Thursday, June 14, 2012

Putting Homeopathy in a Historical Context: Part 1

The Introduction

In the height of the 19th century, homeopathy undoubtedly ruled the day. It was the medicine of choice of intellectuals, the upper class, and the growing middle class on both sides of the Atlantic, and its influence spread all over the world. Many homeopathic medical schools and hospitals were founded, with some of the most famous examples being the Hahnemann Medical College and Hahnemann University Hospital (now both affiliated with Drexel University), as well as the London Homeopathic Hospital, now the Royal London Hospital for Integrative Medicine. Celebrities ranging from Beethoven to Charles Darwin to Mark Twain to the Royal Family were all under the care of homeopathic doctors and there’s even a memorial to Dr Samuel Hahnemann just a few blocks from the White House in Washington DC. It’s no distortion to say that many of the finest minds of the generation were engaged in the practice of homeopathy.

In the early 20th century, however, the system was brought crashingly down. Many colleges and hospitals were closed, and homeopathy lost favor. Currently, most medical doctors and many NDs consider homeopathy to be unsubstantiated nonsense.

How did this change occur? How did a system rise from non-existence to the pinnacle of society and then plummet just as quickly? Were all of these seemingly smart people deluded? Are there lessons to be learned, and is there a place for homeopathy in modern medicine? These are all questions I hope to answer in the next several weeks. I won’t be talking much about the practice of homeopathy, that having been discussed in another blog post, but rather focusing on the history of the system from the 18th century until today.

The Setting

Allow me first to set the scene. Homeopathy arose in the late 18th century, in a time when the Enlightenment was in full sway in Europe. Newton was discovering gravity and calculus, chemistry and physics were racing forward in leaps and bounds, America was developing modern democracy, and on the whole, science was displacing superstition. Carl Linnaeus was an exemplary figure of the age – he developed modern taxonomy in an effort to take the colorful variety of the natural world and order it in a logical and scientific way. Even European cities were changing from knotted tangles of misdirected streets into ordered grids of long straight avenues and boulevards.

Everything seemed to be gaining order except one crucial field – medicine. Medicine hadn’t changed significantly since the time of Galen, 1500 years previously, and modern medicine as we know it wouldn’t really emerge until the 1860’s, when Louis Pasteur, aided by a microscope, would observe and document infective organisms. At the time, diseases were believed to be caused by poisonous gasses called miasma, which emanated from swamps and decomposing matter – those familiar with 18th century literature will perhaps remember references to ‘night vapors’ and similar phenomena as causes of disease. Indeed, the name malaria arises from the Medieval Italian term ‘mala aria’, meaning ‘bad air’ – a testament to the belief that poisonous airs from swamps were the cause of what is now known to be a mosquito-borne illness. These miasma caused illnesses which disrupted the humors, four liquid substances in the body which, when imbalanced, caused illness.

All was not bad, however. Some areas of medicine that had seen real progress during the Renaissance and Enlightenment were anatomy and physiology, in large part because of the return of dissection to science. Scientists and physicians were finally starting to document how the body was put together and how it worked, though this was frequently driven by a desire to find fame, rather than promote real scientific understanding – just as explorers named islands and mountains after themselves, so too did these scientists name body parts after themselves.

However, even though the body was slowly being understood, the area of therapeutics lagged behind substantially – even if they were beginning to understand what the body looked like, and were able to name a disease, they had little idea of what to do with it. George Washington, famously, was bled to death in an effort to fight an infection he’d developed. Bleeding, either by leeches or razors, was common, as was the practice of herbalism by the doctrine of signatures – a practice in which the appearance of a plant was taken to indicate its usefulness in treating disease. In addition to this, developments in chemistry had allowed for the production of a variety of minerals and compounds previously unknown or unavailable in significant quantities, and doctors took to using these compounds medicinally, without much knowledge of how they would affect the body. The classic example of this practice is undoubtedly the use of mercury to treat syphilis.

So this was the milieu in which homeopathy arose – modernity was dawning and people were turning increasingly towards science and reason, but medicine was decidedly medieval and clearly behind the times. It was natural, therefore, for someone to attempt to bring order to the hodgepodge that was medicine, and as we’ll learn in future weeks, that was exactly what happened.

(Note: I am heavily indebted for my knowledge of homeopathic history to Drs Paul Herscu and Amy Rothenberg of the New England School of Homeopathy.)