Paulo Rosenbaum
Hahnemann, 266 years later
Born on April 10, 1755
“Man, considered as an animal, was created more helpless than all other animals. It has no congenital weapons for its defense like the bull, no speed to make it able to escape from its enemies like the deer, it has no wings, it has no feet with interdigital membrane, it does not have fins – it does not have impenetrable armor against violence like the land and freshwater turtle, nowhere to take refuge provided by nature because it is dominated by thousands of insects and worms for your safety .. Man is subject to a very large numbergreater disease than animals, which are born with a secret knowledge of healing methods for these invisible enemies of life, instinct, which man does not possess. The man alone painfully escapes his mother’s womb, smooth, soft, naked, helpless, helpless and deprived of everything that can make his existence bearable, deprived of everything that nature richly contemplates the earth’s worm to make his life happy.”
Samuel Hahnemann in “The Medicine of Experience”
The researcher and the thinker.
First of all, I think it would be fair to explain what will not be prioritized in this work. We will not be concerned with the famous paragraphs of the “ Organon ”, or with the topics of “ Chronic Diseases ”, nor do the conventional revision of its tumultuous biography. We try to take the facts created by Hahnemann as ideas and from these search — using the bio-bibliographic parallels — the clues that led us to the process of creating his theories. Our character played at least two simultaneous and interdependent roles in the sphere of knowledge: researcher on the nature of health phenomena and thinker.
Due to a careful and intentional methodological option, we will not consider your works as finished and definitive pieces. There is never an end to real scientific constructions. On the contrary, we see in its corpus (frequently and naively exalted by its irreplaceable coherence) theoretical gaps, methodological gaps and operational contradictions . We will try to show that all these “inconsistencies” can lead us to interesting logical developments of the original propositions. Correctly assessed, contradictions allow for rediscoveries. Searched gaps and gaps favor the end the progress of clarifications, not the only one, but the last end of scientific knowledge. In this way, we, the descendants and legatees of this medical philosophy, will be able to penetrate each historical segment of their arguments.
We used authors like Koyre, Canguilhem and Khun to better situate Hahnemann’s attack against the normal science of his time, like that of a spirit that is mobilized to undertake and change the medicine of its time. We will weigh the socio-historical influences of the 18th and 19th centuries and seek to show that scientific changes often occur not only through empirical reforms, but mainly, through philosophical movements that redefine scientific horizons and make such reforms possible. In our case, we will see that both the romantic movement and natural philosophy are part of the theoretical trenches that expanded and built the support for transformations.
Backed by historical epistemology, we conclude, quoting Prof. Roberto Machado, that chronological anteriority is not always a logical inferiority. It is possible to apply such a concept in any science, including Hahnemannian work. I explain with an example familiar to our topic. We must consider the hypothesis that perhaps the sixth edition of Organon is not – although the author himself considers it the closest to perfection – the point of greatest evolution of the method. It is also possible to consider that the homeopathy that we do today is not necessarily a progress in relation to the practice of the pioneers. We can even suppose that many of the discussions that we have today, under the illusion of originality, are only faint echoes of what has already been exhaustively and creatively debated and practiced.
From this perspective, we do not consider it any discredit, but proof of vitality to examine issues that have been surprisingly active for over two and a half centuries. This persistence denotes the tenacity of the Hahnemannian records. Studies that privilege critical bias are the only ones that honor the script of science, for if Hahnemann entered the historical debate it was precisely because of his ability to let himself be affected by the surprising phenomena that he was unveiling. Only in this way will we understand the historical-philosophical flow that underpinned it, with the multiple perspectives that its challenges have been launching in these two centuries of permanence.
The inaugural doubt can then be presented: once Hahnemann updates and incorporates scientific modernity in its inductive perspective, including the search for experimental validation , what would be its distinguishing mark in the investigation of medical phenomena? Just beyond that, what will be the point of your exhaustive research? It seems clear that by subscribing to the therapeutic reform originated in the objections of island (Sydenham, Hunter) and French (Bichat, Fodera) clinicians regarding the use of medical material and its therapeutic manipulation, our author puts himself in line with the empirical reform that was taking place. sketching.
Only afterwards did he subvert the order installed in the medical sciences and turn the traditional clinic into an uproar by proposing a very unique and original modernity, especially in relation to the use of drugs in their practical application.
Let’s go back to the end of the 18th century. The thick curtain of the methodological monopoly reigned in the era of the great medical systems. Hahnemann is engaged in what was considered the best medicine of his time. In the end, he did not envision any regeneration for the serious and recurring mistakes found. Let us understand his situation at once: he is a desperate doctor who can no longer act with what he had been trained (that is, treat patients) without serious damage to his conscience. It then restricts itself to adopting a relatively innovative hygienism. He begins to loathe the therapies he witnesses. He prefers to give up clinical practice. Fortunately, his intuition was refractory to his skepticism. He argued his intellectual distrust under the avalanche of uncertainties that obsessed him. He considered it better and admitted that there might be something to be done, notions that deserved to be revisited. Initially it imposes an induction, apparently inspired by the prerogatives of an author who, strangely, never mentioned: Francis Bacon.
We must see the enormous effort of his rescue. It seems clear that the traces left by the medical history for which it was based as a starting point have become its main epistemological guidelines. Hahnemann captures ideas that have not been preserved from the medical tradition, with a view to reincorporating them. When it is finally defined by a method it tests it. But it is certain that the usual methodological losses will not be condemned by the aphorisms of the Novum Organum . It also denies the very common acquisition of knowledge through the application of drugs to the sick (ab usage in morbis ). His interest moves to another research matrix. But where is she? Apparently in the study of the effects of poisoning and accidental poisoning on the healthy.
The year 1796 was decisive in its trajectory. After several smaller essays, published in the same Hufeland newspaper , H. writes a work that will carry a very ambitious title. There he claimed to have discovered nothing less than “a new principle for ascertaining the medicinal power of drugs”. However, how could he announce a novelty when much earlier, as he and even evoked from medical historiography, the principle of similars had already been seen and applied? Analogy and sympathies were marked as common grounds for similarity’s discursive constructions.[1] These were ancient resources, old acquaintances of the healing art. How then does he claim that he induced the birth of a new system of medical understanding when the medieval physician Rhazes and another famous scholar of illustration, Von Haller, already admitted the need to bring the experiment on the healthy to medicine?
What abuse of self-referential sources was he promoting when he claimed to be both an agent and a witness, that is to say, the main protagonist of an announced revolution?
There is perhaps one of those logics of scientific discoveries which, as Khun admits, are motivational, psychological, and therefore crucial. At the end of the 18th century, we would find Hahnemann extremely unhappy. He fueled a deep skepticism in the face of the inefficiency he contemplated. He distrusts his practice by denying the therapeutic successes enacted by his peers. It does not seem to admit that the scientific revolution had really installed itself in therapeutics. It also rebels against the comfort of the repetitions of the chairs. Randomly rummages through the pandora box of medicine. His curiosity generated a significant breakdown in his medical certainties. With intellectual boldness and determined intuition, she puts everything into perspective. Hahnemann is no longer a skeptic: he is already an iconoclast.
The Meissen guy dares to think. It is a true obsessive metaphor, the leit motiv that plagues certain subjects in certain temporal units. His rupture stems from a rational inspiration, fueled by a scientific curiosity that confirms his purpose of methodically reexperiencing and the assumption that he must expose his hypotheses to empirical tests. Tests that, to their own astonishment, are provisionally sanctioned.
The problem of identities and influences: hip ochratisms, animisms and vitalisms.
Much has been discussed about the Hahnemannian sources and it is true that thanks to this we have advanced in the understanding of the bases on which he ends up configuring the homeopathic method. There is still a lot to study. We chose to reduce our approach to the influences that, in our opinion, were the most consistent and original. The first to be highlighted is that of the Hippocratic work. There is no doubt that this influence is notable in addition to many times explained by Hahnemann. [two]
It is impossible to doubt the fascination that genuine Hippocratic writings had on him. The sobriety in describing the phenomena, his ability to peer and reveal without trying to explain what he did not know was among his main virtues. As you know, the Hippocratic doctor should be, first of all, a physiologist , that is, someone who is able to speak correctly about nature. In fact, the supreme virtue of Greek doctors was the establishment of accurate prognostic observations. Or, in this impossibility, say nothing about them.[3]
Many authors pointed to the coincidences between the medical positions of Hahnemann and Hippocrates, calculating that this was yet another reactivation of Greek wisdom.[4] As we know, clubbing simply bases medical history on medicine. Each case must be seen in its particularity and each individuality must be examined in the multiplicity of possible responses.[5] Hahnemann recognizes in the Kos tradition a less invasive, natural and rational, therefore better, medical rationality. He knows the therapeutic limits of hippocratism, so he recognizes the prognostic and diagnostic virtues , after all Hippocrates was the one who introduced the case study by comparison through anamneses.
For Hippocratic medicine that applied the Aristotelian concept of individualization, the important thing was to discern the various pathologies within the variability of individual profiles. Its purposes: to diagnose and predict better. For Hahnemann, foreshadowing the germ of his subsequent ruptures, the particularities of the subject’s biographical / pathographic events also begin to stand out , with eminently therapeutic purposes.
More than one author tried to establish a parallel between Hahnemann and the works of authors from different eras and trends such as, for example, Paracelsus, Von Haller, Claude Bernard, Pavlov and Freud. There is a possibility to justify all these influences and inspirations, but in this study we will take another direction. Other halos of influence need to be exposed.
Chronologically, it is worth mentioning some great previous adventures that have left their mark on the history of medicine. We will start with the Vesalius coverings founding the modern anatomy and establishing the correlation between anatomical form and function. Of course, the break created by Paracelsus and its developments in therapy cannot be neglected in any serious homeopathic study. Nor is Sydenham’s systematic empiricism, of evident hypocratic inspiration. Or even the perspectives of an animated anatomy introduced by Von Haller when he induces the first consistent physiological studies towards overcoming humoral-based pathology , a prolonged inheritance of Galenism. Not to mention the enormous repercussions on all medicine in the 18th century of Morgagni’s research when it correlated experimentally – in systematic autopsies – clinical history and anatomical lesion demonstrating the almost linear correspondence between the complaints and the morphological substrate of the pathology.
Hahnemann studies and cites each of these authors, so it is impossible to doubt his option for empirical validation. The authorities he evoked are mostly clinicians and researchers of eminently experimental ballast. It is a phase in which Hahnemann is particularly interested in the study of chemistry, venereal diseases, and, of course, poisonings
Despite renouncing the idea[6] , our author presents many similar traits to the founder of medical animism, Stahl.[7] Both excellent chemists. They are among the best of their generations, formed under the influence of the schools of Sylvius and Van Helmont[8] (iatrochemistry). Both are among the most reputable medical researchers in their respective periods. They share the same indignation at the irrational interventionism they witness. They test their hypotheses and redefine their activity: from chemistry to the investigation of the vital phenomenon. That was a moment of effervescence in the century of enlightenment: the emergence of empirical physiology was witnessed, Lavoisier founded a chemical revolution , Kant renewed continental philosophy, a romantic reaction to Cartesian mechanics was outlined. Given the proper proportions, it is not only in our time that the world changes rapidly.
Hahnemann, like Stahl, notes that the priority was in the analysis of the vital phenomenon, too important to occupy an insignificant place. Vitalism’s identity had always been in danger of disappearing. However, it always reappeared when the clinic resumed empirical research. Animism and vitalism are progressively increasing in their scientific programs. Despite the agreement, the paths take different destinations. While Stahl takes up Aristotelian metaphysics in a very personal way, that is, shaped by the pietism with which he was involved, Hahn emann privileges Aristotelian logic as a method to solidify the constructs that are to give him the theoretical and experimental support necessary for the progress of the project .[9]
Nevertheless, Stahl mobilized the same themes in the 18th century as Hahnemann in the 19th. It fights the mechanism of the man-machine. He rebels against systematic medicine, starts to doubt the peremptory certainties of therapy, and gives an empirical tone to his treatments. In most of its therapeutic orientations , it adopts expectation as a technique.[10] He does this with great awareness because he considers it a less pernicious method than the available resources. An entire school will imitate him, after all, in the “first place, do no harm” ratifies a resumption of Hippocratic naturalism and, consequently, a return of confidence in the natural medicine . resurrecting the idea of the regenerating power of the hypocratic medicinal nature, when physis would provide for the recovery of the sick. The first Hahnemann did not escape this trend.
Roughly speaking, the Stahlian method, which also adheres to the principle of similarity, ends up in operational difficulties that are not negligible. There is no systematic treatment of the question of anima or how and under what circumstances the drug should be applied. Stahl intimately doubts the therapy, but has nothing better to offer. You only have the option of the expectant clinic. In its therapy, for the first time since the failure of Paracelsus’ psychiatry, we found a primitive psychotherapy – the fundamental disorders are rooted in the anima – which seemed to value the patient’s psycho-mental state, as well as the use of the always useful dietary resources. . Here it successfully imitates Barthez’s experimental tentamen , in any case therapeutically as not very operative as his, because they both had no medical instruments except those inherited from a tradition they had performed and tried to distance themselves from.
Hahnemann, on the other hand, creates a new path. He pursues the epistemological maturity that he slowly incorporates into his instrumental guide – Organon . This incorporation decisively affects its practice. He quickly moves from initial research, the embryo of his scientific program , to application in the sick. Again, he submits his hypothesis to the tests, increasing his casuistry with the traditional difficulties already familiar to everyone who knows his biography.
But what he gets goes far beyond what he initially assumed. He observes tangible results between the event (drug introduction) and the effects observed within a plausible time gradient. This intervention, he thinks, changes the natural evolution of the disease. This is the first step, he calculates. Careful, that r map your findings with caution. It is necessary to understand that originally he was prioritizing – until now he had not expressed his criticism of the inconjugability of nosologies – the pathological entity itself, the disease, as an object of study. Po ssivelmente was worried about a quick comparison of results.
Thus his pragmatism is reinforced by the verification that, with adjustments, he is even before a new path. It is not, strictly speaking, a new principle, but it is definitely one in our path here. Rota, which for many reasons will be terribly arid for the innovative doctor: the empirical school was undermined by the great medical systems (especially those of Hoffmann and Boerhaave), the study of the totality was being sacrificed by the principle of localization [11]
The symptoms (and with this the clinical history) were no longer so important because they had been restricted to “lesion slaves”[12] . Similitude was in disuse and was practically ignored by major medical schools. Nobody valued it, much less operationalized the tenuous medicines of Hippocratic medicine.[13] The romantic movement (as well as natural philosophy, Schelling’s “nathurphilososophie” ) that decisively influenced our author, did not exactly produce a scientific endorsement for the new researchers. Let us add to this panel the difficulties to challenge the hegemony of Newtonian physiology and its convincing mechanics applied to biology.
Furthermore, and most importantly, Montpellier’s vitalism was isolated and discredited by the advancement of the medical schools of Paris and of island medicine . In the medical field, the elision of vitalism was a fact. In this way, the environment – despite the fact that famous analysts saw the opposite – was inhospitable to what was about to unfold, to the theses that were about to be enunciated. Hahnemann, just as Galileo really acts against everything and everyone, or as Hilton Japiassú wants, referring to the famous stronome “despite everything and everyone”. Finally, it organizes a counter-thought and makes an epistemological cut in medical knowledge.
Again our inconoclast dares. He is not exactly concerned with “scientific coherence”, or “political articulations”, moreover, on the contrary, he is extremely unskilled in this sphere. He wears himself out excessively in the fight against rivals, he is defeated internally in his intention to keep homeopathy on the idealized route, he sees himself facing the constant threats of interdiction of the movement. All because he had well-defined priorities. He is stubborn with the idea of the “new way”, which allows to progressively refine the theory. References to vitalism, up to the fourth edition of Organon , were quite incipient . It is developed by crossing information and refining medical knowledge with ideas arising from practice, that is: the totality-purpose, interactions between mind / body-medicines-environment. He begins to borrow concepts and ideas from the vitalist tradition, voluntarily or not, starting to resort to them to explain the phenomena he witnesses.
Only during this period did he introduce the expression ” lebenskraft “, a vital force. Expression that will take on different characteristics in each school and that composes only one of the items of the conceptual structure of vitalist philosophy. However, what is most dear to the Hahnemannian corpus is not the “vital energy”, but the very concept of vitality “lato sensu”, as if defining a way in which the living organism operates. What started to matter, primarily, were the modes of operation of these organisms as non- mechanical, non-inertial totalities , especially analyzed in their operational functions: form / function / purpose. Hahnemann, like Stahl and Barthez, realizes the insufficiency of mechanistic principles to account for pathological and therapeutic phenomena.
With effect, vitalism can be placed more a consequence of these investigations and that the cause of these. It is also very important to show that the mechanism-vitalism polarity was never its starting point. It emerges as a natural result of research, which only increases its epistemological weight. Interpreting the results of the events, investing all his intellectual and deductive efforts, he ends up giving his newly conceived theory the status of method. Hahnemann reexplores a theory in which he can couple his findings. It is about reactivating an empirical vitalism replacing “wild” empiricism. Of course, as you realize how important and operative these assertions are, more positivity is added to the method. His research is becoming more and more oriented. He is increasingly determined to seek support for the enormous variety of hypotheses he raises.
Epistemological plans: from the induction of similarity to the deduction of singularity.
Break with primitive similarity . Susceptibility, or the exalted peculiarity. The infinitesimal is nothing. The vitalist research program. An evil worse than the original: suppression.
Thus, before trying to define the basic traits of his personality, or trace an outline of his historical costume, it is necessary to redefine the various traits of his work in the construction of his methodology.
In the first place, our thinker emerges as a doctor formed from conventional schools, whose main theoretical matrix was iatroquímica (Vienna, Leip zig, Erlarngen). His therapeutic vision is therefore centered on medical chemistry in the 18th century. Despite numerous proofs of his intellectual precocity and his refined intuitive ability, Hahnemann was unlikely to change his praxis in such a radical way. It would be less expected, given the absolute dominance and hegemony of that trend, that he would found a new medical school.
What takes you to your destination will probably remain ignored in the recesses of your most intimate metaphors, which I fear, we will never have satisfactorily clarifying access. It remained for us to follow the lead of their arguments. His primitive dissatisfaction with systematic medicine and his courage to denounce the lack of effectiveness of the medical systems to which he was exposed denote his first phase. Hermeneuts would call this their first application. But our problem remains the same. We have not yet been able to efficiently diagnose how and under what conditions he conceived his “new principle”.
By isolating himself and claiming to have abandoned medical art, as he confided: “I thought that art was doomed to nothing”, he sentenced himself to the search for something better. Once it has discarded the practice of its time, its next company will be to detect the failures of the great medical systems . These ended up becoming the great epistemic breach to objectify your doubt: there is something to be rethought, quickly and radically.
His research originates in the sphere of theoretical review, and between libraries and translations, among incunabula and folio s lost medical history records his rescue: Hippocratic similarity and model experimentation of the old empirical schools. Nowadays it would be equivalent to depreciating the genomic tendency and to resume, with extra-historiographic purposes, the recommendations of Hellenic medicine. He elaborates his own synthesis and sees the need to experiment on human bodies. [14] But it will not do so in the face of pathologies, it will be necessary “not sick” to obtain more reliable reports. At the same time, it is concerned with distinguishing its new formulation from Paracelsus’ correspondences and refutes, in advance, the possible attacks against what would come to disqualify it as naive empiricism. For the first, he recommends severe criticism, confronting the tradition of the markings , for the second, systematic studies against the “empirical accidents” recorded in historiography.
But, confirming what Canguilhem noticed, the sources matter less and the treatment given to them is much more important, and in this case , H. does this work in a very original way. It goes beyond medical texts and advances its research focus on works of natural history, of travelers and explorers who visited other peoples and cultures collecting therapeutic jobs and registering, almost journalistically, the medicinal habits and customs of the colonies of European countries. He is much more interested in clinical records than in books on doctrine and therapeutics. It was relatively common in the seventeenth and eighteenth centuries for medical authors to transcribe their clinical cases, as if to publish their daily experiences, to write down their therapeutic successes (even those that Hahnemann will later demonstrate as suppressions), so that others could know what their behaviors were like in prá ethics.
- it ingeniously takes advantage of this immense source of therapeutic imbroglios, contesting the axiom that the masters are always right. Gumpert was happy to refer to him as a hard-core rebel. It uses the authorities, in a legitimate movement of co- thought, to disallow them. Take advantage of only the symptoms that emerge from “wild” treatments and the intoxications that you identified in these records .[15]
Although Hahnemann recognized the enormous value of applied chemistry and that many substances were useful in palliating certain pathological states, he refused to admit that we would need to restrict their knowledge to their proximity to the “natural system”, or to their taxonomic kinship. He admits that there may be, in fact, analogies between the external, physical-morphological evidence of the substances and the medicinal effects. But he does not accept them – as the doctrine of signatures predicted – as a given reality. He wants a research program to prove it or refute it. In this sense, Hahnemann undermines the epistemology of “signatures”. However, as Foucault had detected, those who work with similarities also necessarily have to deal with the signs. [16]
The difference is that the signatures (or markings) that interested Hahnemann were of a different nature, they could not be botanical because they were also subjective, they were experiences [17] , making it impossible for these to be correlated to organs, physiological systems or pathologies. He begins to look for methodical observation and experiment in the possibility of registering the manifestations of the human totality.
He states that “botanical affinity” would never allow conclusive inferences about the similarity of the action since the “external similarities” were superficial and insufficient to know possible medicinal effects. Here his critique of primitive similarity and the doctrine of Paracelsian signatures, as well as the whole system of medical matter, appears again, and in a much more evident way.[18]
Hahnemann had a double influence: one of them was the great medical systems of his time, iatro-chemistry, and on the other hand he was deeply impressed by the empirical propositions. It is precisely in this mid-term between the tensions of a rational and empirical nature that he forges his proposals. For this reason, it is not possible to present only one facet of its concerns, since it is committed from the beginning to divisions that will permeate the entire project. It is the contradictions generated by them that move the history of their propositions.
It uses the concept of similarity, but adheres in this field to a new epistemic , modern, therefore analogical. In other words, during the experimentation process, it seeks to detect, from the point of view of the subjectivity and subjectivity of the subject, which expresses symptoms and the changes that the substance has inflicted on him.
These revisions give him the pejorative title of “book physician” from his enemies and the other scientists and historians of his time, the diagnosis of the founder of a ” pure metaphysical system “.[19] A little unfair to anyone who published a libel sanctioning the medicine of experience. Thus, the central role of all the controversy that Hahnemann is about to create only at this stage outlines more defined features. He is about to reach his next target: the “botanization” of diseases, or better, his taxonomization. In one of these passages, one asks: “Should we happen to trust a botanist who is restricted to dividing plants between herbs and shrubs?”.
It should be noted that Hahnemann was not only concerned with the visible, potentially triggerable signs of medicinal substances. He begins to occupy himself with the totality of manifestations, such as experiences, dreams, sensations and all sorts of subjective symptoms , obtained from the medication. Its semiology is, to borrow an expression of propaedeutics, “in the open”. For this very reason it obtains for my medical matter a myriad of new symptoms: objective, constitutional and especially mental symptoms . It incorporates all sorts of subjective symptoms, usually overlooked by semiology.[20] Found a new model of clinical history.
It attacks the episteme that placed nosos as the main object of therapy. What it means to say: it shakes the building that had, and still has, the central role of all therapeutics, the framework even of Western typifying medicine. Here we come to something truly revolutionary. Here is the embryo of one of its epistemological ruptures. What he says to us means “no to typifications” and at the same time “to look for unpredictable symptoms”. It is worth asking why you do this?
Did he perceive the little scope of the symptoms taken only as confirmations of the anatomo-clinical pictures ? Or do you suspect the efficiency of the therapy under the semiological direction undertaken until then? All of these hypotheses are plausible, however, what Hahnemann foreshadows is the concept of nonspecific susceptibility, only officially formulated almost a century later. In other words, it discovers the semiological-therapeutic importance of modalized symptoms. It gives primacy to the rarity of the clinic. Unveils the manifestations that express the disturbances in an imprecise way. In other words, it discovers the value of the unexpected , of the unpredictable phenomena in natural illness.
Redundant to say the degree of innovation of this proposal. It starts to incorporate this orientation as an inseparable part of the method. From this guideline, it is natural to deduce that it is no longer possible to prescribe based semiologically on the predictable syndromic conditions. That is, following the Hahnemanian reasoning, the pathognomonic symptoms of diseases can no longer be taken as the only semiological guides for therapy. Unless these symptoms have a personal note, it is worth mentioning those that have idiosyncratic characteristics.[21]
Now, if your review can rescue similarity and experimentation, why not go further and do the complete job by demolishing the whole system of classifying nosologies? Here we will have to sharpen our discriminatory capacity: its primary target was not this. What he wanted to do was to anticipate the enormous insufficiency of that classifying system for the establishment of therapy . Knowing what it is, that is to say, knowing the name of the disease, does not necessarily give the diagnostician the predicate of prescribers, the notion of knowing how to treat.
But you cannot avoid the logic: why, if the experiences reveal susceptibilities and “sensitive fibers” of different qualities that respond to different amounts and stimuli, why consider only specific remedies? In fact, if the medication actions are diversified and affect the entire economy, why then the privilege of a diaphoretic, a revulsive, an astringent, emenagogues or sweat? If the illnesses are inconjugable why are the drug correspondences chosen by local affinities? Why not be suspicious of organotropisms that do not take into account the totality of manifestations in the subject? =
In addition, another rescue was imminent. After concluding that it is impossible to establish a therapy under the banner of pathology, Hahnemann is visibly concerned with the paths that these can take, when they are suppressed / modified in their natural path. His conclusions again coincide punctually with what he finds registered in medical historiography: he starts to check for substitutive pathologies. It promotes yet another resurrection, this time it is the turn of the old doctrine of “morbid metastases”. It finds that in the course of any therapeutic action, pathological versions worse than the original ones may appear. It implies that the expectation may be a lesser evil (since here the suppression would be in charge of the vis medicatrix ) of what is the therapy. At the same time, it finds that the analysis of the totality and the application of mild medications are more rational means to protect the subject, or at least minimize the risks of a possible harmful path, such as the one mentioned above.
Finally, the most indestructible epistemological question. What do you look for in attenuations: to optimize the action of the drug through a lesser medicinal effect? Get the subtle alchemical body of substances? Deviate from aggravations? Coercing the vital energy? It is possible for all questions to obtain affirmative answers simultaneously and successively. But let us judge by the beginning. Hahnemann, for familiarity or opportunity, begins his work with poisons: heleborism, arsenicals, mercurials, sulfur, zinc and other toxics fill his repertoire. Check the rules that lead toxics to produce their effects under strong and low doses. It notes that qualitatively those susceptible respond to doses well below the toxic threshold. That the action of drugs on subjects is extremely heterogeneous. Now, if the clinical and mental conditions reappear under different intoxications, the minimum amounts to awaken the symptoms can be different for each subject and much smaller than expected. What laws and clinical-pharmacological criteria do these phenomena obey? None satisfactorily known. There must be individual variability that induces subjects to non-homogeneous responses. How do you proceed? Dilute and try it, only in a second stage it dynamizes the drug, after all the simal infinite is nothing.
The ethical imperative. =
“There are circumstances in which neither the like nor the opposite heal; it is what should heal ”
Hippocrates
In the years that followed his greatest research, Hahnemann now finds himself immersed in his experience, immersed in his work of caring for patients. They have been sketching and building an ethical corpus . He does all his work looking for a system that includes an action compatible with the delicacy that semiological and therapeutic work requires from the homeopathic project. And already knowing this, he fuses his expectation of curative purpose with a pedagogical-philosophical action that would also induce the subject to a more articulated action between nature and destiny, between spirit and body, between environment and work.
However, our author pears the creative with prudence in the statement of these propositions. He fears for the worst – rightly so – when he gives homeopathy a character of univocal universal philosophy, because if, on the one hand, he knows that the sectarians will always be pre-called to defend it at all odds , on the other, he realizes the danger of a fallacious aura that this double meaning can provide for a method that was intended to be articulated as a scientific practice.
At no time, however, does it state or denote that among the particularities of the drug’s action are an action in the spirit per se . The references to an immaterial action of the medications only match the idea of ”quasi-spirit” in a specific context: like us, he, despite noting the positive effects, ignored the mechanism of action of ultramolecular doses. Indeed, he sees that the medicine conveys generic, imprecise, “quasi-spirit” possibilities that are assumed as information by the set of organic systems (mind-body-environment complex) of the subject[22] can change your most intimate perspectives, but who can know for sure?
Thus, in parallel with the scientist Hahnemann, we have a thinker of completeness who stands in favor of ethics. So what would be the Hahnemanni ana ethics then ? Here we leave aside, at least for now, the methodological constructions and the induction that our author proposes. We will try to understand what is convenient for him for curative action.
First, Hahnemann does not judge, he only listens carefully to the subject in his narrative, which, as we know, presupposes unusual details in clinical histories. These are the usually negligible symptomatic “wastes” that contemporary clinic has renamed as “neuro-vegetative disorders” or, at best , subjective symptoms. What mattered to a clinic based on the names of the illnesses if vertigo made the subject recline to the right with cold, if perspiration produces ecstasy, if along with the headache a desperate desire for lemon arose or even if the crises of anxiety to break out at 17 o’clock on time? These ended up – here it is not possible to analyze why – because they turn into mere parasitic symptoms of the medical occupation. No previous clinician valued or transcribed the patients ‘ symptoms with such obsessive care. H. had learned how to apply them in practice. The truth is that even the best doctors from other periods, including those who recorded very complete medical histories like, for example, Sydenham, did not know how to treat material from detailed anamnesis.
Second, the analysis of the cases attended by Hahnemann shows the commitment to all symptoms. No pre-valuation. No anticipated hierarchical criteria. No schemes chosen beforehand. Just a motto: any peculiarity will be exalted . Whether in the “Archives of Stapf”, in the “Notebooks of patients” or in the various records such as, for example, those pointed out in the rescue of Genneper, these guidelines overlap, apparently not very methodological. What you can see in all your records is the meticulousness of the record: the original words, the type of music, the details in the dreams, the empirical verification of clairvoyance, the altered perceptions, the dream recesses, the perverted functions and the body in anguish.
So when he proposes to put sculapio on the scale he weighs his positivism against his metaphysics. He realizes that he cannot, even with the deepest personal effort, hide his polarity as Masi-Elizalde has so well shown. Ass ume that, if on the one hand he will give the scientific aspect of his propositions a logical-formal tone, on the other hand he will continue to affirm what he believes in, enunciating his deep philosophical-religious concern, focusing on the very meaning of existence. Hahnemann induces and deduces all the time. After all, he shows himself to be a researcher who cannot hide his motivations. In this case, at the same time that he uses ontological substantialism to define the properties of being, he rejects part of these characteristics a pr iori , which will be the object of further control, during the experiments.
Another important methodological criterion introduced by Hahnemann is found in the explicit and repeated recommendations that each drug should be used exclusively. The idea of non-mixing is yet another field of spistemological maturity in your medical system as it seeks to control the intervening variables with the most understandable of the arguments: two drugs together cause a third and unknown element that makes the analysis of the effects uncontrollable and very little need.
The use of inert substances should also be mentioned. It should be noted that this use is recommended in a strictly ethical context: the commitment to the other also involves the controversial act of apprehension of “not medicating”, namely, the use of the compliant medication. It is precisely because he understands that imprecision is inherent in the homeopathic method and its operational difficulties that Hahnemann allows and encourages the use of non-medicinal “something” when the need and / or indication of the verum is not clear. How impressive was his ability to perceive the need and importance of a therapeutic artifact, however pseudo-medicinal, as a step in the work that allows for a better research of the improvements, the worsens and the stability in a homeopathic treatment.
The Hahnemannian version of “creative leisure” – as in the famous letter to the workaholic tailor “[23] – is one of the most auspicious and denotes the recognition that there is, after all, a scale of values, criteria and priorities. Work, it is clear, cannot be harmful. It should not be counted as a sacrifice to health. Faced with the epidemic front classified under the CID of RSI “injury by repetitive efforts”, once again our author foresees the worrying fate of organisms reduced to “bodies that produce”. To the perplexity of neo-pragmatism, Hahnemann’s complex axiological system never separates the construction of homeopathic science from its ethical commitments. Of these, a certain teleologism of the human statute that identifies the vital phenomenon with the inclusion of certain perspectives of refinement: cultural, affective, spiritual cannot be underestimated.
Whether we like it or not, Hahnemann has no quibbles about spirituality, which he sees with a practical focus, that is, it is not in the sphere of alienation or in the turmoil of a contemplative asceticism. Nor is it a dogmatic metaphysics and still less the contemporary neo-esotericism freely associated with homeopathic doctrine. According to him, man has an internal system that allows him to detect the transcendent nature of his spirit, as well as his ability to recognize Gd. Even this certainty did not make him hostage to the Salvationist theses.
There is a sophisticated mix in our author: on the one hand, it adheres to a kind of personal synthesis of naturalist philosophy[24] which tends to a vitalism of a spiritualistic nature (Luz, 1988) with the perception that it must always be united to “being here”. On the other, it assumes scientific positivism as an incorruptible duty to the medical object. Perhaps, for this very reason, on purpose, he never intended to assemble a set of medical knowledge under a metaphysical safeguard of a mystical or religious nature. It is an insurrection against this prerogative. Waiving any form of sectarianism to put your hypotheses under question.
After recognizing the transcendent nature of man, the founder pleads for the scientific and conceptual clarity of homeopathy as a logical, pragmatic, scientific choice. First, the methodological choice. Then he admits a metaphysical-based ontology – warning that “all are kings” there – that he must undergo the tests of empirical evidence.
In other words, it admits an empirical metaphysics. Its accurate scale no longer weighs just sculápio. It weighs values, supports the search for a broader medical approach, emphasizes hygiene, the role of the environment, the need and finding references in existence. Hence his option – this is particularly interesting in his epistolary – for an existential religious spirit not linked or subordinate to schools or hermetic doctrines. Hahnemann prefers to subordinate this acquisition to the subject’s achievements, case by case. He deduces that there is a kind of tribute to the singular of each subject, as there is an unmistakable merit in personal discoveries: they are non-transferable and configure subjectivity.
If in this way each subject can obtain pedagogical, philosophical and homeopathic help, so much the better, since the high ends do not know the dimensions and the quality of existence cannot be measured, except by very peculiar measures: exactly from references of the very nature treated / cared for.
Hahnemann understood that it was exactly this nature that would allow man to refer any health project to a reconsideration of the importance of the status of mental status in therapy. The mood starts to be considered[25] not only as a semiological-therapeutic reference but, and mainly, as a kind of “marker” for the improvement of the subject’s general state. However, in order to refer this improvement to more sophisticated projects, Hahnemann recommends, in addition to the dynamized drug, a continuous personal effort that can be enhanced or not by a pedagogical-philosophical action through what he called “auxiliary mental regime”.
The posterity of the inheritance: in addition to the contradictory and simibilus principles, which is appropriate.
When we see the immense responsibility that homeopathy has as perhaps the last medical rationality that is truly divergent from hegemonic thinking, we are apprehensive and concerned about its future. The internal disagreements of the movement , the difficulty of the various schools in assuming their identity and the radicalizations about each of the Hahnemanian phases started to hinder the development as well as the goals of the homeopathic movement.
Many critics of homeopathy substantiate their criticisms of the lack of scientific curiosity of homeopaths who did not update the method in the light of a review of medical theories after Hahnemann. Despite the exaggeration and ideological bias embedded in it, there is a basis for these criticisms. We need to recognize the exaggerations, the flaws and the important elisions in his work. After all, it is not a revealed text. We have to admit that a certain programmed ingenuity permeates the homeopathic environment that expects nothing less than the perfection of a scientific construction. But here we also see the opposite bias: adapting uncritically to current research norms and standards can mean the rise of a pragmatic version of similarity and the ruin of a resistance that fought to preserve a set of knowledge and medical procedures that characterize a particular iatrophilosophy.
Hahnemann’s merits were many: preparing an immense terrain still unfinished, not only leaving faithful followers but contaminating critical passers-by , not having defined rigid strategies and living immersed in a fruitful resistance whose deep traces reach all the medicine of our time, marks epistemological issues that are making themselves felt even in other disciplines. However, it is no longer enough that we repeat the content architected by the Hahnemannian code to exhaustion. This has already served us, now it brings a scientific suspicion. The accusation of cult of personality is rekindled. It exposes us to the fragility of sameness. Stoic restatements embarrass us in the fragile era of immobility as warned us in different ways and in different historian-author versions like Dudgeon, Bradford, Haehl and Marcy and Fortier-Bernorville. The repetitions, the mere reaffirmation of our resistance, do not deserve to be taken by a positive heuristic .
Homeopathy does not have any special attribute that credits it as a different knowledge from the others. There are no innate or acquired invulnerabilities, there is no guarantee for anything. It is part of the game to submit to the refutations, to face the internal contradictions and to bow to the criteria of knowledge criticism required to be able to continue to be validated and thus remain as a practice. Homeopathic ideas need to circulate in order to be preserved. Their logic was challenged and put under question. We restrict ourselves to cheering only for increasingly clear evidence and for the expansion of the investigation.
Paradoxically to his strong doctrinal sense, Hahnemann positions himself as one of the first revisionists of homeopathy. Let us remember that his conversion from iatroquímica to a cosmic-synthetic vitalism, where he incorporates similarity as a method, was a direct consequence of a spirit willing to be affected by research. Only afterwards, seeing the insufficiency (or “excessive” sufficiency ) of the analogue as therapeutic reasoning, does it incorporate infinitezimalization as in order to obtain modified, subtle, but convenient responses.
And, in the end, when he did not need to risk his prestige, he resolved to bear the turbulent consequences by enunciating a sketch of medical anthropology, seeking a hidden malaise, a meta-meaning underlying the empirical-phenomenological of the symptoms. It is the phase that enunciates the psoric theory. In other words, there is everything in Hahneman’s reasoning, including contempt for a straight and cumulative coherence that exhaustively demands adherents and enemies.
Stick to the medical object to meet the demand for a more efficient clinic, namely, with the specific purpose of curing or controlling defined pathologies is an ancient problem of medicine. Here, too, our inventor imposes changes. In his ethics, the radical commitment to the other does not mean only being attentive to changes of a pathological character as the primacy of medical care. The originality here was to have pretended to be defined by an ethical-synthetic humanism, whose main attributes must be the solidarity and understanding of the suffering subject. Sufferings manifest through imaginary or real idiosyncrasies that the sick subject tells the doctor, seeking relief and support. Homeopathic help does not come (or could not come) only against the morphology of sick bodies, it will always come as an answer to the incomprehensible sensations, metaphors and allusions that invade and plague the subject.
Hahnemann finally builds a methodology in which it will always be necessary to ask “what ails you?” and “what do you suffer from?” to find out, in the end “who is it”? This dissolves, once and for all, the contemporary illusion of a future in which machines that detect vital qualities would replace medical action using electrodes that trigger the simile. At least for the Hahnemannian subject, the original perspective remains: the essence of the clinical spirit is the procedure of one man in front of another.
It is necessary to show that homeo patia conveys a therapeutic possibility of order and dimensions completely foreign to those of the fields of action defined by the causalist model of biomedicine as the only ones specific to the medical act. This distinction brings us directly to the scope that we see in homeopathy as an original proposal that must finally be taken as a way of making medicine. Homeopathy then needs to be identified as an iatrophilosophy. A subject medicine, an interactive medicine beyond the specifics of diseases. We build a healing art that is much broader than the application of similarity. Its fundamental distinction, which even highlights it from other medical rationalities, lodges itself elsewhere: it is in its “what to do”, when it understands man in his aspiration to be understood by the totality of manifestations.
Homeopathy already needed and had its martyrs, already experienced the taste of exile, the ban, banishment. Homeopaths fought (and fought) with doctors from other traditions and between themselves endless disputes , both long and useless. Whether we are going to prolong this strife or finally dedicate ourselves to what matters is an option exclusively under our yoke.
So, let’s talk about the impropriety of the always mistaken question “what would Hahnemann say”? Impossible to know how he would behave. The inferences of his scientific testament show that we should foresee doses of rationality and moderation. We are pleased to note that the influences of romanticism were not, in the end, negligible items in the analyzed influence hall. since, as is known, this movement was extremely important in the subject’s rescue route. Therefore, after these prolonged disputes, we would expect a relaxation of doctrinal inflexibility so that everyone really interested in the renewal of medicine could adhere to the third Hippocratic principle. No prior hegemony. No methodological monopoly. Only intellectual openness as a premise, doubt as a compass. In view of the current immensity of modern medical possibilities, neither the opposite nor the similar as univocal concepts, just what suits each patient.
Finally, what we recognize as genius in Hahnemann is spread throughout the corpus . Notable as an original thinker , revolutionary as an epistemologist of medicine, generous as a doctor. He sealed his contribution to knowledge as an inducer, deductor and inventor. Challenges that will still occupy several generations and that should produce developments that will expand to have access to those more complex traits of the human spirit and its sufferings. However, all these efforts will be recognized as a single duration and as long as we are able to recycle the notion of progress we want. They will remain true and efficient as long as we are able to recap – which necessarily means selecting and maturing – the contents of this great cornerstone of knowledge that we call medicine, and one of its therapeutic arms that we call homeopathy.
Grades
[1] Cf. Foucault, M. “The four similarities” in “The words and the things” 1966.
[2] “We have never been closer to the discovery of the science of medicine than in the time of Hippocrates. This thoughtful unsophisticated observer sought nature in nature. He saw and described diseases before he precisely, without addition, without coloring, without speculation. ” Hahnemann, Lesser Writtings, 1852.
[3] “In the faculty of pure observation he was not surpassed by any other doctor who came after him. Only an important part of medical art was this favored son of nature deprived: – besides that he was a complete teacher in his art – in the knowledge of the rivers and their application. But he did not simulate such knowledge – he recognized his disability by the fact that he gave almost no medicine (because he knew them very imperfectly) and relied almost entirely on the diet. ” Hahnemann, S Lesser Writti ngs, 1852
[4] We know the aphorism that has guided many generations of medical historians: “the natural history of medicine is a successive sequence of returns to Hippocrates”
[5] This conception of the medical school in Kos was briefly taken up by the dream of merging horizons represented by the legendary school in Salerno with its aegretidines diagnosis . Cf. Homeopathy and Vitalism. 1996
[6] Critically criticizes Stahl’s idea of ”animal soul”. He does the same with the supposed influences of paracelcism on his work.
[7] Cf. Coulter, HL Divided legacy. op. cit. Vol II.
[8] Jean Baptista Van Helmont , a systematic physician and Belgian chemist, was the first to distinguish gases from air (he invented the word gas) he and Silvius are the first to recommend, based on the idea of fermentatio fermentation) use of acidifying and alkalizing to improve abnormal digestive performance.
[9] The sparks of Kant’s critical philosophy can be seen here.
[10] According to Entralgo, his therapy was basically restricted to the use of tonics and purgatives. Cf. Entralgo, PL Historia de la Medicina, Modern and Contemporary Medicine. Los Grandes Sistemáticos. 1954. p. 245
[11] Subsequently explained by Virchow.
[12] As Morgagni pointed out in his “De Sedibus”
[13] Even when attempting to reissue it in the low doses of Van Helmont.
[14] For Koyré, scientific revolutions are due more to the mutation of philosophical ideas than to empirical discoveries. Cf. Koyre, A. Pensar La Ciência. p. 27.
[15] This is basically the spirit of his first medical subject: Fragmenta, from 1805.
[16] Here is what Hahnemann points out: “Due to the fact that the cinchona cortex has a bitter and astringent taste, therefore the bitter and astringent cortexes of ash, horse chestnut, willow, etc., were considered to have the same action. that the cinchona cortex, – as if the taste could determine the action! Due to the fact that some plants have a bitter taste, especially gentiana centaureum, called fel terrae, for this reason only professionals were convinced that they could not act as substitutes for the bile! Since the arenaria carex root has an external resemblance to the sarsaparilla root, it was deduced that the former must have the same properties as the latter ”Hahnemann, S. Lesser Writtings, 1856
[17] Cf. Rosenbaum. P. Homeopathy: interactive medicine. Imago Editora. Rio de Janeiro, 2000 (Publication of the Master ‘s dissertation in the Department of Preventive Medicine – FMUSP “Homeopathy as Medicine of the subject, historical roots, epistemological frontiers”)
[18] “Therapists attributed to star anise the same expectant qualities that are possessed by anise seeds, merely because the latter have a similarity in taste and odor to the seed capsules of the former and even some parts of the tree (iliceum anisatum ) that produces these capsules is used in the Philippine Islands as a poison for suicidal purposes. – This is what I call the philosophical and experimental origin of medical matter! ” Hahnemann, S. Lesser Writtings. 1852
[19] More contemporaneously Entralgo came to classify homeopathy as “free medicine” .Cf. Entralgo, PL Historia de La Medicina. Modern and Contemporary Medicine. Madrid, 1954
[20] With the exception of substances classically producing changes in the psyche, such as opiates , alcohol and other medicines of plant origin such as cannabis indica, cannabis sativa and others – in the compilations that he scrutinized.
[21] For example: in the case of mental illnesses, pathognomonic psychic symptoms must be excluded from the scrutiny since they are expected in a framework, the main characteristic of which is precisely the disturbances of the mental sphere. Ditto for the expected symptoms of any pathology.
[22] For the Hahnemanian man a substantial compound is inseparable.
[23] This is advice that Hahnemann sends to a patient, a tailor, in which he warns him about the risks of overwork and the need to put other priorities in his life.
[24] Since it criticizes nathurphilosophie
[25] This was one of the important differences between Stahl’s and Barthez’s projects. Cf Homeopathy, Interactive Medicine . op. cit.
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