Hahnemann in Köthenthe Search for Meaning
There is something striking about the time Hahnemann spent in Köthen (1821-35) that stands out from the rest of his life as unusual. It is the fact that he finally nailed his colours to the mast of vitalism by declaring in the 5th Organon homeopathy's allegiance to the innate vital powers, the miasm theory and the invisible potency energy of tiny doses. Before the 5th Organon, these were merely half-suggested hints and shadows and had never declared overtly. The 5th Organon changed all that, but what events and cogitations had led up to it? Was it the result of some desire on his part to underpin homeopathy with a meaningful rationale? It is a quite plausible hypothesis.
Having spent so much time in the first half of
his career so thoroughly immersed in the experimental methods of science and
tinkering endlessly in the development of a new working system or medical
method, it would seem only natural that later on, in the second half of his
career, in the light of accumulating considerable experience in using it, that
he should next endeavour to piece together a 'meaning framework' so as to understand
how it works. It is perhaps in this spirit during the Köthen period that he
began to construct a provisional underpinning rationale to explain how and why
it works in the way it does. However, the first task before us is to see what
he had learned from the disastrous events of
In December 1819, "the pharmacists of
Being prevented from dispensing his own
medicines in Leipzig, "after the
persecutions of the jealous physicians and apothecaries had driven him from
Leipsic," (Bradford, 132) "Hahnemann
had now no longer a wish to remain in the ungrateful city of Leipsic ; in fact,
without the privilege of practicing be could not remain." (
In fact, Hahnemann had for many years been preparing and dispensing his own medicines. This longstanding preference first emerged in the late 1780s, arising primarily from his profound dissatisfaction with what he regarded as the inferior products supplied by the apothecaries, who he felt had for years been making a very good living supplying medical practitioners with dubious botanical preparations obtained cheaply and sold on very profitably at exorbitant prices. He felt medical practitioners deserved to be supplied with medicines from sources of the highest quality. His habit of preparing his own medicines thus partly arose through his distrust of what he saw as the unscrupulous and profiteering behaviour of the apothecaries. It also arose because he was sceptical of the drug information contained in the materia medica, which spurred his own desire to ascertain personally the actual therapeutic properties of drugs on the healthy person when used individually. Having rejected the complicated drug mixturesthe most nonsensical mixtures, (Gumpert, 96)then in common use, he preferred to use drugs singly.
This unusual habit of preparing his own medicines
had not gone unnoticed by the German apothecaries! And throughout the 1790s he
had been pursued wherever he lived by irate apothecaries trying to enforce
legal prohibition of his medical practice on the basis that he was encroaching
upon their ancient and privileged right to be the sole collectors, purveyors
and dispensers of drugs. The inveterate
enmity and persecution of the apothecaries
began in 1799. (Dudgeon, xlv) Therefore,
what happened in
Throughout the 1780s and 1790s, he had been
widely acknowledged and lauded as a vigorous champion of the scientific method,
applauded by the scientific and medical community and held in very high esteem
and regard especially for his scientific translations and essays on chemistry
(e.g. his wine test). Yet in
Hahnemann's "battle for
The Move to Köthen
Hahnemann finally obtained in April written approval
from the Duke for a position in Köthen, and moved there in June 1821. (Cook,
25) Most importantly, the Dukes edict allowed Hahnemann to do precisely what
he had been denied in
After residing for less than one year in
Köthen, "Hahnemann was created
Hofrath on May 13, 1822. The title Hofrath signifies Councillor to the Court,"
In Köthen he licked his wounds and began to
take stock of his new situation; in many ways, it was the end of one era and
the start of another. Hahnemann by the 1820s was forced to confront the
terrible setbacks of
Dudgeon comments on his unbelievable determination, tenacity, resolve and resilience in spite of all the obstacles placed in his lifes path: his "indomitable perseverance...notwithstanding every difficulty and discouragement." (Dudgeon, xli) Though his industry and working powers bordered on the marvellous, (Dudgeon, xlviii) experience had made him suspicious and impatient of the opposition of others. (Dudgeon, xliv) He was "undeterred for one instant by the hard necessities of poverty, or by the sneers and persecutions...of his professional brethren." (Dudgeon, xli)
Being under the Duke's guidance and returning to freemasonry, did he begin to consider the hidden spiritual side of life once againand see the underlying patterns emerge? Did he at this point begin to realise the value of a 'meaning framework' largely hidden from view both in life and in homeopathy? Did he decide at some point that he wanted homeopathy to be blessed with some kind of rationale as allopathy hadalbeit in a crude form? Although the allopathy of his day had largely abandoned the ancient theoretical garb of Galenic medicine, it still employed the wide gamut of its broadly depleting and humour-expelling measures. Did he want a kind of rationale to underpin and to help explain the methods of homeopathy in order to counter the charge that he was little more than a mere empiric? Homeopathy was dismissed as a mere theory, as outright quackery and its doses as ludicrous.
At this time, did the central importance of the vital force in homeopathy dawn on him as a means of explaining and underpinning it and as comprising precisely the type of coherent rationale which he wanted? Had not the vital force concept always been present in an unacknowledged sense throughout all his work, and now he could at last openly admit it instead of hiding or denying it? Did he now seek to bring out into the open and make overt and explicit that which for so long had merely dwelt in the shadows as a covert implication? Did he realise that miasms were a big complement to the vital force idea?
He knew that all these ideas were incompatible
with and would be condemned and vilifed by mainstream science and medicine, yet
still he went ahead with his vitalist revisions of the 5th Organon. He also knew that the vital force concept had only
recently been rejected by mainstream science and medicine as a wholly redundant
After the upheavals of Leipzig, did he feel that his long fight with allopaths had been a pretty futile endeavour, a failed enterprise, and so he had nothing really to lose from making a declaration of homeopathy's fundamental vitalistic leanings, seeing that he had by now entirely lost the last shreds of what respect he once had within the scientific and medical community? He was shunned by his medical brethren as a pariah.
So, in Köthen did he finally see that what he had tried in Leipzig had been an absolute failure, and that he must abandon any further contact for converting allopaths to homeopathy? Did he not see this henceforth to be a wholly doomed prospectus? He was mercilessly attacked and dishonoured.
If he had learned anything from the events of Leipzig, then he had surely realised that it would take a little more than one tiny David to bring the lumbering Goliath of allopathic medicine down to its knees or to get such a rigid and monolithic structure, so undesirous of change, to see sense and reason, no matter how just was his cause or how sure was his aim. Medical practice in the early 19th century had undergone no fundamental change over hundreds of years and was rooted in tradition. The profession was decidedly reactionary and opposed to change (and) aimed at rigid conformity with accepted practice. (Cook, 127) And venesection, emetics and other purgatives had been the practice for 3,000 years. (Cook, 141) But for Hahnemann he knew the weapons in his hands were poisoned, (Gumpert, 67) and so he rejected the fearful martyrdom of mercury. (Gumpert, 68)
Did he thus resolve henceforth to plough his own furrow and focus solely on clarifying things for his homeopathic followers and to ignore allopathy entirely? All his later work was written for them, not for the allopaths. He clearly decided not to make any attempt to court their favour, but to get on with his own work and ignore allopaths completely.
In the face of allopathic opposition and condemnation, signalling that he had actually abandoned his previous aim of winning allopaths round and converting them to his view, did he not now turn his focus inwards to his own thoughts and projects and to the work of his followers? Therefore, did he not feel that the time was right to make a clear and unambiguous declaration of homeopathy's allegiance to vitalism? Doesnt this explain why we have the 5th Organon so laced with references to the vital force, a volume so unlike all its previous editions?
"From his schooldays onwards he had followed Descartes, Spinoza and Leibnitz...and then proceeded to vitalism and to the naturalism of Schelling and Hegel...Wunderlich says in his 'History of Medicine' that the naturalist philosophy of Hegel and Schelling movement actually afforded help to the rise of homeopathy."(Haehl, 1, 251-2) With "the promulgation of the psora-theory, we notice a remarkable alteration in Hahnemann's ideas respecting posology." (Dudgeon, 405) The new metaphysical ideas of the 5th Organon stand in very stark contrast to his own earlier attitudes. In the early part of his career "his theorising was always subordinate to his observation of facts," (Dudgeon, 50) and he "was not at this point capable of jumping to a conclusion from a single observation." (Dudgeon, 117) As Dudgeon notes, and unlike all his early work, his doctrine of chronic diseases is an unmitigated hypothesis. (Dudgeon, 29)
Having all his life "battered his way through obstructions," (Gumpert, 86) and having "waged war...against the obscurities of science," (Gumpert, 62) for long he had "cast tradition aside, and had recourse only to the medicines he had learned, tasted and confirmed," (Gumpert, 67) for himself, for "it is to Hahnemann that we owe our knowledge of a number of the most valuable plants and herbs. They were outlawed along with him," (Gumpert, 128-9) because he "was accused of prescribing fatal poisons." (Gumpert, 129) His desire "to break away from hypotheses and systems," (Gumpert, 122) had led him to strive "continually for clarity," (Gumpert, 24) and "everything that savoured of theory he swept drastically out of his mind." (Gumpert, 24) He "was forced to endure poverty and contempt on his painful road," (Gumpert, 118) as he strove through his "desperate struggle for a clear conception of healing," (Gumpert, 96) to establish a medical art "free from all hypotheses and obscurities." (Gumpert, 67) His unceasing "urge towards clarity had made him shun everything that might conceal the danger of confusion," (Gumpert, 28) and even in "the use of words he detested confusion and distortion." (Gumpert, 51)
As a physician he had always been grounded primarily in the practicalities of what actually cures sickness, and early on in his career, and for decades all Hahnemanns views and doctrines were made subservient to his therapeutics. (Dudgeon, 243) He had roundly condemned "speculative refinements, arbitrary axioms dogmatic assumptions (and the) magnificent conjuring games of so-called theoretical medicine." (Ameke, 134) Initially, he had looked for the most simple, comprehensible and trusted principles in medicine, easy to apply, and without any speculative intrusion or unnecessary recourse to the opinion of so-called authorities, whose validity he rejected. However, as Dudgeon ruefully points out, this is not strictly the full picture. Though Hahnemann inveighed against theories, he was not that enemy of theory he is represented to be (he had) a highly speculative mind (and) was very prone, nay perhaps too prone, to theory. (Dudgeon, 28) He was naturally of a speculative turn of mind. (Dudgeon, 29)
All the novelties of the 5th Organon arose
during the Köthen period of his life (1821-35), during which his thinking about
homeopathy underwent many deep changes, and which duly spawned a much more
nebulous, metaphysical and vitalist philosophy to embellish what had hitherto
been primarily a practical system of medicine. We might ascribe these changes
in his thinking to several possible causes. For example, the loss of his
Hahnemann certainly endorsed the notion that the organism is possessed of a "dynamic...strange, immaterial, spirit-like function," (Gumpert, 147) or life force. Whether he always held this view remains unclear, for it was only first made fully explicit during the late 1820s with his publication of the 5th Organon. There is no doubt that along with the miasm theory, the vital force idea had compelled him to make the crossing of "the perilous borderland of the metaphysical." (Gumpert, 167) Though he had indeed "made his dauntless passage through the dense undergrowth of the medicine of his times," (Gumpert, 128) and being certainly "the pioneer of experience without dogma," (Gumpert, 128) it remains unclear if "Hahnemann was always a convinced vitalist along theological lines," (Gumpert, 128) as this is actually an undocumented assumption on our part. His accumulated experiences probably had "led him to become a heretic who denied the materialistic science," (Gumpert, 126) of his day, for "he saw things with an independent, timeless eye," (Gumpert, 147) and felt that "medical science had lost its way in the materialism of the new age." (Gumpert, 186) He was therefore "determined to renew and reorganise the art of healing," (Gumpert, 148) and yet for this very reason he had become the "disparaged and vilified outsider of the healing art." (Gumpert, 155)
In the absence of anything more definite, these seem like the most likely causes lying behind the profound revisions of the 5th Organon and his decision henceforth to tie homeopathy much more firmly to metaphysical concepts. And it is richly ironic that the very concepts which he had previously dismissed as "the splendid juggling of so-called theoretical medicine a priori conceptions and speculative subtleties a pseudo-scientific fabrication," (Preface to the 2nd Organon, xv), he was now to be found busily weaving into every paragraph of his two final Organon editions. It really is hard to imagine a more speculative subtlety, arbitrary axiom or dogmatic assumption than a miasm. Finally, it seems he did indeed come to appreciate the possible relevance of the superfluous rubbish of hypotheses," (Gumpert, 26) in medicine.
His publication in 1828 of The Chronic Diseases, opened up an entirely new chapter by exploring what he regarded as the underlying causes of disease as rooted solely in three ancient dyscrasias: skin diseases (Psora), gonorrhoea (Sycosis) and Syphilis. From "frequent observations, Hahnemann had discovered that chronic maladies had some connection with a previous outbreak of Psora." (Haehl, vol. 1, 138) His publication of The Chronic Diseases caused a great controversy, (Cook, 149) among his followers. The Psora theory precipitated a considerable measure of alienation amongst his own followers. (Hobhouse, 224)
His first wife died in 1830 and Duke Ferdinand died in 1831 and curiously that is also about the time when he insisted that miasms and vital force comprised a deeper, metaphysical bedrock of homeopathy. These new 5th Organon ideas were by no means accepted or appreciated universally by all homeopaths; they led to new disputes, many dismissing and disputing them as unnecessary, theoretical accretions to the basic homeopathic teachings.
On 8th October 1834 (Cook, 164), four and a
half years after the death of his first wife, Johanna, a new lady entered his
life: Melanie DHervilly Gohier (1800-1878), a young, attractive and
well-connected French artist, who paid him a surprise visit in Köthen. Over
forty years younger than him, she became first his patient, then his homeopathy
student and then his lover. They were married on 18th January 1835 in Köthen.
(Cook, 166) Before very long a project
was conceived by the newly married pair to visit
Why he left Köthen with Melanie probably flows from Melanie convincing him of her vision of what she thought homeopathy could become there, and which it would never become in Germany, where the misdirected energies of his fighting spirit were spent, that he had to make a fresh start, take it to a new place, the cities of the world, into a much wider forum, to show the world its wonderful effectiveness. Why else would he have abandoned his pleasant life in Köthen? his decision to leave Köthen with Melanie also reveals that he must have decided that he no longer had anything really to gain from staying in "his beloved Saxony," (Bradford, 29); there was nothing left for him there and potentially much to be gained in Paris, "the capital of the beau monde," (Dudgeon, xxxix) and the fashionable showcase of the whole world.
Certainly, Hahnemanns time in Köthen can be
related back to his time in
His original intention had been to set up a homeopathic teaching institute (ref) in the town, but the lack of interest in the project inspired him to enquire instead about what possible opportunities there might be to teach homeopathy at the university medical school. He was informed that he could only do that if he submitted and successfully defended a learned thesis on a relevant topic to gain admission to the faculty. (ref) This took place in the summer of 1812, was a very grand affair and he then assumed his professorial duties teaching homeopathy in the autumn term. (ref)
In Köthen, Hahnemann must have looked back on
those years in
Turning next to the vital powers issue, we have not really found sufficient evidence that Hahnemann had specifically set out to create a rationale for homeopathy, but the idea remains a plausible one. It seems likely that had become one of the aims of his work in Köthen. Certainly the miasm theory and the central importance of the vital force emerged from the darkness into the light during his stay in Köthen, but their true origins still remain shrouded in mystery. It is quite possible that his discussions with the Duke concerning freemasonry might have inspired him to consider a vitalistic basis for homeopathy, but this idea remains undocumented and therefore unproven.
It is not documented where any of his metaphysical ideas of the period came from, what had inspired them or why he had implanted them so thoroughly and enthusiastically into the 5th Organon. Even his claim to have discovered the three miasms through observation of clinical cases over a twelve year period, cannot be absolutely confirmed as true, because the venereal miasms can be traced back to his early work as a doctor, and the Psora miasm was published by at least 3 other German doctors, two during his own time. Therefore, the possibility of direct or indirect plagiarism on his partconsciously or otherwisecannot be ruled out. Therefore, all we have been able to do at this stage is make a few informed guesses. On that basis we have covered the ground adequately and arrived at various tentative conclusions, which can only be resolved by future research.
Why is the 5th Organon so Metaphysical?
Until all the important conceptual elements of life science are thoroughly and satisfactorily worked out, you cannot really even enter into the field of health and sickness, or pontificate therein about causes and effects, with a shred of credibility. In other words, unless and until you can clearly define what an organism is and how it functions in health, then how can you even begin to speculate sensibly and convincingly about sickness and its cure? And this I believe is what Hahnemann realised when he retired to Kothen. Sooner or later homeopathy just had to 'move up a gear' and begin to address the deeper conceptual issues concerning living things, if ever it was to transcend and shake off the stigma of being labelled as a mere form of empirical medicine utterly devoid of deeper and binding principles.
It is this important matter of establishing a sound epistemological bedrock or foundation, a convincing elucidation of deeper principles that might, in part, have driven Hahnemann to engage with this task during the Kothen period, when he had much more time to contemplate such matters, and which led him, in due course, to introduce an interesting succession of illuminating and unheralded innovations: the miasm theory (1828), the 30th potency (1829) and the highly metaphysical 5th Organon (1833). These innovations just seemed to burst forth from him without any warning, in a very short period of time (3-4 years) taking all his followers by complete surprise.
These three innovations clearly did not spring from nowhere, but must have been the end-products of some sustained and prolonged cogitation on his part of all the key issues. It seems a peculiar form of coincidence that these events also occurred soon after the announcement of Wohler's synthesis of Urea in 1828, about which Hahnemann must have known, and the alleged death-knell for vitalism in mainstream science that many have argued Wohler's experiment precipitated. Wohler's experiment, and the anti-vitalist furore it provoked in science, must have brought to Hahnemann's attention the whole issue of the vital powers. It was duly lifted up the agenda and its public profile raised. Arguably these events might then have prompted Hahnemann to commence a deeper scrutiny of the crucial role of the vital powers in homeopathy and to hasten his resolve to finally nail his colours to the mast of vitalism, which he most certainly did in the 5th Organon. And it seems another peculiar coincidence that he should have done that at the very same time that vitalism in mainstream science was officially being buried. While these arguments do have some credibility in themselves, as far as they go, yet they fail to explain why Hahnemann never saw the importance of or even mentioned the vital powers before the 5th Organon. Also, if he had had his 'St Paul moment' about the vital force soon after Wohler's synthesis of urea, or as a result of his miasm theory, both occurring in 1828, then why did he not incorporate those ideas into the 4th Organon edition of 1829 (Bradford, 519)? There is clearly more to be found on this.
However, there are some other pertinent factors, a few more practical and pressing, less theoretical events, much closer to him that must also have contributed to this dramatic change in his homeopathic views, and which probably pushed him in the same direction. He lost his wife at the end of March 1830, and his patron, the Duke, only four months later, in August of the same year. "After four weeks in bed her condition gradually declined." (Cook, 151) In spite of his most valiant efforts, there was seemingly nothing he could do to save his wife of 48 years. There is no doubt that he would have regarded these events as devastating losses for him personally, as well as big disappointments for homeopathy as a medical system he treated them both with. Being personally responsible for their health and well-being, first as a husband and second as Hofrath or court physician to the Duke, he could not really avoid feeling that way.
These tragic events must have weighed very heavily on his conscience and probably led him to contemplate afresh, rendered even more acute and profound by the emotion of the moment, the crucial role played by the vital powers in health and in sickness. What must have become clear to him was that for any person when their vital powers are depleted, expended or utterly exhausted, as at some point they must be for all people, then serious illness and death will inevitably ensue, no matter what well-chosen remedies are given or what dosage pattern is employed. Perhaps he had not previously apprehended this point quite so vividly? He must then have become acutely aware that these highly relevant factors do necessarily impinge upon every other aspect of homeopathy. These factors would have explained and made sense of the tragic loss of these two closest companions for whose health and life he must have battled strenuously, but in vain, in their final days. He would therefore feel compelled to incorporate this crucial new information about homeopathy and vital powers into a new Organon edition so that all future homeopaths would be cognisant of something important which he had previously overlooked.
Arguably what these emotional events demonstrated to him was that you cannot cure someone with remedies unless they still possess some modicum of vital powers operating within the organism. Remedies alone are simply not sufficient, no matter how well-chosen. There must be a certain minimum of reactive powers present in the organism and upon which the remedies can act, for there to be a curative response. In spite of his best efforts toiling with remedies, the loss of his wife and patron would have been a devastating blow, but it may eventually have enabled him to realise the crucial role the vital powers play in the living organism and so in homeopathy. And this would in turn have hastened his realisation that without the vital powers the human organism is merely a corpse, and that it is solely the vital powers within the living organism upon which a remedy acts and via which its therapeutic effects are always mediated and expressed. And it is precisely these points that form the essence of almost everything new he has to say in the 5th Organon. This would explain why he says without the vital force there can be no cure and no reaction to the remedies.
The above events seem much more likely to have forced him to contemplate the true nature of the vital powers and thus to have spawned the metaphysical nature of the 5th Organon. I believe these tragic and deeply emotional events triggered his renewed interest in the vital powers and his renewed engagement with the whole matter of the vital powers in homeopathy, leading him, by 1833, to make the numerous metaphysical comments in the 5th Organon. The fact that he filled the 5th Organon on virtually every line with references to the vital force, unlike all four previous editions, amply illustrates the considerable emotional force with which he had arrived at this new conviction. These events seem far more significant than any idle desire he may have harboured to supply homeopathy with an underpinning philosophy, a rationale all of its own, or of the possible implications of Wohler's experiments for the vital force in science, neither of which would have impelled him with any sense of force or urgency. Neither of those factors could have created the passion and certainty of conviction to have spawned the powerful changes in viewpoints which are so clearly evident in the 5th Organon and which underpin almost every paragraph of it. The language of the 5th Organon leaves no doubt of the certainty with which he speaks of the vital powers, and the same sentiments stand unchanged even in the 6th Organon of 1842, showing that his views on the subject had not changed almost ten years later.
In a broader sense, his conscience holds the key. There is also a parallel or precedent to this situation also concerning the power of his conscience. He was always pricked by a very strong sense of conscience. It was his conscience that had forced him to abandon the crude medicine of his day because it was too harmful and uncurative to his patients, especially the more depletive measures like blood letting and purging. It was also his conscience that had led him to investigate and seek out safe and gentle therapeutic measures for the treatment of his own family c.1790-1801. And he freely admits this (quote). It was his conscience that led him for years to eke out a meagre living on translation work, when he could have practised old school medicine and made a handsome living. It was his conscience that forced him to endure great poverty for most of his life. It was his conscience that forced him to attend the funeral in October 1820 of General Schwarzenburg: "his lips were sealed and his conscience clear, (as he) walked behind the hearse with the other mourners," (Cook, 122) even though he was later apportioned some blame by medical colleagues for the general's death. It was his conscience that forced him to move from town to town for years until he had finally reached definite views about the nature of sickness and medicine. It was also his troubled conscience that allowed him to humbly accept, rather than challenge, the court's vindictive decision that prohibited him from prescribing his own medicines and thus led to his flight from Leipzig in 1821. As Gumpert says, "he feared his conscience." (Gumpert, 104)
Wilhelm Ameke, History of Homopathy, with an Appendix on the
Thomas L Bradford, The Life and Letters of Hahnemann,
Trevor Cook, Samuel Hahnemann, the Founder of
Robert E Dudgeon, Lectures on the Theory and Practice of Homeopathy,
Martin Gumpert, Samuel Hahnemann: The Adventurous Career of a Medical Rebel,
Richard Haehl, Samuel Hahnemann, His Life and Works (2 volumes),
Samuel Hahnemann, The Organon of Medicine, combined 5th/6th Edition, Translated by
R.E. Dudgeon, and edited by William Boericke,
Rosa W Hobhouse, The Life of Christian Samuel Hahnemann Founder of Homeopathy,