MR. CHAIRMAN, MEMBERS OF THE CONGRESS OF STATES, AND GUESTS- I wish to recognize, and express my appreciation of the courtesy which you have extended in inviting me to participate in your programme.
I am not qualified to speak as a homoeopath. There is some question whether I can speak even as a representative of the faculty and board of trustees of the Hahnemann Medical College, in as much as I have not discussed the matter of my coming here, nor the context of my paper with the faculty other than with three members of our faculty, who are also devoted members of the American Institute of Homoeopathy.
Our problems at the Hahnemann Medical College in recent months have not been primarily related to homoeopathy. They have been much broader and more comprehensive in their nature than the subject of one of our activities. Indeed, they have concerned the whole basic structure of medical education and our facilities for meeting the requirements of high scholastic standards.
However, as a part of my acquaintance with the college and its problems. I have had an opportunity to learn informally from a large number of our faculty about their interests in homoeopathy. Also, as time has provided, I have attempted to acquaint myself with the teachings of homoeopathy so that I might be in the best possible position to serve the Hahnemann Medical College as its educational administrator.
In the definition of the homoeopathic physician as given by the American Institute of Homoeopathy, it is stated that “all that pertains to the great field of medical training is his by tradition, by inheritance, and by right.” Therefore, the fundamentals and principles of medical education in general should apply the same to homoeopathic education, as to any other variety of education in the rapidly expanding and progressing field of medicine. Techniques and methods of pedagogy should be the same.
The difference comes in material taught, in that it essentially covers a system of therapeutics as applied under a special doctrine of thinking and reasoning, together with the materia medica available at one time which seemed adequate in the minds of many for the diagnosis and treatment of disease and human ills. There are still many, who feel that such a system is adequate for the practice of medicine.
With the increasing knowledge arising from scientific investigation, many of the views and theories and principles of medicine, formerly thought complete and adequate, now are recognized as being outmoded, incorrect, and even obsolete or archaic.
With the modern methods of study, many of the medicinal substances thought to be of value either in the cure or amelioration of disease have been replaced by more effective remedies. This is true in all systems of practice. In particular instances, we may revert to the re-study and use of some of these drugs or remedies, which have been considered in the past as obsolete.
There is no dishonour nor is there disgrace in recombing the field of materia medica to re-evaluate drugs, that seem to have some merit, but because of lack of proof in older methods of research, or replacement by seemingly better drugs, at some time, have been ruled as useless. Both non-homoeopathic and homoeopathic medicine faces this responsibility in exactly the same light, namely looking for better remedies in whatever sources at hand or in the tremendous chemical and biological developments ahead.
Homoeopathic education almost automatically is defined into under-graduate and post-graduate activities. This is equally true of non-homoeopathic medicine. In undergraduate education we are primarily interested in producing good physicians, who will serve the greatest proportion of the people in their communities, that is the general practitioners, and indeed it is our responsibility primarily just to do this.
The education of the specialist is a post-graduate activity and indeed includes the education of the general practitioner to make him more adequate in serving his community with modern methods. In my elementary exploration of homoeopathy, it appears that homoeopathy consists of three parts, namely a philosophy, a system of therapeutics, and a particular materia medica, which serves as the remedy in the application of this philosophy and system of therapy.
For a moment, let us look at the sources of homoeopathic education. I understand there are several hospitals or groups of physicians, which provide post-graduate courses in homoeopathy. So far as I have been able to determine there are only three medical schools which provide homoeopathic education as an undergraduate activity, namely, the Hahnemann Medical College, the New York Medical College, and the University of California. I understand the course in homoeopathy at the University of California is elected about 10 per cent. of the students. The course in homoeopathy at the Hahnemann Medical College is required of all students. A total of sixty-four hours as distributed equally over the four years as follows:.
Freshman- Principles of Homoeopathy 16 hours.
Sophomore- Pharmacodynamics 16 hours.
Junior- Materia Medica 16 hours.
Senior- Materia Medica 16 hours.
In addition, a part of ninety-six hours instruction in therapeutics, clinics, lectures, and conferences in the senior and junior years include instruction in homoeopathy. I am not sure what the situation is at the New York Medical College, but probably Dr. Hetrick will refer to that in his paper. I am not sure of the percentage of survival of undergraduate instruction in homoeopathy that this represents among the sixty-eight medical schools now in existence.
It seems unlikely that any significant number of new medical schools will be created in the immediate future. The present number of medical schools imposes a tremendous responsibility on the already existing ones in meeting the tremendous demands for medical education.
Although we have been receiving applications at the Hahnemann Medical College for the 1947-48 session for only three months and still have seven months before the opening of this session, we have 653 applications for 105 places. No doubt, other medical schools, which have had less difficulties than we, have a much larger demand. It would appear that other schools, which have already dropped homoeopathy, are unlikely to reinstate it in their undergraduate teaching and, therefore, undergraduate teaching of homoeopathy likely will remain only in the three schools mentioned.
It is my impression that many of our applicants are not interested in coming to Hahnemann because of the course in homoeopathy, but because it is another good medical school in which they have a chance for admission. From my contact with the present senior class at Hahnemann, I would think that about 20 per cent. of them are especially interested in homoeopathy. These particular students should be excellent candidates for a post-graduate course in homoeopathy because they have been fired with enthusiasm of our excellent teachers in this subject.
I was interested in reading the paper by Dr. Harvey Farrington in the January number of the Journal of the American Institute of Homoeopathy. On page 13, question 8, and his answer, which I quote in part, is as follows:.
“Do you believe that the teaching of homoeopathy must be given during the ordinary training of the Regular School, or is it better to give it as a Post-graduate Course? Post-graduate courses are not only preferable, but more practical. The regular curriculum is so filled with scientific subjects, surgery, pharmacology, and other branches of therapeutics that there is little or no room for an adequate course in homoeopathy.”.
Above, I have referred to the modern methods of re-study and further investigation of drugs and methods. Especially, with the development of the sulpha drugs and the antibiotics, modern pharmacology has instituted a method of study, which has to do with the determination of absorption, transport, and exertion of drugs as related to their effectiveness against certain kinds of diseases. If such methods could be applied to homoeopathic therapeutics, it would seem that research along these lines would do much to appraise and evaluate the effectiveness of the homoeopathic principle and materia medica.
I realize fully that our present chemical methods may not be fine enough to carry out such studies in which such minute quantities of a given drug are under investigation. However, our modern way of thinking in pharmacology is mandatory in these respects in our present-day approach to therapeutics.
I am also equally aware of the fact that many empirical remedies have a therapeutic usefulness even though they cannot be tested by such methods. No doubt, in the minds of many the effectiveness of homoeopathic therapeutics will remain in this category of empiricism until and if there are more objective methods of proof.
In the survey of this whole problem it is apparent that the homoeopathic principle is considered adequate by a minority group of physicians and that there are relatively few places in which homoeopathic education can be obtained as an undergraduate activity. There are many within the classification of homoeopathic physicians, who believe that homoeopathy has a very real, but limited, usefulness in our modern medicine.
The majority of the medical profession feels that homoeopathy has outlived its usefulness as a complete basis of foundation for a medical school, that it alone is inadequate in the diagnosis and treatment of human ills as we now understand them, and recognize that many of the principles and some of the remedies have been absorbed by so-called regular physicians and, thereby, lost their original homoeopathic identity. It seems to me that we must look at this problem from a practical standpoint, at least as far as the Hahnemann medical College is concerned.
For many years, the Hahnemann Medical College has provided excellent regular medical education, and homoeopathic education has been required, but is minimal in its relationship to the full four-year course. Yet, it is referred to as a homoeopathic school and, of course, enjoys the favourable and loyal support of those who are devoted to her, but also is deprived of the enthusiastic support, which she so richly deserves, from those physicians and other agencies which now consider homoeopathy in a less important light.
From a practical standpoint, the continued existence of Hahnemann is not primarily related to undergraduate homoeopathic education, but to that of providing the highest grade of scholarship in medicine, and it is our desire and intention to pursue this goal until our graduates have regained the high place they formerly held in all academic accomplishments, and to even go further in the realization that they may be even more competent than graduates from other institutions.
As long as we remain one of the institutions with the responsibility of teaching undergraduate homoeopathy, it would appear that the course in homoeopathy should be co-ordinated with and remain a part of our course in therapeutics, with the provision that our department of therapeutics teach in addition a wholly adequate course in therapeutics the same as any other medical school. As pointed out by Dr. Farrington, and in view of the already over-crowded medical school course, there is no more time available than to give an elementary type of instruction in homoeopathy, and in reality a physician, who is perfected in the field of homoeopathy, must gain this perfection through post- graduate education.
Such an arrangement is not without precedent in other fields of special therapy already existent in all medical schools. Perhaps, it would be better to even restrict the teaching of homoeopathy to post-graduate education and then homoeopathy could step out to take its place with any other speciality, supported by its methods establish by research and investigation of both the fundamental and clinical type.
The British Homoeopathic Journal, Vol. XXXVII., No. 2.