Organon 200th Anniversary Essay
Commemorating two hundred years since the publication of the 1st Organon edition, this essay analyses the contents and evolution of what is widely regarded as Hahnemann's masterwork, and attempts to place the Organon in a longer and wider historical and epistemological context. Drawing heavily, as it goes, on the work of Dudgeon, Gumpert and Haehl, amongst others, it seeks to explore some deeper aspects of the topic. The numerous twists and turns in Hahnemann's medical thinking are dissected for the reader as the evolution of homeopathy is unfolded. The 5th Organon is examined in special depth as a path-breaking metaphysical revision of its four predecessors. The essay closes with a brief consideration of the final and unpublished 6th edition and Hahnemann's introduction of the now popular LM potencies.
Organon, vital force, materia medica, single drug, metaphysics, similars, provings, miasm theory, olfaction, liquid doses, hypothesis, cholera, Hahnemann, Duke Fredrick Ferdinand, LM potency
Dudgeon notes that "his diligence must have been something extraordinary," (Dudgeon, xxii) and praises "the brilliant discoveries of his genius." (Dudgeon, 560) Hobhouse points to the relentless thoroughness with which Hahnemann set himself to any task. (Hobhouse, 64)
"I marvel at the transcendent acuteness his wonderful perceptive powers Hahnemanns own doings are tenfold as great and important as all the labours of all his predecessors and all his followers. (Dudgeon, 241)
In the matter of Materia Medica, we all must acknowledge that among them that are born of women there hath not arisen a greater than Samuel Hahnemann. (Dudgeon, 241)
The year 2010 marks the 200th anniversary of the publication of Hahnemann's monumental masterwork, the Organon, and 2011 marks the 200th of its companion volume, the Materia Medica Pura. It is therefore useful to consider their importance and significance not only regarding the prestigious position they both still hold today among homeopaths vis-à-vis homeopathy as a working system, but also in their origins and evolution. The first edition of The Organon, published 1810, (Dudgeon, 341) can justifiably be regarded as Hahnemann's ongoing 'medical diary' that he updated periodically, filling it with fresh practical hints deriving mostly from his own medical practice and concepts from his theoretical musings. The Organon seems to have been conceived and written in the format of Francis Bacon's Novum Organum and Aristotle's Organon (Close, 15, 27-28, & 248-9), and as Dudgeon says: "his immortal Organon was an amplification and extension of his Medicine of Experience, worked up with greater care, and put into a more methodical and aphoristic form, after the model of the Hippocratic writings." (Dudgeon, xxx-xxxi) This comment alludes to the elevated importance and philosophical gravitas which Hahnemann attached to this work and which he felt he had imparted to it.
Being clearly modelled on profound philosophical treatises, he seems to have regarded the veracity of its aphorisms as sacrosanct. "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) Hahnemann clearly intended his Organon to become refined over time such that its principles could be amplified, clarified and updated, being elevated eventually to the status of 'natural laws'. That he published a further four editions over the next twenty years, might well be viewed as good evidence of this tendency to revise and elevate.
The Organon "gives clear expression of Hahnemann's originality, but is also the product of a mind steeped in the ideas of the eighteenth-century Enlightenment, and informed by the liberal humanitarianism of Jean-Jacques Rousseau." (Handley, 1990, 3) The 'Organon of the Art of Healing' "is presented in sections after the manner of a legal code, (its)...sections manifest the notable and intimidating terseness of legal paragraphs, which, despite their unequivocal and final character, can scarcely be understood without prolific commentaries. Many authoritative minds have expounded them, and have read into them profound significance or nonsense, according to their own estimate." (Gumpert, 133)
His remarkable essay, the forerunner of the Organon, entitled The Medicine of Experience, (Dudgeon, 399) was published in 1805. A number of other essays of 1805, 1808 and 1809, were also highly relevant and connected to the Organon itself, amounting to magnificent critiques of every mode of medical treatment then extant and discussions of why similars and single drugs are superior, and always have been. The Materia Medica Pura (1811) and Organon (1810) are the greatest landmarks in the establishment of homeopathy. The Organon should thus be considered in relation to its chief predecessor his essay, The Medicine of Experience, and its companion volume, the Materia Medica Pura to its predecessor the Fragmenta. The Fragmenta is more distantly related to his earlier unfinished project, his learned and laborious Pharmaceutical Lexicon, (Dudgeon, xxv) which he worked on during the period 1793-9. (
While Hahnemann presented the Organon to the world as a guidebook on how to practice homeopathywith some hints about whythe Materia Medica Pura presents the methods or tools which are required for such practice. The word Pura also needs some amplification, as does the word rational, which appears in the title of the later Organon editions. Pura refers to what Hahnemann saw as that pure knowledge of drugs deriving from those pure symptoms seen in the pure experiments (provings) of pure (single) drugsas opposed to what he regarded as the 'impure' mixtures used in the allopathy of his dayand also that the symptoms are pure because they derive from tests on healthy volunteers standing in stark contrast to allopathy, which in his view peddled spurious, misleading and impure knowledge about drugs obtained from their use upon the sick and from folklore. Rational means sensible as opposed to what he saw as the chaotic and irrational medicine of his times.
The overall purpose of the Organon was to firmly strike out a new medical path away from the old systems that relied on strong doses of mixed & unproven drugs whose alleged therapeutic properties were largely inferred from old texts, old wives tales, myths and legends and the dictates of old medical authorities who Hahnemann came to regard as thoroughly outdated and unreliable guides to curative therapy. He had come to this conclusion from bitter personal testimony of the ineffectiveness and dangers of their methods and the stupidity of their theories, which had inspired his desire to break free from the old medical systems and create something simpler, newer and more valid. Its origins are thus quite complex.
While his medical colleagues were all stubbornly holding "fast to emetics, venesections, and other depletives, etc, because this has been the practice for 3,000 years," (Haehl, 1, 141) Hahnemann, by contrast, sought new medical methods that were gentle, non-depleting, safe and effective. He expressed his "growing horror (at the) dangers remedies and palliatives (and became) filled with shame and assailed by torturing doubts (at) how simple people knew more about the most dangerous illnesses and how to deal with them successfully than the scientific physician." (Haehl, 1, 267) Therefore, he decided, "to give up his medical practice," (Haehl, 1, 267) soon after his marriage in November 1782 (Haehl, 1, 28), and so occupy himself solely "with chemistry and writing." (Haehl, 1, 267) He "retired disgusted with the uncertainty of medical practice and devoted himself to chemistry and literature." (Dudgeon, xxi)
His abandonment of "the lucrative practice of medicine when his faith was shaken in it, and supporting his family for some time upon the proceeds of his chemical discoveries and by the tenfold greater labour of translating books for publishers," (Dudgeon, xlvi) is a testament to the moral strength of his conscience. By acceding to a conscience deeply troubled by the paucity and inefficacy of its methods, he abandoned what he saw as a dangerous though lucrative medical practice, and thus deliberately chose to endure years of great poverty in order to pursue the one great aim of his existence: (Dudgeon, liii) the creation of a medical system employing safe and curative drugs able to stand in contrast to the violent and palliative drugs in common use.
He rejected "the absurdity of giving complex mixtures," (Dudgeon, xxiv) of drugs, referring to them as "abominable and nonsensical compounds," (Dudgeon, xxviii) and "a confused jumble of unknown drugs." (Dudgeon, xxviii) He "became disillusioned and dissatisfied with current medical practice. He began experiments, later called provings, on himself and other healthy individuals." (Flinn, 425-7) Being left with no option but to undertake the entire radical and reforming task by himself, and in the still relatively new tradition of empirical science, he endeavoured therefore to push aside forever the old, unreliable materia medica, by ascertaining with much greater certainty the pure effects of single drugs through direct observation of their effects in experiments which he conducted personally.
Hahnemann "made out an eloquent case for the pharmacological experimental method," (Cameron, 32) and rejected the authorised allopathic "Materia Medica based on conjectures and compound prescriptions," (Organon, §54) seeking through experience guided by principle, to create a new materia medica founded on the bedrock of pure symptoms induced in healthy persons by administering measured doses of a potentised drug under carefully regulated conditions; in other words, by proving drugs on the healthy. In his 1797 essay On the Obstacles to Certainty and Simplicity in Medicine, published in Hufeland's journal, Hahnemann had announced his "proposed reform and perfecting of the materia medica," (Dudgeon, 179) but, to his surprise and disappointment, this request was "met with nothing but derision and contempt from his colleagues." (Dudgeon, 179) Not a single physician agreed with his analysis or offered to help him in this important task. Thus, rebuffed he had to take on this task entirely by himself in a limited way that thus necessarily became extended over a period of time.
His colleagues either did not share his grave misgivings about the chaotic and uncertain state of the materia medica or the dangers of medical practice, or their consciences were not sufficiently troubled, as was his own, by the unscientific and uncurative nature of the medicine then in vogue. He was temperamentally quite unsuited to deceive his patients and 'calm their fears' when he knew full-well that most treatments on offer were useless: he was not more clumsy or stupid than other doctors; he simply lacked that power to shuffle off responsibility which enabled them to face every failure." (Gumpert, 43) His conscience for those who entrusted themselves to his care "was more and more troubled." (Haehl, I, 267). While his medical colleagues seemed content to enjoy handsome livelihoods by charging patients for strong doses of mixed drugs, and for bleeding and purging them, he clearly wasn't. This is why the emergence of homeopathy can indeed be depicted as "the successful attempt of a man buried alive to force his way out into the open air." (Gumpert, 86) The story of the Organon is therefore the story of the origin and unfoldment of homeopathy itself.
Sometime after the Cinchona proving of 1790, Hahnemann collected histories of cases of poisoning. His purpose was to establish a physiological doctrine of medical remedies, free from all suppositions, and based solely on experiments." (Gumpert, 92) He "set himself diligently to collect from the writings of ancient and modern medical authors all the cases of poisoning he could lay his hands on, and to institute experiments with different drugs on himself and various friends." (Dudgeon, 49) He "contented himself with hunting up in the works of the ancient authors for hints respecting the physiological action of different substances," (Dudgeon, xxii) and "in this way he collected together a tolerable pathogenesis of many powerful substances, and on this basis he endeavoured to practise." (Dudgeon, xlvii) But the results of this endeavour "were inadequate to afford him sufficiently accurate pictures of morbid states corresponding to the natural diseases he had to treat," (Dudgeon, xlvii) and the resulting drug pictures "were so vague and indefinite...(comprising) slovenly detailed cases of poisoning...(which) would never do to found a method of treatment on." (Dudgeon, 178-9) He "now began to search diligently all the records of medicine, to see if he could find examples where the various medicines had been so tested, and to try them on his own person, in a desultory and unmethodical manner." (Dudgeon, 176-7) Up to 1798, "I should say his knowledge of medicines was entirely derived from the records of poisonings in allopathic literature, and a few desultory and unmethodical experiments on himself and friends." (Dudgeon, 52)
Hahnemann clearly perceived that the whole edifice of the old Materia Medica must be rebuilt from the very foundation, as that Materia Medica furnished nothing positive regarding the (true) pathogenetic actions of drugs." (Dudgeon, 176) He was therefore left with little alternative but "to test the medicines and poisons accurately and systematically upon the healthy individual."(Dudgeon, xlvii) He therefore undertook careful and more detailed "experiments with different drugs on himself and various friends." (Dudgeon, 49) The "ten volumes of provings he has left us are an eternal monument to his energy, perseverance, conscientiousness and self-sacrifice." (Dudgeon, xlvii)
The first fruit of this immense labour was the 'Fragmenta de viribus' (1805), a small volume in Latin, which gave to the world the brand new symptom pictures of 27 drugs. The contents consisted mostly of symptoms he had collected from ancient medical literature combined with some from partial provings he had made himself. "Hahnemanns 'Fragmenta de viribus medicamentorum positivis'...gives us, for the first time, an insight into the remarkable, and so far unknown, methods of investigation, which he employed. It supplies reports on the tests of twenty seven medicines the results of years of experiment on himself and his family." (Gumpert, 122) He wished for a medicine "without the superfluous rubbish of hypotheses." (Gumpert, 26)
However, he was disappointed that the content of this work was not entirely empirical, but in fact resulted from the confluence of two streams. By far the largest stream comprised information he had culled from the ancient and modern literature, supplemented with some new data drawn from his own dismal experiments. This task, which Hahnemann had set in motion, to create a brand new materia medica, is still ongoing. New drugs have continuously been proved since his day and so on to this day and their symptom pictures added to the ever-growing homeopathic materia medica.
His experiments had led him to use single drugs in small doses based not on contraries or ancient prescriptions of longstanding and unquestioned clinical use, but on the similars concept derived first from the results of accidental poisonings (as recorded in the medical literature) and second from more systematic provings of drugs on the healthy. "I found from the toxicological reports of earlier writers that the effects of large quantities of noxious substances ingested by healthy people...largely coincided with my own findings from experiments with those substances on myself or other healthy people." (Organon, §110) From 1796 onwards "he selected his remedies from the standpoint of similarity." (Haehl, 1, 311) "The physician prescribes individually by the study of the whole person according to their basic temperament and responses." (Cook, 97) He based his practice on "the similarity between disease and remedy...(and) only prescribed one medicine at a time."(Dudgeon, 315) He succinctly described 'similarity' as "a remedy so capable of producing a counterpart of the symptoms," (
Hahnemann lambasted old school medicine in the Organon good and proper, calling it the "most senseless mode of treatment (a) mischievous so-called art," (Organon, xxix) and "a pernicious practice," (Organon, xxix) but apart from its rich cargo of criticisms of the old school, and in spite of its dense language and elevated philosophical tone, the Organon does nevertheless very largely consist of information concerning the effects of single drugs on the healthy and how they might be successfully made serviceable for the treatment of the sick. Any objective assessment of Hahnemann's works cannot therefore avoid the simple truth that the Organon and the Materia Medica Pura are impossible to view in isolation from each other. The two really did emerge simultaneously and were 'born as twins.' Any assessment of the one makes little real sense unless accompanied by a close consideration of the other.
The 2nd Organon was published in
These changes follow soon after his publication of the first volume of The Chronic Diseases in 1828 and his desire to see 30c potency accepted by all homeopaths as a kind of standard. "In the year 1829 Hahnemann came upon the strange idea of setting up a kind of standard dose for all curative remedies used in homeopathy. This was to be the 30th centesimal." (Haehl, 1, 322) With "the promulgation of the psora-theory, we notice a remarkable alteration in Hahnemann's ideas respecting posology." (Dudgeon, 405) This meant that "after his invention of the psora-theory he fixed the uniform standard for the dose of all remedies at a globule of the 30th dilution, (Dudgeon, 408) which he claimed is the standard by which we should all abide in order to obtain uniform results. (Dudgeon, 352) He also introduced, at the same time, new methods of administering the remedy, such as Olfaction and liquid doses, deriving from his endless experiments with dosage. In the technique of "olfaction: the patient was asked to inhale the remedy...a method he had first introduced in 1829 and never subsequently abandoned."(Handley, 1997, 133) Liquid remedies were first introduced in 1834. (Handley, 1997, 135) The changes between the 4th Organon of 1829 and the 5th of 1833 are quite remarkable.
Tangentially, regarding the Psora theory en passant, the fact that three other German physicians had published virtually the same theory before him could hardly have escaped Hahnemanns notice. These were, Frederick Hoffmann in the 18th century (Dudgeon, 259), Autenrieths work published in 1808 (Dudgeon, 259-60) and Dr K Wenzels book published in 1825 (Dudgeon, 262). Autenrieths views correspond remarkably with those of Hahnemann, (Dudgeon, 262) whose observations were published in 1808, but Hahnemann alleges he was not acquainted with them before the publication of the first edition of his Chronic Diseases. (Dudgeon, 260) He made a similar response to Dr Trinks regarding the alleged influence of Paracelsus in homeopathy, which remains equally hard to believe: when Trinks, from his own narrative, pointed out to Hahnemann whilst visiting him in Köthen in 1825, that the main features of homeopathy were to be found in Paracelsus, Hahnemann replied that it was unknown to him. (Haehl, 1, 273-4)
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) As a physician he had always been grounded primarily in the practicalities of what actually cures sickness, and early on in his career, all Hahnemanns views and doctrines were made subservient to his therapeutics. (Dudgeon, 243) For decades he had condemned "speculative refinements, arbitrary axioms dogmatic assumptions (and the) magnificent conjuring games of so-called theoretical medicine." (Ameke, 134) Initially, he 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) Why then did he implement these massive changes in the 5th Organon?
All these 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 merely a practical system of medicine. We might ascribe these changes in his thinking to several possible causes. For example, the loss of his practice in
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 more than 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 first wife died in 1830 and Duke Ferdinand died in 1831 and curiously that is also about the time when he insisted 30c should become the universal or standard potency in use and 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. However, in contrast to all this new metaphysics there arose at the same time his decidedly modern and bacteriological views about the excessively minute, invisible, living creatures of which the contagious matter of cholera most probably consists. (The Mode of Propagation of the Asiatic Cholera, 1831, in Lesser Writings, p.758; see also Haehl, 1, 173-179 & Bradford, 253-7)
It was also in the Köthen period of his life that Hahnemann became very pedantic and fussy concerning how his homeopathic colleagues practised homeopathy, insisting on only the very strictest adherence to his own detailed instructions. His most severe castigation of certain colleagues arose during this period and during which he was developing the finer points of homeopathic philosophy along metaphysical lines. It is not very clear why these disputes arose or why he felt it so necessary to pick arguments with those who had been in all essentials his long-term friends and allies rather than his enemies. Perhaps there was something about these finer metaphysical points that inspired him to become more dogmatic and inflexible.
For example, the establishment of the first homeopathic hospital in
Furthermore, "his intolerance for those who differed from him latterly attained to such a height that he used to say, He who does not walk on exactly the same line with me, who diverges, if it be but the breadth of a straw, to the right or to the left, is an apostate and a traitor, and with him I will have nothing to do." (
Much fuss has been made in some quarters, in recent decades, about the allegedly great merits of the 6th Organon. Yet, the revisions of the 6th Organon are nowhere near as significant as the changes found in the 5th over the 4th edition, because they merely amount to a few minor amplifications of points already present in the 5th, and some small clarifications in wording. There simply cannot be found in the 6th Organon those massive changes in layout and conception that signalled the dramatic shift from the 4th to the 5th Organon. Therefore, because the 6th edition does not differ so very much from the 5th, so it does not therefore warrant the deeper study which the 5th edition demands due to the masses of new material it introduced into homeopathy for the very first time. In any case, the so-called 6th edition is merely a 5th edition manuscript from February 1842 which Hahnemann himself had annotated with numerous handwritten notes and corrections. It is not a totally fresh edition in its own right and remained in an unfinished and unpublished state at the time of his death in
Wilhelm Ameke, History of Homopathy, with an appendix on the present state of University medicine, translated by A. E. Drysdale, edited by R. E. Dudgeon,
Thomas L Bradford, The Life and Letters of Hahnemann,
Charles S Cameron, Homeopathy in Retrospect, Trans. Stud. Coll. Phys. Philadelphia, 27, 1959, 28-33
Stuart Close, The Genius of Homeopathy: Lectures and Essays on Homeopathic Philosophy, 1924
Trevor Cook, Samuel Hahnemann, the Founder of
Robert E Dudgeon, Lectures on the Theory and Practice of Homeopathy,
Lewis B Flinn, Homeopathic Influences in the
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,
Rima Handley, A Homeopathic Love
Rima Handley, In Search of the Later
Rosa W Hobhouse, The Life of Christian Samuel Hahnemann Founder of Homeopathy,
Chris Kurz, Imagine Homeopathy: a Book of Experiments, Images, and Metaphors,
Fernando F Villalva, LM Scale 50 Millesimal Potencies, Leads Press, 2008