During my tenure of a chair in the London School of Homoeopathy, I occupied the Summer Session of 1881 by reading with my class the Organon of Medicine of Hahnemann, expounding and commenting as I went. I collated, for this purpose, the five editions through which the work had passed. Being called upon, in the October of that year, to deliver the then annual Hahnemannian Lecture, I utilised the studies of the Summer, and discoursed on Hahnemann as a Medical Philosopher, with especial reference to the Organon. The lecture was published, but is probably long ago out of print; and its subject is of so much importance to our present enquiry that I think I cannot do better than reproduce its substance here.
1. The Organon was first issued in 1810. A Second Edition appeared in 1819; a Third in 1824; a Fourth in 1829; and a Fifth and last in 1833. Each of these is described as “augmented” (2nd), “improved” (3rd), or both “augmented and improved” (4th and 5th); and in truth all save the Third, show considerable changes as compared with their immediate predecessors. It is quite impossible to form an adequate estimate, either of the work or of its author, without some knowledge of the changes it has undergone in its successive stages. Without this, neither foe can criticise it nor disciple learn from it aright. For instance, the hypothesis of the origin of much Chronic Diseases in Psora, which hostile critics are never weary of ridiculing as one of the fundamental principles of Homoeopathy, first appeared in the Fourth Edition, i.e., in 1829.
Theory of the dynamization of medicines i.e., of the actual increase of power obtained by attenuation, when accompanied by trituration or succussion is hardly propounded until the Fifth Edition. Again, there is the doctrine of a “vital force,” as the source of all the phenomena of life, as the sphere in which disease begins and medicines act. This has been regarded by many of Hahnemann’s followers as an essential part of his Philosophy. “Voici donc” exclaims M. Leon Simon (the first of the three who have made this name distinguished) “la pensee fondamentale de Hahnemann, la pierre angulaire du system!” But the earliest mention of this conception occurs in the Fourth Edition; and the full statement of it with which we are familiar in the Fifth (9-16) appears there for the first time.
You may ask how you are to get a knowledge of this development of our text-book. To some extent, I shall give it to you in the present Lecture; but you may all obtain for yourselves, and in full detail, by gaining possession of the translation of the “Organon” by Dr. Dudgeon, issued by the Hahnemann Publishing Society in 1893. In this volume, besides a revision of his version of 1849, our learned colleague has supplied an Appendix containing a full exhibition of the changes the work has undergone between 1810 and 1833; so that we have its growth before us at a glance. This is not the least of the many boons Dr. Dudgeon has bestowed upon Homoeopathic literature.
II. The “Organon” is Hahnemann’s exposition and vindication of his therapeutic method. It had been preceded by a number of essays in HUFELAND’S JOURNAL the leading medical organ of the time, in Germany. Of these the most noteworthy were “On a New Principle for ascertaining the Curative Powers of Drugs” (1792): “Are the obstacles to certainty and simplicity in Practical Medicine insurmountable?” (1797); and “The Medicine of Experience” (1806). The time seemed now to have come when there should be published separately a full account of the new departure he was advocating; and hence the “Organon” of 1810.
Why did he give his treatise this name? He must, there can be little doubt, have had Aristotle in memory, whose various treatise on Logic were summed up under the common title “Organon.” Logic the art of reasoning is the INSTRUMENT of research and discovery: Hahnemann designed his method as one which should be a medical logic, an instrument which the physician should use for the discovery of the best remedies for diseases. But the example immediately before his mind, and through whom he was probably led to Aristotle, must have been Bacon.
The second treatise of the “Instauratio Magna” of the English Chancellor is entitled “Novum Organum”: it was the setting forth of a new mode of reasoning, which in scientific research should supersede that of Aristotle, and lead to developments of knowledge hitherto unattained. That Hahnemann should aspire to do such work for medicine as was done for science in general by Bacon has been scouted by his enemies, and even deprecated by his friends, as presumption. And yet no comparison could better illustrate the real position of the man both in its strength and in its weakness.
If he erred as to special points of Pathology, and even of practice, we must remember that Bacon was a doubtful acceptor of the Copernican Astronomy and ridiculed Harvey’s doctrine of the circulation, while he saw no difficulty in the transmutation of metals. But on the other side, how truly Baconian is the whole spirit and aim of the “Organon”! Like his great exemplar, Hahnemann sought to recall men from the spinning of thought-cobwebs to the patient investigation of facts.
Like him, he set up the practical which in this case is the healing of disease as the proper aim of medical Philosophy; not seeking “in Knowledge a terrace, for a wandering and variable mind to walk up and down with a fair prospect,” but rather accounting it “a rich store-house, for the glory of the Creator, and THE RELIEF OF MAN’S ESTATE.” Like him, his chief strength was devoted to the exposition and perfecting of his proposed method of further progress towards this end, leaving to the future the carrying it into effect.
Another Descartes may arise in medicine whose perception of special fields of knowledge may be keener, and who may leave his mark more clearly traced on certain branches of our art. But Hahnemann, when once his method shall have won the acceptance we claim for it will ever be reckoned as the Bacon of Therapeutics the fruitful thinker who taught us what was our great aim as physicians and how we should best attain to it.
Hahnemann first called his work “Organon of the Rational Medical Science!” (In my Hahnemannian Lecture, I rendered “Kunde” by “doctrine”. A consideration of the discussion on the subject carried on in the HOMOEOPATHIC WORLD of 1881 suggests that I shall be more closely adhering to the German, while not weakening my argument, if I now translate it “science.” (HEILKUNDE); but from the Second Edition onwards the title was changed to “Organon of the Healing Art” (HEILKUNST) the “rational” being here, and in all other places of its occurrence, either dropped or replaced by “true” or “genuine” (WAHRE).
Why this alteration? The elimination of the term “rational” has been supposed to “imply that his followers were required to accept his doctrines as though they were the revelations of a new Gospel, to be received as such, and not to be subjected to rational criticism.” (BRIT. JOURN. OF HOMOEO., XXXVI., 63.) I cannot think so. To me the clue of it seems to be afforded (and the Preface to the Second Edition bears out my view) by the coincident change from “Heilkunde” to “Heilkunst.” The name “science,” the epithet “rational,” were in continual use for the hypothetical system of the day. The promulgation of his views had arrayed the advocates of all these in bitter opposition against him. Hahnemann was accordingly anxious to make it clear that, in entering the lists of conflict, he came armed with quite other weapons. He was seeking, not the consistency of a theory, but the success of a practical art: to him it mattered little whether a thing commanded itself or not to the speculative reason, his one concern was that it should be true.
III. On the title-page of his First Edition, Hahnemann placed a motto from the poet Gellert, which has been rendered into English thus:
“The truth we mortals need
Us blest to make and keep
The All-wise slightly covered o’er
But did not bury deep.”
This was replaced in subsequent Editions by the words “Aude sapere”; but it continued to denote the profound conviction and motive inspiration of Hahnemann’s mind. It was the same thought as that which he expressed in the “Medicine of Experience”: “As the wise and beneficent Creator has permitted those innumerable states of the human body differing from health, which we term diseases. He must at the same time have revealed to us a distinct mode whereby we may obtain a knowledge of diseases that shall suffice to enable us to employ the remedies capable of subduing them: He must have shown to us an equally distinct mode whereby we may discover in medicines those properties that render them suitable for the cure of diseases if He did not mean to leave his children helpless, or to require of them what was beyond their power.
This art, so indispensable to suffering humanity, cannot therefore remain concealed in the unfathomable depths of obscure speculation, or be diffused through the boundless void of conjecture; it must be accessible, READILY ACCESSIBLE to us within the sphere of our external and internal perceptive faculties.” Hahnemann believed in the illimitable possibilities of medicine, because he believed in God.
I lay more stress on this faith of Hahnemann’s, from the contrast presented to it by the language of the only fair and calm examination (to my knowledge) which the “Organon,” has received in this country. I refer to the Address in Medicine delivered before the British Medical Association in the same year already referred to (1881) by the late Dr. Bristwoe. The able and candid physician asks “What grounds of reason and experience have we to justify the belief that for every disease an antidote or cure will sooner or later be discovered?” and going further still, declares it to be in his judgment “utopian to expect that disease generally shall become curable by therapeutical or any other treatment.” That this melancholy Pyrrhonism is of extensive prevalence appeared also that year at the International Congress in London, where according to the LANCET (Aug. 27, 1881.) “therapy” was conspicuous by its absence. It was not so at the Homoeopathic Convention which preceded it; and this just stamps the difference between the two attitudes of mind.
I cannot prove at any rate here that the faith of the founder of Homoeopathy was sound, and the scepticism of its critics otherwise; but it is evident which is the more fruitful. As a lover of my kind, and not a mere man of science, I can say MALO CUM HAHNEMANNO ERRARE QUAM CUM well, it would be personal, as well as difficult, to Latinise the rest, but my hearers will supply it.
IV. Hahnemann, whose heart was indeed bubbling up with his good matter, and whose tongue was certainly the pen of a ready writer, wrote a separate Preface for each edition of his work. I cannot give any account of them here, but they are all well worth reading. The Second especially deserves notice as a full statement in brief, of the author’s view of the existing state of medicine; nowhere does Bacon speak more clearly through him than in his emphatic statements here regarding the relation of reason to experience in the study of the subject.
I pass on to the Introduction which in every edition forms a considerable proportion of the whole volume. It has altered very much, however, between its earliest and latest appearance. In the first three editions, it consists of a series of unintentional Homoeopathic cures (so considered) taken from medical literature, with a few preparatory and concluding remarks. But in the Second and Third, Hahnemann had introduced into the body of the work a long section of destructive criticism on existing theories and modes of treatment; and this, when he issued the Fourth, seemed to him to find a more appropriate place in the Introduction.
Thither, accordingly, it was transferred, forming under the title “Survey of the Allopathy (So written in the Fourth Edition of the original, but in the Fifth more correctly given as “Allopathy,” which I think the translators should have reproduced. “A not is Hahnemann’s antithesis to and as the latter forms Homoeopathy, the former should be Allopathy.) of the hitherto-prevailing School of Medicine” a first part; while the “Instances of involuntary Homoeopathic Cures” took place as a second. In the Fifth Edition, these last disappeared altogether, being merely referred to in a note; and the Introduction became a continuous essay, its subject being the medicine of the author’s contemporaries and predecessors.
I think that no one who is acquainted with the state of medical thought and practice in Hahnemann’s day will question the general justice of the strictures he here makes upon it. The critic to whom I have referred admits, “the chaotic state of therapeutical theory and practice at that time prevalent”; but he hardly appreciates Hahnemann’s merits in prescribing and stigmatizing it as he did. Chaos itself, to the habitual dwellers in it, seems to be cosmos:” it can only be apprehended for what it is by those who have the cosmos in their souls.
Thus it was with Hahnemann’s. He saw all around him two things which he cites, Gregory Nazianzen as pronouncing ag——– and (Lesser Writings, p. 501. Hahnemann ascribes the phase to “Greg. Mag.” but surely Gregory the Great did not write in Greek.) On the one side were the men of note the Stahls and Hoffmanns and Browns and Cullens building up their ingenious and ambitious systems on hypothetical data; on the other were the mass of practitioners, quite unable to utilise these imaginings, and treating disease according to empirical maxims or the directions of the prescription-book. The physician’s art was the butt of every satirist, the dread of all who fell ill, the despair of the minds that formed a nobler ideal of it. Hahnemann himself, as you may read in his life, for a time gave himself up to such despair, till his experiment with Cinchona-bark proved the clue of Ariadne which suggested the true law of the phenomena and led the way to better things.
If we were going through the Introduction in detail, there would be many points on which criticism and correction would be necessary; but the general soundness of its attitude must be sufficient for us to-day. It bears to the body of the work the same relation as Bacon’s “De Augmentis” to his “Novum Organum” and the treatise on “Ancient Medicine” to the “Aphorisms” of Hippocrates. Before leaving it, I must say a few words about the instances of cure, which, though dropped by himself were inserted from the Fourth Edition in Dr. Dudgeon’s first version of the Fifth, and are therefore familiar to us all. (In the translation of 1849, Dr. Dudgeon, not having the original of the Fourth Edition at hand, transferred these instances from an older version (Devrient’s).
Several errors crept in accordingly, but these have of course been corrected in the revision of 1893, where the cases in question will be found in the Appendix). His critic has singled out the first and last of these, and has no difficulty in disposing of them as without bearing on the point to be proved. But a more thorough examination would show that “A DOUBUS DISCERE OMNES” was hardly a safe mode of proceeding. Of the forty-five references made (I speak from consultation of the original sources) six are indeed quite worthless, and fifteen more dubious; but the remaining twenty-four will stand the most searching scrutiny.
The cures were reported by the best observers of their time; the remedies employed were undoubtedly Homoeopathic to the disorders present, and have no other mode of action to which their benefits could by any plausibility be ascribed. We could multiply and perhaps improve upon them now; but such as they are, they do speak the language as utterers of which Hahnemann cited them.
V. We come now to the `Organon’ proper. It consists of a series of aphorisms in its latest form 294 in number, to which are appended numerous and often lengthy notes. This is a form of composition eminently suggestive and stimulating. It is endeared to many of us by Coleridge’s “Aids to Reflection”; but Hahnemann must have taken it from the `Novum Organum,’ perhaps also with a recollection of the father of Medicine which derives its name therefrom.
While each aphorism is complete in itself, and might be made the text of a medical discourse, the work they collectively constitute has a definite outline and structure, which remains unchanged through the successive editions, and is as evident in the first as in the last. This outline is given in the third aphorism, which with the exception of “rational” for “true” (practitioner) in the first is identical in all editions:
“If the physician clearly perceive what is to be cured in diseases, that is to say, in every individual case of disease (KNOWLEDGE OF DISEASE, INDICATION); if he clearly perceives what is curative in medicines, that is to say, in each individual medicine (KNOWLEDGE OF MEDICINAL POWERS); and if he knows how to adapt, according to clearly-defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that recovery must ensue to adapt it as well in respect to the suitableness of the medicine most appropriate according to its mode of action to the case before him (CHOICE OF THE REMEDY, THE MEDICINE INDICATED), as also in respect to the exact mode of preparation and quantity of it required (proper DOSE), and the proper period for repeating the dose, if, finally, he knows the obstacles to recovery and is aware how to remove them, so that the restoration may be permanent: Then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art.”
The three desiderata, then, are
1st. The knowledge of the morbid state which supplies the indication:
2nd. The knowledge of medicinal powers which gives the instrument.
3rd. The knowledge how to choose and administer the remedy which is the thing indicated.
The First Part of the Organon (down to aphorism 70) treats of these points doctrinally, by way of argument; (aphorism 5-18 discuss knowledge of disease, 9-21 knowledge of medicines, 22-27 knowledge of application of one to the other; and 28-69 are an explanation and defence of the mode of application by similarity) the Second practically, in the form of precept. The summing up of the doctrinal portion is contained in aphorism 70, in these words:-
“From what has been already adduced we cannot fail to draw the following inferences:
“That everything, of a really morbid character, and which ought to be cured, that the physician can discover in diseases consists solely of the sufferings of the patient and the sensible alterations in his health in a word, solely of the totality of the symptoms, by means of which the disease demands the medicine requisite for its relief.
“That this derangement of the state of health, which we term disease, can only be converted into health by another revolution effected in the system by means of medicines, whose curative powers, consequently, can only so consist in altering a man’s state of health that is, in a peculiar excitation of morbid, symptoms, and can be learned with most distinctness and purity by proving them on the healthy body.
“That, according to all experience, a natural disease can never be cured by medicines whose power is to produce in the healthy individual an alien morbid state (dissimilar morbid symptoms) DIFFERING form that of the disease to be cured (never that is, by an Allopathic mode of treatment); and that even in Nature, no cure ever takes place in which an inherent disease is removed, annihilated and cured by the addition of another disease dissimilar to it, be the new one ever so strong.
“That, moreover, all experience proves that by means of medicines which have a tendency to produce in the healthy individual an artificial morbid symptom ANTAGONISTIC to the single symptom of disease sought to be cured, the cure of a long- standing affection will never be effected, but merely a very transient alleviation, always followed by its aggravation; and that, in a word, this antipathic and merely palliative treatment in long-standing diseases of a serious character is absolutely inefficacious.
“That, however, the third and only other possible mode of treatment (the HOMOEOPATHIC), in which there is employed for the totality of the symptoms of a natural disease a medicine capable of producing the most similar symptoms possible in the healthy individual, given in suitable dose, is the only efficacious remedial method, whereby diseases, which are purely dynamic, deranging irritations of the vital force are overpowered, and being thus easily, perfectly, and permanently extinguished, must therefore cease to exist and for this mode of procedure we have the example of unfettered Nature herself, when to an old disease there is added a new one similar to the first, whereby the old one is rapidly and for ever annihilated and cured.”
Then in aphorism71, Hahnemann propounds the practical questions which in the remainder of the Treatise he seeks to answer, thus:
1st. How is the physician to ascertain what is necessary to be known in order to cure the disease? 2nd. How is he to gain a knowledge of the instruments adapted for the cure of the natural disease the pathogenetic powers of medicines? 3rd. What is the most suitable method of employing these artificial morbific agents (medicines) for the cure of natural diseases?.