Happy Birthday, Samuel Hahnemann

Today is the birthday of Samuel Hahnemann, the man who created homeopathy. It is a good reason to reflect on the evolution of science, and the mistakes that were (and are) made in the process.

Today is the birthday of Samuel Hahnemann, the German physician who created homeopathy, a system of healing that is currently enjoying a revival. He was born on April 10th, 1755 in Meissen, Saxony, in a family of porcelain painters and designers. Hahnemann studied medicine at Leizpig and Vienna, and graduated as an MD at the University of Erlangen on August 10th, 1779. He quickly became disillusioned with medical knowledge and practice, thinking -quite correctly- that it did just as much harm as it did good. As a result, he abandoned medicine and started working as a translator and language teacher. He died in Paris, on July 2nd, 1843. One of the works he translated, was A Treatise on the Materia Medica, by William Cullen. In the book, he read that the bark of Cinchona, a South American shrub or small tree, was effective in treating malaria, thanks to its astringent properties. Hahnemann claimed that other astringents did nothing to reduce malaria, so he was sceptical and tried it on himself. He said that the bark had a malaria-like effect on him and concluded that similia similibus curentur or like cures like, meaning that illnesses should be cured by a product that caused similar symptoms as the illness it is supposed to cure, an approach he called "homeopathy". Like cures like may sound ridiculous now, with the benefit of hindsight, but it wasn't so ridiculous at the time. We must not forget that medicine was a very primitive (non-)science at the time. Although micro-organisms were known for more than a hundred years, germ theory, one of the fundamentals of modern medicine, had yet to be discovered. Hahnemann began practicing his new method and wrote several articles about it and published the first version of what can be called the Bible of Homeopathy, the Organon der rationellen Heilkunde in 1810. Later editions were called later to be called Organon der Heilkunst. The book was highly successful and was translated in English under the title Organon of medicine. I often like to compare Hahnemann's Organon with a book that has appeared 40 years later, Darwin's On the Origin of Species. While the second is a delightful read, even today, the first is almost impossible to endure. The reason for this is simple: Darwin was a true scientist. He worked through observation, verification and falsification. Hahnemann was not a true scientist. He had stumbled upon something he was convinced to be true and he sought only to confirm that which he "knew" to be true. As a result, the first part of the book is essentially a rant against the medical practice of the time, which was, let's face, a sinister affair. This was the time of heroic medicine where the cure was often deadlier than the disease. The second part, explains homeopathic practice and is just about equally boring. However, when read from a proper perspective, it is quite entertaining, for it gives us a glimpse in the way people of the time were looking at the world around them, and at diseases in particular. Although Hahnemann's book was controversial from the beginning, he had one great thing going for his hypotheses: they worked. Although no reliable statistics are available, it is not much of a leap of faith to accept that Hahnemann's patients were -on average- probably quite a bit better of than those choosing "scientific" medicine. Medicine was still much closer to magic than it was to science. It is not my intention to discuss the entire Organon at this time, but allow me to quote this passage from the first American edition:

It has often happened that a letter, written in the chamber of a patient, has communicated the same contagious disease to the person who read it. Can we entertain the opinion, that any thing material entered into the humours in this instance? But why all these proofs ? How often have we seen that an offensive or vexatious word has brought on a bilious fever which endangered life;—a superstitious prophecy of death, actually occasion death at the very epoch predicted ; afflicting news, or an agreeable surprise, suddenly suspend the vital powers? Where is there, in any of these cases, the morbific material principle, which entered, in substance, into the body, which produced disease and kept it up, and, without the expulsion or destruction of which, by medicines, all radical cure would be impossible?

The supporters of an hypothesis so gross, as that of morbific principles, ought to blush, that they have so thoughtlessly overlooked and disregarded the spiritual nature of our life, and the spiritual dynamic power of morbific agents, and have thus reduced themselves to mere scouring physicians, who, instead of curing, destroy life by their attempts to drive out of the body peccant matters which never had an existence there.

Hahnemann is suggesting here that there are nearly no diseases that have a physical cause but that the vast majority of diseases have only a spiritual cause. This is important, because this is one of the principles many of today's homeopaths still believe. Why, for example, vaccinate against diseases, if they are only spiritual anyway, and not caused by microbes? It is ironic that Hahnemann who published his first article on homeopathy in 1796, the very year that the British physician Edward Jenner tested a cowpox vaccine as an immunization method against human smallpox (he was not the inventor of vaccination, however), was actually in favour of vaccination and that so many homeopaths are now endangering the lives of their patients by advising against it. The very one thing that Hahnemann got right, is the thing his followers deny. So, what are the principles of homeopathy? I mentioned the first one already: like cures like. According to the Organon, a patient is administered a substance that causes (in a healthy person) the same symptoms it causes in a person who is ill. This is a natural way to create an artificial disease on which the body then concentrates when it (or the vital force) perceives it as a bigger threat. By attacking the artificial disease, the original one is annihilated with it, never to be seen again. This is not necessarily as silly as it sounds. Imagine that you are looking at a burning candle in the dark. You see the flame quite clearly. However, if someone now shines a floodlight straight in your face, you will be blinded by the stronger light and the light of the candle will simply disappear from your perception. The second part is that the substance which is used to create the artificial disease, must be highly diluted. The more it is diluted, the less it will weaken the vital force which can then attack the original disease even better. For example, if the toxic substance is a plant, the homeopath must mix equal parts of the fresh juice of the plant and alcohol. Of that mixture, he/she must take two drops and mix that with 98 drops of alcohol (i.e. 1% juice, 99% alcohol). This mixture must be succussed twice (fifth edition of the Organon). Succuss is a medical term, it means "shake". Of this mixture, 1 drop must be taken and diluted with 99 drops of alchohol, followed by two succussions. This process must be done 29 times in order to obtain a so-called 30C dilution, according to Hahnemann, the most common dilution. This is called "potentization": the more diluted and succussed the substance is, the more powerful it is. The succussion is vital in this process. Hahnemann claims in the Organon that doctors who take their preparations with them on the road risk making them too powerful, as a result of too much shaking: they had no concrete or asphalt roadways in those days, and the horse-drawn carriages of the time weren't quite as comfy as today's shock-absorbing vehicles, shaking was definitely a reality. Again, it is easy to merely dismiss this as utterly silly, but science had not yet discovered the atom at the time, so there was no reason to suspect that dilutions could not go on forever. We now know that at a dilution of 30C (which is equal to 10 to a power of 60), there is not a single molecule left in the product unless sheer luck would decide otherwise, and that it is pure alcohol (or water, since water is used as well). As improbable as it may sound, homeopathy was actually quite valuable when it was invented. Since medicine was such a dangerous endeavour for the patients, they were, statistically speaking, a lot better off with homeopathy than with medicine. Since homeopathic products contain no active substances, they did no harm, giving the patients a better chance of survival. That also explains the huge success of homeopathy at the time. Fortunately, we have since long moved beyond this type of practice and medicine is -again, statistically- far better at saving and prolonging lives than it once was. The safety provided by non-treatments such as homeopathy is no longer a rational option. That said, I think that it is important not to forget Hahnemann and his homeopathy. It is part of the sinuous road humanity is following from the darkness of ignorance and superstition to an ever better understanding of reality. Hahnemann and his theory deserve to be remembered, along with other now defunct theories, such as the phlogiston theory, the homunculus theory, creationism and the Ptolemy's geocentric astronomical model, to name but a few. Therefore: Happy Birthday, Samuel!