THE EVOLUTIONARY SIGNIFICANCE OF SAMUEL HAHNEMANN L. R. TWENTYMAN
(BHJ. Vol. LXIV, 3/1975)
I am very honoured that you have invited me to speak to this Congress of the League on the 50th anniversary of its founding here in Rotterdam, the city of Erasmus. I am happy to recall that we, from across the water, were present at the original foundation, with Dr. FERGIE WOODS playing a significant role in the establishment of this International League, and I am also glad that another of our islanders, Dr. John PATERSON, played his part, after the last internecine holocaust that overwhelmed our continent and this very city of Rotterdam, in healing the terrible wounds and grievances it left behind. We are at times a tiresome lot in those offshore islands, as many since Julius CAESAR have found, but we belong to the culture and history of Europe. We have played our part in carrying the seeds of this culture to the five continents of our common globe and reciprocally in introducing theirs to enrich our own. And not all this legacy to mankind has been evil and ugly. It was in Europe that the idea and religion of the Universal Man first took historic root and however distorted and disfigured it may have become in the course of the passionate conflicts of the centuries, it remains the ideal and the impulse for the healing of nations and the reconciling of our conflicts. Within this ideal all our differentiated cultures can enrich each other. The discovery of the world, initiated by the Portuguese voyages, and carried on particularly by the Dutch and British, has led now to the fact of our planetary unity and interdependence. At the very beginning of this movement here in Rotterdam, Erasmus carried the torch of Humanist culture and tolerance. He was a close friend of our English Sir Thomas More whose Utopia—or Eutopia as he also called it—is still far ahead of all current politics. I recall with pleasure that when Erasmus visited England he was delighted with our English girls who greeted him with affectionate kisses, so much so that he wrote quickly to his friend to come and join him as soon as possible. It was through the Humanists that the idea of the individual, the value of personality and of its highest potentiality, genius, was really worked into our culture. So it is most fitting that our League was founded here in this city of Erasmus and here meets again to further the cause of Homœopathy, an ideal of medicine which seeks to put the individual human in the centre of the medical picture. At the same time, up the Rhine at Basle, none other than Theophrastus Bombastus von Hohenheim, the noted and passionate Paracelsus, let loose his attack on the medical academics of his time. Erasmus himself was successfully treated by him whilst there.
Perhaps these few words of mine, intended to acknowledge our debt to this city and its creators, will serve as an introduction to what I want to speak about. For that moment of time, when the New World at its discovery still held out a hope of Paradise and when our modern world based on natural science was in status nascendi, marked a turning point or rather, an inauguration of a radically new epoch in human evolution. Our own time, with its overwhelming dangers, catastrophes, chaos, is really a culmination of what was then first glimpsed. The realization of the ideal of freedom then envisaged has now become a necessity of our survival. I mean particularly the inner freedom, individual initiatives, the awakening and bestirring of ourselves to individual responsibility in our thoughts and feelings. These are now the very issues of life and death.
I have personally always felt an instinctive distrust of efforts to show the identity of outlook or principle in such divergent figures as HIPPOCRATES and HAHNEMANN. From time to time I have attempted to make clear to myself and others the justification of this distrust. I am unhappy with these efforts because they depend on reducing the complex, living, paradoxical genius of great men to a mere formula and in doing so are in great danger of killing the living impulse and producing a dead abstraction.
There are in the course of history great intellectual battles, heroes rise up on either side and the air is full of trumpets, drums, slogans and calls to battle for the Truth. In the last hundred and fifty years the historic battle over Homœopathy was perhaps waged with greatest fury in the USA and we are all indebted to Harris COULTER for his account of this ruthlessly waged conflict. It is the tragic outcome of great conflicts that the infinite complexity of reality gets reduced to the polarity of black and white or good and evil and the varied real world of differentiated colours is lost to sight. In the mental exhaustion characteristic of the aftermath of anger and war, it is difficult to raise the intensity of inner thought required to face these complexities of real life. We today who work in the discipline of Homœopathy live not only in the aftermath of these conflicts, but in the general atmosphere of spiritual exhaustion of our time. After two world catastrophes, it is a time when nearly everyone wants an easy, comfortable, simple method and formula for Truth and Life. Natural science wants to reduce everything to the fewest and simplest explanations possible, but thereby divorces ever more absolutely its abstract theoretical formulae from our actual experiences.
In this situation I cannot help feeling that it may prove helpful to look at the evolutionary changes that are the background against which historic actions take place. It may help us to find our real position in life with greater certainty and so strengthen our capacities and our intentions for constructive thought and action. In the wellnigh universal loss of bearings in which we all find ourselves today, surrounded by chaos in every field of life, such at least is my hope. In using the word evolution as distinct from history in my title I seek to distinguish those broad, immense changes of human consciousness which arise out of unconscious or supraconscious impulses, from the historic achievements proper which I would understand as the contribution of individual effort and free will to the general world. I believe that if we try to see HAHNEMANN in this light it may, as I have said, help us to find our own place better within the scheme of things. And that, I maintain, is our first task if we are to have any chance of succeeding in making a healthy contribution to the world’s problems.
Now, if we cast our minds back to the time of HIPPOCRATES, about the time of PLATO and ARISTOTLE, we come up against immense difficulties. It is almost impossible to enter into this world, we feel the consciousness of the time to be so different from our own. Of course, the legacy of classical education which perisisted into my school days gave a false sense that we could understand them—after all, we had to translate them. But the more we look into that age the more it is evident that we do not without great difficulty and imaginative effort understand it at all. In the first place, before SOCRATES and PLATO the concept as such did not exist in our culture, before ARISTOTLE there were no laws of logic. The first beginning of intellectualism are only then and there discernible. How much of the glory of PLATO still lies in the famous myths he tells in order to awaken or understanding and vision. Already in his pupil ARISTOTLE we are in the world of systematization and logic. At ths time we can see the germs of intellectual thinking arising, out of an earlier state of consciousness that was more imaginative, dreamlike and mythical.
I remember a boy aged 9 or 10, and therefore approximately recapitualating in his individual life the ancient Greek period, who came in from walking by the sea and who before sitting down to eat his lunch gave forth an eulogy on water, without it nothing would grow, nothing would live. It rises up from the ocean to the clouds and falls as rain and so the crops grow up. Out of it came forth all animal forms. And so on, so that one felt transported into the ancient world of Hellas and could hear again Thales in the city of Miletos. All is water. Now clearly these thoughts were not, as we should say, thought out. They were born out of the perception of the sea and nature and arose spontaneously within the soul. But it marked a new moment in the evolution of Mankind, and the intellectual development of man grew from then. We can speak of thoughts in these early scientist philosophers in a way that we cannot in the case of earlier cultures, the grandiose cultures and civilizations of Egypt and the Orient.
Now there stands at the very origin of Greek medicine a strange figure, CHEIRON, whose name could perhaps be translated as the Handyman. To him, in his cave on Mount Pelion, APOLLO took his infant child ASKLEPIOS, after saving him from the funeral pyre of his mother, CORONIS, there to be brought up and taught by this figure CHEIRON, the Centaur. From CHEIRON, ASKLEPIOS, and as we are told ACHILLES also, learnt the lore of medicine and the use of medicinal herbs. CHEIRON, half man half horse, points back to the immemorial antiquity of our race and to an instinctive clairvoyant knowledge of the nature of things. It would seem that ancient Hellas stood at the sunset of this primordial wisdom and at the origins of our intellectual consciousness. HIPPOCRATES of the family of the Asklepiadae is the figure to whom legend and tradition attribute the pioneering steps in founding medicine as an intellectual discipline. We need not worry about the authenticity of the so-called Hippocratic works. They stand there as a monument to the time when mankind began to think about illness. The glories of an older mankind were created, as are the achievements of our own childhood, without thinking, but out of a spiritual, non-intellectual, consciousness. We find, of course, in the so-called Hippocratic works, observations of sick patients and of epidemics, an immense interest in prognosis, considerable knowledge of the craft of surgery. There is observation of the influence of airs and waters on health and there are the early ideas of the four humours which were, in their balance and disbalance, to dominate wellnigh 2000 years of medical practice and thought. There is much on regimens and some use of medicines, mostly herbal. Nature is regarded as the supreme healer in these writings and the wise physician must be guided by her. This resulted in the formulation of a Similia principle for therapy. Work with rather than oppose Nature. But on many occasions the contrary principle is also invoked. I get the impression that a great deal of the Hippocratic tradition is to be found today in the varied methods of Natural Healing. But also it must be emphasized that in these Hippocratic works interest is focused more on correct observation of disease, on prognosis and on good immediate practical aid to the sufferer than on theories of treatment.
It is extraordinary, looking back from nearly 2½ millennia how, together with this sudden amazing dawn of unprecedented rationalism in medicine there flourished and continued to flourish a Temple medicine. In ancient times, as SIGERIST points out, disease was looked upon as divine punishment. Healing likewise was a divine intervention and in the temples of Asklepios as they developed in the Hellenistic period and on into the first Christian centuries, healing was the Epiphany of the God, his manifestation. Indeed in those first centuries of Christianity the cult of Asklepios was one of the greatest of the rivals to the growing Christianity. More or less together with the birth of secularism in science and medicine, with the quest for natural explanations and the discovery of natural laws, there arose these great Temples of Healing at Epidauros, Cos, Pergamon and in many other centres. Here disease was treated by ritual invocation of the God after due preparation. Here the atmosphere is magical and religious rather than secular and natural. This stream of medicine has always existed. But in ancient times before the birth of intellectualism and thinking, no sharp division had come about between religious and natural approaches to healing. In the earlier forms of consciousness, referred to by anthropologists as participation mystique, they were still undifferentiated.
When one looks into the Hippocratic works there is very little which can honestly be characterized as dealing with individuals. Even when individual cases are discussed and their prognosis considered it is in fact always the medical case which comes under review. Nothing which we would call personal, to do with the inner experiences of the individual, is considered. The place which the disease takes in the personal destiny or development of the patient is of no importance. The disease is considered as a natural phenomenon with which nature’s own healing forces will deal. It is not considered as a personal experience. Even the so-called Sacred Disease, epilepsy, is demoted to the status of an ordinary disease. But in the Temples of Asklepios the individual personal element is to the fore, and the divine manifestation to the patient, whilst in the Temple Sleep, is the essence of the cure.
Now I must draw attention to an outstanding characteristic of the Hippocratic view of disease. Nature is regarded as acting purposefully, out of wisdom and foresight. Nature is still a goddess. The physician is urged to learn from and be guided by the wisdom of nature. This view of nature, this experience of nature, is, in our modern abstract terminology, teleological, but it is still a living, loving experience of togetherness with nature, of being carried and nourished by this living mother of us all. As late as the Middle Ages the goddess Natura was still revered. It is only to the extent that we can imaginatively re-enter this vanished world of childhood, when everything was still magical and rivers and mountains, lakes and waterfalls were still the playgrounds and workgrounds of nymphs and satyrs and gods and goddesses, that we can in my judgment realize at all the meaning and value of these old texts and traditions. We have come far away from those realms and only poets can today find again the hidden entry to the secret garden.
What now gradually developed from these early beginnings? The observation and study of disease grew out of these Greek origins. Nothing like it had been known before. Of course, as the centuries rolled by, the fresh wonder of a new beginning became deadened into tradition and stultified into mere systematization. Less and less did any living reality enter into these concepts of the four humours and the four elements. Further and further the away faded the memory of the divine presences within nature, and the instinctive knowledge of remedies handed down by Cheiron vanished ever more completely.
We cannot pass on to HAHNEMANN without at least the briefest consideration of Paracelsus. Standing at the very end of the Mediaeval and the beginning of the modern world, this frail but tempestuous figure still commands us to pay attention to his utterance. It is to my ears an immensely different message from that coming to us from antiquity. Man is now the microcosm but even more significantly the very link between God and nature. Every process in nature is lifted up and purified in man in whom the process of perfectioning can be carried to completion. Diseases are stages in this process of perfectioning which it is the vocation of the physician to aid and guide. The word of the physician can heal, it is indeed, when it comes from the heart, the main healing agent. And the remedy is the extension of this sacred healing impulse. “The physician and the remedy belong together like man and wife.” Man, not nature, is now the centre of the world, though indeed it is only working in the world amidst the elemental forces of nature, and striving with them constantly, that true knowledge can be gained, rather than by delving in the libraries and compiling ancient texts. PARACELSUS could not have existed without the Christian impulse. He challenges us with a new high ideal of the sacrificial vocation of the physician. The transformed personality of the physician is held up to us as an ideal yet to be realized. In our age, when medicine has been invaded by commercialism of the crudest kinds, when financial profits are one of the major driving forces in the pharmaceutical industry and when mere intellectual knowledge is regarded as the criterion of physicianship, is not this challenge to the moral development of the physician of greater import than ever? Here stands for all time the challenge to the physician to labour to become such a person that his word spoken from the heart can heal and so to develop his wisdom and insight that he can perceive how to use the substances and forces of nature in harmonious extension of his healing personality. Here Christ’s command to heal the sick begins to be answered in a manner permeated through and through by his impulse. Nature is no longer the whole which contains man and heals him with a mother’s wisdom. On the contrary, man contains the whole of nature within him and healing must now arise from the human heart. Here the Christ impulse is present and unites man to the spiritual world. Surely we must see that a profound change in consciousness underlies this reorientation.
HAHNEMANN appeared 300 years after PARACELSUS at a critical point in the development of medicine. The tradition of medicine originating at the time of HIPPOCRATES and essentially clinical in observation and humoral in its pathological theory, was now decadent and even dead, awaiting decent burial. Therapy had never been the strong suit of this tradition, remedies had been carried over into it from a much older world and their use on traditional indications had become increasingly without insight. Methods of purging, bleeding, sweating were also in almost universal use. I confess to a suspicion that, in their day, when the biological exuberance of mediaeval man must have been in itself a cause of disharmony and disease, these methods may well have been valuable. But by the time of HAHNEMANN they had become additional iatrogenic factors in the aetiology and aggravation of disease. At this moment too the new natural scientific invasion of medicine had not matured enough to result in valid therapeutic impulses. There were therapeutic impulses about, however. SYDENHAM had restated the Hippocratic view that symptoms are the expression of nature’s healing power. STAHL, the inventor of the Phlogiston theory, had in the same spirit seen these symptoms as the expression of the soul which he seems also to have called “nature”. The soul he regarded as the director and giver of life to the body and its functions both healthy and diseased. Therefore these symptoms should not be suppressed. CULLEN and BROWN in Edinburgh both made the nervous system the centre of their pathological systems which sought to be the basis of therapeutic guidance. At this same time the ancient ritualistic temple medicine after its passage through the form of exorcism in the Church, erupted in a secular form in Mesmerism from which gradually evolved psychoanalysis and other therapeutic systems based on unconscious psychic powers.
So there was a chaos of decaying tradition and of a very primitive natural science, struggling to do justice to living phenomena with inadequate methods. How does HAHNEMANN fit into this? The ideal of natural science was currently, and still is, basically mechanistic. The consciousness aimed at was and is that of a mere onlooker, observing an objective outer natural phenomenon without in any way affecting it. The naive vitalism of STAHL and his successors was an inadequate protest and involved an equally naive teleology. Only GOETHE in his works on biology seems to have grasped how to extend the scientific method into the field of living organisms. HAHNEMANN starts with a radically new beginning. The task of the physician is to heal. Further he emphasizes, “His mission is not, however, to construct so-called systems, by interweaving empty speculations and hypotheses concerning the internal essential nature of the vital processes and the mode in which diseases originate in the invisible interior of the organism (whereon so many physicians have hitherto ambitiously wasted their talents and their time); nor is it to attempt to give countless explanations regarding the phenomena in diseases and their proximate cause (which must ever remain concealed).” Then he goes on, “The unprejudiced observer—well aware of the futility of transcendental speculations which can receive no confirmation from experience—be his powers of penetration ever so great, takes note of nothing in every individual disease except the changes in the health of the body and of the mind which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now deceased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.” And he goes on, of course, to state that if the symptoms are eliminated so is the disease.
I must again confess that to me these affirmations establish a radically new and different concept of disease. Here is no teleological explanation, there is no question of nature’s healing efforts expressed in the symptoms. The disease and the symptoms in their totality are one. The symptoms, of course, are multiple and appear at first chaotic. We gradually bring order into this chaos by means of ideas or principles. HIPPOCRATES and SYDENHAM tried to order the chaos of symptomns by ideas of purpose, of nature’s healing efforts. BROWN’s ideas were of hyper and hypo nervous irritability and with these principles he erected a system which had a wide vogue both in Europe and America. HAHNEMANN’s striking idea was that the chaos of symptoms could be grasped as a unity in the idea of the remedy. The remedy occurs in outer nature as a unity and this is the unity of the symptoms. HAHNEMANN identifies the disease manifesting in the varied symptoms with the remedy which becomes the unifying idea through which this multiplicity is grasped as a unity. Two realms of phenomena are here identified, the disease manifesting in the symptoms, and the remedy occurring in outer nature. This remedy, perhaps Pulsatilla, becomes the very idea of the disease and the symbol which holds together that varied range of symptoms catarrh, venosity, tearfulness, need for affection, variability in mood and the rest of the picture of this lovely remedy.
At this point of time, when the ancient and traditional medicine of HIPPOCRATES had died, it was possible for HAHNEMANN to establish in his monumental manner a new orientation in medicine. In this new beginning he maintains an astounding and simple affirmation of the principle. The same idea or theme or melody which manifests in the symptoms manifests also in the remedy in its natural development. Disease and remedy are one, two manifestations of the same theme, two metamorphoses of the same idea. He knows the power of the physician’s personality, as his comments on Mesmerism show, but he is above all concerned with the capacity of the physician to grasp the totality of the symptoms and to choose the similar remedy. The faculty needed for this activity is indeed imagination or intuition, but it is a conscious imaginative thinking in contrast to the instinctive, dream-like intuition of ancient times. It depends on the individual’s capacity to unite into a living whole all those innumerable individual items of the Materia Medica and to create the Drug Picture out of the naturally occurring form of the remedy. The activity of the physician’s will is most active in this whole-making imaginative activity, synthesizing the bits and pieces of Materia Medica and of the patient’s symptoms.
You may now be willing to follow me in a characterization of three phases of medical practice. The ancient consciousness in its instinctive clairvoyant at-oneness with nature perceived the remedy. Perhaps we can understand this as the gift of the abdominal, metabolic world and of its nervous centres in the solar plexus; at the most it can only have been a dream-like consciousness. In PARACELSUS we feel the pulse beat of the heart and a passionate enthusiasm for healing. In his alchemical conception of microcosm and macrocosm a heart’s knowledge of the relationships between remedy and disease begins to flame up. It is still from clairvoyant insight that this knowledge largely stems, but an actively achieved insight. In HAHNEMANN the appeal is to our fully awake consciousness, but to an enlivened thinking which can synthesize as well as analyse. This is no longer instinctive but consciously intuitive, and it is in the human alone that we seek for the purposive element. Without the physician’s guiding hand nature will make a mess of the healing process.
So we see how at the death of the old medicine a door was opened by HAHNEMANN to the discovery of a new way of healing, one which could grow with the new scientific consciousness then arising. What has happened since then? The whole development of the scientific medicine of today has grown up with its incredible technical sophistication. Apparently HAHNEMANN’s injunction as to the futility of investigating into the inner processes of the organism is proved wrong. The whole practice of modern medicine appears to be based on such studies. Biochemistry has proudly asserted its claim to unveil the mysteries of life. The DNA double helix is claimed to explain the riddles of inheritance. The studies of the brain are supposed to reveal the nature of thought. And out of these studies has been produced the plethora of chemical substances which are then distributed as the miracle drugs of today.
But is all well? What, to start with, has become of the individual, the human person. In all this mechanistically conceived phantasmagoria we can nowhere find a human being. I said earlier that in Hippocratic medicine there was no real interest in the individual patient as the experience of illness. At that time man began to look at disease as a merely natural process. But nature was still ensouled, and living. This organismic natural history of disease died at the time of HAHNEMANN. Its burial rites were performed by Karl ROKITANSKY in 1843, the year of Hahnemann’s death. Thereafter the new natural scientific impulse, soulless and lifeless, utterly structural and mechanistic, developed as the mummified corpse of the ancient medicine of HIPPOCRATES. It had started on its course when VESALIUS published the Anatomy of the Corpse in 1543 in the same year as COPERNICUS’ anatomy of the solar system was published.
Need I characterize further the fundamental failure of modern medicine to establish any adequate basis for a human medicine? Neurology has to admit total failure to elucidate how we in reality move, it also has to admit total inability to elucidate how we see, hear or smell anything. All real sensory experience escapes its investigations. I could go on, but perhaps I have said enough to indicate the theoretical weakness of a modern medical science still caught in the Descartian guillotine. Its practical weakness is shown in the absence of healing both as an aim and an achievement. The achievements of modern medicine which are indeed immense do not include healing. They consist mainly in replacement of deficiencies, as for instance insulin, vitamin B12, thyroxine, or in chemical sterilization to remove bacteria which are believed to be the cause of some diseases. Further there is the concept of metabolic antagonists so that overproduction of, say, cholesterol or uric acid can be blocked by introducing molecules structurally similar to the molecules in the metabolic pathway leading to the excessive end-product. This is indeed a concept on the way to Hahnemann’s, the giving of a drug disease to compete with the natural one. But there is a world of difference between the two nevertheless. For HAHNEMANN the disease is the disturbed human being with his outwardly visible and inwardly experienced changes. For modern science it lies in the quantitatively measurable excess of particular chemical molecules.
The human being as the bearer and experience of disease has been cast out of the main stream of modern medicine into the hands of the psycho-analytical schools. There he finds himself caricatured and the victim of unconscious powers. Ideals are treated as illusions and all progress to perfection is meaningless. It is true that JUNG does much better than this, but nevertheless we are left with the sense that all psychological development is only subjective. The separation of objective and subjective remains and we are left with no image of man, but with a hybrid of unensouled body and disembodied soul.
HAHNEMANN was himself, so far as I can see, unable to give an adequate idea of the constitution of Man. Perhaps this is the reason why he talks as if a restoration of previous health were both possible and desirable whereas today we seek a deeper significance in illness and grope towards a concept of creative illness. Georg GRODDECK, that most subtle and farseeing of all the pioneers of a psychosomatic medicine in this century, saw that many illnesses are a pregnancy from which the patient experiences a kind of rebirth and enters a new period of life rather than a regression to the old state. Homœopathy in its great development in the USA from HERING to KENT, was wedded to Swedenborgianism and gained from this connection a physiology of man. SWEDENBORG’s great physiological works are entitled The Economy of the Animal Kingdom and The Animal Kingdom. The meaning is obscured today until we recognize that Animal here means the Soul. They are, in fact, the Economy of the Kingdom of the Soul and The Kingdom of the Soul. In these works physiology is put forward as the science of the soul’s kingdom.
We are in a dilemma. We cannot base our homœopathic therapy on the mechanistic sciences of today, nor can we envisage merely restating the Swedenborgian-homœopathic synthesis which reached its final statement in KENT. Our consciousness has again changed. In what way has it changed? Through our scientific thinking we have killed the idea of nature into mechanism, and through our scientific technology we are spreading mechanism, death and destruction throughout her realms. The world has been electrified since Kent’s time. We are now alienated from the reality of nature. By this sacrifice of nature we have, however, purchased our individual freedom and we see everywhere the positive and negative aspects of this new-won emancipation. Our thoughts have become abstract and dead and death-promoting, we must with all our will enliven these thoughts. Our actions have become violent, irrational, instinctive; we must inform our will with true human ideals and purposes. We must become again whole and wholesome.
Falling ill and healing are two poles of one whole and the heart of this whole is the reality of metamorphosis, of transformation. If HIPPOCRATES is seen as the inaugurator of the study of disease, then HAHNEMANN completes and makes whole his work by inaugurating the study of healing. PARACELSUS with his vision of the microcosm and macrocosm and of the transforming purifications wrought by disease and healing provides the heart of this needed synthesis. Without a resurrection of the living science of man and his physiology and pathology, we are powerless to transform the death-dealing science of today. Without a renewal of Hahnemannian truth we lack the essentials for a Science of Healing and without a rebirth of Paracelsian enthusiasm our physicianhood is in danger of falling into inhumanity. These three do belong together, but they are quite distinct, and arise from quite different levels of consciousness, and only if we distinguish them can we reconcile them and find the way to the creative renewal of the science and art of medicine.