused Hahnemann himself of metaphysics, was his theory of `miasms'. To quote Campbell, `If you read Hahnemann's account of the manifestations of psora, you will see that they include almost every imaginable symptom and disease. Ask yourself what form of chronic disease is not due to psora, and you will see the dif®culty; by explaining everything, the theory really explains nothing . . . '.3 In the absence of scienti®c evidence available in his time, what in fact Hahnemann was trying to do was to ®nd some rational way of explaining the cause of the disease in the same naturalistic tradition of Nietzsche and Spinoza and indeed of Freud in the 20th century. Well before the science of microbiology developed, Hahnemann had begun to use the term `miasm' to refer to `infecting living parasites' a little later, in 1830, he referred to this phenomenon as based on `brood of . . . .excessively minute, invisible creatures'.13 Hahnemann's theory of chronic diseases including tumour formation, was based upon various psychological, physical and environmental factors interacting with latent hereditary traits which he called `miasm'. It was a theory, which bears comparison with the modern development in the medical thought where `inherited traits or miasms'14 are increasingly seen as predisposing causes for activating the onset of chronic diseases, including the onset of malignancy. In Hahnemann's early 19th century language, only those persons with such latent `miasm' were susceptible to succumb when exposed to external and internal initiating factors. `His theories on treatment of chronic disease therefore include discussion of remedies intended to provoke a suitable counterreaction to the latent trait or miasms which he argues is activated to produce gross symptoms as well as those appropriate to precipitating factors . . . '.14
Kentian irrationalism On the other hand, Campbell's strictures on the Swedenborgian twist given to the miasm theory of Hahnemann by Kent and his followers were, I believe, perfectly justi®ed. Kent was responsible for importing into Hahnemannian classical homeopathy, his own dogmatic and moralistic prejudices. For him and his followers, disease was seen `as the blight of the corrupted spirit'. It was moral as well as physical problem and the treatment of the mind and the soul an integral aspect of the therapeutic endeavours. `The Swedenborgian gave a de®nite moral twist to the miasm theory.'; `For Hahnemann, the miasms had been acquired `infections', but for the Swedenborgians they were moral
taints passing from generation to generation, and psora in particular took on some of the characteristics of Original Sin' (my emphasis).3 Thus according to Kent, all diseases were built on psora. It was the very primitive wrong and the spiritual sickness of the human race (my emphasis).10 Schmidt's `The Esoteric and Exoteric View of Homoeopathy' in a recent issue of the British Homeopathic Journal was devoted to comparing the philosophical giant, Hegel's `Absolute Idealism' with Kent's crude religious mysticism. Hegel's main project his major works Philosophy of History, was to explain his conception of history as `life of the world spirit'. `History, according to Hegel, `is not miscellany of the mighty deeds and catastrophes. It is the increase, now gradual, then sudden, in the self-awareness of the world spirit'.15 Kent's main `philosophical' project, on the other hand, was rather a pedestrian one. It was to try and reconcile homeopathy with his interpretation of Christian theology, ` . . . that theology and homeopathy `cannot be divorced', that divine providence must be recognised . . . '.1 My other criticism of Schmidt is the use of the concepts `esoteric' and `exoteric', which instead of elucidating, cause confusion. They seemed to imply that the author believed that all true homoeopathic practitioners, like Kent, explain `homeopathy esoterically'. On the other hand, according to the writer, a homoeopathic physician in¯uenced by the so-called `exoteric' view, will have greater `potential for scepticism, mistrust, uncertainty, generalisation, lack of motivation and ultimately, often a super®cial approach to history taking, analysis and prescribing . . . ' (!) (my emphasis).1 I have discussed in some detail this article, to demonstrate the powerful hold of Kentian irrationalism on otherwise Ð presumably Ð rational individuals to the detriment of homeopathy in general. It was the association of psora to the very primitive wrong and the spiritual sickness of the human race that was the basis of the exclusive prominence given to the mental symptoms in Kent's repertory. The claim made in the foreword of his repertory that he was following Hahnemann in giving primacy to the mentals, was totally false. The mind certainly played a very signi®cant part in affecting the disease processes; but primarily and most importantly, Hahnemann's homeopathy was matching a set of symptoms with a drug picture and especially the matching of uncommon and peculiar symptoms of the patient with similar symptoms recorded during drug provings. But for Kent, the whole picture was a mystical one. `The will and understanding constitute Man; conjoined they make life and activity. With the will and understanding operating in order we have a healthy man . . . '.16 Here again, Kent was putting across the primacy of the mental symptoms at the expense of principle of similimum, which formed the foundation of Hahnemann's homeopathy. For classical homeopathy
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Was Kent a Hahnemannian? A Cassam
82
could literally be de®ned as a therapeutic method which clinically applied law of similars.
Triumph of the Kentian approach in the U.K. Writing in the The Journal of the Society of Homoeopaths, Dennis Maceoin expressed his great concern about the metaphysical approach to homeopathy in mostly lay homoeopaths. `What worries me', he wrote, `is the possibility that this leaning towards metaphysics instead of rational, empirically based medical practice may retard the process of broad political and scienti®c acceptance of homeopathy for decades, if not inde®nitely'.17 He however, rejoiced in the fact that `rational tradition of homeopathy continues to ¯ourish within the ranks of doctor homoeopaths'.17 To quote again: `But it is clear that the dominant tradition among medically-trained homoeopaths remains much closer to the secular rationalist and scienti®c ideals of the wider medico-scienti®c community within which they have been educated and to which most of them still aspire to belong'.17 These were very interesting observations in view of the fact that according to one survey published in 1962, `eighty percent of British and American homoeopaths who had graduated from regular medical schools, belonged to religious minorities and=or believed in reincarnation'.This information was incidentally gleaned by the author from Br Hom J., Vol L1 (1962).18 Moreover, despite the wholesale incorporation into homeopathy of the mystical and metaphysical Swedenborgian philosophy by Kent, the Kentian school became victorious within the same medically quali®ed homeopathic establishment in Britain. `We (Kentians) are now the of®cial voice of British homeopathy, and . . . we sincerely believe ourselves to be the chosen people who are correctly interpreting Hahnemann's teaching' (my emphasis).18 This view got further support in 1998 `Homoeopathic literature generally explains homeopathy esoterically that is as seen through the eyes of devoted practitioner, in terms of faithful obedience to universal laws, eternal truth, divine revelation, etc' (my emphasis).1
Hahnemann's similimum principle jettisoned This at last brings me to the main reason for my article. It is to voice serious concern and even dismay at the almost unstoppable trend within a very signi®cant and in¯uential section of homoeopaths Ð both lay and medically trained Ð to jettison Hahnemann's similimum principle that formed the backbone of classical homeopathy, and replace it with Kent's almost exclusive concentration on the mental symptoms.
I will illustrate this with just one case presented by Dr R. Latha Iyer in the Asian edition of Homoeopathic Links.19 In case 2, Dr Latha Iyer described a case where all the ten rubrics taken were mentals. What was even worse, those taken were based on the homoeopath's own personal interpretation of patient's history, which seemed highly suspect to say the least. This patient had no one to look after her and she therefore felt lonely. `So she also (my emphasis) thought of committing suicide.' The rubric taken for this mild expression was, `Loathing for life'. This sounded to me as simply incredible. `I was religious right from childhood', the patient had reported. How many Indian women in India (and also men) were not religious from childhood? Notwithstanding, the rubric taken was `religious'! Another rubric taken was `Caring' without the least evidence produced for it. Most Indian women are indeed very caring for their children especially when they also happen to be boys. `Caring' might have meant something if it was shown that she was generally caring towards outsiders as well. There was nothing in her own story or hobbies (watching cricket, playing carrom) to indicate this. On the contrary. Her two sons were married in her absence, presumably due to her objection to `intercaste' marriages: `My two daughter-in-laws were already known to me but I still have hatred towards them' (my emphasis). Why? Was it because her two sons' wives came from different castes? Whatever the reason, one surely needed an opposite rubric to `caring' if one was to be used at all. The same applied to the rubric `sympathetic' which was also used. The only mental `change' reported by the patient was that she had become irritable during her illness. But that was ignored, in line with, one supposes, `the attitude of Kent and his spiritualist school which went so far as to say that `pathognomonic signs of the disease have no importance in the selection of the homoeopathic drug'.10
Conclusion Fortunately, all is not lost for classical homeopathy. Kent's metaphysical homeopathy has been repudiated by some highly reputable homeopaths who have elected to follow Hahnemann's classical homeopathy. In his book entitled Essentials of Homeopathic Therapeutics,20 the eminent French homoeopath, Jacques Jouanny categorically stated the opposite. `Only changes in general behaviour during the course of the illness should be taken into account . . . '; `It should never be forgotten that for Hahnemann the only reactional symptom to be considered was change in the way of feeling or acting' (my emphasis). `The character of the patient is only important if the change in the nervous behaviour occurred at the same time as the chronic disease'. As for psychic symptoms, `They
Was Kent a Hahnemannian? A Cassam
are, however, too unsure for homeopathic physicians to base reactional therapy on them'(p.78). Similar advice in a different context, was given by Edward Whitmont in his seminar Opening Doors. As soon as `we enter into psychological or psychoanalytical ®eld, we are no longer observing, we are interpreting'.20 Information in this ®eld is less reliable because psychological characteristics had necessarily to be based on the interpretive subjectivity of both the therapist and the patient. Jacques Jouanny went further and condemned not only the Kentian homoeopathic method but even the use of the repertories to arrive at the likely remedy. `Hahnemann warned against the use of repertories . . . ';21 ` . . . compared to Hahnemann's homoeopathic methods, which were somato-psychic, those of Kent are psychosomatic Ð in accord with the author's philosophy Ð detached from nosology. Strictly speaking, Kent's Repertory therefore is not `Hahnemannian' . . . '21 besides being not entirely trustworthy. But that is not all by any means. `Homoeopathy is a method of matching a set of symptoms in every system of the body with the drug picture' (my emphasis).16 Every system of the body, not just psychic ones. Yet despite using only the mental rubrics (and even those used were Ð as explained in detail above Ð the results of dubious interpretive subjectivity of the therapist), Aurum muriaticum 200 c Ð according to the case report Ð apparently worked! All one can say is that it was still not homeopathy. It might be that this and the `Essence' school have discovered an irrational and unproven therapy based on mystical and subjective predilections of the therapist in collusion with the gullibility of the patient. Unproven because apart from such therapists' inevitably subjective assessments of the positive outcomes (at least, in all cases reported) from their prescriptions, there were no objective criteria available to the readers for independently evaluating the results.
References 1 Schmidt JM. The esoteric and exoteric view of homoeopathy. Br Hom J 1998; 87: 100 ± 105. 2 Campbell A. Two Faces of Homoeopathy. Robert Hale, London, 1984 3 Campbell A. The two faces of homoeopathy. Br Hom J 1985; 74: 1 ± 10 4 Nietzsche The Gay Science, p 373 Ð quoted by Brian Leiter in the TLS, p 31, October 1998. 5 Risquez F. Psychiatry and Homeopathy New Delhi: B. Jain Publishers Ltd, 1995, p 128. 6 Clover AM. Hahnemann's theories of potentisation. Br Hom J 1987; 76: 195 ± 198 7 Hehr GS. Relevance of history to homoeopathy. Br Hom J 1985; 74: 163 8 Clover AM. A theory of tumour development. Br Hom J 1984; 73: 187 ± 191 9 Williams DTH. Homoeopathy and traditional Chinese medicine. Br Hom J 1985; 74: 76 ± 90 10 Hehr GS. Was Kent a Hahnemannian? Br Hom J 1984; 73: 71 ± 74 11 Peacocke C. Insights, truth and hope. T L S, 11th September 1998, p 34. 12 Leiter B. One health, one earth, one sun. T L S, 2nd October 1998, p 30 ± 31 13 Hehr GS. Relevance of history to homoeopathy. Br Hom J 1985; 74: 158 ± 167 14 Clover AM. Therapeutic implication of Hahnemann's theories on tumour development. Br Hom J 1985; 74: 12 ± 15 15 Cohen GA. Karl Marx's Theory of History, Oxford: Clarendon Press 1978, p 3 16 Leary B. How important are the mentals? Br Hom J 1986; 75: 177 ± 179 17 Maceoin D. The choice of Homoeopathic Models: The patient's dilemma. The Journal of the Society of Homoeopaths 1993; 51: 108 ± 114 18 Nicholls PA. Homoeopathy and the Medical Profession. Beckenham, Kent: Croom Helm 1988, p 271. 19 Iyer RL. The same but different. Hom Links 1997; 2: 38 ± 39. 20 Jouanny J. The Essentials of Homoeopathic Materia Medica, France: Boiron 1984, p 78. 21 Jouanny J. Against tendentious interpretations of Hahnemann's writings. Br Hom J 1989; 78: 123 ± 126
83
EDUCATION AND DEBATE
Was Kent a Hahnemannian? A Cassam1* 1
14 Westpoint, 49 Putney Hill, London, SW15 6RU, UK. This article voices concern at the trend among an in¯uential section of homeopaths the world over, to jettison Hahnemann's similimum principle and replace it with Kent's almost exclusive concentration on mental and psychic symptoms. This concern raises the question whether Kent was a true Hahnemannian. In order to discuss this question, two schools of thoughts are investigated. The ®rst argues that Hahnemann's theories were scienti®c whereas Kent's were metaphysical. The second criticises Kent's more severely for being metaphysical. At the same time, it accuses Hahnemann himself of increasingly losing his way, with increasing age, into metaphysical homeopathy. The author believes there was no break in Hahnemann's thinking as alleged, but a gradual development with increasing experience, together with judicious use of rational insight, when scienti®c explanation was not yet available. The yardstick used to accuse Hahnemann of being metaphysical is crudely empirical and long outdated. Keywords: rational insight; metaphysics; irrationalism; psychic symptoms
Introduction Was Kent a Hahnemannian? This question has exercised the minds of many thinking homeopaths since Kent was alive and practising. As recently as the April 1998 issue of the British Homoeopathic Journal, Joseph Schmidt wrote, `Kent's esoteric philosophy will seem utterly plausible to anyone who considers Hahnemann the greatest physician of all times, Kent a true Hahnemannian (my emphasis) and the law of similars a God-given revelation . . . .'.1 On the other hand, there have been many who have thought otherwise. Over the years, there have been two distinct trends of thought in this controversy. One critical school argued that Hahnemann's theories were scienti®c, by which they probably meant that his views were based on the laws of nature. On the other hand, this critical school believed that Kent's views were `metaphysical'. Presumably, Schmidt (quoted above) meant the same thing when he referred to `Kent's esoteric philosophy'. The second school of criticism accused Hahnemann himself of being metaphysical, but with the caveat that this applied to only Hahnemann in his later years. This school held that Hahnemann increasingly lost his way into metaphysical homeopathy as he grew older. *Correspondence author. A Cassam, 14 Westpoint, 49 Putney Hill, London, SW15 6RU, UK.
The most recent such critique was by Anthony Campbell in his book Two Faces of Homoeopathy published in 1985.2 Campbell's second thesis was that Kent was a follower of this later Hahnemann but went much further incorporating into homeopathy many of the mystical concepts of Swedenborg whose mystical philosophy he espoused wholeheartedly. In order to discuss these two schools of thought, I propose to investigate the three fundamental aspects of Hahnemann's theory. These are vitalism, dynamization or potentization and the theory of miasms. Campbell condemned all these three theories as metaphysical and, as remarked earlier, claimed they belonged to Hahnemann's later period starting in about 1821 when he was forced to move to the tiny principality of Kothen. In order to de®ne what he meant by `metaphysics', Campbell followed Karl Popper, according to whom all theories or concepts which were inherently in capable of objective falsi®cation by the established `scienti®c' methods were necessarily `metaphysical' At the same time, Campbell enlisted a mechanistic 18th century criterion for his de®nition. `By de®nition', he wrote, `the vital force cannot be seen or weighed; it cannot be detected by the senses or with instruments. It remains a mere theoretical construct and is no more accessible to scienti®c investigation than is the soul or the ether'.3 It is interesting to read what Nietzsche had to say about such a way of looking at the world. Nietzsche, who was a naturalist Ð meaning the way of under-
Was Kent a Hahnemannian? A Cassam
standing the nature through the universal laws and rules of nature Ð was nevertheless a ®erce opponent of the type of materialism advocated by Campbell. He asserted that such a mechanistic interpretation `that permits counting, calculating, weighing, seeing and touching, and nothing more, is a crudity and naivete, assuming that it is not a mental illness or idiocy'.4 Moreover, in enlisting the help of the 18th and part of the 19th century mechanistic and deterministic view of the world, Campbell was perhaps not aware that Hahnemann was following the ideas of Leibniz and Wolff, thinkers of impeccable philosophical credentials. According to Fernando Risquez, in his book Psychiatry and Homeopathy,5 the signi®cance of Leibniz's monadology in medicine was as follows: a Substance is the living force. b Everything that exists is made up of in®nite and eternal substances Ð the monads. c These monads may be classi®ed into: i. Monads of an inactive inorganic nature. ii. Monads of active but unconscious vegetable nature. iii. Monads of sensible animal nature. iv. Monads of rational human nature. According to Leibniz, therefore, the world is fully alive with beings animated by live forces of these four kinds of monads. Hahnemann used this concept of Leibniz and others to develop his theory of vitalism in homeopathic medicine.
Hahnemann's theory of vitalism For the purposes of our present discussion, vitalism and dynamization are being considered together because it was the process of dynamization, which, according to Hahnemann, released the spirit-like vital force. It is important to notice that Hahnemann arrived at the theory of vitalism not as a result of any preconceived predilection for such a concept. He came to it as his way of explaining the results of his experiments with smaller and smaller doses of medicines he was using for his patients. He experimented with smaller and smaller doses of medicines in order to reduce the toxic side effects or aggravations caused by these medicines when given in more concentrated form. He soon noticed that greater bene®ts were obtained when the indicated medicine was used in a diluted form, along with the reduction in aggravations. It was only after Hahnemann had observed this enhanced therapeutic effect with increasing dilution and succussion that the connection between dynamization and vitalism began to take shape in his mind. This in effect, reversed his previous assessment. This changed started early as 1814, only four years after the publication of the ®rst edition of Organon;6 although as late as 1824, he had not fully adopted the concept and even after that, `it was only as a probable explanation'.7 According to Ann Clover, in 1822±1827, Hahnemann started to use gradually increasing dilutions of medicines of up to 30 c.
Indeed, well before that, in the 2nd volume of his Materia Medica Pure in 1816, Hahnemann recommended the use of Arsenicum album in the 30th centesimal dilution.6 But he was against the use of any higher potencies beyond 30 c until 1833. In a letter written before 1833 to his Austrian and Russian colleagues, he expressed `his disapproval of potencies higher than 30th centesimal'.6 However, since there is not a single molecule of medicine left after 12c, we were already in the realm of Campbell's `metaphysics' as early as 1814±16 rather than 1821 as claimed by him. Moreover it also showed that there was no break in Hahnemann's, but a gradual evolution of his thinking, based on practice and experience. It has to be said that it is not clear on reading Campbell, whether he regarded the introduction of 30 c, or only the use of much higher potencies, as `metaphysical'. If the latter, his claim that by 1828, Hahnemann was well into his `metaphysical' period, cannot be sustained for, even at the time of the publication of his Chronic Diseases in 1828, and indeed as late as 1833, Hahnemann was not in favour of the use of potencies above 30 c.6 As far as vitalism was concerned, it was in the Preface of the 5th volume of Chronic Diseases that Hahnemann drew a distinction between dilution and dynamization with succussion. The latter was a process of preparation `by which the medicinal properties which are latent in natural substances while in their crude state, become aroused, and then become enabled to act in an almost spiritual manner on our life'.6 Hahnemann then went on to suggest that every human organism, whatever its state of health, was ruled by its vital force. A similar vital force was lying dormant in each natural substance, which was then released by the process of dilution and succussion. When the released vital force of the medicine was applied to the cause of the disease in the prescribed manner, healing resulted. The concept of spirit-like vital force even in an inanimate substance being released by dynamization that is by serial dilution and succussion, was a far cry from the religious or esoteric concept of spiritualism. It was the crude empiricism of critics like Campbell, which rejected everything which could not be seen or weighed or measured or detected by senses as `metaphysical', which was in fact out of line with the advancing knowledge. The idea of solid entities or irreducible atoms had long since been exploded. Campbell's idea was an inheritance from the crude empiricist world-view which, when applied to medicine, insisted on denying that a disease was a `real' one unless it revealed gross physical signs supported by clinical data and laboratory ®ndings. The absence of such corroboration meant that there was no `real' cause to be found and therefore the disease did not exist. Long before the advent of psychology and psychiatry, Hahnemann coined the word `vitalism' to refer to those factors. In to-day's language these would be considered psychological factors. Long before Freud and Jung, Hahneman realised that `Since the physical body is a
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dynamic form, it follows logically that the energies of thought and feeling are in continuous kinetic interaction with the apparently physical aspects of being'.8 He realised over years of practice and experience that factors initiating a disease were dynamic and were not always capable of being recognised or diagnosed by physical, chemical or laboratory analysis. If this was metaphysics then Freud and his followers were metaphysicians par excellence. It is true that within last few decades, Freudian psychoanalytic theories and the method itself have come under severe critical onslaught, some of which, I believe, is deserved. But the point I am making is in no way affected by this controversy. What remains a fact is that Freud's theories were accepted by the establishment of the time and helped to bring into general acceptance the role of psychosomatic factors in the development and progress of the disease. This was precisely what Hahnemann contended in the only vocabulary that was available to him at the time.
Kent's theory of vitalism This leads us directly to Kent and his role. Hering, but especially Kent, who brought the seminal formulations of Hahnemann into disrepute by turning his `vital force' into god-like spiritual force. For Hahnemann, the vital force was an unconscious force without the capacity for re¯ection and moreover, it was present in both animate and inanimate things. The resemblance between Hahnemann's `vital force' to the concept of `Qi' (Chi) in traditional Chinese medical philosophy, is extremely close.9 The Qi, like the vital force is believed to be present both in animate and inanimate substances. The Qi itself consisted of `Yin' and `Yang' and was the source of all change. Chinese Taoist philosophy did not postulate any divine creator, but this was the predominant concern of Kent and played a crucial role in his homoeopathic thinking. Kent moved away from this Hahnemannian concept of the vital force and the Taoist concept of Qi. He substituted his own concept of `simple substance' and then proceeded to turn this into an explicitly religious concept. For him, the simple substance was endowed with formative intelligence. In this, and in re-interpreting a number of other seminal Hahnemannian concepts, he followed the Swedish mystic, Emanuel Swedenborg. For Swedenborg, the idea that there was a mystical correspondence between the spirit world and our own, was fundamental. He also believed that the form and the function of man was modelled on and re¯ected that of heaven. Whatever happened in the spirit world must have its correspondence here on earth. It was natural for a Swedenborgian like Kent to regard this correspondence as divinely ordained Law of Nature. In his Lectures on Homoeopathic Philosophy he stated, `We must begin by having respect for law . . . .
Let us acknowledge the (its) authority.' (p.19); `It is necessary that the exact and proper position of experience should be realised . . . . Experience has only con®rmatory place. It can only con®rm that which has been discovered through principle. (That is Law) . . . . Experience leads to no discoveries . . . . One who has no doctrines imagines he discovers by experience.' (p.43). This meant that, for Kent, the process of discovery and advance in knowledge in any ®eld of human endeavour through research and experiment was irrelevant. What one needed was the knowledge of the Divine Laws and this was for him the foundation of homeopathy.
Contrasts between two views highlighted There could be no greater contrast between these views of Kent and those of his supposed mentor. For Hahnemann, `The true healing art is in its nature a pure science of experience . . . '; . . . 'the complete true healing art . . . (is) only to be discovered by due attention to nature by means of our senses, by careful honest observations and experiments conducted with all possible purity and in no other way'.10 This of course did not mean that empiricism should be the only guide. Another legitimate guide might be rational insight. Christopher Peacocke, reviewing the book entitled In Defense of Pure Reason by Laurence Bonjour in the Times Literary Supplement wrote, `there must, he (the author) argues, also be a priori principles, which ensure that we are epistemically justi®ed in having beliefs about matters beyond our immediate experience'.11 Hahnemann himself, I would contend, made full use of this rational insight in trying to interpret the results of his experiments with medicines. However, this is a diametrically opposite position to that of Kent who would have absolutely nothing to do with facts discovered by due attention to nature by means of our senses, by careful honest observations and `experiment' or the achievement of a new insight with the help of pure reason. It is interesting to read Nietzsche in Beyond Good and Evil where he wrote about man who `is hardened in the discipline of science, he stands before the rest of nature, with intrepid Oedipus eyes and sealed Odysseus ear, deaf to the siren songs of old metaphysical bird catchers, who have been piping at him all too long, `You are more, you are higher, you are of a different origin!' ` (my emphasis).12 Spinoza said the same thing. `So the way to understanding nature of anything, of whatever kind, must always be the same, viz through the universal laws and rules of nature'.12 This was exactly what Hahnemann believed. He wrote in another context, ` I demand no faith at all, and do not demand that anybody should comprehend it; it is enough that it is a
Was Kent a Hahnemannian? A Cassam
fact and nothing else. Experience alone declares it and I believe more in experience than in my own intelligence'.10
Hahnemann's theory of miasm The third ground on which Campbell accused Hahnemann himself of metaphysics, was his theory of `miasms'. To quote Campbell, `If you read Hahnemann's account of the manifestations of psora, you will see that they include almost every imaginable symptom and disease. Ask yourself what form of chronic disease is not due to psora, and you will see the dif®culty; by explaining everything, the theory really explains nothing . . . '.3 In the absence of scienti®c evidence available in his time, what in fact Hahnemann was trying to do was to ®nd some rational way of explaining the cause of the disease in the same naturalistic tradition of Nietzsche and Spinoza and indeed of Freud in the 20th century. Well before the science of microbiology developed, Hahnemann had begun to use the term `miasm' to refer to `infecting living parasites' a little later, in 1830, he referred to this phenomenon as based on `brood of . . . .excessively minute, invisible creatures'.13 Hahnemann's theory of chronic diseases including tumour formation, was based upon various psychological, physical and environmental factors interacting with latent hereditary traits which he called `miasm'. It was a theory, which bears comparison with the modern development in the medical thought where `inherited traits or miasms'14 are increasingly seen as predisposing causes for activating the onset of chronic diseases, including the onset of malignancy. In Hahnemann's early 19th century language, only those persons with such latent `miasm' were susceptible to succumb when exposed to external and internal initiating factors. `His theories on treatment of chronic disease therefore include discussion of remedies intended to provoke a suitable counterreaction to the latent trait or miasms which he argues is activated to produce gross symptoms as well as those appropriate to precipitating factors . . . '.14
Kentian irrationalism On the other hand, Campbell's strictures on the Swedenborgian twist given to the miasm theory of Hahnemann by Kent and his followers were, I believe, perfectly justi®ed. Kent was responsible for importing into Hahnemannian classical homeopathy, his own dogmatic and moralistic prejudices. For him and his followers, disease was seen `as the blight of the corrupted spirit'. It was moral as well as physical problem and the treatment of the mind and the soul an integral aspect of the therapeutic endeavours. `The Swedenborgian gave a de®nite moral twist to the miasm theory.'; `For Hahnemann, the miasms had been acquired `infections', but for the Swedenborgians they were moral
taints passing from generation to generation, and psora in particular took on some of the characteristics of Original Sin' (my emphasis).3 Thus according to Kent, all diseases were built on psora. It was the very primitive wrong and the spiritual sickness of the human race (my emphasis).10 Schmidt's `The Esoteric and Exoteric View of Homoeopathy' in a recent issue of the British Homeopathic Journal was devoted to comparing the philosophical giant, Hegel's `Absolute Idealism' with Kent's crude religious mysticism. Hegel's main project his major works Philosophy of History, was to explain his conception of history as `life of the world spirit'. `History, according to Hegel, `is not miscellany of the mighty deeds and catastrophes. It is the increase, now gradual, then sudden, in the self-awareness of the world spirit'.15 Kent's main `philosophical' project, on the other hand, was rather a pedestrian one. It was to try and reconcile homeopathy with his interpretation of Christian theology, ` . . . that theology and homeopathy `cannot be divorced', that divine providence must be recognised . . . '.1 My other criticism of Schmidt is the use of the concepts `esoteric' and `exoteric', which instead of elucidating, cause confusion. They seemed to imply that the author believed that all true homoeopathic practitioners, like Kent, explain `homeopathy esoterically'. On the other hand, according to the writer, a homoeopathic physician in¯uenced by the so-called `exoteric' view, will have greater `potential for scepticism, mistrust, uncertainty, generalisation, lack of motivation and ultimately, often a super®cial approach to history taking, analysis and prescribing . . . ' (!) (my emphasis).1 I have discussed in some detail this article, to demonstrate the powerful hold of Kentian irrationalism on otherwise Ð presumably Ð rational individuals to the detriment of homeopathy in general. It was the association of psora to the very primitive wrong and the spiritual sickness of the human race that was the basis of the exclusive prominence given to the mental symptoms in Kent's repertory. The claim made in the foreword of his repertory that he was following Hahnemann in giving primacy to the mentals, was totally false. The mind certainly played a very signi®cant part in affecting the disease processes; but primarily and most importantly, Hahnemann's homeopathy was matching a set of symptoms with a drug picture and especially the matching of uncommon and peculiar symptoms of the patient with similar symptoms recorded during drug provings. But for Kent, the whole picture was a mystical one. `The will and understanding constitute Man; conjoined they make life and activity. With the will and understanding operating in order we have a healthy man . . . '.16 Here again, Kent was putting across the primacy of the mental symptoms at the expense of principle of similimum, which formed the foundation of Hahnemann's homeopathy. For classical homeopathy
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could literally be de®ned as a therapeutic method which clinically applied law of similars.
Triumph of the Kentian approach in the U.K. Writing in the The Journal of the Society of Homoeopaths, Dennis Maceoin expressed his great concern about the metaphysical approach to homeopathy in mostly lay homoeopaths. `What worries me', he wrote, `is the possibility that this leaning towards metaphysics instead of rational, empirically based medical practice may retard the process of broad political and scienti®c acceptance of homeopathy for decades, if not inde®nitely'.17 He however, rejoiced in the fact that `rational tradition of homeopathy continues to ¯ourish within the ranks of doctor homoeopaths'.17 To quote again: `But it is clear that the dominant tradition among medically-trained homoeopaths remains much closer to the secular rationalist and scienti®c ideals of the wider medico-scienti®c community within which they have been educated and to which most of them still aspire to belong'.17 These were very interesting observations in view of the fact that according to one survey published in 1962, `eighty percent of British and American homoeopaths who had graduated from regular medical schools, belonged to religious minorities and=or believed in reincarnation'.This information was incidentally gleaned by the author from Br Hom J., Vol L1 (1962).18 Moreover, despite the wholesale incorporation into homeopathy of the mystical and metaphysical Swedenborgian philosophy by Kent, the Kentian school became victorious within the same medically quali®ed homeopathic establishment in Britain. `We (Kentians) are now the of®cial voice of British homeopathy, and . . . we sincerely believe ourselves to be the chosen people who are correctly interpreting Hahnemann's teaching' (my emphasis).18 This view got further support in 1998 `Homoeopathic literature generally explains homeopathy esoterically that is as seen through the eyes of devoted practitioner, in terms of faithful obedience to universal laws, eternal truth, divine revelation, etc' (my emphasis).1
Hahnemann's similimum principle jettisoned This at last brings me to the main reason for my article. It is to voice serious concern and even dismay at the almost unstoppable trend within a very signi®cant and in¯uential section of homoeopaths Ð both lay and medically trained Ð to jettison Hahnemann's similimum principle that formed the backbone of classical homeopathy, and replace it with Kent's almost exclusive concentration on the mental symptoms.
I will illustrate this with just one case presented by Dr R. Latha Iyer in the Asian edition of Homoeopathic Links.19 In case 2, Dr Latha Iyer described a case where all the ten rubrics taken were mentals. What was even worse, those taken were based on the homoeopath's own personal interpretation of patient's history, which seemed highly suspect to say the least. This patient had no one to look after her and she therefore felt lonely. `So she also (my emphasis) thought of committing suicide.' The rubric taken for this mild expression was, `Loathing for life'. This sounded to me as simply incredible. `I was religious right from childhood', the patient had reported. How many Indian women in India (and also men) were not religious from childhood? Notwithstanding, the rubric taken was `religious'! Another rubric taken was `Caring' without the least evidence produced for it. Most Indian women are indeed very caring for their children especially when they also happen to be boys. `Caring' might have meant something if it was shown that she was generally caring towards outsiders as well. There was nothing in her own story or hobbies (watching cricket, playing carrom) to indicate this. On the contrary. Her two sons were married in her absence, presumably due to her objection to `intercaste' marriages: `My two daughter-in-laws were already known to me but I still have hatred towards them' (my emphasis). Why? Was it because her two sons' wives came from different castes? Whatever the reason, one surely needed an opposite rubric to `caring' if one was to be used at all. The same applied to the rubric `sympathetic' which was also used. The only mental `change' reported by the patient was that she had become irritable during her illness. But that was ignored, in line with, one supposes, `the attitude of Kent and his spiritualist school which went so far as to say that `pathognomonic signs of the disease have no importance in the selection of the homoeopathic drug'.10
Conclusion Fortunately, all is not lost for classical homeopathy. Kent's metaphysical homeopathy has been repudiated by some highly reputable homeopaths who have elected to follow Hahnemann's classical homeopathy. In his book entitled Essentials of Homeopathic Therapeutics,20 the eminent French homoeopath, Jacques Jouanny categorically stated the opposite. `Only changes in general behaviour during the course of the illness should be taken into account . . . '; `It should never be forgotten that for Hahnemann the only reactional symptom to be considered was change in the way of feeling or acting' (my emphasis). `The character of the patient is only important if the change in the nervous behaviour occurred at the same time as the chronic disease'. As for psychic symptoms, `They
Was Kent a Hahnemannian? A Cassam
are, however, too unsure for homeopathic physicians to base reactional therapy on them'(p.78). Similar advice in a different context, was given by Edward Whitmont in his seminar Opening Doors. As soon as `we enter into psychological or psychoanalytical ®eld, we are no longer observing, we are interpreting'.20 Information in this ®eld is less reliable because psychological characteristics had necessarily to be based on the interpretive subjectivity of both the therapist and the patient. Jacques Jouanny went further and condemned not only the Kentian homoeopathic method but even the use of the repertories to arrive at the likely remedy. `Hahnemann warned against the use of repertories . . . ';21 ` . . . compared to Hahnemann's homoeopathic methods, which were somato-psychic, those of Kent are psychosomatic Ð in accord with the author's philosophy Ð detached from nosology. Strictly speaking, Kent's Repertory therefore is not `Hahnemannian' . . . '21 besides being not entirely trustworthy. But that is not all by any means. `Homoeopathy is a method of matching a set of symptoms in every system of the body with the drug picture' (my emphasis).16 Every system of the body, not just psychic ones. Yet despite using only the mental rubrics (and even those used were Ð as explained in detail above Ð the results of dubious interpretive subjectivity of the therapist), Aurum muriaticum 200 c Ð according to the case report Ð apparently worked! All one can say is that it was still not homeopathy. It might be that this and the `Essence' school have discovered an irrational and unproven therapy based on mystical and subjective predilections of the therapist in collusion with the gullibility of the patient. Unproven because apart from such therapists' inevitably subjective assessments of the positive outcomes (at least, in all cases reported) from their prescriptions, there were no objective criteria available to the readers for independently evaluating the results.
References 1 Schmidt JM. The esoteric and exoteric view of homoeopathy. Br Hom J 1998; 87: 100 ± 105. 2 Campbell A. Two Faces of Homoeopathy. Robert Hale, London, 1984 3 Campbell A. The two faces of homoeopathy. Br Hom J 1985; 74: 1 ± 10 4 Nietzsche The Gay Science, p 373 Ð quoted by Brian Leiter in the TLS, p 31, October 1998. 5 Risquez F. Psychiatry and Homeopathy New Delhi: B. Jain Publishers Ltd, 1995, p 128. 6 Clover AM. Hahnemann's theories of potentisation. Br Hom J 1987; 76: 195 ± 198 7 Hehr GS. Relevance of history to homoeopathy. Br Hom J 1985; 74: 163 8 Clover AM. A theory of tumour development. Br Hom J 1984; 73: 187 ± 191 9 Williams DTH. Homoeopathy and traditional Chinese medicine. Br Hom J 1985; 74: 76 ± 90 10 Hehr GS. Was Kent a Hahnemannian? Br Hom J 1984; 73: 71 ± 74 11 Peacocke C. Insights, truth and hope. T L S, 11th September 1998, p 34. 12 Leiter B. One health, one earth, one sun. T L S, 2nd October 1998, p 30 ± 31 13 Hehr GS. Relevance of history to homoeopathy. Br Hom J 1985; 74: 158 ± 167 14 Clover AM. Therapeutic implication of Hahnemann's theories on tumour development. Br Hom J 1985; 74: 12 ± 15 15 Cohen GA. Karl Marx's Theory of History, Oxford: Clarendon Press 1978, p 3 16 Leary B. How important are the mentals? Br Hom J 1986; 75: 177 ± 179 17 Maceoin D. The choice of Homoeopathic Models: The patient's dilemma. The Journal of the Society of Homoeopaths 1993; 51: 108 ± 114 18 Nicholls PA. Homoeopathy and the Medical Profession. Beckenham, Kent: Croom Helm 1988, p 271. 19 Iyer RL. The same but different. Hom Links 1997; 2: 38 ± 39. 20 Jouanny J. The Essentials of Homoeopathic Materia Medica, France: Boiron 1984, p 78. 21 Jouanny J. Against tendentious interpretations of Hahnemann's writings. Br Hom J 1989; 78: 123 ± 126
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