Pathways of Homoeopathic Medicine

Bettina Blessing Pathways of Homoeopathic Medicine

Bettina Blessing

Pathways of Homoeopathic Medicine Complex Homoeopathy in its relationship to homoeopathy, naturopathy and conventional medicine With a Foreword by Robert Jütte Translated from the German by Margot M. Saar

With 23 Figures

Dr. phil. Bettina Blessing Institute for the History of Medicine Robert Bosch Foundation Straußweg 17 70184 Stuttgart Germany

ISBN 978-3-642-14970-2 Springer Medizin Verlag Heidelberg Bibliografische Information der Deutschen Bibliothek The Deutsche Bibliothek lists this publication in Deutsche Nationalbibliographie; detailed bibliographic data is available in the internet at http://dnb.ddb.de. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable to prosecution under the German Copyright Law. Springer Medizin Verlag springer.com © Springer Medizin Verlag Heidelberg 2011 The use of general descriptive names, registered names, trademarks, etc. in this publications does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Planning: Renate Scheddin, Heidelberg Projectmanagement: Ulrike Dächert, Heidelberg Copy-Editing: Hilger VerlagsService, Heidelberg Cover design: deblik Berlin Typesetting: Hilger VerlagsService, Heidelberg Printer: Stürtz GmbH, Würzburg SPIN: 12994786 Printed on acid free paper

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Foreword Interest in homoeopathy is undiminished. 72% of Germans prefer to be treated with homoeopathic medicines (Marplan-Institute 1995). Two representative surveys show that homoeopathy has become the most popular alternative healing method in Germany: one was conducted by the pharmacy journal Apotheken Umschau in spring 2001, the other in spring 2003 by the market research institute Gesellschaft für Konsumgüterforschung (GfK). A survey among general practitioners and internists commissioned by the medical journal Ärztliche Allgemeine revealed that 76.9% of these physicians prescribe homoeopathic medicines, including many complex remedies, “very often, often or occasionally”. In Europe, interest in homoeopathy has also been on the rise for many years now, although harmonisation in European pharmaceutical law still seems a far cry. Like orthodox medicine, homoeopathy encompasses various approaches, some of which look back on a long tradition. Next to classical homoeopathy which is based on Hahnemann’s teachings and only uses single remedies there is also complex homoeopathy. Complex remedies are preparations containing several active ingredients that complement each other. They are usually sold as drops or tablets and are suitable for self medication; physicians and alternative practitioners appreciate them because they can reduce the often time-consuming examination of the patient and simplify the complicated remedy selection typical in classical homoeopathy. Similar to orthodox medicines, complex remedies are commonly based on a diagnosis and the general symptom picture. This does not mean that complex homoeopathy goes against the fundamentals of homoeopathy (especially the similarity principle) as has often been suggested, even quite recently. Proponents of complex homoeopathy early on posed the question why ingredients with similar effects could not be combined if the clinical effect of each homoeopathic agent was known from drug provings on the healthy person. Considering the role played by the complex remedies of various manufacturers on the complementary drug market it surprises that the historical roots of this homoeopathic approach have remained largely unexplored. The history of medicine has tended to focus almost exclusively on the main streams, i.e. Hahnemann’s classical homoeopathy and the scientific-critical approach that emerged in the 19th century and flourished in the first half of the last century. Dr Blessing’s study therefore breaks new ground on several accounts, one of which is its investigation of the historically evolved relationship between homoeopathy and naturopathy. Despite all the delimitation attempts on both sides there have been repeated rapprochements in the past. One outstanding example is Emanuel Felke (1856–1926), who, though most famous for inventing the “clay therapy”, throughout his career regarded homoeopathy as the backbone of his healing system, the still very popular “Felke Cure”. Spagyrics, although it constitutes a separate section of the medical market, still shares some common ground with homoeopathy in general and with complex homoeopathy in particular. They are linked by what is known as ‘electro-homoeopathy’. Little is known about the origin and complex development of electro-homoeopathy. It was introduced by Cesare Mattei (1809–1896), Albert Sauter (life dates not known) and Carl Friedrich Zimpel (1801–1878) among others. All three of them developed spagyrics, a healing method that goes back to Paracelsus, and they created, in strict observation of Hahnemann’s similarity principle, a new system which made them pioneers of complex homoeopathy. It is also little known that the founder of homoeopathy, Samuel Hahnemann (1755–1843), to whom classical homoeopaths like to refer, experimented with so-called “double remedies” encouraged by his pupil Karl Julius Aegidi (1794–1874) and his friend Clemens Maria Franz von

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Foreword

Bönninghausen (1785–1864), only to reject them after all in favour of the uncompromised use of single remedies. One of the most important advocates of double remedies was the homoeopath Arthur Lutze (1813–1870), who was very much in demand as a practitioner in Coethen around the middle of the 19th century. He published an unauthorised sixth edition of the Organon in 1865 and, without further explanation, reinstated the paragraph on double remedies that Hahnemann had decided to omit. In her study which draws on a number of sources, Dr Blessing traces the most important contemporary views on the changing and mixing of homoeopathic medicines and proves that the forerunners of today’s complex remedies had many supporters at an early stage. Reading today’s disputations about homoeopathy we are reminded of the controversy waged in the columns of the leading medical journals of the mid-1920s which had been ignited by the famous Berlin surgeon August Bier (1861–1949) remarking favourably on homoeopathy. Bier had pleaded that critics of homoeopathy examine the controversial approach without prejudice as he himself had done in his Berlin clinic. It was August Bier who saw in the experiments of the Greifswald pharmacologist Hugo Schulz (1853–1932) a convincing scientific foundation for the rule of similars. Since 1903 Bier had publicly supported the Arndt Schulz Rule which states that “weak stimuli excite life processes, medium strong stimuli enhance them, strong stimuli inhibit and the strongest terminate them.” This axiom is still quoted today to explain regulation therapies (to which homoeopathy also belongs). After World War II Hans-Heinrich Reckeweg (1905–1985) was among the physicians who promoted a healing approach that arose from “holistic thinking”. His treatment system, known as homotoxicology, was the attempt to bring about a synthesis of homoeopathy and scientific medicine. Its historical roots are documented here for the first time. While studying in Berlin, Reckeweg had attended the lectures of Ernst Ferdinand Sauerbruch (1875–1951) and August Bier. Yet, the main influence on the man who was to found the Heel Company was, without doubt, August Bier. At the time when August Bier stood up for homoeopathy, i.e. the mid-1920s, a group of physicians came together who were convinced that it was necessary to merge the various therapeutic approaches into a “scientifically founded healing method that was developed into an art”. Their motto was “ars una, species mille” (there is only one art, but a thousand approaches). The movement’s mouthpiece or media platform was the journal Hippokrates, which had been founded in 1929 and featured the programmatic subtitle: Zeitschrift für Einheitsbestrebungen der Gegenwartsmedizin (journal for the unity of modern-day medicine). Its editor, Professor Georg Honigmann MD (1863–1930), outlined the journal’s objectives in its first issue: “Medicine must not develop in sole reliance on the ultimately accidental, inadequate, simultaneous or successive, discoveries of the natural sciences, though it should by no means ignore their fertile influence. It must be guided and governed by one unified concept in the development of which it can come to understand the meaning of human disease symptoms.” He also calls for complementing and improving the findings of a “mechanistic, generalising method with other considerations”. Honigmann and his many fellow campaigners, among them a number of renowned physicians, echoed what Bismarck’s personal physician Professor Ernst Schweninger (1850–1924) in his 1906 book Der Arzt (The Physician) had expressed in rather a militant and exaggerated manner: “Smash the gauge that the scholars with unseemly urgency want to impose upon you. Establish your own pathology that addresses the sick person; hurl down the therapy templates of science that shred the human being into small fractions and submit them to the experts for treatment.”

vii Foreword

Today’s health care system is viewed with similar reservations. For some years now it has been the aim of the Dialogue Forum on Pluralism in Medicine to facilitate, through open dialogue, the constructive discourse between representatives of orthodox and complementary medicines in order to achieve the best possible patient care. The relationship between orthodox and complementary medicines (the latter includes all alternative medical approaches) is still marked by mutual distrust and delimitation tendencies. This applies also to the German health care system. There is no systematic cooperation yet between the various medical schools of thought. If anything, there is some kind of “asymmetric co-existence” where medical schools teach and apply almost only orthodox medicine while the additional use of complementary medicine has become quite common in wide areas of ambulant health care. The Dialogue Forum on Pluralism in Medicine, founded in autumn 2000 with the support of the president of the German Medical Association (Bundesärztekammer), Professor Dr Jörg-Dietrich Hoppe, has therefore set itself the task of pursuing a critical dialogue among the different medical orientations. Similar to August Bier who spoke up for homoeopathy 80 years ago, there are again representatives of scientific medicine who welcome research into complementary medicine and are open to a constructive dialogue. Dr Blessing’s historical study shows that homoeopathy was not just under attack from its first beginnings, but that there have always been physicians who approached the controversial healing method openly and without prejudice. That it was complex homoeopathy which helped to build the bridge is one of many insights that this profound historical-scientific documentation from the pen of a recognised expert in social and medical history conveys. Stuttgart, Spring 2009 Prof. Robert Jütte PhD

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Content 1 The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

The Controversy About the Double Remedy During Hahnemann’s Lifetime . . . . . . . . . . . . . . . . . Arthur Lutze’s Views on Drug Mixtures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complex Remedies in Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Central Homoeopathic Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “What Attitude Should we Have Towards Complex Homoeopathy?” . . . . . . . . . . . . . . . . . . . . . . . Single Remedy Homoeopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complex Remedies as a Compromise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clinical Homoeopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Dissemination of Complex Homoeopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Felke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Madaus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Reckeweg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zähres . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Schwabe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pascoe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Excursus: Spagyrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Electro-Homoeopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mattei . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sauter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zimpel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Krauss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sonntag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 7 9 11 12 12 14 14 16 18 19 22 25 26 27 28 28 28 31 32 34 36

2 The Connection Between Homoeopathy and Naturopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Naturopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pathological Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Emanuel Felke and his Therapeutic Concept: Homoeopathy and Naturopathy . . . . . . . . . . . . . . Felke’s Pathological Concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Felke’s Healing Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sitzbaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Light-, Air- and Sun Baths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clay Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nutrition and Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hahnemann’s Dietetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Syntheses of the Healing Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

39 40 41 43 45 45 46 46 47 49 50

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3 Homoeopathy as Part of a “Holistic Medicine” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 The “Crisis” of Orthodox Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . August Bier (1861–1949) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . August Bier’s Attitude Towards Homoeopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ferdinand Sauerbruch: “Taking up the Cudgels for August” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conflicts of Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Similarity Principle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “Curative inflammations” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Stimulants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drug Proving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Symptom Complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Posology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Arndt-Schulz Rule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Potentisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hahnemann’s Homoeopathy as a System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . August Bier and the “World’s Biggest Natural Healing Institute” . . . . . . . . . . . . . . . . . . . . . . . . Establishing Homoeopathy at the University of Berlin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hans-Heinrich Reckeweg’s Pathology and Therapy Concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fever and Inflammation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phases of Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Homoeopathy and Homotoxicology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Injection Therapy with Homoeopathic Remedies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nutrition and Sutoxins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Homoeopathy as the “Mother of Medicine” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

51 53 59 60 62 64 64 64 66 66 67 67 69 71 71 73 75 79 81 81 82 84 87 88

4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Archives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

1 The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

The Controversy About the Double Remedy During Hahnemann’s Lifetime1 Homoeopathy has developed in many different ways over the last 200 years. Next to what is known as “classical homoeopathy” another approach was already established in Samuel Hahnemann’s (1755–1843) lifetime. This method experimented with and used double remedies and, in doing so, went against Hahnemann’s fundamental principle of single remedy treatment. The homoeopathic double remedy can be said to have originated in 1831/32 which indicates that the history of the homoeopathic drug mixtures is almost as old as that of homoeopathy itself.2 Hahnemann’s correspondence with his colleagues shows his ambivalence with regard to the reliability of drug mixtures. In a letter he wrote in April 1833 he still rejected Karl Julius Aegidi’s (1794–1874) eager-

ness to experiment with double remedies.3 Aegidi, a medical doctor who had gained the position of personal physician to Princess Louise of Prussia on Hahnemann’s recommendation, practised privately in Düsseldorf in addition to his tasks as a regimental physician.4 He often accompanied the princess on long journeys and in his absence his patients consulted the Cologne physician Johann Stoll (1769–1848).5 According to Aegidi, Stoll had the reputation of being a homoeopath although he not only – in Aegidi’s opinion – disregarded the similarity principle; he also did not expect any medical advancement from individual drug provings or the pharmacopoeia.6 He nonetheless used potentised homoeopathic medicines. He divided all remedies into two classes and chose one of each, in high dilution and combined in alcohol, for each given case of illness.7

1 Since the beginning of the 1990s there has been a differentiation between “complex remedies” (naturally occurring compounds) and “combination remedies” (manmade mixtures). This differentiation is not relevant to the purpose of this historical documentation. Weingärtner (2007), p. 39 and id. (2006), p. 4. 2 1796 is usually considered to be the birth year of Hahnemann’s doctrine. In 1807 Hahnemann first used the term “homoeopathic” and from 1810 he used “homoeopathy”. Cf. Jütte (1996), p. 24.

3 Hahnemann’s letter to Aegidi of 28th April 1833. Printed in: Haehl (1971), vol. 1, p. 393: “[…] but do cease to pay any attention to Dr Stoll’s mixtures; otherwise I might fear that you were not yet convinced of the eternal necessity of treating patients with simple unmixed remedies. I have even seen shepherds and hangmen do some wonderful things now and then. Are we to chance to luck in the same way?” 4 For a biography on Karl Julius Aegidis cf. Vigoureux (2001). 5 The sources do not show what induced the Cologne physician to use double remedies. 6 Aegidi (1838), p. 278. 7 The criteria for the two classes are not known.

B. Blessing, Pathways of Homoeopathic Medicine, DOI 10.1007/978-3-642-14971-9_1, © Springer Medizin Verlag Heidelberg 2011

2

Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

In less than a month Hahnemann experienced a complete change of heart.10 As his friend von Bönninghausen shared this opinion, he now welcomed the use of double remedies as long as the homoeopathic principles were adhered to, and he offered to test the method himself. At the same time he announced his intention of publishing the double remedy method in the fifth edition of the Organon. One month later he wrote with similar enthusiasm to von Bönninghausen admitting that he had once smelled two combined remedies and had found it very successful.11 Against his usual habit Hahnemann did apparently not conduct any more detailed research. In this letter he stated

Karl Julius Aegidi (1794–1874)

Inspired by Stoll, Aegidi, who had been sceptical initially, also began to experiment with double remedies in October 1832. When he realized that the success exceeded his expectations he informed Hahnemann.8 But Aegidi only agreed to the use of a double remedy when the smallest doses of single remedies had remained without effect; and only those drugs could be combined that in the given situation competed for priority. Aegidi did not think that the second remedy would cancel out the effect of the first. The patient received the double remedy either as two pilules or he simultaneously smelled one remedy with one nostril and the second remedy with the other nostril. Encouraged by Aegidi’s trials Clemens Maria Franz von Bönninghausen (1785–1864) and Georg Heinrich Gottlieb Jahr (1800–1875) tested the effect of double remedies with a similarly positive result as Aegidi.9 After they had agreed discretion, Aegidi asked the “highest authority”, in other words Hahnemann, to examine and publish the results. 8 Aegidi’s letter to Hahnemann of 8 May 1833. Printed in Vigoureux (2001), p. 79. Aegidi wrote that he conducted “some 80 trials of this kind”. 9 The lawyer Clemens Maria Franz von Bönninghausen was, next to Hahnemann, one of the most prominent homoeopaths of that time. He was general commissioner for the registration of lands in the provinces of Rhineland and Westphalia and, at the same time, director of the Botanical Gardens in Münster. When he fell seriously ill with tuberculosis, he met Hahnemann

after years of suffering. From then on his interest in homoeopathy grew steadily. From 1830 he himself started treating with the homoeopathic method. Until 1836 he continued his work in the land registry next to his homoeopathic practice. In 1843 he received official permission from the German King Frederick William IV of Prussia to work as a homoeopath. In 1848, von Bönninghausen instituted the Assembly of homoeopathic physicians in Rhineland and Westphalia. His patients included the Empress Eugénia and the poet Annette von Droste-Hülshoff. The Thuringian Georg Heinrich Gottlieb Jahr was first a school teacher in Düsseldorf and maintained friendly contact with Karl Julius Aegidi. On Hahnemann’s recommendation he succeeded Aegidi as personal physician to the Princess of Prussia who had dismissed Aegidi because of his “growing disinterest”. After Jahr had also quit the service of the princess he studied medicine in Bonn and became personal physician to a rich Englishman in Southern France. Later he settled in Paris where he was in contact with Hahnemann whom he knew from Coethen. Schroers (2006), p. 16, 68. Haehl (1922), vol. 1, pp. 430–434, 444–446. 10 Hahnemann’s letter to Aegidi dated 15 May 1833. Printed in: Bradford (2004), p. 487. “[…] Hence I am delighted that such a happy idea has occurred to you, and that you have kept it within necessary limits; ‘that two medicinal substances (in smallest dose, or by olfaction) should be given together only in a case where both seem homoeopathically suitable, but each from a different side.’ Under such circumstances the procedure is so consonant with the requirements of our art that nothing can be urged against it; on the contrary, homoeopathy must be congratulated on your discovery. I myself will take the first opportunity of putting it into practice, and I have no doubt concerning the good result. I am glad that von Bönninghausen is entirely of our opinion and acts accordingly. I think, too, that both remedies should be given together; just as we take Sulphur and Calcarea together when we cause our patients to take or smell Hepar sulph, or Sulphur and Mercury when they take or smell Cinnabar. Permit me then to give your discovery to the world in the fifth edition of the ‘Organon,’ which will soon be published. Until then, however, I beg you to keep it to yourself, and try to get Mr Jahr, whom I greatly esteem, to do the same. At the same time I there protest and earnestly warn against all abuse of the practice by a frivolous choice of two medicines to be used in combination.” 11 Hahnemann’s letter to von Bönninghausen dated 17 June 1833. Printed in: Haehl (1922), vol. 2, p. 259.

3 The Controversy About the Double Remedy During Hahnemann’s Lifetime

explicitly that he would devote a special paragraph in the Organon to the double remedy. A month later he informed his friend Aegidi that he had sent the manuscript of the fifth edition of the Organon to his publisher Arnold with the inclusion of the paragraph on double remedies.12 Section 274b of the Organon, which Arthur Lutze claimed to have found among Hahnemann’s estate, was to read as follows: “There are individual complex cases of disease in which the administration of a double remedy is perfectly homoeopathic and truly rational; where, for instance, each of two medicines appears suited for the case of disease, but each from a different side ; or where the case of disease depends on more than one of the three radical causes of chronic diseases discovered by me, as when in addition to psora we have to do with syphilis or sycosis also. Just as in very rapid acute diseases I give two or three of the most appropriate remedies in alternation; i.e., in cholera, Cuprum and Veratrum ; or in croup, Aconite, Hepar sulph. and Spongia; so in chronic diseases I may give together two well-indicated homoeopathic remedies acting from different sides, in the smallest dose. I must here deprecate most distinctly all thoughtless mixtures or frivolous choice of two medicines, which would be analogous to Allopathic polypharmacy. I must also once again particularly insist that such rightly chosen homoeopathic double remedies must only be given in the most highly potentised and attenuated doses.”13 If we assume that Hahnemann was the author of these lines, it follows that he had planned to permit highly potentised double remedies in complicated cases as long as each of the substances was homoeopathic to the disease. Administration of a double remedy was, however, only indicated for chronic complaints and he warned against slipping into “allopathic polypharmacy”. Section 274 b was never printed with Hahnemann’s permission. Judging from his letter to von Bönninghausen of 15 September 1833 it was above all his fear of being associated with allopathy that kept him from including the double remedy paragraph in the Organon. According to Hahnemann, Wilhelm Hufeland (1762–1836) was “rejoicing at the fact that 12 Hahnemann’s letter to Aegidi dated 19 July 1833. Printed in: Lutze (1860), p. XXVI. 13 Printed in: Bradford (2004), p. 486.

1

Clemens Maria Franz v. Bönninghausen (1785–1864)

homoeopathy will have to return at last to the bosom of the only saving church and would again have to join the old science.”14 Because the treatment with double remedies was in his opinion not absolutely necessary for recovery and publishing the method would be of disadvantage, Hahnemann decided in the end against publishing the double remedy paragraph. With reference to Hufeland he added in his letter that “the orthodox pope of the old school will be considerably upset when he sees in the Organon a publication which will make his rejoicing melt away.”15 One month later Hahnemann again explained his point of view to von Bönninghausen.16 There he stated that he had not been convinced by the advantages of the double remedies. Having only achieved a cure in two cases did not allow him to establish a “new 14 Hahnemann’s letter to von Bönninghausen dated 15 September 1833. Quoted in: Verspoor (2003), p. 26. 15 Hahnemann’s letter to von Bönninghausen dated 15 September 1833. Quoted in: Verspoor (2003), p. 25, 26. The physician Christoph Wilhelm Hufeland was one of the most prominent and most read medical writers of his time. His concept of health and illness was based on the idea of a vital force that inspired all life processes. Illness was for Hufeland any disturbance of the vital force through pathogenic influences. Eckart (2005), pp. 158, 160. 16 Hahnemann’s letter to von Bönninghausen of 16 October 1833. Quoted in: Verspoor (2003), p. 26.

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Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

rule”. Although he had sent his manuscript to the publisher with section 274 b included he now wrote to his friend: “I was therefore too inexperienced in this practice to support it with full conviction. Consequently it required only slight momentum to induce me to alter that passage in the new Organon […].” Although he did not deny the effect of double remedies in a few cases, he emphasized that the procedure was difficult and questionable. He expressed similar reservations towards Aegidi at the beginning of 1834 pointing out that he considered the method with two similes to be too complicated.17 He regretted that most homoeopaths were not able or willing to “discover only ONE remedy, exactly suitable in accurate similarity to the characteristic symptoms”. He described finding the one suitable remedy as difficult and laborious and remained therefore in favour of single remedy homoeopathy.18 According to Arthur Lutze (1813–1870) Hahnemann’s rejection to permit the double remedy had to do with the hostile attitude of the homoeopathic physicians.19 When the founder of homoeopathy presented the treatment with double remedies, which had until then been kept a secret, at a small gathering of homoeopathic physicians in Coethen on 10 August 1833, it was they who apparently likened the method to the polypharmacy of the allopaths and who convinced Hahnemann to refrain from its publication. One of the physicians present was therefore authorised by him to “suppress the paragraph which had already been printed” while passing through Dresden on his journey home. 17 Hahnemann’s letter to Aegidi dated 9 January 1834. Quoted in: Verspoor (2003), p. 30. 18 Section 273 of the fifth edition of the Organon consequently read: “In no case under treatment is it necessary and therefore not permissible to administer to a patient more than one single, simple medicinal substance at one time. It is inconceivable how the slightest doubt could exist as to whether it was more consistent with nature and more rational to prescribe a single medicine at one time in a disease or a mixture of several differently acting drugs. It is absolutely not allowed in homoeopathy, the one true, simple and natural art of healing, to give the patient at one time two different medicinal substances.” In a footnote he added: “Some homoeopaths have made the experiment, in cases where they deemed one remedy homoeopathically suitable for one portion of the symptoms of a case of disease, and a second for another portion, of administering both remedies at the same time; but I earnestly deprecate such a hazardous experiment, which can never be necessary, though it may sometimes seem to be of use.” 19 Lutze (1862), p. 5.

The omission of the double remedy paragraph and the related rejection of mixed homoeopathic remedies were to arouse more heated debate in the years to come. Because Georg Heinrich Gottlieb Jahr had pointed out in the preface of his first manual, which was dedicated to Aegidi and von Bönninghausen, that Aegidi had been the “first” to experiment with the combination of two substances, it was up to him to explicate this “still little regulated experience” in detail.20 In the Archives for Homoeopathic Medicine, Aegidi reluctantly described the criteria that justified administration of a double remedy.21 As he had done in his letter of 8 May 1833 to Hahnemann he declared again that double remedies were only permissible in exceptional cases, i.e. if no single substance could be found that corresponded to the “disease in the totality of its symptoms”. The method, he continued, did not violate the purity of homoeopathy seeing that combined remedies had always been used in homoeopathy, as was shown by the treatment with augite, “vesurien” [probably a printing error, should read: vesuvianite. BB] and lapis lazuli, all of which consisted of several individual substances. But not all homoeopaths agreed to the use of double remedies in exceptional cases. One of the opponents of the method was the editor of the Archive for Homoeopathic Medicine, Johannes Ernst Stapf (1788–1860),22 who thought that original substances were not mixtures, but “specific independent substances” where none of the ingredients predominated, while manmade mixtures neither penetrated each other nor formed a whole.23 In February 1835 Hahnemann again referred to the administration of homoeopathic drug mixtures in a letter to Aegidi.24 He also differentiated between homoeopathic remedies that consisted in naturally occurring compounds and the medicines put together 20 Georg Heinrich Gottlieb Jahr named Karl Julius Aegidi and not Johann Stoll as the inventor of the double remedy. Cf. preface in Jahr (1834). For Georg Heinrich Gottlieb Jahr p. 8. 21 Aegidi (1834), pp. 81, 83–85. 22 The physician Johannes Ernst Stapf, Saxon ministry counsellor and private physician to the Duke of Meiningen, had a close connection to Hahnemann and was an ardent defender of the “pure” doctrine. Cf. Schroers (2006), p. 137. 23 Comments of editor Stapf in: Aegidi (1834), pp. 85–87. Also printed in: Vigoureux (2001), p. 84. 24 Hahnemann’s letter to Aegidi dated 11th February 1834. (IGM of the Robert Bosch Foundation, Bestand A 58). Printed in: Vigoureux (2001), p. 85.

5 The Controversy About the Double Remedy During Hahnemann’s Lifetime

by the homoeopath, pointing out that the latter were of inferior quality; they could never be joined together as uniformly and closely as was the case with the original substances. Tietze (1799–1847) requested in the Allgemeine Homöopathische Zeitung of 1834 that the mixtures should be tested on the healthy person in order to establish how the single remedies and the manmade “compositions” differed in the effects they caused.25 At the same time he pointed out that beginners who struggled to find their way into homoeopathy, as the practice showed, were mixing substances wildly. Those who had not yet been fully weaned from allopathy would find the mixing very plausible and this would prevent them from ever becoming “genuine” homoeopaths. If one permitted the use of two substances, it would not be long before three, four or five substances were mixed together until in the end as many substances would be combined as there were symptoms. In 1835, Aegidi explained again in the Allgemeine Homöopathische Zeitung that the use of double remedies was only permissible if the single remedy remained without effect, i.e. the use of double remedies should be the exception rather than the rule.26 He mentioned the numerous cases of illness where a homoeopathic single remedy had not effected an improvement. While the opponents of the double remedy saw the unity of homoeopathy under threat and feared that it paved the way for polypharmacy, Aegidi accused them of driving the patients who had not been cured with homoeopathic preparations into the arms of the allopaths or leaving them to suffer, although hundreds of experiments had yielded positive results. He also thought that “the uniformity of the homoeopathic method […] had long been shaken by the psora theory, the necessity to administer drugs repeatedly or to give interim substances”. He accused his opponents of condemning a method without testing it just like the allopaths. Aegidi nevertheless explicitly dissociated himself from those who would mix together “4, 5, 6 substances in one pot”; they had not understood his proposition, as it was extremely difficult in any case to find even two suitable substances. 25 Tietze (1834), pp. 238. 26 Aegidi (1835), p. 30. Also printed in: Vigoureux (2001), p. 86.

1

Johannes Ernst Stapf (1788–1860)

Critics such as Friedrich Ludwig Schrön (1804– 1854) accused Aegidi of not caring if “not a shred” of the uniformity of homoeopathy was retained.27 Even though homoeopathy was not without its shortcomings it would not be right to add to these the ignorance about new drug mixtures, because it was crucial, not just to preserve the knowledge for future generations but to keep it “pure”. There was the general danger that, the more difficult it was to find the right remedy and the less experience someone had, the greater the inclination to administer several suitable substances. Schrön saw it as self-contradictory that Aegidi wanted to allow double remedies only in exceptional cases although he had, as he claimed, proved their definite efficacy in “hundreds of experiments”. Homoeopaths such as Philipp Wilhelm Ludwig Griesselich (1804–1848) requested that the application of mixtures be preceded by testing on the healthy as homoeopathy would otherwise go against its own principles.28 The mixing technique was still far too little explored to be submitted as a guideline to therapists. In his opinion, the overall effect of the mixture did not constitute the sum of the effects of 27 Schrön (1938), p. 35. 28 Griesselich (1836), pp. 520–524.

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Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Philipp Wilhem Ludwig Griesselich (1804–1848)

the individual substances contained in the mixture. He argued moreover that it did not inspire confidence in the therapist if he was unable to find the right simile in complex cases of disease. Just like the other defenders of the single remedy Griesselich warned that authorising the double remedy would pave the way for drug mixtures that were made up of several substances. In contrast to Molin (life dates unknown) Griesselich did not think of Hepar sulphuris, cinnabar, salts and mineral baths as composites.29 The view expressed by complex remedy homoeopaths that double remedies were more efficacious was rejected by the single remedy homoeopaths who said that in medicine, particularly in homoeopathy, that same argument encompassed much that was made up or thought out. It was also considered impermissible to rub one substance into the skin while using another “internally”, as this made it impossible to tell which of the two worked. Even the reform-friendly Karl Friedrich Trinks (1800–1868) regarded the suggestion that had been made public in Coethen as a return to the bosom of

29 Griesselich (1848), p. 270. For Molin cf. p. 9 below.

the allopaths.30 His experiments with drug mixtures, like those of Griesselich, had not yielded convincing results.31 Von Bönninghausen no longer fully agreed with Aegidi either; although he still wrote in 1836 that “it had happened more than once that two remedies that were related competed so closely in a disease that the choice was very difficult and each of them covered a few subsidiary symptoms that the other one did not address.”32 Now he no longer recommended to administer the remedies at the same time, but to alternate them in not too long intervals. Despite his public vote against the use of double remedies it is not sure whether he adhered to it; Hahnemann seemed to have heard something different because he wrote to von Bönninghausen: “[…] Is it true what Dr Foissac just now assured me of, that you are giving patients two remedies in combination with great success?”33 Hahnemann again emphasized that combinations that were copied from nature did not possess the same quality as the original products. In the same letter he asked whether Aegidi had not yet left the path of heresy that would deal the death blow to homoeopathy.34 At the meeting of homoeopathic physicians in Coethen on 10 August 1833 Aegidi considered refraining from publicising his method because of the opposition that was tangible there.35 In 1838 he deplored the abuse of double remedies, siding with those who protested against the use of drug mixtures, even in exceptional cases.36 Because a large number of homoeopaths had apparently referred to Aegidi’s 30 31 32 33

Trinks (1836), p. 169. Schroers (2006), p. 148. Griesselich (1848), p. 271. Bönninghausen (1836), p. 8. Hahnemann’s letter to von Bönninghausen dated 18.09.1836. Printed in: Haehl (1971), vol. 2, p. 254. 34 We do not have an answer by von Bönninghausen. Winai quotes, though without reference, a letter written almost 30 years later, dated 25 March 1865, which he assigns to von Bönninghausen. Von Bönninghausen was no longer alive at that time as he had died on 26 January 1864. Cf. Haehl (1922), vol. 1, p. 433. The author of the letter admits to having warned Hahnemann against the use of double remedies. Together they had come to be convinced that this new step would damage homoeopathy. At that time neither he nor Hahnemann had given mixed remedies. He admitted, however, that the successes with double remedies had sometimes been surprisingly good. Printed in: Winai (1932), p. 21. Cf. also Classen (1927), p. 394. 35 Aegidi (1834), p. 85. 36 Aegidi (1838), p. 279.

7 Arthur Lutze’s Views on Drug Mixtures

1

formation as to whether Hahnemann feared that he might suffer financial losses as well as damage to his reputation and whether this might have led him to omit the double remedy paragraph from the Organon.39 Another reason for withdrawing the double remedy paragraph was his own lack of investigation into the efficacy of combined preparations. Although Hahnemann did not deny the effect of double remedies in cases of complex and chronic disease, he was convinced that the man-made combination of two remedies did not meet the quality requirements in the way “nature’s single remedies” did. Hahnemann had, in cases of inveterate disease arising from psora, permitted the administration of two or more homoeopathic substances in succession, provided that the effect of the preceding remedy had subsided before the next one was applied.40

Karl Friedrich Trinks (1800–1868)

authority when they advertised the drug mixtures, he voiced his disapproval in 1857 and again in 1865 in the Allgemeine Homöopathische Zeitung declaring that the use of double remedies must not become the norm and that their application constituted abuse.37 Hahnemann was concerned, on the one hand, that the introduction of the double remedy would bring him close to the allopaths whose mixtures could be made up of up to 30 substances and even more, and, on the other hand, that the use of double remedies would lead to the omission of the exact analysis of individual symptoms.38 The sources contain no in37 Aegidi (1857), p. 96: “The undersigned feels even more justified in joining in with the accusations that have recently come forward against the homoeopathic use of the double remedies, as he himself has been accused of having initiated this disreputable method. In full agreement with all the indisputable reasons brought forward by competent parties the undersigned must audibly and publically disapprove of such abuse of our wonderful and so efficacious remedies as has recently been recommended in a seemingly systematic way as the norm, so that his alleged authority can no longer be used to promote proceedings which, even when he (Stapf ’s Archives, 1834, vol. 14) believed to be able to recommend a modification of same method in very rare exceptions, had nothing in common with the mischief that is now being done and advised.” 38 Sahler (2003), p. 20.

Arthur Lutze’s Views on Drug Mixtures Arthur Lutze (1813–1870), a physician who was as popular as he was controversial, was one of the leading pioneers of double and complex remedies.41 After the inauguration of his newly built clinic in Coethen in 1855 he started treating patients with double remedies.42 Research puts his double remedy prescription down to the overwhelming stream of patients who came to see him.43 There was, the argument goes, 39 As put forward in Sauter’s Homöopathisches Institut (no date), p. 28, as well as in part of the more recent literature on homoeopathy. Cf. Sahler (2003), p. 29. 40 Section 171 of the Organon (5th and 6th edition): “In nonvenerial chronic disease, those, therefore, that arise from psora, we often require, in order to effect a cure, to give several antipsoric remedies in succession, every successive one being homoeopathically chosen in consonance with the group of symptoms remaining after completion of the action of the previous remedy.” He had stated this view also in editions one to four (sections 145; 211; 180; 168) of the Organon. 41 After studying theology, Arthur Lutze first worked for the post office for financial reasons. He began to study medicine later in life and went on to become the greatest promulgator of homoeopathy and the most successful clinical entrepreneur of his time. Cf. Eppenich (1996), p. 332. For a detailed biography of Lutze cf. Streuber (1996), pp. 160–184. Sahler points out that Lutze’s healing successes were due to double as well as complex medicines. Sahler (2003), p. 40. 42 Arthur Lutze had a 72-room hospital built in Coethen, in the neo-Gothic style, which was even centrally heated. Eppenich (1996), p. 332 and in more detail id. (1995), p. 123–126. 43 Sahler (2003), p. 39.

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Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Arthur Lutze (1813–1870)

simply not enough time for intensive case taking and the usual process of selecting the suitable single simile. Lutze is said to have treated 26,690 patients in his hospital in 1864.44 He himself claimed to have had plenty of opportunity to carry out provings with double remedies and that he had registered “thousands of examples of fortunate successes”.45 In his much read textbook on homoeopathy he emphasized the adequacy of the double remedies while warning at the same time against the arbitrary combination of two remedies of which not each was homoeopathic to the existing case, which meant it did not correspond to the symptoms.46 Just as one would alternate two remedies in acute cases if both were indicated, one could also give two remedies simultaneously for chronic complaints, which meant that one could dissolve three or four granules of each substance in one and the same tumbler of water, and, as was habitual with chronic disease, take these over four of five days; it was important, however, that this was followed by a pause of some months. He himself 44 Throughout the year, all rooms were completely booked out, and Lutze seems to have treated three quarters of his patients free of charge. Cf. Eppenich (1996), p. 333. 45 Lutze (1860), p. XXXI. 46 Lutze (1862), p. 2.

wrote: “[...] In case of tetter, for instance, or debility from loss of blood, Sulphur and China may be given in combination. Sulphur for the psora, China for the debility, and the result shows that this combination cures much more effectually than then either of these drugs, if given singly.”47 The opponents of double remedies, who as before likened them to allopathic polypharmacy, he accused of having neither apprehended the essence of homoeopathy nor the meaning of potentisation. If a remedy had been selected in conformity with the law of similarity, he argued, there was no arbitrariness involved. It was wrong to compare the arbitrary mixtures of the allopaths to the homoeopathic medicines which were combined based on particular laws. One could, in any case, only speak of mixtures where coarse materials were concerned, not with high dynamisations which were divested of their material constituents. High dynamisations contained merely the spiritual essence of the original substance and this made them so very potent.48 Lutze compared the effects of the double remedies to the human memory “in which thousands objects, whether acquired or invented, are ranged side by side without being mixed; if this should take place, it shows mental disease, derangement, insanity.”49 Lutze also differentiated between the original substances whose ingredients formed a whole and the double remedies that worked parallel to each other, each from another side.50 Lutze compared the effects of the double remedies to mesmerism which he also practised.51 If somebody suffered from a headache that affected 47 Lutze (1862), p. 2. 48 Hahnemann had also argued that, through potentisation, the remedies became “almost spiritual” and that the “power of the remedy” was transferred to the lactose and the alcohol. Tischner (1939), p. 713. 49 Lutze (1862), p. 6. 50 Lutze (1860), p. XXX. 51 Lutze (1860), p. 7. According to Franz Anton Mesmer (1734– 1815) the human being is made up of the same substance as the universe and thus subject to the same cosmic influences. An ethereal physical fluid interlinked the earth, the stars and all creatures. Mesmer called this medium “animal magnetism” and thought that each human being possesses a certain amount of it. All illness was due to an irregular distribution of this fluid within the body. Magnetic therapy made it possible to activate and strengthen the fluid. Originally, Mesmer used a magnet to manipulate the fluid, but later realized that he himself had the capacity to gather and distribute the fluid. For a detailed description cf. Jütte (1996), pp. 103–106.

9 Complex Remedies in Europe

both sides of the forehead or temples, he would, first with the right then with the left hand, stroke the sides of the head, one after the other and the pain would disappear in that order. If he stroked both sides simultaneously with both hands, the pain would disappear simultaneously on both sides. Lutze magnetised all his homoeopathic remedies with the power of his hands, convinced that this would enhance their healing potential.52 He was supported by a number of homoeopaths who obtained their medicine chests from him and who claimed that his remedies had a stronger and faster effect than those procured from other homoeopaths.53 Hahnemann had also attached great importance to mesmerism and dedicated an entire paragraph to it in the sixth edition of the Organon.54 Lutze earned well selling remedies that he prepared and magnetised himself. In 1864 alone, he shipped 2,706 homoeopathic preparations to North and South America, India, China and Australia.55 At first he obtained the original substances from various pharmacies, later from the Central Homoeopathic Pharmacy run by Willmar Schwabe in Leipzig from 1863.56 Arthur Lutze promoted his healing method also by publishing writings and books in his own publishing house that was attached to his hospital.57 Lutze’s “gigantomania” and his time management would hardly have met with the approval of Hahnemann who had written as early as 1834: “What a time it takes to find the useful remedy for one patient, when searching and consulting our manuals. They [the homoeopaths] cannot possibly devote the necessary time to examine thirty or forty patients. How would they be able to find something exactly suited to each one? Or have these gentlemen memorized the materia medica and all the remedies in chronic diseases etc., so well, that after enquiring into the circumstances of the patient, for which they

52 53 54 55 56 57

Sahler (2003), p. 40. Sahler (2003), p. 41. Organon, 6th edition, paragraph 288. Sahler (2003), p. 41. For Schwabe cf. p. 25 below. One example is the widely read homoeopathic journal Hahnemannia, Fliegende Blätter für Stadt und Land über Homöopathie. For Lutze’s publishing activities cf. Willfahrt (1996), pp. 278–280.

1

frequently need half to three quarters of an hour, they may be able to find at once a suitable remedy in their mind?”58 It was not only his tight time regime and the consequent “fast processing” of patients that provoked the criticism of other homoeopathic physicians, but also his “obtrusive and boastful behaviour” and the fact that he published the sixth edition of the Organon without having authorisation to do so.59 One of the points of contention was the above quoted section 274 b, on which Lutze drew to justify his double remedy treatments. He deplored that the world had been “robbed of a most important discovery these 21 years”.60 Lutze might have been at the centre of much criticism, but he nevertheless succeeded in paving the way for the double remedies. He believed that they worked faster than single remedies, but, at the same time, warned against putting substances together at random. Like Stapf he was convinced that each substance in a dual mixture had its individual effect and that they did not mix as original compounds did.

Complex Remedies in Europe The interest in complex remedies was not restricted to Germany alone. There was awareness of the development of complex homoeopathy also abroad and similar experiments were conducted there as well as in the homeland of homoeopathy. Around 1840, Dr Molin, of Spain, hoped that new and important impulses would arise for homoeopathy from the combination of different substances which he had tested on the healthy subject.61 Molin had conducted tests on five volunteers using Nux vomica 58 Quoted from Haehl (1971), vol. 2, p. 399. 59 Lutze had published his daily routine in 1866 and evoked vehement critcism. Printed in: Eppenich (1995), p. 130. For reasons of rationalisation Lutze had also introduced the “Fliegende Journal” (flying journal), which consisted of loose printed sheets on which he wrote the most important comments and which were then used to wrap up the powders. After six weeks he would receive the envelope back with a report on the remedy, and he continued to note down on it the current condition. This had made it possible for Lutze to manage 80,000 prescriptions by letter in 1853, and 20,000 to 30,000 in his clinic. Lutze (1860), p. LXIV and Eppenich (1995), p. 127. 60 Lutze (1862), p. 5. 61 Kirschleger (1841), pp. 371–373.

10 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

and Sulphur, Belladonna and Aconite, belladonna and Nux vom. Mercur. and Pulsat., Mercur. and Sulphur, Arsenic and Lachesis. The results achieved with complex remedies he claimed to be equal to those attained with single remedies, yet he considered them incomplete. He divided the effect of the remedies into three categories according to their influence on 1. the vital force or the organism in its totality, 2. individual organ systems and functions, and 3. individual organs. If various local symptoms were present and no remedy was found that addressed all of them, one was justified, in his view, to take recourse to a mixture to make sure that all symptoms were targeted. He did not see the homoeopathic principle of the single remedy violated by this. The mixture, he argued, constituted a totality, a “compositium simplex”. It remained a prerequisite, however, that tests were first carried out on the healthy person before the mixture was prescribed for a patient. His tests with Nux vomica and Sulphur provoked symptoms that corresponded to both remedies and other symptoms that could be attributed to the one or the other. There were also symptoms that resulted from the combination of the two substances and these were immensely important for the future. Complex homoeopathy also became widespread in Italy where it was closely linked to the name of the clergyman Gaudenzio Soleri (life dates not known), a former court preacher to the House of Piedmont.62 Soleri once fell seriously ill and was only cured when he turned to homoeopathy. Around 1850 he began treating sick people homoeopathically himself, first with single and later also with complex remedies. He discovered complex homoeopathy by accident: a patient had taken the remedies he had prescribed simultaneously instead of successively and had been cured. He found a follower in his nephew, the physician Giuseppe Belotti (life dates unknown) who, around 1861, intended to provide a scientific grounding for his uncle’s system but was prevented from doing so by his premature death. Belotti had studied how the remedies affected the various cell structures, tissues 62 Balzli (1925), p. 334.

and organs and established 27 remedy groups based on the insights he had gained.63 The manufacturing methods and composition of the complex remedies he kept a secret. Belotti, who had been active in Italy, became particularly influential in France. He thought that the organism was able to decide whether or not to assimilate a substance. If it found the substance beneficial, it would assimilate it; if it found it harmful it would reject it.64 The organism’s natural instinct supported the body in choosing from the different substances offered, whereas the therapist would draw a blank if he gave the wrong substance. According to Belotti the body is able to differentiate between the substances in order to fight the disease, as long as the suitable remedies are chosen with the greatest possible precision.65 Based on Belotti’s insights the former medical officer L. Finella (life dates unknown) from Sardinia suggested that homoeopathy was still in its infancy and its application far too difficult; complex diseases could not be cured due to the restrictiveness of the single remedy principle that rendered any progress impossible. Finella recommended 29 drug mixtures pointing out that single remedies often only worked on one single organ, while mixtures worked on all the relevant tissues and organs simultaneously.66 For this reason he considered an exact diagnosis to be unnecessary as the mixture would reach all tissues and organs of the “area in question”. His mixtures were made up of seven to 17 individual substances. Finella was willing to publish the composition of his remedies and potencies. P. Ponzio (life dates unknown) also needs mentioning in this context. He rejected the theory that, next to a main mixture that cured all diseases of the organism, only one mixture should be produced for any organ. As various diseases could affect one particular organ, there should also be various mixtures for it. Ponzio offered eight special remedies, five dynamic fluids, eight ancillary remedies and five kinds of remedies for external use which were named after the disease groups.67 He also published

63 64 65 66 67

Balzli (1925), p. 337. Sahler (2003), p. 55. Sahler (2003), p. 55. Balzli (1925), p. 338. Balzli (1925), p. 340.

11 The Central Homoeopathic Association

the composition of his mixtures, but recommended to procure them from his pharmacist to guarantee the best possible results. A Frenchman named Conan developed a very individual approach in the 1870s. He poured a few drops of the patient’s urine over his homoeopathic tinctures, added two or three drops of sulphuric acid and examined the mixture under the microscope.68 If the waste products disappeared he thought to have found the right remedy and prescribed it. If not, he kept experimenting until a positive result was achieved. He would prescribe the substances that effected the dissolution of the waste product. These were usually mixtures as one substance was rarely sufficient. Finella and Belotti are known as the first homoeopathic practitioners to have established and published their own system of complex remedies.69 It was mainly Belotti’s complex remedy system, however, that spread fast in Italy and abroad.70 In Switzerland, G.A. Clerc (life dates unknown) based his own complex homoeopathy on Belotti’s system. In 1903 he wrote his own textbook which also found many readers in Germany.71 Clerc saw Hahnemann’s fundamental principle, that one simple remedy which covered several symptoms also removed all symptoms, as a beautiful, but unrealistic theory. A homoeopathic physician was often forced to prescribe several remedies in succession, and by giving them simultaneously one could save oneself much time and “groping in the dark”.

The Central Homoeopathic Association In the meantime Dr Fritz Tritschler (1832–1889) of Germany, assistant physician at the Leipzig Homoeopathic Polyclinic, committed a similar faux pas to Arthur Lutze in the eyes of the Central Homoeopathic Association.72 He published a book in 1880 using the printers of the Stuttgart Homoeopathic Central Pharmacy, which stood under the management of Edwin Hahn, and in his book he almost 68 69 70 71

Without reference in Weingärtner (2007), p. 32. As mentioned by Sahler (2003), p. 56. Sahler (2003), p. 56. Emanuel Felke and Friedrich H. Pascoe referred to Clerc’s work, among others. Cf. p. 18 below. Clerc (1903), pp. 23–25. 72 Haehl and Stiegele (1929), p. 65–67.

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exclusively recommended complex remedies. On top of that, he had the audacity to keep their composition a secret.73 He escaped the certain conflict with the Central Association by cancelling his membership on 1 October 1880 and resigning from his position in the clinic, apparently for the same reason. Despite his resignation the executive council of the Central Homoeopathic Association expressly dissociated itself from Tritschler in its 49th central meeting in Berlin, on 9 and 10 August 1881. The Association accused him of having spread the “veil of a private mystery” over his remedies, a step that was without precedence in the homoeopathic literature and that abetted the “condemnable secretiveness about remedies”.74 The publisher, Edwin Hahn, also had to leave the Association. The history of the Central Homoeopathic Association shows that it often gave short shrift to renegades because it feared that their attention-arousing activities might strengthen the allopathic camp.75 At the Central Association meeting in Dresden in 1924, Friedrich Gisevius (born 1861), whose father Bruno Gisevius produced complex remedies against influenza, had spoken out sharply against the whole “complex remedy business”.76 At the end of the 1920s the Central Homoeopathic Association was still averse to the administration of double or complex remedies. Erich Haehl (1901–1950), who published a book in celebration of the Association’s centenary, with a preface by Alfons Stiegele, argued that the scientifically-minded physician would never 73 He commented: “In other areas the inventor is given a patent; much is said and written on the protection of intellectual property: ‘I consider the finding of remedies which I prepare in a particular ratio, in a consistent sequence to be also my intellectual property which I can only secure for myself by leaving the preparation to one pharmacist only in whom I fully trust, and that is Mr Edwin Hahn in Stuttgart. There can also be noble reasons that force someone to keep their remedies a secret. Rolfing (who died in Jena 1673 as a professor) said in a Chimia in artis formam redacta Lib. I. Ch. 4‘. Nobody is obliged to lay all his secret remedies open to the public and one cannot simply accuse those of greed, ambition, thirst for fame and envy who keep many things to themselves. It is an old wisdom: by secret remedy loses its effect when made public.” Cf. Tritschler (1880), p. VIII. 74 Adjudication printed in: Haehl and Stiegele (1929), p. 65. 75 For a general outline on the Central Homoeopathic Association cf. Jütte (1996), pp. 206–208. 76 Donner (1956), p. 514. Friedrich Gisevius advocated the objectivity of the drug proving in particular. Cf. Tischner (1939), p. 708.

12 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

revert to double and complex remedies or even secret remedies, because their use would deprive him of the opportunity to observe the patient and gain reliable bedside experience concerning the efficacy of single preparations.77 If the physician stood firmly on the ground of the similarity principle and had a good and exact grasp of the totality of the symptoms, he could always reach the desired goal with the single remedy.78 It is not surprising that the Central Homoeopathic Association, which rejected complex remedies, was also opposed to the electro-homoeopathy of Count Mattei and his successors.79 It did not consider Mattei’s products to be in consonance with Hahnemann’s doctrine. As the medicines were not named and nothing was known about their origin, composition and preparation, electro-homoeopathy had to be part of the “condemnable secretiveness of modern times”.80 That the Central Association avowed itself to single remedy homoeopathy and disapproved of complex remedies did not keep the one or other of its members – among them also prominent and wellknown representatives – from producing medicine complexes, some even in their own factories and under an assumed name.81 At the 99th general meeting in Bad Tölz in 1938, the Association nevertheless pronounced that it was its objective, in accordance with paragraph 4, item 3b of its statutes, to put a stop to the grievous trend of referring to remedy mixtures as “homoeopathic remedies”.82

“What Attitude Should we Have Towards Complex Homoeopathy?” From the beginning of the 20th century and especially after World War I homoeopathic complex remedies 77 The physician Erich Haehl (1901–1950) was the son of Richard Haehl (1873–1932), who had inherited Hahnemann’s and von Bönninghausen’s the entire estates. Cf. Schroers (2006), p. 48. For Mattei’s electro-homoeopathy cf. p. 28 below. 78 Haehl and Stiegele (1929), p. 64. 79 The Association’s attitude with regard to iridology was similar. 80 Rejected by the Homoeopathic Association at its 47th annual meeting in Hanover, 1879. 81 Donner (1956), p. 515. 82 Satzung des Deutschen Zentralvereins homöopathischer Ärzte – 99. Hauptversammlung in Bad Tölz 26. Mai 1938. (Statutes of the German Central Association of Homoeopathic Physicians. – 99th general meeting in Bad Tölz/Germany on 26 May 1938)

had gained more and more importance.83 In analogy to the much quoted essay by the Berlin surgeon August Bier’s (1861–1849) – What attitude should we have towards homoeopathy? – homoeopaths began to ask in the 1920s and 30s: “What attitude should we have towards complex homoeopathy?”84, a question that has remained controversial until today.

Single Remedy Homoeopathy Classical homoeopaths continued to insist that no “proper” homoeopathic physician would ever revert to drug mixtures. They held on to the principle that Hahnemann’s “pure” homoeopathy was the most efficacious.85 While they rejected the substance mixtures that practitioners prepared individually for their patients, the orthodox homoeopaths found this more valuable than “feeding them with mass-produced complexes that were aimed at the names of diseases”.86 Pharmaceutical companies such as Madaus who produced complex remedies were accused of putting commercial interests first.87 According to Hans Balzli, Schwabe was the only manufacturer in the 1920s that did not name its mixed preparations after diseases, but after one of the ingredients.88 The proponents of single remedy homoeopathy were not only concerned about what they perceived to be a lack of efficacy in the complex remedies, but also about the vast number of lay practitioners offering remedy mixtures “who had sprung up like mushrooms in recent years”.89 Fritz Donner (1896–1979) thought that the rising number of lay practitioners after World War I was due to changing values that led more people to become health practitioners.90 According to the Reich statistics the number of practitioners had risen by 63 per cent between 1909 and 1927, but the number of qualified physicians has also grown by 27 per cent; in 1909 there were 4,414 lay practitioners and 31,969 physicians; in 1927 there were 11,791 lay 83 84 85 86 87 88

Donner (1956), p. 514. Winai (1932), p. 20. Winai (1932), p. 20. For August Bier cf. p. 52 below. Winai (1932), p. 20. Balzli (1925), p. 336. Wapler (1926), p. 91. Balzli (1925), p. 343. For the problem of sources on the complex homoeopathic lay movement cf. Karrasch (1998), p. 150. 89 Winai (1932), p. 20. 90 Donner (1956), p. 514.

13 “What Attitude Should we Have Towards Complex Homoeopathy?”

practitioners and 43,717 physicians.91 The growth rate for lay practitioners kept pace with the general expansion of health care, but their number grew faster than that of university trained physicians. Around the turn of the century, the majority of lay healers in Prussia had a background in the crafts, agriculture or trade; a quarter of them were women92; few were former labourers. It was mostly the physicians among the homoeopaths who accused the lay healers of abusing Hahnemann’s doctrine for their own commercial interests; their “hotchpotch homoeopathy”, they argued, was only paving the ground for ruthless business operations.93 They criticized them as well for bringing homoeopathy together with other healing approaches such as iridology.94 The physicians also deplored the homoeopathic lay healers’ shocking lack of expertise and skills which they tried to conceal behind their arbitrary remedy mixtures. The physicians, on their part, were also vehemently attacked by the lay practitioners. The tightly organised and programmatic “guild of quacks” was said to have kept on insulting and vilifying the medical fraternity; it appears that the lay practitioners did not suffer from a weak self image.95 Parallel to the lay movement, the pharmaceutical industry also grew. Not just the lay practitioners, but homoeopathic physicians and pharmacists also founded pharmaceutical factories for the manufacture of complex remedies. They tried to further sale and distribution of their complex homoeopathy by supporting the training of lay practitioners while committing them at the same time to prescribe their complex remedies.96 At the beginning of the 19th century, chemical scientists discovered how to isolate certain active agents from plants and began to synthetically

91 Although these statistics do not include dentists, midwives, assistants and nurses, they probably still include a number of individuals who are not medical practitioners in the narrower sense. For the problems of statistical surveys cf. Faltin (2000), p. 242. 92 The statistical information about Prussia also includes assistants, barbers, masseurs and dentists. Faltin (2000), p. 257. 93 Winai (1932), p. 20. 94 Cf. p. 19 below. 95 Balzli (1925), p. 325. For the concept of “quack doctor” cf. Jütte (1996), p. 38. Concerning the self-image of the lay associations cf. Grubitzsch (1996), p. 59–64. 96 Winai (1932), p. 20.

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produce organic compounds,97 a development that encouraged the industrial production of drugs and drug mixtures from the 1850s onwards. Modern advertising strategies allowed the companies to open up ever wider markets. Some of them soon began to sell their products internationally.98 A common argument used by single remedy homoeopaths against complex remedies, other than accusing them of commercial greed, was that they did not conduct drug provings on the healthy person which is one of the main pillars of Hahnemann’s homoeopathy. Classical homoeopaths moreover objected to the systematic use of complexes that went against another mainstay of Hahnemann’s homoeopathy, the principle of individual treatment.99 Another objection was that no clinical research results were published and that the use of complex remedies encouraged ignorance and laziness; it was, after all, less time-consuming and much quicker to use mixtures instead of establishing a diagnosis on the basis of the similarity principle. Mastering the simile rule took up a lot of time that qualified as well as unqualified quack doctors knew to put to more lucrative use. The classical homoeopaths were also astonished that the manufacturers of complex remedies did not recommend the “same mixtures” for the “same disease” as the logic of the complex supporters would indicate.100 If the complex remedies were produced, as was claimed, according to strict scientific criteria, the preparation should not differ. As in Hahnemann’s lifetime, the classical homoeopaths feared a regress to the “polypharmacy of the Middle Ages”.101 What brought the complex remedies into further disrepute was the fact that they cost more than single remedies.102 The higher price was due to more cost-intensive preliminary investigations and tests, the sending of samples to physicians, the preparation and distribution of the pertaining literature and a higher advertising budget.103 97 98 99 100 101 102 103

Sahler (2003), p. 119. Heinze (ed.) (1996), p. 160. Winai (1932), p. 20. Balzli (1925), p. 347. Balzli (1925), p. 370. Schwabe (1939), p. 31. Homoeopathic single remedies which were produced by the manufacturers on the basis of the same indication, did not cost the same, either. The factory-produced brands were cheaper than the dilutions made up in pharmacies. Consumers often

14 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Complex Remedies as a Compromise Apart from the strict single remedy homoeopaths there was also a school of thought that was open to compromise in exceptional cases. If the symptom complex could not be covered by one single substance, this group would permit the prescription of complex remedies, just as in Aegidi’s times. Another group accepted preparations mixed by homoeopaths while rejecting those that were ready-made.104 The physician Karl Stauffer (1870–1930) remained on the fence: he did not deny complex homoeopathy its efficacy, seeing that they could be used very successfully in practice, but he said that they were of no use to science.105 Scientific homoeopathy required the use of just one single remedy as that was the only way to gain insight into how a medicinal substance worked. The scientific thinker was eager to find out, “what” a remedy was, in “which” cases of disease and “why” and in “which” dosage it was salubrious. Another school of thought proposed not to insist on either single or complex homoeopathy, “but to put everything to the test and keep the best”. Only the bedside experience could determine this rather than any categorical “either-or” or “as well as” approaches.106 The charge that remedy mixtures were not homoeopathic was refuted with the argument that they were produced on the basis of homoeopathic drug provings. As the use of homoeopathic medicines was based on the assumption that the diseased cell complex would respond to the suitable remedy, which was determined according to the similarity of the symptoms, and that the remedy did not affect healthy cell groups, the wrong remedy would consequently show no effect, irrelevant of whether it was a complex or not. The chance of success was higher with complex remedies than if the right remedy was deduced from the sum of modalities.107

104 105

106 107

preferred the more expensive remedy thinking that it was more effective because of its higher price. Cf. Sahler (2003), p. 120. Will (1925), p. 124. Stauffer (1938), p. 20. For a short time Karl Stauffer had also experimented with electro-homoeopathy but soon returned to Hahnemannian homoeopathy. Cf. Tischner (1939), p. 800. Weiss (1935), p. 452. Weiss (1935), p. 453.

In Berlin, where physicians had the right of dispensation, it was habitual for physicians in the early 1930s to prescribe what was called an “omnibus” for colds.108 This was a preparation made up of various remedies for colds which physicians carried with them on their home visits in order to be able to give their patients an instantly effective medicine. During the course of the flu-epidemic they would then modify the composition to suit the current epidemiological characteristics.

Clinical Homoeopathy109 The question now arises whether and to what extent single and complex remedies were prescribed in hospitals. In 1926 Ernst Bastanier (1870–1953) had taken up a clear position. This was two years before he was assigned a lectureship at the University of Berlin and three years before he was made director of the Berlin Polyclinic which had been set up with private funds from Madaus and Schwabe to train physicians and students.110 In Bastanier’s view, complex homoeopathy was “allopathy with homoeopathic means”. He not so much denied the complexes their efficacy as opposed to mixtures that were, once and for ever, allocated to particular types of disease. His main criticism was that there was no testing on the healthy subject, which meant according to Hahnemann, that no insights into the effects of the preparations could be gained. Therefore it was not homoeopathy. The name ‘complex remedy homoeopathy’ was incorrect, scientifically unwarranted and misleading and only suitable for circles with a lack of profound knowledge. “For these circles the remedies with their promising and even mysterious names and their simplicity of application are just right. It is therefore a point of honour for all homoeopathic physicians to do everything in their power to prevent the name homoeopathy from being abused for these unhomoeopathic, often purely commercial practices. Mister Madaus, so far one of the busiest and most successful repre108 Donner (1956), p. 524. 109 The term “clinical homoeopathy” refers to the use of homoeopathy in hospitals. It can also describe a particular form of homoeopathy as delimited from classical homoeopathy. Cf. Faltin (2002), p. 5. Pastschenko (2000), p. 132. 110 Bastanier (1926), p. 579. For Bastanier cf. p. 76 below.

15 “What Attitude Should we Have Towards Complex Homoeopathy?”

sentatives and promoter of complex homoeopathy has understood and admitted this and has begun to call his remedies ‘oligoplexes’ thus omitting the word ‘homoeopathy’.”111 When Fritz Donner (1896–1979) visited the polyclinic of the Berlin Association in 1927, he found to his amazement that the doctor on duty gave his patients three or four little flasks, each containing mixtures of four homoeopathic substances. Some patients took home four little bottles each containing a combination of four remedies of which they were meant to take a certain number of drops during the day.112 When Donner asked how he reconciled these proceedings with the principles of homoeopathy, he received the answer: “Well, what you are referring to is the theory, and this is the practice.”113 When Fritz Donner took up his work at the homoeopathic university polyclinic in Berlin and rejected the complex remedies offered to him by a manufacturer who was also a physician, the latter replied: “But the majority of your most orthodox homoeopathic colleagues are doing the same” and he named a few gentlemen who were known to treat their patients in that way.114 Donner did understand his colleagues because they worked hard and stood under enormous time pressure. They even offered additional surgery hours free of charge in the Association’s polyclinic on certain days. One of these physicians was so popular that he saw 40 to 50 people in his free surgery hour. He held surgery in the morning followed by home visits, arrived after lunch, at around three o’clock, in the polyclinic and continued his practice at home at 4.30 pm. During the hour and a half which he spent in the polyclinic, he advised and examined his patients and gave them remedies that he dispensed himself. 111 Bastanier (1926), p. 579. 112 Fritz Donner, pupil of Hans Wapler, had first been assistant physician and then registrar at the Robert Bosch Hospital in Stuttgart and worked in Berlin from 1931 where he first was registrar (1931–1939) at the homoeopathic university polyclinic under Ernst Bastanier. From 1934 to 1945 he was lecturer for homoeopathy at the Berlin academy for medical studies. From 1936 to 1943 he took on the homoeopathic department of the Rudolf-Virchow-Hospital in Berlin. From after the war till his retirement he was medical director of the municipal Behring Hospital in Berlin-Zehlendorf and of the Internal and Infection Department. After World War II he ceased practising clinical homoeopathy. Cf. Schroers (2006), p. 26. 113 Donner (1956), p. 517. 114 Donner (1956), p. 518.

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Fritz Donner (1896–1979)

At the Robert Bosch Hospital in Stuttgart, Alfons Stiegele (1871–1956) tried to restrict himself to one or two remedies.115 This approach that respected the individualisation principle was later also taken up by his pupil, Fritz Donner, in Berlin, who considered it meaningful to use a preparation made up of one or two substances in exceptional cases, as long as its composition was known, even though this contravened section 273 of the Organon.116 Donner also pointed out that it was much more difficult to verify whether a complex or a single remedy worked faster than was generally assumed in homoeopathy. The 115 Donner (1956), p. 516. From 1901, Alfons Stiegele had worked as a physician at the homoeopathic polyclinic in Stuttgart. From 1921 to 1940 he directed the homoeopathic temporary hospital in Stuttgart and from 1940 to 1945 he was medical director of the Robert-Bosch-Hospital. Cf. Faltin (2002), p. 388. 116 “If an old man with coronary sclerosis complains about sleeping problems and frequent heart sensations in the night, and it turns out that he sleeps better after taking Passiflora and, from Crataegus, has less heart sensations, then it is in my view legitimate, in order to simplify the nocturnal intake of medicines and in order to prevent a confusion of remedies which has often been observed in old people due to their age-related weak sight, to give them Crataegus and Passiflora as a mixture in one bottle or an industrially manufactured medicine that contains both substances, although I am aware of the fact that this goes against section 273.” Cf. Donner (1956), p. 525.

16 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Physicians at the Robert Bosch Hospital also thought that homoeopathic remedies were organotropic which made modern diagnostics an important precondition for the homoeopathic choice of remedy.117 In the Stuttgart Aushilfskrankenhaus [temporary hospital] as well as in the Robert Bosch Hospital low potencies were the preferred option.118 The remaining patient files of the temporary hospital show that none of the remedies prescribed was potentised above D6.119 At the Robert Bosch Hospital some medicines were even administered undiluted. High potencies were basically out of the question here. Alfons Stiegele did not usually prescribe dilutions above D15. At the temporary hospital the remedies changed frequently. In none of the treatments only one remedy was prescribed; only in exceptional cases several remedies were given simultaneously, which meant that it took longer to find the right remedy or that a change in the disease picture indicated the need for a new remedy.120 Hans Ritter (1897–1988), head physician at the polyclinic of the Robert Bosch Hospital from 1957 to 1969, saw the single remedy as the still valid ideal to strive for. One was nevertheless generally forced, he argued, to prescribe two or more substances simultaneously because with disease processes that were mostly limited to one organ the symptoms could not always be matched to one remedy.121 In these cases two or several substances of the same organotropy had to be combined. Hans Ritter introduced the concept of homotropic remedy combinations. He admitted at the same time that, in case the mixture was successful, conclusions as to the effect of the individual compo117 Many classical homoeopaths rejected the diagnostics, especially before 1945. Cf. Faltin (2002), p. 121. 118 Faltin (2002), p. 121. 119 Faltin (2002), p. 121. 120 Faltin (2002), p. 122. 121 Ritter (1962), p. 90. Hans Theodor Ritter (1897–1988), who was born in Hamburg, studied medicine in Tübingen and Munich. After gaining his doctorate he practised as a physician in Rostock, where he also lectured on homoeopathy and occupational disease. In 1946, he completed his habilitation in Rostock and in 1953 a further habilitation at Frankfurt medical school. In 1957 he was appointed associate professor at the University of Frankfurt. Before being promoted to the post of head physician at the polyclinic of the Robert Bosch Hospital he practised in Plettenberg. Since 1971 he was a member of the advisory council for drug research in the Ministry of Health. Like Hans Wapler and Fritz Donner he supported the scientific-critical stream of homoeopathy. Homoeopathy for him was solely a complementary method. Cf. Schroers (2006), p. 115 and Faltin (2002), pp. 147, 375.

nents were not possible. He agreed with the famous surgeon of the Berlin University Clinic, August Bier (1861–1949), that the symptom picture of a given disease case was so complex, so polysymptomatic and extended to so many organ areas, that it was not possible to target the entire disease picture with just one remedy.122 In these cases it was best to combine remedies that addressed the different sections of the disease picture.123 After the war, there was a tendency in Stuttgart to combine a low potency organotropic remedy with a higher potency constitutional.124 Even August Bier, who was strictly opposed to polypharmacy, favoured the use of several substances that went well together. He tended to use potencies of D6 and below; his prescriptions never went beyond D12.125

The Dissemination of Complex Homoeopathy Physicians, lay practitioners and pharmaceutical manufacturers promoted the dissemination of complex homoeopathy from the beginning of the 20th century. The complex homoeopaths rejected the single homoeopaths’ idea that homoeopathy was complete. They wanted to further explore the dynamics underlying homoeopathy and to keep developing them in the light of new discoveries. In keeping with the premise that science could never stand still as it was subject to continuous change, they developed complex homoeopathy in different ways some of which were based on totally new concepts. Although they used different explanatory models all complex homoeopaths were committed to Hahnemann’s similarity principle. They rejected the argument that the prescription of complex remedies had nothing in common with homoeopathy by pointing out that the 122 For August Bier cf. p. 52 below. 123 “One can, in the case of a menopausal condition, give Sepia for the vasomotor syndrome, and at the same time Bryonia, or better even formic acid, against the accompanying arthropathy. […] We can call this a heterotropic drug mixture. […]. It compares favourably to the homotropic one because as a rule one can draw conclusions concerning the effect of each component. In practice, the mixture can be used without reservations, while the homotropic should be restricted because of the danger of obfuscation.” Cf. Ritter (1962), p. 91. 124 Cf. also p. 83 below. 125 Schlegel (1939), pp. 186, 271. Cf. also on p. 82 below.

17 The Dissemination of Complex Homoeopathy

single remedy homoeopaths did not own exclusive rights to the name “homoeopathy”.126 Everyone had the right to research and experiment independently and the duty to make his findings available to the general public.127 Lay practitioner Heinrich Hense (1868–1955) argued that, as a committed Hahnemannian, he had studied Hahnemann’s doctrine for years; just like the classical homoeopaths he had followed in the master’s footsteps; he had, however, not stopped there to idolize him, but had moved on, endeavouring to bring Hahnemann’s principles together with contemporary insights.128 Developing homoeopathy further did not imply that one questioned Hahnemann’s greatness and his importance for the movement. The rigid adherence to Hahnemann’s words, the cry of his followers that each step away from his path, each divergence from the tradition, was a crime against the master and the cause, constituted the same kind of attitude that the homoeopaths accused the allopaths of assuming. By rejecting all progress, Hense thought, one would sink to the level of intolerable ignorance. Hahnemann, the pioneer of the similarity principle, had not proposed such blind, everlasting allegiance to each and every detail of his teachings, which in any case reflected the state of knowledge at his time. Many complex homoeopaths believed that the administration of only one remedy at a time was no longer tenable; complex remedies achieved a better and faster effect and a reliable complex system eliminated the laborious task of finding the right single substance.129 Patients were also frequently unable to supply the necessary details during case taking which made the choice of the right remedy potentially very difficult if not impossible.130 It was also argued that, in Hahnemann’s times, it had still been possible to test remedies empirically in order to gain exact insights concerning their efficacy; in the meantime it had become increasingly difficult to establish the suitable homoeopathic single remedy on the basis of the similarity principle, because of the great number of remedies available and the vast amount and variety of listed symptoms.131 The 126 127 128 129 130 131

Hense (1931), pp. 18–25. Harbeck (1926), p. 55. Hense (1931), pp. 18–25. Weiss (1935), p. 453. Sahler (2003), p. 50. Clerc (1903), p. 23. Sahler (2003), p. 53.

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necessary procedure ultimately led to mistakes and time-consuming trials so that one had to begin to question its justification. The Swiss homoeopath Clerc (life dates unknown) thought that Hahnemann had not had time enough to complete his life’s work and had left it to posteriority to keep building on the foundations he had provided. Referring to scientific progress, the complex homoeopaths proposed that the unity of a remedy in the strict sense had turned out to be purely fictional.132 In earlier times people had assumed that elements such as air and water constituted a unity, while one knew now that they were composites; most homoeopathic remedies also constituted groups of substances made up by nature. In every tincture one could detect compounds which, over time, had been modified through the interaction of the acids, bases, alkaloids with the alcohol which was reflected in their colour, smell, density and also their effect. Apart from the fact that further chemical processes took place in the stomach, the lactose used for trituration also constituted a complexity. To the accusation that no drug provings on the healthy person were carried out, the complex homoeopaths said that the drug mixtures did not constitute polypharmacy, but were a selection of single remedies that complemented each other with each of them having proved its value a “thousandfold” in medical practice. One could also, they continued, trust in the body’s ability to make choices seeing that it took in food mixtures, rather than single ingredients, on a daily basis and only selected the components it.133 Among the most eminent lay practitioners who manufactured complex preparations in Germany in the early 19th century were Emanuel Felke (1856– 1926), Heinrich Hense (1868–1955) and Magdalene Madaus (1857–1925). Hense as well as Magdalene Madaus had come across complex homoeopathy as pupils of Felke.134 Another follower of Felke was the practitioner Heinrich Reckeweg (1877–1944), whose sons, just as those of Magdalene Madaus, were to build up large pharmaceutical enterprises based on their parents’ drug formulations. The pharmacists 132 Harbeck (1926), p. 57. Belotti used a similar argument, cf. p. 10 above; so did the proponents of spagyrics. Cf. Sauter p. 31 below. 133 Ottinger (1933), p. 5. Stauffen-Pharma (1979)], p. 3. 134 For Emanuel Felke cf. p. 41 below.

18 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Friedrich H. Pascoe (1867–1930) and Richard Mauch (1871–1936) as well as the practitioner Wilhelm Zähres (life dates unknown) were also Felke adherents. Felke is counted among the greatest thinkers “of the pioneering phase of complex homoeopathy”.135 Many homoeopathic complex systems that were introduced after the war owe their existence to him or trace back to his system. His pupils went on to modify the complex system he had created according to their own experiences.136

Felke To start with, the lay practitioner Emanuel Felke (1856–1926), who combined naturopathy and homoeopathy, had only used simple homoeopathic remedies, which he later also prescribed for acute illness; in this respect he always had been, as he wrote to his friend Max Vits in 1899, a thoroughbred Hahnemannian.137 Homoeopathy, he claimed, was the “backbone of his method”.138 Felke did not restrict himself to pure naturopathy which around 1900 rejected any kind of medicinal intervention, but believed that clay and water applications could be further individualised with the help of homoeopathy.139 He referred to various homoeopathic works, such as Clerc’s complex homoeopathy.140 Like all complex homoeopaths he was committed to Hahnemann’s simile principle: “When a disease picture becomes apparent in a number of symptoms, we do not, like allopaths, give one remedy to suppress these, but we give the one exact remedy that is able to provoke similar symptoms in the healthy person. Homoeopathic remedies apply the lever in exactly the same place where nature applies it and for this reason homoeopathy has a greater and more deeply rooted right than any other method to call itself a natural healing approach. In short: homoeopathy teaches to give the sick person the same substance in a small dosage that would provoke similar symptoms

135 Schimmel (1962), p. 6. 136 Schimmel (1962), p. 6. 137 Emanuel Felke’s letter to Max Vits, 1899. Printed in: Kramer (1986), p. 52. Mauch (1926), p. 7. For Felke cf. also p. 41 below. 138 Stader (no date), p. 36. 139 For the development of naturopathy cf. Heyll (2006), p. 173. 140 From Felke’s letter to Max Vits, 1899. Printed in: Kramer (1986), p. 54.

in the healthy person. Homoeopathy rests upon the experiment on the healthy; it rests upon the law of similars.”141 He tended to give higher potencies to children and women and low potencies to men and less sensitive patients. In cases of fast progressing, dangerous and acute diseases or complaints that were accompanied by reduced sensitivity he also gave lower potencies, while he chose higher and high potencies for slowly progressing, i.e. chronic, cases.142 Erna Bier, his receptionist of many years, described in her little book on Felke’s healing approach that homoeopathic remedies were not even harmful if the wrong substance was chosen, because the homoeopathic “medicine atoms” would only target the diseased cells that corresponded to them while simply passing by the healthy cells that corresponded to them.143 Lower potencies should only be used by a conscientious physician in order to prevent or reverse possible damage. At the beginning of the treatment, single remedies were given in hourly alternation and, if there were signs of improvement, every two hours. Complex remedies, in contrast, were given in three-hourly alternation or every two hours in exceptional cases.144 From 1922 Felke had his complex preparations made by his close friend Richard Mauch in Cologne; in 1924 he authorised the company “Dr. Mauch Köln” to act as the national and international “Felke Centre”. Up to his death he kept control over his complex remedies and discussed all changes that became necessary with Richard Mauch.145 Later, the Felke complexes were manufactured by Willmar Schwabe and Pascoe as well and, until a few years ago, also by Truw. Felke based his approach on humoral pathology and did not acknowledge diseases of individual organs, as any diseased organ was a sign that the whole body was, to a greater or lesser extent, affected by pathogens.146 “Especially where one particular organ does not recover despite all manners of treatment the total vitiation of the humours is apparent.”147 Depending on the individual case, Felke prescribed various 141 142 143 144

Quoted from Stader (no date), p. 37. Stader (no date), p. 39. Bier (1920), p. 2. Bier (1920), p. 30. In very severe cases of disease, the single remedies could be alternated even more frequently. 145 Mauch (1926), p. 1. 146 For Felke’s pathological concept cf. p. 43 below. 147 Quoted from Stader (no date), p. 42.

19 The Dissemination of Complex Homoeopathy

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homoeopathic single remedies as a complex; his concept implied that humours that were burdened with debilitating toxins caused the complaints. Depending on the organs that were mostly affected he differentiated between strained heart, liver, kidneys, lungs etc. “If it happened, for instance, that at one time liver and lungs were affected and at another time kidneys and stomach were mostly disturbed, Felke put together a composition of remedies that would address each single one of these cases.”148 He adhered to the simile principle because he compared the various symptoms in his patients with the drug pictures of the individual remedies. As this comparison could reveal several suitable remedies he would combine these. In this way he arrived again and again at similar combinations for similar types of disease.149 Practitioners apparently ended up with 150 Felke complexes at their disposal.150 Felke was also an iridologist and claimed that his complex remedies corresponded to the disease complexes he detected in the iris.151 Magdalene Madaus (1857–1925)

Madaus A woman also made her mark in the field of complex homoeopathy at the beginning of the 20th century. Magdalene Madaus (1857–1925), the wife of Lutheran pastor Heinrich Pieter Madaus (1853–1915) from Radevormwald, had consulted Emanuel Felke in his “Fountain of Youth” health clinic in Repelen on the Lower Rhine when her youngest son contracted polio and also because of her own health problems. With the help of iridology Felke diagnosed pelvic inflammation in her case which he was able to cure.152 For her son Hans he prescribed a treatment therapy that included homoeopathic complex preparations and he cured him as well. Magdalene Madaus became a committed follower of homoeopathy in Repelen. From Felke she learned the fundamentals of complex therapy and she set up her own system of complex remedies.153 Felke also won her over to eye diag148 149 150 151

Sahler (2003), p. 96. Sahler (2003), p. 96. Ersfeld and Hahn (1991), p. 500. Bier (1920), p. 1. Eye diagnosis has nothing in common with homoeopathy, but this does not mean that is was not used by homoeopaths. Tischner (1939), p. 668. 152 Sahler (2003), p. 107. Dietrichkeit (1991), p. 7. 153 www.oligoplexe.de/Magdalene-Madaus.1239.0.html.

nosis.154 Soon after, Magdalene Madaus started her own practice in Radevormwald where, from 1908, she used her own preparations. From the beginning, her mixtures were made up of plant, mineral and organic single remedies in subliminal dosage and were specially adjusted to particular disease pictures taking into consideration the overall constitution. The combined preparations proved to be more efficacious than unmixed single remedies. Her concept was based on the premise, that mixing several substances in high dilution would not only 154 In 1915 she published a textbook on iridology. The book was withdrawn soon after its publication, probably due to the influence of iridology opponents, and could only be published again in 1918. Her protestation at the time led to her being threatened with the madhouse if she continued to publicly advocate iris diagnosis. On 1 July 1920 she founded the specialist journal Iris-Correspondenz to promote further knowledge and thus played a crucial part in coining the term “iridology”. Cf. Todesanzeige und Lebenslauf, Magdalene Madaus (1925). Iris diagnosis and iris constitution were further developed by her daughter Eva Flink (1886–1959). Mother and daughter founded a school for iridology. In the training sessions, the complex system developed by Magdalene Madaus in connection with eye diagnosis was taught to physicians. Cf. Sahler (2003), p. 109. Madaus (1916). www.oligoplexe.de/ Magdalene-Madaus.1239.0.html.

20 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Friedemund, Gerhard and Hans Madaus, company’s founders of „Dr. Madaus & Co., Pharmazeutisches Laboratorium“

reduce or even eliminate unwanted side-effects, but also enhance the desired effect.155 At first, Magdalene Madaus had her complex preparations produced by Dr Bischoff (Niederbreisig) and, some months later, by the Schrakampsche Apotheke (Gelsenkirchen). From 1919, manufacture and sale of all her products were taken over by her sons in a company specially founded for the purpose.156 Magdalene Madaus’ complex remedies essentially formed the basis for the company Dr. Madaus & Co., Pharmazeutisches Laboratorium.157 The firm 155 Dietrichkeit (1991), p. 92. 156 From the beginning the company produced “biochemistry, complex homoeopathy, homoeopathy, specialities”. In 1921, it relocated from Bonn to Radeburg near Dresden; in 1929 the parent company moved to Radebeul near Dresden; in 1945 the factory in Radebeul was dismantled and dispossessed; 1946 provisional registration in Bonn; in 1947 the company’s head office moves to Cologne. Cf. Dietrichkeit (1991), pp. 26–33. 157 www.oligoplexe.de/Magdalene-Madaus.1239.0.html.

had been founded in 1919 by the brothers Friedemund, Gerhard and Hans Madaus. Friedemund Madaus had previously worked for a bank, while Gerhard Madaus had studied medicine and Hans Madaus pharmacy. The combination preparations were renamed “oligoplexes” in 1925. The name was chosen to express that they were mixtures of nontoxic amounts of substances (from the Greek: oligos = little, few), but also to guarantee their authenticity.158 Their composition was based on empirically gained insights.159 They were sold as drops, pilules, powder and tablets. Non-toxic substances were given in a strong tincture, toxic substances as high potencies.160 The oligoplexes were divided into the categories constitutionals, special remedies and organ remedies. The oligoplexes were mostly distributed by nonmedical practitioners who had attended the further training courses offered by Madaus.161 When restrictions to the “freedom to practise medicine” (Kurierfreiheit) threatened towards the end of the 1920s, the Madaus company tried to work against the insecurity this caused among lay practitioners by offering further training courses that, next to the fundamental medical knowledge needed for the medical examination, also conveyed knowledge of the oligoplexes. The former doctor of tropical medicine Professor Dr Ludwig Külz (1875–1938) was enlisted as a lecturer. He was the brother of the politician Dr Wilhelm Külz (1875–1948) who was Reich interior minister in 1926/27 and, from 1931 to 1933, mayor of Dresden.162 Between 1928 and 1930, such courses took place in 26 German cities. During the 1930s, orthodox physicians could also be persuaded to prescribe oligoplexes. Apart from the fact that the drug mixtures rendered the time consuming search for the simile unnecessary, the physicians were also promised that the combination preparations, because they were recognized by the statutory health insurers, 158 Dietrichkeit (1991), p. 93. www.madaus.de/1919-1939.111.0. html. 159 Dietrichkeit (1991), p. 23. Madaus-Präparate (1941), p. 55. 160 Madaus (1931/32), p. 8. 161 Dietrichkeit (1991), pp. 23–25. 162 Ludwig Külz, previously a government physician in the former German colonies, 1902–1905 in Togo, then up to 1913 in Camerun and finally for a short spell in German New Guinea. Cf. Dietrichkeit (1991), p. 25. For views on colonial hygiene and politics and the change in duties within the colonial medical system cf. Eckart (1997), pp. 58–61, 65–67, 69–72, 145, 312, 454–457.

21 The Dissemination of Complex Homoeopathy

would give them access also to non-private patients. By travelling through Germany and giving lectures, Gerhard Madaus made contact with the physicians. Publication of his three-volume textbook secured the Madaus Company wide-spread public recognition. Gerhard Madaus was most interested in the treatment with medicinal plants which, in his opinion, was most effectual if fresh plants were used. Under his guidance a new procedure was developed for the manufacture of fresh plant triturations that included a gentle way of drying them.163 He rejected concerns about the possible neutralisation of remedies that were made up from several substances as they might counteract each other, and argued that, for decades, Ipecacuanha and Opium, two truly antagonistic remedies, had been prescribed in combination as “Dover’s Tablets” and were well known for their stimulating effect on the intestines. Madaus’ complex remedies nevertheless avoided mixtures of substances that produced contrary effects. Only substances with the same or similar effects were used to make sure that their effects would always add up even if they did not always potentise.164 At Madaus it was thought wrong to hold on to the rigid dogmas of homoeopathy despite the progresses made in pharmacology. Because a series of damaging influences was necessary to cause a disease, it needed a complex of medicinal substances to treat it.165 By combining a special selection of homoeopathic remedies, according to Bürgi’s Principle, their efficacy would be noticeably enhanced. Madaus referred to the combination principle of the Swiss pharmacologist and chemist Emil Bürgi (1872–1947) to explain their successful use of homoeopathic complex remedies. They argued that orthodox medicine had discovered the law of potentisation through empirical research by combining various narcotics. Bürgi had claimed that drugs with the same therapeutic action add up when they have the same target point, and potentiate when they address different pharmacological targets.166 Gerhard Madaus found Bürgi’s theory confirmed in the trials with Yatren (iodine-containing antiseptic) that August Bier’s assistant physician 163 164 165 166

Dietrichkeit (1991), p. 4. Dr. Madaus & Co (ed.) (no date), p. 6. Dr. Madaus & Co. (ed.) (1925), p. 3. Dr. Madaus & Co. (ed.) (1925), p. 3. Bürgi (1932), pp. 25–48.

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Arnold Zimmer had carried out in the clinic.167 In the Madaus formulation manual we read that their complex homoeopathy was based on the combination of homoeopathic remedies which had opposite targets: “Each individual remedy is chosen to balance out the sum total of the damages that most likely provoked the corresponding disease.”168 Gerhard Madaus thought that with combinations one could reduce the dosage of strongly working drugs, cancel out the danger of forming a drug habit, enhance susceptibility to a drug and exclude any chance of insensitivity to it.169 In his view it was certainly possible for a physician to prescribe his own combination successfully; he still considered it dangerous as this kind of prescribing that lacked clinical and experimental foundations could easily go wrong. He was convinced that, by using only single remedies, many valuable opportunities were missed; the patient’s suffering was unnecessarily drawn out if untested mixtures or single remedies were used. He did admit that with mixtures the effects could hardly be predicted, or only if they had definite targets in the organism which was only the case with very few remedies. In order to improve the manufacture of complex remedies on the whole Gerhard Madaus encouraged the manufacturers to be always aware of the preparations available on the market, because they did not only “save drugs” but considerably improved the tools available to the physician. This did not replace the study of single remedies which was still the most important basis of the combination doctrine. “But just as the gardener does not give only potash or phosphor to his plant, the physician will not give his patients only one single remedy, as a matter of principle.”170 Madaus objected to the one-sided importance that the classical Hahnemannian school, in his view, attached to the disease symptoms while disregarding the medical ancillary sciences such as pathological anatomy, because as a consequence the cause of a disease, i.e. the diseased organ, was not treated.171 He also rejected Hahnemann’s idea that the proving on the healthy person was crucial to finding the right 167 168 169 170 171

Madaus (1926), p. 55. Dr. Madaus & Co. (ed.) (1925), p. 4. Madaus (1938), p. 45. Madaus (1938), p. 46. Dietrichkeit (1991), p. 93.

22 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

remedy. His argument was that some substances, such as bearberry leaves, only had an effect when taken by a sick person, the healthy would simply excrete them. And he was opposed to Hahnemann’s belief in the immaterial effect of drugs and the resulting high potencies. Gerhard Madaus called classical homoeopathy the “simple” homoeopathy and pharmacology the forerunner of complex homoeopathy, but conceded that the term “complex homoeopathy” was an unfortunate choice because the complex homoeopaths did not accept all the maxims of classical homoeopathy.172 Hans-Heinrich Reckeweg (1905–1985)

Reckeweg Like the Madaus brothers Hans-Heinrich Reckeweg (1905–1985) and his siblings, two of whom also founded a pharmaceutical company after World War II, had been aware of homoeopathy through their parents from early childhood.173 Their father, Heinrich Reckeweg (1877–1944), who was born in Löhne and moved to Herford in 1903, had been an elementary school teacher until he fell ill. He was mostly interested in alternative medicine which was partly due to his recurring illness. A chronic kidney inflammation and tuberculosis as well as severe tonsillitis had induced him to take early retirement in 1924. Orthodox medicine had no cure for his ailments and so he was led to visit the Felke Baths in Diez on the river Lahn. He was so enthusiastic about Felke’s method that he studied it in depth and opened his own practice in 1926 which he continued to run successfully up to his death. He treated his patients with combination preparations that he produced himself in accordance with Hahnemann’s law of similars.174 Some formulations were taken over by his sons and are still on the market today.175 Hans-Heinrich Reckeweg, who went on to found the Heel Company, studied medicine. After finishing medical school in 1930 and working as an assistant physician in hospitals, first in Völklingen and then in 172 Madaus (1926), p. 54. 173 The sons Alfred and Klaus-Günther Reckeweg founded the company Pharmazeutische Fabrik Dr. Reckeweg und Co in 1947 which still produces homoeopathic complex remedies. 174 Doerper-Reckeweg (1993), p. 10. 175 Sahler (2003), p. 100.

Hamburg until April 1932, Hans-Heinrich Reckweg returned to Berlin where he had studied in 1928/29. He chose Berlin because physicians had the right to dispense there.176 It was there that he attended a homoeopathy introduction course organised by the “Berlin Academy for Ongoing Training in Medicine”, an institution to which he would later return as lecturer. He also became a member of the Berlin Association of Homoeopathic Physicians. To help promote the further development of homoeopathic pharmaceutics, members had to undergo drug provings from time to time. They were given an unknown preparation which they had to potentise to various degrees before testing it on their own person. Then they compared all their symptoms with those of their colleagues who, unknowingly, had taken the same substance. Before starting his private practice in 1933 HansHeinrich Reckeweg had to run a charitable practice for one year so that he would be granted the right of dispensation. From the beginning he examined his patients with the greatest care and dedication. As the minutest symptom could provide indications regarding the homoeopathic treatment he asked his patients in great detail about their history right down to their childhood illnesses. At that time he made important observations that would have a decisive influence on his homotoxicological doctrine. On the basis of their case histories he developed individual homoeopathic remedies for each of his 176 Doerper-Reckeweg (1993), p. 13. Doerper-Reckeweg and Maschke (1996), pp. 12–17.

23 The Dissemination of Complex Homoeopathy

patients. Because he took meticulous notes on each preparation Hans-Heinrich Reckeweg could develop a sound understanding of their effects. The bigger his practice grew the more energy and determination he devoted to the development of his preparations. With the help of numerous tests that he performed on himself he discovered ever new and more effective drug combinations. He wrote later about this time: “When, in 1932, I began my practice in Berlin as a homoeopathic physician I was often impressed to experience how under the influence of a homoeopathic remedy one disease disappeared while another one emerged in its stead. The disease seemed to be chased around the body as by some goblin, looking for a way out and, in disappearing, made space for another, mostly less harmful disease. In numerous cases this became noticeable due to the stimulation of excretionary processes such as sweating in the case of influenza, pus with abscesses and inflammations, mucus with bronchitis etc. This was difficult to explain in the beginning; the same was true for opposite processes. If popular belief suggested that a leg ulcer must not be suppressed because that could lead to cancer developing in another place, one often had to confirm that experience although no obvious explanation could be found for the correlation.”177 Because of the growing demand for Reckeweg’s homoeopathic remedies among his patients he began to make up stock solutions for many of his preparations. The composition of his homoeopathic complex remedies was so successful that, in 1936, he founded his own pharmaceutical enterprise. The name of his company, HEEL, is an acronym for the Latin Herba est ex luce which means “healing plants come from the light”. By the second half of the 1930s HansHeinrich Reckeweg had already launched 26 of his own products, among them Angin-Heel, Hust-Heel and Gripp-Heel. Without questioning the effect of homoeopathic single remedies he was most interested in homoeopathic drug combinations. As his introduction to Heel’s Tropfen [Heel’s Drops] shows, his preparations aimed at producing an organ-specific effect rather than targeting the symptoms in the way single remedy homoeopathy did: “The complex remedy relates to the organism in a more organic, the homoeopathic single remedy in a more generally symp177 Quoted from Doerper-Reckeweg and Maschke (1996), p. 26.

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tomatic way.”178 Hans-Heinrich Reckeweg’s response to the accusation of the lack of individualisation was that the use of homoeopathic single remedies relied to a large extent on subjective considerations and particularly also on the more or less comprehensive knowledge of the prescriber; in other words, individualisation was not based on reliable criteria.179 In order to fight diseases faster and more successfully the selection of the right remedy needed to be simplified. He therefore encouraged practitioners not to waste time with unnecessary trials. As, according to his homotoxicology, a number of toxins were responsible for causing one disease he concluded that the simultaneous application of several remedies was justified.180 With the various drops available from the Heel Company it should be possible to treat all common diseases on the basis of their indications. Two years after the company’s successful foundation it began to manufacture its preparations in tablet form as well. Reckeweg had experienced that, due to their wide-ranging effect, his remedies were particularly suitable for the treatment of diseases with complex symptom pictures. At first he only used the “classical” substances as bases for his homoeopathic remedies: inorganic substances (elements, trace elements, metals, salts and acids), plants, organs (from tissues, cells, cell compartments, filtrates, sera and secretions), animal products, nosodes (i.e. preparations made up from human and animal disease products). The raw materials were sterilised before use.181

Hense Another proponent of complex homoeopathy was the practitioner Heinrich Hense (1868–1955), mentioned earlier, who founded the Thorraduran Works in Hüls near Krefeld in 1907. After a long apprenticeship with Emanuel Felke he began, in 1900, to develop his own treatment system which he based on the synthesis 178 Heel Company Archives/Library – Heel’s Tropfen. After developing his homotoxicology Reckeweg no longer used homoeopathic preparations to target the symptom picture. For more details cf. p. 82 below. 179 Tischner (1939), p. 668. 180 Reckeweg (1958), p. 7. 181 Doerper-Reckeweg and Maschke (1996), p. 39. Later he extended his range by adding “homoeopathized” allopathic remedies and vitamins.

24 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

of humoralism, Virchow’s cellular pathology and neuropathology182 while adhering to the similarity principle. He called his healing system “Truw”.183 He said himself that, until 1905, he had been a strict follower of Hahnemann and had always achieved good results.184 Because the success only ever showed after a while and the remedies as well as the potency had to be changed in any case, he ultimately converted to complex homoeopathy. Hense’s school of thought proposed that each substance worked on a particular organ or on a particular part of the body. The overall effect accounted for the success. For each organ the body would take of the stimulants given those it needed and excrete the excess.185 According to its inventor, the Truw combinations did not need to be excreted

by the body as their minute dosages were completely absorbed, although he did not consider it harmful, if one of the remedies was excreted.186 Hense also used the argument that the organism chose from the multitude of foodstuffs that it took in only what it deemed necessary for maintaining the vital force.187 He did not understand, he said, why – if one treated in accordance with the similarity principle – similarly acting substances should not be combined as long as one was aware of the clinical value of each of them.188 Heinrich Hense held that for the practitioner as well as for the patient it was only the success that counted; it should not be a question of whether a substance was indicated by the symptoms or whether “the firm ground of individualisation had been left behind”.189 As long as there was not scientific explanation of homoeopathy, he admitted, everyone had to “devise his own explanation in accordance with his scientific conscience.”190 Heinrich Hense also explained why the complex remedies worked faster. If one combined the substances, in awareness of how each one worked, so that they addressed the symptom and its cause, one would achieve a faster and deeper effect: “It would be difficult if I tried to kill a sparrow with a canon ball (single remedy), but easy if I used lead shot (complex remedy). The homoeopathic single remedy covers one symptom – I fire a cannon ball – and still, I don’t necessarily hit the cause of the symptom if I fail to establish it, and mostly I do not hit the disorders in the individual organs. With a complex remedy I do not only hit the symptom (in all its manifestations), but also the cause that consists in the disorders of the organ.”191 In order to achieve his goal as fast as possible, Heinrich Hense even administered several different complex remedies in one day. Hense used iridology to diagnose diseases. He believed that this allowed him to detect earlier diseases as well as present damage to and weaknesses of organs.192 He knew exactly how his drug preparations worked. Based on his experiences at the bedside

182 Sahler (2003), p. 115. 183 Truw was short for Thorraduran Works. While the complex remedies carried the name “Truw”, the unabridged name Thorraduran Works was used for the specialities. Cf. Thorraduranwerk (ed.) (1934), pp. 1, 9. 184 Hense (1934), p. 289. 185 Cf. Belotti, p. 10 above.

186 187 188 189 190 191 192

Heinrich Hense (1868–1955)

Hense (1934), pp. 290, 292. Ulrich Ottinger later used the same argument: cf. p. 17 above. Hense (1934), p. 293. Hense (1934), p. 292. Hense (1934), p. 201. Hense (1934), p. 201. Sahler (2003), p. 116.

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which were confirmed by the study published by the pharmacologist Hugo Schulz (1853–1932) on the pharmaco-dynamic effects of drugs, Hense thought that “each medicinal substance finds its own specific target in one particular organ. The change it brings about in this organ provokes a symptom complex that is noticeable to the outside. This symptom complex is identical with what Hahnemann called the drug disease.”193 According to Heinrich Hense the disease appeared in several organs simultaneously. “If one organ is primarily affected by a disease, i.e. something extraordinary happens in the course of its life that upsets its balance, a change will normally also occur in the other organs as they interact harmoniously in the organism; just as a damaged wheel in a watch upsets the functioning of the other wheels.”194 Hense claimed that the selection of his organ specific remedies was fully consonant with Hahnemann’s similarity principle. Wilhelm Zähres (life dates unknown)

Zähres Wilhelm Zähres (life dates unknown) made his name in the history of complex remedies with his Synergon system.195 The man, who was to found the Kattwiga Company, had also consulted Emanuel Felke in his youth because he had suffered from chronic sciatica and a spinal deformity. In Felke’s sanotarium he found his future vocation. He was “first pupil, then friend and finally congenial combatant of the clay pastor”. In 1902 he opened his first practice in Kettwig on the river Ruhr, and in 1908 he founded a sanotarium in the Felke style. Working closely together with Felke he created homoeopathic complex remedies which he called synergons. The initially small company soon developed into a manufacturing enterprise that was entered into the commercial register in 1912 and, in 1913, became the Pharm. Fabrik Kattwiga Dosse & Co. Zähres recruited his friend Albert Dosse (life dates unknown), who was an acknowledged expert on homoeopathic remedies, as a colleague and later signed the company over to him.

193 Hense (1931), p. 23. For Hugo Schulz see on p. 68 below. 194 Hense (1931), p. 23. 195 www. kattwiga.de/das-unternehmen/historie.

The Synergon complex system owes its name to the term synergism which describes the combined action of substances that enhance each other and therefore do not act as antagonists.196 The Synergon system comprised homoeopathic complex remedies with ingredients gained from plants and minerals. The synergism of the single remedies was seen as a prerequisite for complex remedies. Starting point for the composition and preparation of the Kattwiga complex remedies was the cause of the disease, not the diseased organ or the disease itself with its outwardly noticeable symptoms. The relationship between particular disease groups as well as their interdependence formed the foundation for the Kattwiga remedies.

Schwabe The name Schwabe is very closely linked with the history of homoeopathy.197 In 1865, pharmacist Willmar Schwabe (1839–1917) founded the Homöopathische Centralofficin Dr. Willmar Schwabe in Leipzig which 196 Ersfeld and Hahn, p. 511. 197 For Schwabe’s biography and his business strategy cf. Michalak (1991), pp. 147–151, 101–134 as well as Jäger (1991), pp. 171–188.

26 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

The founder of the company Dr. Willmar Schwabe (1839–1917)

specialised in wholesale and export.198 From 1871, the Homöopathische Central-Apotheke zum Samuel Hahnemann supplied the local population with remedies, but also many homoeopaths. As mentioned earlier, Arthur Lutze procured his tinctures from there. All through his life Schwabe remained committed to Hahnemann.199 His intention to produce homoeopathic remedies based on Hahnemann’s original writings led him to put together a systematic list of remedy preparations.200 In 1872, the Pharmakopoe Homoeopathica Polyglotta was published and found general recognition. In 1934, Schwabe’s pharmacopoeia (Dr Willmar Schwabes Arzneibuch) provided the legal foundation for the manufacture of homoeopathic preparations in Germany. It was replaced, in 1978, by the official Homöopathisches Arzneibuch (HAB). 198 Sahler (2003), p. 98. 199 Jäger (1991), p. 175. 200 After World War II the company relocated from Leipzig to Karlsruhe. Cf., for instance, Niederle (2005), p. 59. For Willmar Schwabe in general cf. Schwabe (1939) and for the company history cf. also Jäger (1991), pp. 171–188.

Whether complex remedies were manufactured in Willmar Schwabe’s lifetime cannot be conclusively established from the current state of research. What can be said with certainty is that he manufactured and sold spagyric remedies for some time. The spagyric practitioner Carl Zimpel obtained his homoeopathic remedies from him. Schwabe discontinued the sale of electro-homoeopathic remedies later due to differences with the physicians.201 In 1894 he won a court ruling, however, that forbade his competitor, pharmacy owner Ernst Mylius (1846–1929), to continue to sell homoeopathic remedies, among which the court apparently included electro-homoeopathic remedies, in and around Leipzig.202 In his manual on veterinary medicine, Der Haustierarzt, that Schwabe published in 1873 he expressly avowed himself to single remedy homoeopathy: “Where for one and the same disease several remedies are indicated without more precise details being given, one should begin with the first remedy listed and, if this should fail to show any effect, one should try the remaining remedies one after the other. But each substance needs to be allowed sufficient time to fully unfold its activity because the quick succession of remedies is disadvantageous.” A necessary implication of the homoeopathic principle is the simplicity of the remedy, or the postulation that each remedy chosen in a given case of disease should be administered to the animal individually and without any other medicinal substance mixed into it, so that its effect can unfold without disturbance and impediments. The habit of giving two remedies in alternation can be excused as an emergency measure if none of the remedies selected is suitable for the disease and as long as experience can confirm a beneficial effect.203 The price lists that have been preserved show that the Schwabe Company did sell Ottinger’s complexes and, again, Zimpel’s spagyrics from 1927, and from 1929 also Felke’s complexes and Clerc’s complex remedy system as well as Mattei’s spagyric remedies.204 201 Helmstädter (1990), pp. 98–102. For spagyrics cf. p. 28 below and for Zimpel cf. p. 32 below. 202 For the “Mylius affair” cf. Michalak (1991), pp. 123–126. 203 Schwabe (ed.) (1873), p. 125. 204 I would like to warmly thank Mrs Susanne-Monika Rehm of the Deutsche Homöopathie-Union, head of documentation and library director, for allowing me to use her evaluation of the price lists. Another complex remedy was added in

27 The Dissemination of Complex Homoeopathy

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Pascoe205 The pharmacist Friedrich H. Pascoe (1867–1930), who, in 1896, took over the Mellinghoff Pharmacy in Mühlheim on the river Ruhr, also stood in regular contact with Emanuel Felke.206 Felke had some of his complex remedies manufactured by Pascoe. Their experience exchange as well as the concepts of Zimpel, Mattei and Clerc inspired Pascoe to embark on his own research. In 1918, he founded the company Apotheker Friedrich Pascoe – Pharmazeutische Präparate in Giessen.207 In 1925, after intense research and development, the company presented its own homoeopathic complex system208, which also formed the basis for the similiaplexes. These complexes were newly developed at the beginning of the 1960s although their principle dates back to the year 1896.209 Similiaplexes provide a holistic therapy and are used for prophylactic and curative purposes.210 All the single remedies contained in the complex remedies are directed at the same target: they interact synergistically which means that the individual effects complement and enhance each other.211 Just like other complex remedy manufacturers Pascoe probably found the results achieved by single remedy homoeopathy very promising, but was

205 206 207 208 209 210 211

1935: Nisylen-Grippetropfen (flue drops). For the price lists cf. Archiv der Deutschen Homöopathie-Union Karlsruhe: Illustrierte Preisliste ‘B’ (Ausgabe 103) 1927, (Ausgabe 105) 1929, (Ausgabe 107) 1930, (Ausgabe 112) 1935, (o.A.) 1936 Dr Willmar Schwabe, Leipzig. Illustrierte Preisliste ‘A’ (Ausgabe IV) 1929. Dr Willmar Schwabe, Leipzig. Today, the DHU complex remedy system is registered under the name Pentarkan. I am grateful to Dr Gabriele Weiß, director of Research & Development at the Pascoe Company for the source research. Sahler (2003), p. 110. www.pascoe-global.com/sites Pascoe confirm that the year of their foundation was 1918. In 1930 the son, Fritz Pascoe, became the company’s director. Pascoe (1961), p. 1. Ersfeld and Hahn, p. 510. “Similiaplexes are taken away from meals. Perlingual administration has proven to be most efficient. In acute cases, it might be indicated to give the similiaplexes per minute or in half-hour alternation until an improvement is noticed. When treating chronic diseases, potentisation of the similiaplexes is sometimes indicated. This increases the surface activity which means better and faster resorption can be achieved as well as increased ionisation of the active agents resulting in enhanced influence on the cell metabolism. After administration of potentised similiaplexes chronic processes occasionally deteriorate. Potentisation is carried out as follows. […]. Similiaplexes are categorized according to the functional organ system.” Ersfeld and Hahn (1991), p. 510.

Friedrich H. Pascoe (1867–1930)

concerned about the high risk involved, especially if beginners were concerned.212 A good memory, wide knowledge, years of experience combined with “intuition” and adherence to the principle of individualisation were said to be the preconditions for practising simplex homoeopathy. Only the best in the field met all these criteria while the broad majority was bound to fail due to their lack of competence. It was little wonder therefore that one was exposed to attacks and abuse. The real art consisted in the “right alternation of the right remedy at the right time” which, for the patient, could make the difference between life and death.213 Because disease was not a “rigid” state, but a process where the organism was affected by hardly noticeable changes in climate, diet or the psyche, the unitary homoeopaths found themselves confronted with unexpected situations while complex homoeopathy avoided such difficulties.

212 According to Helmut Schimmel in the Pascoe Company’s scientific journal. Schimmel (1962), p. 3. 213 Schimmel (1962), p. 4.

28 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Excursus: Spagyrics The term spagyrics is derived from alchemy. Its supporters mostly refer to the work of Theophrastus of Hohenheim (1493?–1541), also called Paracelsus. In spagyrics the original substances are separated using alchemical techniques and the substances gained in this way are specially prepared and recombined into a new whole.214 The word comes from the Greek spao (divide) and ageirein (combine). In drug production this means that the pure is separated from the impure. Spagyric procedures are used in processing metals, minerals and animal substances and are not – as is often assumed – limited to plants. Fermentation and distillation are two of several tools.215

Electro-Homoeopathy Mattei Electro-homoeopathy was developed on the basis of spagyrics and goes back to the Italian duke Cesare Mattei (1809–1896).216 Its beginnings date back to the 1850s. Mattei had manufactured remedies in his castle in Bologna very successfully without revealing their composition and he sold them later through the “Consortium for Electro-homoeopathy” in Regensburg.217 Although Mattei also consulted Hahnemann’s doctrine he thought it was in need of further development. In his electro-homoeopathy he saw the great reformation of homoeopathy.218 He chose the name “electro-homoeopathy” because he thought that his remedies worked as fast as electricity.219 Mattei 214 www.iso-arzneimittel.de 215 Sonntag (1939), p. 83. Ersfeld and Hahn, pp. 502, 513. 216 For a detailed biography of Mattei cf. Mattei (1893) and Helmstädter (1990), pp. 19–34. For Mattei in general cf. also Jütte (1996), pp. 229–234. Mattei’s interest in healing had apparently been awakened by a mangy stray dog who ate certain herbs and plants as a consequence of which he soon recovered. At the beginning of the 1860s the press had discovered Mattei who, among other things, treated poor patients free of charge. Arthur Lutze, who visited Mattei, wrote enthusiastically about his cures in his journal Hahnemannia. 217 Sahler (2003), p. 59. For the Regensburg Consortium cf. Helmstädter (1990), pp. 35–37. Cf. also p. 9 above. 218 Mattei (1884), p. X. 219 “I wanted to bring to expression that these remedies are a kind of electricity, in as they possess, while obeying the law of similars, a power and velocity of effect, that it may be permitted to

himself defined it as “a homoeopathy perfected into a safe and thorough medical science, enhanced by the discovery of new therapeutic means […] that work on the blood and empower the organism to rid itself of the pathogens that bring it into disarray.”220 Mattei’s healing system was based on empiricism. The efficacy of a remedy was the most important aspect, while pathogenic and pharmacological considerations were seen as secondary.221 Electrohomoeopathy was not restricted to the functional level of human life, but took into account the essence of life processes, existential drives and the spiritual influences to which all of nature is subjected. He was therefore also interested in the principle of the “vital force”.222 Mattei acknowledged Hahnemann’s similarity principle, while criticizing his doctrine because it used, as he said, only remedies that were not combined and only addressed the symptoms.223 Like the complex homoeopaths he thought that the use of single remedies was a mistake that held back the development of homoeopathy.224 Experience had taught him that one could only cure a disease that came out in various symptoms by using several substances in combination. He also saw the variety of symptoms about which one had to gain clarity when applying the homoeopathic method as the cause for great insecurity that made the diagnosis more difficult.225 Mattei agreed with Hahnemann that a single remedy was able to achieve a simple effect, but it addressed only one aspect. As it was always a complex of causes that was responsible for any disease, these could not be eliminated with one single remedy. If more tissue was affected this would only improve by regression or remain in its diseased state.226 Mattei objected to taking homoeopathic remedies in alternation because

220 221 222 223

224 225 226

compare them to electricity. Due to these new manifestations and, in general, due to the changes my remedies effected in the human organism to restore its health, I claimed that my discovery bestowed on Hahnemann’s medical method what had been missing.” Cf. Mattei (1884), p. 31. Mattei (1880), p. 67. Helmstädter (1990), p. 43. Helmstädter (1990), p. 45. “According to his system one only ever gives one remedy and in this essential point I do not agree with him.” Cf. Mattei (1884), p. VI. Cf. Mattei (1880), p. 28. Mattei (1884), p. VIII. Mattei (1880), p. 29. Mattei (1884), p. VIII.

29 Excursus: Spagyrics

it involved the risk that their effects might cancel each other out. They were also often given in too quick succession which could only lead to aggravation. Like Belotti, Mattei held that the organism itself was responsible for choosing from a number of substances those that it needed for its recovery.227 It would only use the one or the other substance from the combination remedy, all the others were of no use to it which meant that they had no medicinal effect whatsoever and could therefore effect neither improvement nor aggravation.228 In Mattei’s view, his preparations entered the blood stream where all the substances contained in the single remedy came into direct contact with the diseased organ while, at the same time, unfolding their medicinal influence. If another organ became affected before the first one was fully recovered, one had to use another remedy even though the first one was a combination, and administer the remedies in alternation. What Mattei objected to in “pure” homoeopathy was that it gave one remedy in case of dropsy and another one against convulsions. He thought this was wrong because convulsions could have various causes. If they were caused by worms, for instance, they could not be treated with a remedy that cured a disturbed blood circulation or vice versa. In the case of dropsy a single remedy was not sufficient. The remedy that cured abdominal dropsy could not cure that of the pericardium or the ovary. In each of these cases one had to apply the remedies that had a specific effect on the organ which had caused the disease. According to Mattei the specifics in his combinations harmonised well with one another which meant that there was neither antagonism between them nor assimilation. Mattei also had reservations regarding the classical homoeopaths’ drug provings on the healthy person; among other things he questioned whether one could be sure that a substance had the same effect on a sick person that it had on a healthy person. 227 Cf. p. 17 above, for instance. 228 “This law alone can explain the fact that a simple or combined remedy, however small the dose, if administered homoeopathically, is entirely without effect in a completely healthy organism. It is evident that such a law can no longer apply if the dosages are allopathic rather than homoeopathic, i.e. as soon as they can be weighed again.” Cf. Mattei (1884), p. XI.

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Graf Cesare Mattei (1809–1896), at the age of twenty

He was also sceptical about the symptoms listed in the homoeopathic tables because they had not been observed in one individual but in several. His experiments had shown that if the same remedy was absorbed by different organisms it did not necessarily produce the same effect.229 Mattei postulated that the drug provings should be performed on the sick person. He demanded, moreover, to prescribe a remedy in direct relation to the disease with the quantity of the remedy being reciprocal to the severity of the disease. A cure was nothing other than “the result of the reactions provoked in our organs by certain means which we call remedies and that the reactions are the weaker the less life force is contained in the organism and the more pathogens are present; thus one will without effort understand the reason why it is necessary to dilute the remedy when the complaint is severe.”230 Mattei added, however, that the more diluted a remedy was the more frequently it had to be taken.231 229 Mattei (1880), p. 31. 230 Mattei (1880), p. 34. 231 Mattei (1880), p. 71.

30 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

Mattei’s electro-homoeopathic preparations were meant to fight the cause of a disease and thus even prevent the appearance of symptoms. Just as the healthy organism needed various nutrients to remain balanced, the sick organism did not just take in one but several remedies. Electro-homoeopathy was based on the idea that one “nourished” sick organs by giving them medicines. In Mattei’s view this method of treatment did not need intermissions. He did not want to question Hahnemann’s reaction principle which suggests that the organism, once saturated with one medicine, completely – and often on the long-term – lost its ability to absorb other medicines successfully. The problem was that no conscientious physician, unless he was as brilliant as Hahnemann, was able to select a remedy and then wait, in cold blood, 20, 30 or 40 days for a reaction.232 Mattei did also not use wine spirit when preparing his remedies because he thought that an herbal remedy mixed with alcohol would cause side effects. According to Mattei’s theory any malaise had its origin either in the lymph or in the blood or in both. He saw lymph and blood as solidary forces in the functioning of the organism; disturbance of the one would sooner or later result in disturbance of the other. This caused the mixed diseases that one had to combat by alternating the two kinds of remedies.233 He called his remedies Antiscrofoloso for the lymph, Anticanceroso for the blood and Antiangiotico for diseases arising from both. He also produced a special remedy for complementary therapies.234 232 Mattei (1884), p. XVIII. 233 Mattei (1880), p. 68. 234 “Pettorali, as the name suggests, were against diseases of the airways, bronchial tubes and the lung. They were therefore used to treat cough, catarrh, pneumonia and tuberculosis. Febbrifughi were meant to cure any kind of fever as well as diseases of the liver and spleen. They were moreover recommended as specifics against periodically occurring prosopalgia, tics and neuralgia. Vermifughi addressed the intestinal mucosa in particular and worked against any kind of helminthiasis. The Anticancerosi maintained their effect against any scrofulous diseases, also in very severe cases such as indurations or cold nodules. Antivenereo was regarded as a remedy against the venereal diseases. Mattei categorized the individual remedies in subgroups and numbered them consecutively. Application was purely schematic which meant that treatment always began with the number 1 of the relevant series. If the first remedy failed the second was applied after a few days and so on. The special individualisation postulated by homoeopathy was not necessary in Mattei’s experience.” Cf. Sahler (2003), p. 60, and also Mattei (1880), pp. 68–74.

All in all, Mattei’s electro-homoeopathy comprised 30 remedies mostly for internal application as well as a series of remedies for external use. The names of the preparations did not reveal their composition but was merely a reference to their sphere of action. Mattei thought that his remedies did adhere to Hahnemann’s similarity principle because they produced the symptoms of the disease if given in strong dosage, but eliminated the cause if they were taken in appropriate dosage. Experience had not shown, he stated, that the symptoms were provoked in a completely healthy person; in this respect electrohomoeopathy was not able to confirm Hahnemann’s homoeopathy. Mattei did, however, assign an immaterial quality to his electro-homoeopathic medicines: “The electro-homoeopathic remedies, due to their electric nature, work on the living force in the human organism which is located in the nerve system and is electric by nature. […] In other words, the effect […] is not mechanical or chemical, but purely fluidal (dynamic).”235 According to the modern state of knowledge, Mattei’s remedies were complex preparations whose individual, non-toxic herbal ingredients were, as we mentioned before, subjected to spagyric fermentation.236 Theodor Krauss (1864–1924), who had met Mattei, described the process of cohobation.237 If his remedies failed Mattei put this down to a wrong diagnosis, the wrong choice of dosage or to the fact that “destruction” was so advanced that there was no “human” means to effect a cure.238 He was convinced that the effect of his remedies was always guaranteed if they were used at the right time and in the right way. He suggested moreover that the effect of ingested remedies could always be enhanced by external applications; inflammation of the liver, for instance, could be overcome sooner if internal treatment was supported by external poultices and embrocations in the liver and spleen area. Mattei emphasized that his experiences of 25 years justified his repeatedly stated claim that his healing system was superior to homoeopathy.

235 236 237 238

Quoted from Helmstädter (1990), p. 60. Mattei (1880), p. 70. Cf. p. 35 below. Mattei (1884), p. XXIII.

31 Excursus: Spagyrics

The classical homoeopaths, who had rejected complex homoeopathy already, certainly did not acknowledge electro-homoeopathy. Hahnemann had also militated against spagyrics.239 Bastanier said about electro-homoeopathy: “About electro-homoeopathy we can say in short that it is a complex mixing of homoeopathic remedies in high potencies. The endorsement ‘electro’ was added by the lay inventors to characterize the fast and mysterious effect; the name merely aims at the naivety of the uneducated masses.”240 Mattei’s healing system found as many followers as critics. The secrecy about the formulations did not hinder its promulgation but rather promoted it.241

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The Genevan pharmacist Albert Sauter (life dates unknown) assumed sole agency for Mattei’s products in 1876.242 He signed a contract which made him administrator of the Mattei depot and publisher of his textbooks. Due to internal conflicts this contract was dissolved two years later with the consequence that Sauter developed his own healing system in 1879 which he named Sauters homöopathische Sternmittel [Sauter’s homoeopathic star remedies].243 In 1891, he founded his own electro-homoeopathic institute that later became Laboratoires Sauter in Geneva. This company has had an independent agency in Germany since 1925.244 In contrast to Mattei, Sauter declared right from the beginning which plants were used in the production of his remedies. Sauter built his healing concept on the work of Finella, Belotti, Mattei and others.245 He argued that because one and the same disease presented differently in different people or the same disease, if it occurred in different patients, certainly did not ask for

the same remedy, and because it was very difficult in any case to find the right remedy directly at the first attempt or a change of remedy was usually necessary, a complex of remedies had to be used to combat a complex of symptoms.246 A remedy that provoked the exact desired symptoms was hardly ever found. For this reason the complex homoeopath added other substances to his remedy because he knew that the symptoms that presented themselves could be targeted with much greater certainty while an excess of effects was in no way harmful.247 The complex homoeopath, moreover, excluded the possibility of weak or subtle symptoms being overlooked. These hidden manifestations were more easily addressed by the complex remedy. He thought that, strictly speaking, the unity of a remedy was fictitious anyway.248 The remedy introduced by Hahnemann, Mercur. solub. Hahnemanni [Mercurius solubilis], was a chemical compound just as Hepar sulph. [Hepar sulphuris], and a number of other preparations of a complex nature.249 Apart from that, the complexes developed by him did not only target the symptoms but had, like Mattei’s healing system, an effect on blood and lymph. The absolute unity of a remedy could only be found in metals and these were also prescribed as chemical composites with salts and, even if that was not the case, had to go through chemical transformation processes in the stomach, apart from the fact that the lactose used in trituration constituted a complex as well due its salt content.250 Sauter also used spagyrics in the manufacture of his remedies. Fermentation was said to release a force, a dynamic agent, which was also referred to as vegetable electricity.251 His institute stated that the old process had been modified according to the most recent scientific findings. As a result Sauter ended up with fifteen main or basic remedies and various complementary medicines from which ca.

239 “Quite recently there still was the foolish habit of leaving crushed herbs to ferment in water and yeast until they developed a sour smell and to distil them in this rotten and decayed state into a distillate which behaved like weak vinegar mixed with a bit of alcohol; it honours the healthy human sense that these follies have gone out of fashion again.” Cf. Tischner (1939), pp. 286, 664. 240 Bastanier (1926), p. 580. Cf. Sahler (2003), p. 62. 241 Also Sahler (2003), p. 62. For Bastanier see on p. 14 above. 242 Sahler (2003), p. 63. 243 Helmstädter (1990), p. 80. 244 Sauters Laboratorien (1927), p. 5. 245 Helmstädter (1990), p. 81.

246 Sauters Laboratorien (1927), p. 9 and Sauter’s Homöopathisches Institut (no date), p. 29. Cf. also the complex homoeopaths on p. 14 above. 247 Sauters Laboratorien (1927), p. 10. 248 To this argument which was not only presented by the proponents of spagyrics but also the complex homoeopaths cf. p. 17 above. 249 Sauter’s Homöopathisches Institut (no date), p. 27. 250 Sauter’s Homöopathisches Institut (no date), p. 29. 251 Bertholon had published a volume on vegetable electricity as early as 1783. Cf. Sauter’s Homöopathisches Institut (no date), p. 30.

Sauter

32 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

38 medicaments, in the form of granules, were produced for oral use. Other application forms such as fluids, ointments, suppositories, were also available.252 The complexes were assumed to not only work on the symptoms, but also in “various directions”, in particular on blood and lymph, just like Mattei’s system.

Zimpel Among the most important representatives of spagyrics was Carl (Charles) Friedrich Zimpel (1801– 1878).253 He created his own healing system while adhering to Hahnemann’s simile principle. In his view, no healing system whatever its name was perfect, each had its own advantages and drawbacks.254 But although no medical system could be seen as complete, homoeopathy and allopathy together, he suggested, constituted a perfect whole. Zimpel had met homoeopathy in Vienna in 1838 through a Baron von Rothschild of whom nothing further is known. Zimpel became an ardent follower of Hahnemann’s doctrine through Arthur Lutze while working in his hospital for five months in the winter of 1848/49. Although he had never studied medicine the medical faculty in Jena granted him a doctorate with the proviso that he must never practise as a physician in Germany.255 He settled in Italy where the law allowed him to treat foreigners only. The development of his preparations took up all his time so that he hardly had any opportunity to gain experience in therapy. As a consequence he relied all his life mostly on the judgement of the homoeopath Michael Turmb (life dates unknown), a practitioner from the German town of Heiningen near Göppingen, who tested all of Zimpel’s remedies.

252 Sauters Laboratorien (1927), p. 10. 253 Zimpel was born in Sprottau/Lower Saxony. He had lost his parents to tuberculosis at an early age. He was at first an officer in the Prussian infantry and went on to work for various railway administrations in Germany and abroad. For Zimpel’s biography cf. Helmstädter (1990), pp. 83–89. 254 Zimpel (1870), pp. V, VII. 255 In his application he had argued that the medical doctorate would be useful to him on his oriental travels. He had obtained a philosophical doctorate for a dissertation on the American railways.

From 1863 Zimpel procured his homoeopathic remedies from Willmar Schwabe in Leipzig, who in turn sold Zimpel’s spagyric remedies. Zimpel wanted to enable Mattei also to have his remedies manufactured, or at least marketed, by Schwabe. Negotiations failed, however, apparently due to Mattei’s exorbitant demands. Allegedly a result of that, Zimpel decided to manufacture his own spagyric remedies.256 When Schwabe feared that their reputation might suffer because of the spagyric medicines, the Homöopathische Central-Apotheke in Göppingen under ownership of Friedrich Mauch (1837–1905), took on the sale of Zimpel’s preparations in 1873.257 Zimpel probably first met the Göppingen pharmacist in Naples. The latter was immediately enthusiastic about Zimpel’s healing system and bought manuscripts as well as original writings of him.258 Mauch had three sons, one of whom, Richard Mauch (1871–1936), took on the pharmacy and sold it on to a pharmacist by the name of Reich in 1907. In 1910, Carl Müller (1868?–1932), who had worked for the Central-Apotheke for many years, became its director. In 1921 he established the ChemischPharmazeutische Fabrik Müller-Göppingen using the stock of the Central-Apotheke.259 With his family 256 Helmstädter (1990), p. 98. 257 In 1835, Carl Friedrich Raith had sold his pharmacy to his sonin-law, Carl August Mauch (1814–1888) who, in 1862, sold it on to his nephew, Professor Dr Friedrich Mauch (1837–1905), who again sold it to his son Richard Mauch (1871-1936) in 1898. For more detail cf. Auge and Mundorff (1998), p. 77–80. 258 Helmsstädter questions, however, that Zimpel and Mauch ever met. Cf. Helmstädter (1990), p. 100. Zimpel had handed his intellectual estate to Mauch with the words: “For my contemporaries and posteriority my remedies are secured because I have revealed the names of the plants, minerals and chemical substances I used to Professor Dr Mauch in Göppingen. His company will continue to manufacture them according to my instructions and make them available to the public at a moderate cost; their prices in no way reflect my own financial sacrifices.” Cf. Müller (no date), p. 23. 259 Müller had studied sciences and pharmacy at Tübingen university. In 1892 he obtained the license to practice pharmacy, after which he worked in his profession in several places. After joining Mauch’s pharmacy he intensely studied alternative medicine. His wide lecturing activities and the fact that he founded the association as well as the journal for spagyrics, and his correspondence with homoeopathic physicians all bear witness to his deep interest in this medical approach. Later on Müller passed on his business to his two sons-in-law Pohl and Alfred. A second company, Staufen Pharma, was founded in 1956. Cf. Sahler (2003), p. 113 and Surya (1923), p 294–302. Auge and Mundorff (1998), p. 81.

33 Excursus: Spagyrics

Richard Mauch moved to Cologne where he founded the company Dr. Richard Mauch GmbH which later relocated to Bad Honnef. Among his clients and future friends was Emanuel Felke.260 Mauch did not only produce complex remedies for Felke, but also Clerc’s complex remedy system. Zimpel’s healing system aimed at cleansing the blood from the “corruption of all pathogens”. While classical humoralism tried to clean the body by the excretion of fluids, Zimpel intended to neutralize them with his spagyric remedies.261 Like Mattei, he did not only want to target the symptoms of a disease but also its causes. His healing system was also based on religious explanation patterns;262 he derived the theory of elements from God.263 He referred in particular to the theosophists Jacob Böhme (1575–1624) and Friedrich Christoph Oetinger (1702–1782) and was convinced that the stars greatly influenced life on earth.264 He saw it as the physician’s foremost duty to explore nature in all its relations so that he could learn to understand that all remedies whatever their substance were not based on matter “but on spiritual essence”. For years Zimpel had been an enthusiastic Hahnemann adherent.265 Later in his life he found, however, that the main difficulty with homoeopathy was the right choice of remedy. Referring to von Bönninghausen, who in the preface to his Therapeutisches Taschenbuch [Therapeutic Diary] had postulated to “only find the right remedy and, as long as the necessary natural powers are present, there 260 In order to establish contact with Felke, Richard Mauch had sent his son Walter, who worked in the paternal company, to Felke’s surgery. In 1989, the companies Truw and Mauch amalgamated. Cf. Sahler (2003), p. 117. 261 Helmstädter (1990), p. 114. 262 “Those who have the slightest knowledge of God and his Essence will readily admit that in all of creation nothing dead is thinkable, that, on the contrary, everything is alive and has to be alive as otherwise it would not be consonant with the essence of the Creator who himself is spirit.” Quoted from Zimpel (1858), p. 130. 263 “Fire, water, air and earth are thus for him the main channels through which the Creator works on all things in the world. By addressing the fire as the original power of God and the water as the Holy Spirit, he brings together his hermeticism and his religious beliefs. Both together were hence, as ‘fiery water’ or ‘watery fire’, the necessary substances for the creation of all things in this solar system.” Quoted from Helmstädter (1990), p. 111. 264 Zimpel (1870), pp. 1–4. 265 Müller (no date), p. 36.

1

will be healing”, Zimpel pointed out that the entire pharmacopoeia, including the Northern American and Brazilian schools, comprised c. 1000 remedies each of which, after thorough proving on the healthy person, included c. 1000 disease symptoms. A conscientious physician would therefore have to consider approximately one million symptoms; this could not be achieved in reality.266 On top of this vast amount of homoeopathic remedies there were the different views on potencies. While the majority of practising homoeopathic physicians concentrated on the disease symptoms and the remedies that covered them, Lutze267 had reduced the chronic diseases to their origin and, instead of seeing it as his main task to match disease pictures and drug pictures, he had endeavoured to match a remedy’s overall sphere of activity to the underlying cause of the disease. Müller, who sold Zimpel’s healing system, was of the opinion, with regard to the advances in research and complex homoeopathy, that it was wrong to hold on to dogmatic principles in the face of the new insights supplied by sciences such as biology.268 Just like his “colleagues” he pointed out that “simple remedy” was not “a relative term”, as according to the newest state of science the “simple bodies” were actually complex bodies that exerted a complex effect: “Those who know something about pharmacognosy and pharmacology will have to accept that many, I would even say the majority of, homoeopathic mother tinctures and essences are not simple substances but substances of a complex nature. Let us look at some of the better known tinctures such as aconite, belladonna, china, digitalis, opium etc. When we study the pharmaceutical and pharmacological literature we find that the alcoholic-watery essences = tinctures contain all kinds of simple and highly complicated substances of which your ordinary homoeopath often has no inkling.”269 Zimpel’s preparations such as his blood remedies, psora remedies, Arkanum, were made up of seven different substances, a fact which Müller considered to be justified because every disease was complex in nature; a disease did not manifest in one but several symptoms and consequently required not 266 267 268 269

Zimpel (1869), pp. 25–30. Zimpel does not refer to Belotti here. Müller (no date), p. 39. Müller (no date), p. 39.

34 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

one but several remedies that corresponded to the main symptoms of the disease.270 The simile rule was not bypassed or violated if one mixed the complex remedies in a reasonable manner. It should not be overlooked, so Müller, that Zimpel’s spagyrics were substances that were quite different from those in homoeopathic potencies or biochemical triturations. As the main secret of the preparation of spagyric remedies consisted in the fermentation, all substances of a remedy were combined to form a unity; the processes involved could by far exceed the effect of homoeopathic potencies.271 As other representatives of complex homoeopathy and the spagyric method had done, Müller also explained that the combination of preparations was not arbitrary, but that years of pharmaceutical studies were necessary to know which substances would complement each other or which were diametrical in their effect and might cancel each other out. Whether single or complex remedies were used was, however, not the main issue as long as Hahnemann’s main principle was adhered to, which was the simile rule. It took years of research before Zimpel presented his system which was divided into three categories: 1. seven internal spagyric (electro-spagyric) herbal remedies; 2. seven electric remedies for external use, and 3. 16 special remedies. In contrast to Mattei, Zimpel did not keep his formulations secret.272 Most of his ingredients were herbs. They were partly medicinal plants which are still in use today, but Zimpel also used poisonous plants. Fresh plants that grow in the wild were gathered at the time of blossoming, with their roots. Originally he used only plants that were found in their natural habitat because he said that they contained more healing powers and substances than those that were cultivated.273 Before the plants began to wilt, soil and mouldy leaves were removed and the plants were washed, cut and crushed. Special yeasts were then added to induce an alcoholic fermentation process whose length differed depending on the plant. This process served to release the healing power and 270 271 272 273

Müller (no date), p. 15. Müller (no date), p. 16. Müller (no date), p. 51. Ersfeld and Hahn (1991), p. 517.

volatile essences and free many active agents from their chemical bonds. The fermented mass was then distilled. The residue left behind in the distillation kettle had to be dried and reduced to ashes.274 After that, the ashes were eluted with the distillate, which means that the minerals and trace elements that had been lost were added again to the distillate which represented the spiritual, “etheric” part.275 In the end the solution was filtered; an extended storage period would allow the essences to gradually mature. Müller thought that “if one compares, without prejudice, this utterly careful, though time-consuming and thus expensive, hermetic-spagyric method of preparation to the way homoeopathic and allopathic essences are prepared, the spagyric method will doubtlessly triumph over the simple, empirical way of production of the latter because it aims at a separation of poison and balm and at a pure, ennobled representation of the spiritual principle of a herbal, animal or mineral substance.”276

Krauss Electro-homoeopathy owed its dissemination in Germany also to Theodor Krauss (1884–1924), who was born in Bohemia and whose grandfather had been a pupil of Hahnemann’s. To start with, Krauss practised under the guidance of his grandfather, but after the latter’s death he deepened his knowledge by working with the physician Franz Pesendorfer (life dates unknown) in Gmunden/Austria, who was considered an authority in the field of homoeopathy. As part of his research Krauss had also intensely studied Mattei’s electro-homoeopathy and had kept contact with him. He promoted electro-homoeopathy through lectures and publications, founded associations and trained electro-homoeopathic physicians and lay healers. Around 1909, the Ecole supérieure libre bestowed on him the honorary title of “professor for the chair of occult and hermetic medicine”.277 Theodor Krauss also advocated homoeopathic double remedies.278 In contrast to the double remedies of the allopaths, which were little proven, coarse mate274 275 276 277 278

Müller (no date), p. 12. Ersfeld and Hahn (1991), p. 517. Müller (no date), p. 13. www.iso-arzneimittel.de; Sahler (2003), p. 104. Krauss (1921), pp. 43–47.

35 Excursus: Spagyrics

rial remedies that due to their arbitrary combination produced other chemical composites, he saw in the homoeopathic double remedies that were manufactured in accordance with the similarity principle medicinal powers set free from their material fetters. Their high potentisation meant that they were no longer subject to chemical, but to physical laws. Their effect was purely one of radiation. This meant, in his view, that there was no risk that homoeopathic remedies in high dilution would exclude each other; they would rather complement each other harmoniously. Also, the effect of each of the combined healing powers was known: “The powers of homoeopathically chosen and homoeopathically diluted (dynamised) remedies do not change in the mixing, but they go harmoniously together (parallel).”279 Theodor Krauss compared the effect of homoeopathic medicines to light and sun: “The light is not the sun itself but it is the bearer of those powers and properties which have their origin in the sun and which continue from it into the ether as its oscillations (emanation).” He deplored that homoeopathy had become stuck in the conflicts on double remedies and had not further evolved. While the “old” homoeopathy with its single remedy was merely able to work on one particular organ and its functions, Mattei had produced mixtures that could target organs and organ groups. The “new” homoeopathy was capable of targeting a whole group of interacting organs and tissues and of producing a more comprehensive and thus more thorough as well as faster effect. Krauss rejected the use of mineral substances because they could not be digested and assimilated. The plant, in contrast, was part of the evolutionary hierarchy; it was the link, the mediator, between the lower level of the minerals and the higher level of the animal. Like Mattei, Krauss rejected the preparation of plant essences with wine spirit. Spirit of wine was not a neutral substance, but exerted a very strong influence due to its extremely high alcohol content; this meant that remedies prepared with alcohol could never have a pure effect, but only an effect that was 279 “By establishing the doctrine of the homoeopathic double remedies and their practical application an important step had been taken towards developing this healing method. It was the dawn of the great reform of homoeopathy which was crowned by the discovery of Count Mattei”. Krauss (1921), p. 47.

1

Theodor Krauss (1884–1924)

influenced by the alcohol.280 Krauss, like other supporters of spagyrics, saw as the weak point of the “old” homoeopathy its preparation and dilution procedures. He favoured cohobation, a cold distillation process with fermentation that retained the living, radio-active powers of the plants by accumulating or suspending them in the obtained essence. He recommended to gather the shoots, seeds, branches, leaves, blossoms, fruit, bark, bulbs or roots of the plants one needed in the spring or autumn, when the juices of the plant organism were active, extract their juices by making incisions and soak them in distilled water (maceration) at 35 °C. After that, one had to keep macerating fresh plant material, not in water, but in that solution. The solution gained more and more medicinal substance in the process until full saturation was achieved. The tincture should then be poured into big glass containers, called recipients, where it remained until it was completely clear; as a result of the fermenting process the impure substances would settle on the ground of the recipient as sludge, while the pure, clear essence contained all the medicinal properties of the plant in a refined, “virtually spiri280 Krauss (1921), pp. 51–60.

36 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

tualised” form, but without the ballast of the plant body and only bound to a small amount of water. In contrast to allopathic medicines which worked through their substance and produced a more or less chemical effect, the electro-homoeopathic remedies had an energetic, in other words physical, power. Because disease was never local, but always an overall disturbance, the remedy did not affect just one organ or tissue in the body, but worked on the entire organism.

Sonntag JSO complex healing is a medicinal method which is also based on Hahnemann’s simile principle, but does not use substances of organic chemical, mineral or animal origin.281 The names of Theodor Krauss and Johann Sonntag are closely linked to the JSO healing method. On 1 November 1891 the Engel Apotheke in Regensburg passed into the ownership of pharmacist Johannes Sonntag (1863–1945), who managed it until his death.282 In the drawers of a desk or cupboard he found a homoeopathic “compartment” which formed the foundation of what would later become the JSO Works. According to the principle that “a science that is not developed further is doomed”, Johann Sonntag studied the electro-homoeopathy of Count Cesare Mattei. In 1879, a “Consortium for electro-homoeopathy” had been established in in Regensburg under Baroness Ernestine von Aufsess, with the aim of disseminating Mattei’s writings and to make it easier for its members to get hold of Mattei’s remedies.283 In July 1883, the “Consortium for 281 The strict use of herbal substances only was explained as follows: “In nature’s order the plant is the mediator between the world of the inorganic and that of the organic. It has the capacity to absorb the soil’s mineral substances with its roots that extend into the ground and to process them within its organism into building blocks for the living protoplasm. Thus all green plant leaves are rich in potassium and magnesium, with sodium, calcium and iron always present. Silica is mostly used in the supporting tissues, while nitrogen-phosphor and sulphur compounds are mostly found in seeds and fruit which are rich in protein. All these substances are taken from the soil in which they are contained as minerals.” Cf. Wüst (1939), p. 68. The JSO healing method is also known as the ISO healing method. 282 Sonntag (1939), p. 1–7. www.iso-arzneimittel.de 283 In 1879 a court ruling forbade the Consortium the sale of electro-homoeopathic remedies. Cf. Jütte (1966), p. 233. Stolberg (1999), p. 71. For details on the Regensburg “Consortium” cf. also Helmstädter (1990), p. 35.

Electro-homoeopathy” apparently had 7000 members.284 In 1886, an electro-homoeopathic clinic even opened in Regensburg albeit without a license. It seems that the Engel pharmacy took on the sale of Mattei’s remedies in 1883 while the “Consortium” for the time being remained in charge of publications and consultations.285 Towards the end of World War I and after the war, Johann Sonntag, now owner of the Engel pharmacy, remained in close contact with Theodor Krauss who, as permanent scientific assistant and, from 1 October 1890 director of the Consortium, also lived in Regensburg.286 Together with the physician Johannes Dingfelder senior they developed the JSO complex healing method. In 1923, manufacture and distribution were separated from the Engel pharmacy and the JSO Works (the name is an acronym of the initials Johannes Sonntag) were formally registered.287 Until this day Hahnemann’s similarity principle and herbalism have remained the main pillars of the JSO complex healing method. Because of the complexity of the disease pictures the founders of this method rejected single remedy therapies arguing that their failure rate was too high in complicated cases. Instead they considered it appropriate, especially as Hahnemann had agreed to the alternation of different remedies, to create complex systems. They could not find a convincing argument against the simultaneous administration of different remedies: “It is certainly most essential that in the case of a disease not several remedies are given, be it in alternation or in combination, that might compromise or eliminate each other’s effect, but that the combination is established in such a way that remedies with similar effect, which support and complement each other, are mixed together and advance with closed ranks against the common enemy.”288

284 www.iso-arzneimittel.de. 285 The publishing library Johann Sonntag was only founded on 4th October 1921. www.iso-arzneimittel.de 286 www.iso-arzneimittel.de. 287 The factory was a family business. The registered founders are Johannes Sonntag, Elisabeth Sonntag, Fritz Sonntag, Wilhelm Sonntag, Theodor Engel, Georg Neumann and Hans Retter. Cf. Sonntag (1939), p. 2. 288 Wüst (1939), p. 70.

37 Excursus: Spagyrics

Another argument for the introduction of drug mixtures was often used by complex homoeopaths: remedies even if they were made from one single plant were very complex as they contained a variety of chemical compounds.289 It was therefore the task of physicians or pharmacologists to discover remedies that were related and complemented or supported each other and to mix them so that no mutual elimination of active agents could occur. Experience had shown that quite comprehensive complexes of twenty or more plants could exert a tremendous effect, as if the diseased organism had the capacity to choose from the plethora of remedies on offer the ones that it needed most in the given situation. The JSO healing method owed its success above all to its complexes. Similar to other representatives of complex homoeopathy and spagyrics, the proponents of the JSO method were convinced that the organism possessed recognition and differentiation capacities which helped it select and make use of the medicines offered to it. The obvious prerequisite was that the medicines had to be prepared and combined in appropriate ways. Another argument in favour of complex remedies was that human beings, animals and plants consisted only of complexes.290 With the JSO complexes the organism did not have to ward off an excess of unsuitably presented medicinal substances or try to cope with them without suffering too much damage as was the case with allopathic drugs; instead it could absorb the remedy’s supporting power and use it in an appropriate way for its recovery.291 Only plants were used in which the effects complemented and supported each other i.e. addressed the same disease process from different sides. Apart from supplying special healing agents the complexes provided the organism with remedies that strengthened, soothed and enlivened it and made up for functions and substances that were lacking. The argument for the varying dosages of individual minerals was that certain plants preferred special kinds of soil and were therefore particularly rich in the salts and other chemical compounds that prevailed there. The JSO complexes were prepared according to Thomas Krauss’ spagyric manufacturing process. 289 Aegidi had used the same argument in his time. 290 Lux (no date), p. 14. 291 Wüst (1939), p. 71.

1

Johannes Sonntag (1863–1945)

As was pointed out earlier, this healing method was based on the concept that not the symptoms but the cause of a disease was to be found and removed. This meant that the selection of remedies depended on the character of the disturbance.292 Different dilution grades were on offer. Depending on the strength of dosage they could produce a certain reaction (initial aggravation). If the right dosage was chosen these often unpleasant reactions that were confusing for the patient, did not occur at all or only very subtly. If there was a reaction this was not be seen as a negative sign as it was proof that the remedy had started to work on the focus of the disease. The basic rule was: strong doses (i.e. low potencies) stimulate while weak doses (i.e. high potencies) constrain. Chronic diseases, i.e. very long-term complaints, required weak dosages. Young children and old people could tolerate stronger dosages. Patients, who were not bedridden, were best given dry granules in D4–D6. If tablets were given instead, the potency should be three steps higher to guarantee the same remedy 292 Lux (1941), p. 7.

38 Chapter 1 · The Development of Complex Homoeopathy from the 19th Century to the End of the Weimar Republic

proportion. The effect of ingested remedies could be further enhanced by the external use of ointments, poultices, rinsing, gargling, bathing or massaging.

The examples described so far show that, in the field of homoeopathy, there were different approaches and theories concerning the effect of homoeopathic remedy combinations. The following chapter will illustrate how homoeopathy was brought together with other medical approaches.

2 The Connection Between Homoeopathy and Naturopathy

Naturopathy Next to homoeopathy, naturopathy established itself at the beginning of the 19th century and has, just like Hahnemann’s doctrine, remained a popular alternative approach to healing right up to the present time.293 It developed out of the old hydrotherapy.294 In contrast to the modern notion of natural medicine which is more comprehensive, the 19th century saw it merely as a regime for the prevention and cure of diseases that was based on the healing influence of water, light and air as well

293 Alternative healing methods are those that “within a particular medical culture which itself is subjected to a historical transformation process, are more or less strongly rejected at a certain point in time or over a longer period of time by the predominant medical orientation because they question parts or all of the therapy forms of the predominant medical orientation or because their aim is to achieve the immediate and fundamental change of the medical system. In this context ‘alternative’ also signifies that these therapies are carried by social movements or certain social groupings. The healer who propagates his own healing method with little success and hardly finds, negative or positive, public resonance beyond his limited circle of patients or sphere of action is in this sense not, or only to a limited extent, alternative.” Quoted from Jütte (1996), p. 13. For the the conceptual history and definition of alternative medicine cf. now also Eckart and Jütte (2007), pp. 296–298. 294 Jütte (1996), p. 29.

as exercise and nutrition.295 Like the homoeopaths, the naturopaths were critical of orthodox medicine.296 The first period of naturopathy stretched from the beginning to the end of the 19th century; it is known as Classical or Traditional Naturopathy and differs from scientific medicine and homoeopathy as well as from humoral pathology in that it rejects drug therapy.297 Traditional naturopathy regarded any drug as a poison which was foreign to the body and as such in the way of a natural recovery or harmful. If a patient took a drug and recovered, he recovered in spite of it rather than because of it.298 Whether they were chemical drugs, medicinal herbs or homoeopathic remedies was irrelevant.299 The only

295 The definition of natural medicine has undergone a change over the last decades. Today it includes almost all medical approaches that are not part of orthodox medicine. Regin (1995), p. 27. 296 For the concept of orthodox medicine in delimitation to healing approaches and methods that are not part of academic medicine cf. Eckart and Jütte (2007), p. 338. 297 Today, homoeopathy is often also referred to as naturopathy. Regin (1995), p. 29. 298 Regin (1995), p. 107. 299 For herbal medicine cf. Jütte (2001), p. 390. According to Heyll herbal medicine did not play a part in naturopathy until 1933. Heyll (2006), p. 253.

B. Blessing, Pathways of Homoeopathic Medicine, DOI 10.1007/978-3-642-14971-9_2, © Springer Medizin Verlag Heidelberg 2011

40 Chapter 2 · The Connection Between Homoeopathy and Naturopathy

exceptions granted were analgesics for incurably ill patients and narcotic drugs in cases where surgery was unavoidable.300 Classical naturopathy postulated the radical return to a natural lifestyle.301 Even though the former natural state was not clearly defined, the movement’s followers eulogised a paradisiacal original state where the needs of men and women were fully in tune with the environmental conditions.302 Nature man acted in accordance with his infallible instinct. While naturopathy strove to restore nature’s order, the life reformers wanted to develop the social life because they considered the process of civilisation to be in need of correction.303 The life reform movement had adopted a number of classical naturopathic ideals such as healthy eating, physical exercise and teetotalism, but had added concepts of its own that included social and political issues.304 Towards the end of the 19th century naturopathy gradually began to change when it was discovered by a number of academically trained physicians.305 Because many followers of the naturopathic movement remained devoted to the classical ideals, conflicts were inevitable. The academic physicians did not want to be put on a par with lay practitioners. They also objected to the idea that a diagnosis was not necessary and criticized the rejection of drugs. The university-trained naturopaths dissociated themselves from the uncompromising traditional naturopathy 300 Regin (1995), pp. 106–112. 301 Naturopathy identified with the ideas of Jean-Jacques Rousseau (1712–1778) far beyond the 19th century. In the increasing scientific knowledge it did not see an improvement of life conditions, but rather the decay of manners and morality. For Rousseau’s naturism and how it was received in medicine cf. Rothschuh (1983), pp. 12–18. 302 Heyll (2006), p. 44. For the concept of natural healing cf. Wolff (1989), pp. 221–236 and for the relationship of nature, technology and modern times in general cf. Rohrkrämer (1999). 303 Heyll (2006), p. 201. On the life reform movement in general cf. Krabbe (2001), pp. 25–29. The term “life reform” which was coined in the mid-90s referred to “the programme and the name of a movement, which strives for the fundamental renewal of the entire lifestyle including nutrition in order to counteract the growing health deterioration of modern humanity through civilisational damage.” Quoted from Regin (1995), p. 43. For general information on the life reform movement cf. also Fritzen (2006). 304 Such as the settlement and garden city movements. 305 In 1894, 31 physicians were employed by nature associations, in 1902/03 their number had risen to 142. Cf. Heyll (2006), pp. 174, 176, 192.

and called for a reform of the old principles. They were certainly keen on entering into constructive dialogue with the medical establishment. Most of these physicians envisaged a naturopathy that was based on the principles of scientific medicine while arriving at its own conclusions.306

Pathological Concepts Classical naturopathy was inspired by humoral pathology,307 but its concept was based on the idea that the body takes in substances from the outside and uses them before excreting them in a modified form. Metabolism, according to this theory, served the constant restoration of the body which it compared to a machine that was continuously maintaining and renewing itself.308 The Dresden naturopath Friedrich Eduard Bilz (1842–1922) was of the opinion that the body’s “building blocks” completely renewed themselves within ten years. Metabolism was steered and controlled by the “vital force”.309 Unlike scientific medicine, neither traditional naturopathy nor classical homoeopathy knew clearly defined organ diseases.310 The human body was seen as an indivisible unity.311 Naturopathic healers thought that any disease could be reduced to foreign substances, which they often also called toxins.312 These substances that harmed the body were taken in with foods or in306 Heyll (2006), p. 192. 307 At the turn of the 19th century when homoeopathy and naturopathy were still in their infancy, the ideas of illness were still firmly rooted in the humoral pathology of antiquity which in its essence goes back to Hippocrates’ teachings of the humors. Cf. for example Seidler and Leven ( 2003), p. 45. 308 Heyll (2006), p. 59. 309 The vital force also played an important part in homoeopathy. In the first edition of the Organon Hahnemann spoke of a “change of the inner essence” while, in the fifth edition, he referred to the “disturbance of the vital force”. Cf. Schmidt (2001), p. 41. 310 Regin (1995), p. 27. 311 Homoeopathy also regards body, spirit and soul as a unity. It sees disease as essentially indefinable; disease is a disturbance that affects the entire person and manifests in symptoms such as coughing, rash, fever, pain etc. It is not the disease that is at the centre of the homoeopathic method, but the individual patient with his feeling of ill-health. Therefore all symptoms are seen as the expression of an individual disease. Only a few acute conditions constitute an exception. N.N. (1996), p. 151. Karrasch (1998), pp. 173–192. 312 Heyll (2006), pp. 59–63.

41 Emanuel Felke and his Therapeutic Concept: Homoeopathy and Naturopathy

haled with the air. Once inside the body they would weaken the vital force and disrupt metabolic processes before being deposited as waste that would eventually begin to hinder the blood flow. In the view of the naturopaths all disease was poisoning. Diseases were neither classified nor were they diagnosed and treatment was always directed at the organism as a whole.313 As soon as the toxin had entered the organism the body would react by trying to eliminate the disturbance.314 The patient did not suffer from the disease but from the effects of the body trying to fight it off. Under normal circumstances, the natural healing force, a particular manifestation of the vital force, would soon eliminate the toxins. With regard to chronic disease Johann Heinrich Rausse (18051848) differentiated three stages: stage one was “the time in which the organism undertook frequent and easily recurring efforts to heal itself.”315 In this case, the vital force was strong enough to eliminate the toxins through frequent acute illness. At the stage of “apparently tolerable health” the “organism no longer had the power to heal itself, but was still strong enough to maintain […] the status quo.” The patients thought of themselves as healthy. This was followed by the “stage of destruction”. There were now so many toxins that the immune system would break down. Decades might pass between the first signs of illness and the destruction stage. How severe a disease was and which symptoms prevailed depended on the lifestyle of the individual patient. As each sick person had different failings, the disease picture varied from case to case. Applying natural vital stimulants such as light, air, water, exercise and diets was enough to make the patient better.

Emanuel Felke and his Therapeutic Concept: Homoeopathy and Naturopathy The German Protestant pastor Emanuel Felke (1856–1926) broke new ground at the end of the 19th century by bringing together homoeopathy and

313 Heyll (2006), p. 61. 314 Heyll (2006), p. 61. 315 Quoted from Heyll (2006), p. 63 (Rausse (1859) vol. 3, pp. 7–9).

2

naturopathy.316 From a very early age he had witnessed severe illness in his family. As his father had generally treated him and his siblings successfully with homoeopathic remedies Felke had always been enthusiastic about Hahnemann’s methods. Throughout his life Felke remained devoted to his “beloved and good homoeopathy” which he called the backbone of his healing system.317 “It was homoeopathy that won me over with its simplicity and uniformity of therapy. It is the backbone of my entire method; everything else has been gradually annexed to it. Its Materia Medica has given me completely new insights into the diagnosis and treatment of diseases and they were then consolidated with the help of Helvetius, Gall, Lavater, Baumgaertner, Kuehne, Peczely, Lijequist, “Donner and others into the diagnostic and therapeutic methods that I use now. In my practice the noble prelate Kneipp holds the uppermost place and around him are gathered Priessnitz, Schrodt, Rausse, Ricli, Kuhne and others. I owe especially much to the fine and inspired A. Just […].” 318 All through his life Felke advocated the combination of naturopathic medicine and homoeopathy. For him, homoeopathy was the bridge between the older and the newer naturopathy.319 He was critical of the proponents of classical naturopathy who in remaining faithful to their principles developed the 316 Erdmann Leopold Stephanus Emanuel Felke was born the son of the seminar leader Friedrich Felke in Klaeden near Stendal (Northeast Germany). After finishing school he studied protestant theology in Berlin. During that time he deepened his interest in medicine and attended medical lectures while pursuing private studies in homoeopathy. In 1886 he became pastor in Cronenberg (near Wuppertal) where he stayed for seven years. Because of the knowledge he had acquired he could treat the sick in his congregation homoeopathically. During a diphtheria epidemic he achieved very good results with his homoeopathic remedies. In 1894 he accepted the rectorate in Repelen near Moers (Lower Rhine). Next to fulfilling his duties as a clergyman he continued to treat the sick and he founded a “Jungborn” (fountain of youth) in Repelen based on Adolf Just’s (1859–1936) model. In 1912 Felke resigned as pastor and established another fountain of youth in Sobernheim, followed by a further health spa in Dietz on the river Lahn. Felke died in 1926 from cancer of the colon and was buried in Sobernheim. For Felke’s biography cf. N.N. (no date), p. 6 and Kramer (1986), pp. 15–33. 317 Felke said this in a speech he gave in Cologne (1905). Reproduced in: Kramer (1986), pp. 56, 68. 318 Quoted from Felke (1899). Reproduced in: Kramer (1986), p. 50. 319 Felke, in his speech given in Cologne (1905). Reproduced in: Kramer (1986), p. 57.

42 Chapter 2 · The Connection Between Homoeopathy and Naturopathy

Emanuel Felke (1856–1926)

most extraordinary peculiarities. He argued that the “cultured man” of his time was no longer able to return to nature to a degree that would allow him to lead a wholly natural life. Leading a “sensible life” was at the centre of Felke’s concept. He distanced himself both from the “original nature man” and the modern “cultured man” and declared their synthesis to be the “golden mean”.320 While Felke – as mentioned above – admitted to being a “thoroughbred Hahnemannian” where acute disease was concerned; naturopathy and complex homoeopathy for him came into their own in chronic disease.321 In his view, as few drugs as possible should be used, but he found homoeopathic remedies necessary because “cultured man” was not able to fully return to nature and do without any medication. Based on Felke’s work a mass movement developed around the turn of the 19th century that was very critical of medicine.322 Like the Catholic pastor 320 Felke, in his speech given in Cologne (1905). Reproduced in: Kramer (1986), p. 57. 321 Quoted from Felke (1899). Reproduced in: Kramer (1986), p. 52. For the complex remedies see p. 14 above. 322 N.N. (no date), p. 6.

Kneipp (1821–1896), who did not reject orthodox medicine in principle, Felke was also sharply criticized by the naturopaths for supporting homoeopathy. They observed with unease how the number of Felke’s followers grew: there were 21 Felke societies before World War I, all in the German Rhine-Ruhr area. By the mid-1930s the association counted more than 4,000 members.323 There had always been attempts at denying the Felke societies the right to call themselves “association for natural living and healing”.324 Numerous voices warned against the creeping in of remedial doctrines into natural healing.325 One of them was Dr Chr. Diehl who, in the journal Naturarzt, called the synthesis of homoeopathy and naturopathy a “jumble” and spoke rather cynically of Felke and his healing approach:326 “What in Felke’s method is his own spiritual property? Nothing at all. He puts homoeopathy and natural healing into one pot. There is nothing original about his eye diagnosis either, he copied it from Lilljequist. What is left is the commercial aspect which is decidedly original. Natural healing methods, Kneipp’s clay, Lilljequist’s eye diagnosis, Just’s fountain of youth and on top of that a few dozen homoeopathic remedies, the newest nutrient salts, the famous ‘Kuester ointment’ in which we find a small remnant of allopathy as well. My dearest, what more can you ask?”327 It is not astonishing that the naturopaths also criticized homoeopathic complex remedies because this modification of homoeopathy supplied them with the necessary ammunition to accuse the homoeopaths of going against Hahnemann’s pure doctrine. Thus Diehl reproached Felke for prescribing complex remedies consisting of up to five or six, even up to 12 different homoeopathic substances. But it was this “mishmash”, of which his opponents were so critical, that turned out to be the secret of Felke’s success. He wanted to avoid one-sidedness and did not like to be seen as blindly advocating one

323 Jütte (1996), p. 142. Karrasch (1998), pp. 177–192. 324 Stader (1930), p. 8. Heinrich Stader was the first editor of the Felke Journal which was published for the first time in 1906 and ceased to be published in 1941 due to the war. The first “Liederbuch für Felke-Vereine” (song book for Felke societies) was also published by Stader. Cf. Jütte (1996), p. 142. 325 Lahmann (1896), p. 106. 326 Diehl (1905), p. 78. 327 Diehl (1905), p. 78.

43 Emanuel Felke and his Therapeutic Concept: Homoeopathy and Naturopathy

particular approach. At the centre of Felke’s therapy concept stood the whole person whose active contribution was essential to the healing process.328 Even though Felke was not the “creator” of a method, he was celebrated as “a brilliant conductor who gets the various instruments to sound harmoniously together”.329 Felke himself never claimed to have developed his own method; in 1899 he wrote to his friend Max Vits (life dates not known): “If you now ask whether I have not thought out and invented anything of my own I say ‘no’ and ‘no’ again! In short: I admire Hahnemann, Kneipp, Just, I want to be called their pupil and do not lay claim to fame for myself in this field. Magnetism and electricity I use as long as I fully understand them, but there I am still in leading- strings and in need of good tuition.”330 Felke also warned his friend against people who vaunted that they could heal anybody and pointed out that “the blessing comes from above”.331 For the religious Felke healing was not possible without God’s help. In his practice rooms a Bible verse was displayed (Jeremiah 30:17) to remind his patients that it was God who helped them. He himself was merely God’s instrument.332 Felke saw spirit and soul as one and he wanted to be a “physician for body and soul” in equal measure.333 Due to his knowledge of the natural sciences and his theological-philosophical studies a keen interest arose in him to learn to understand the unfathomable interaction of body and soul.

Felke’s Pathological Concept Felke’s pathological concept was founded on classical naturopathy which means that he was convinced that almost all diseases were caused by foreign substances that did not belong to the body.334 The stronger the 328 Schlau (1963), pp. 14–27. Felke envisaged “that the human being should advance to the point that, at least from the age of forty, he could be his own physician and healer.” Kramer (1986), p. 9. 329 Brauchle Alfred, Naturheilkunde in Lebensbildern, Leipzig 1937. Quoted from Kramer (1986), p. 175. 330 Reproduced in: Kramer (1986), p. 52. 331 Kramer (1986), p. 48. 332 Jeremiah 30; 17: “For I will restore health unto thee and I will heal thee of thy wounds, saith the Lord.” 333 N.N. (no date), p. 19. 334 For details of Felke’s pathology cf. Müller (1912), pp. 1–13 and Stader (1930), pp. 9–12.

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vital force the more energy was available to rid the body of the unhealthy fluids.335 The disease was a unity, however diversely it presented itself, because it was caused by bad fluids, the foreign substances in the blood.336 They could have arrived in the body in various ways, through inheritance, lack of hygiene or with the intake of foods.337 Felke also called all “poisonous drugs” dangerous foreign substances and concluded that thousands of people a year were made ill for the rest of their lives by poisons such as morphine, quinine, salicyl, sulphonal, antipyrine, bromine, iodine, arsenic, santonine, opium etc. Felke thought that the toxins were mostly concentrated in the lower body from where, after a fermenting process stimulated by the body heat, they were spread to and deposited in various parts of the organism. They would appear primarily along the outer body walls and only affect the inner organs such as heart and liver at a later stage. Felke claimed that he could clearly perceive the progress of these substances: patients who were particularly gaunt were of a dried up appearance while obese people looked bloated.338 The retention of urine and faeces was also dangerous for the patient because it would render the foreign matter in the body particularly poisonous. Like many naturopaths Felke argued that disease was simply the expression of the body’s immune system in which the natural healing force had become active.339 The individual organs acted as valves through which the engine, i.e. the body, disposed of all superfluous matter. The body suffered when strong toxins such as drugs suppressed its defence mechanism or caused further strain. Felke thought that the failure of one organ would affect others as well. The mistreatment of one organ would upset the whole organism just as caring for the whole organism by taking walks and baths etc. would benefit each part of the body. Toxins, especially malignant ones, were not immediately deposited as solids or fluids but appeared first only as vapours. Flatulence, dizziness and “bloatedness” he considered to be indicators of 335 Bier (1925), p. 4. 336 Rheinfeld (1924), p. 2. 337 Strongly spiced dishes and swallowed pieces of meat were said to deprive the body of substances needed to build up muscle, bones and blood. 338 Cf. the science of facial expressions and p. 77. 339 Müller (1912), p. 10.

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deposited toxins. If the body was not encouraged to rid itself of these vapours, they would be compressed into fluids and enter the body’s tissues and cavities. Depending on the composition of the fluids and the prevailing chemical and psychological influences either crystallisation or the development of a solid lump such as a tumour would ensue. Because the foreign substances were not only present in the body due to the wrong kind of intake, but also due to the wrong kind of excretion, Felke, along with numerous other naturopaths, emphasized the importance of skin care as, in their view, the skin acted as a “poison exhalation organ” which meant that toxic waste could be eliminated via the skin. How harmful the excreted substances were could be shown with a simple experiment, said Felke: if one injected the sweat of a healthy person into the bloodstream of an animal it would die a faster or slower death depending on the toxicity of the sweat sample. For, if the skin, for whatever reason, was unable to excrete the toxins, they would first affect lung, liver, kidneys and intestines.340 The skin care recommended by Felke as ideal, were baths in light, air and sun. Because the under- and outerwear popular at the time prevented the proper exhalation of the body Felke also postulated appropriate clothing. He favoured the garments advertised by Dr Heinrich Lahmann (1860–1905) who had, after extensive investigation, come to the conclusion that clothes made from cotton were the most breathable.341 His designs were cut in a way that did not “change the body’s natural shape in an unhealthy manner”.342 Felke was not content with analyzing symptoms, he also used iris diagnosis to establish the causes of a disease.343 Iridology had been invented by the Hungarian physician Dr Ignaz von Péczely (born c. 1822/26) and met with severe opposition already in 340 This, at least, was the argument supplied by Müller (1912), p. 54. 341 Lahmann also supported the view that obstructed skin activity hindered cutaneous excretion and could thus lead to conditions such as rheumatism, pneumonia etc. Müller (1912), p. 55. 342 For Lahmann’s reform clothing cf. Heyll (2006), pp. 96–98. Lahmann also made a name for himself with his “vegetable plant milk” as a substitute for breast milk. The “nutrient salt preparations” he sold as nutritional supplements were also very popular. 343 Stader (1930), p. 72, Schlegel (1921). For eye diagnosis cf. p. 19 above.

Felke’s lifetime.344 Its supporters propose that signs and marks on the iris can be indicative of certain diseases.345 The iridologist divides the iris into small segments each of which is said to correspond to a particular part of the body or organ. This way of diagnosing is based on the assumption that all body parts and organs have a direct connection to the iris with the right eye representing the right side of the body and the left eye the left side. Felke thought he could prove that one could see in the eye whether stomach, liver or spleen were affected by disease. The advantage of this way of diagnosing was, as he said, that it was very fast which made it superior to any diagnostic procedures in orthodox medicine.346In order to find an objective diagnosis Felke also applied the study of facial expressions which, in actual fact, does not only examine features of the face but of the whole body.347 The method is based on the supposition that foreign substances which have entered the body will cause physiognomic changes from which conclusions regarding functional disorders can be drawn.348 The diagnosis was made known by Louis Kuhne (1835–1901) who had founded his own naturopathic therapy centre where this method was used. But the supporters of diagnosis from physiognomy agreed, without giving any further explanation, that the method was not suited to give evidence of “the smallest details of pathological changes”. Felke complemented the objective diagnosis by asking the patient about subjective symptoms. He rejected any kind of schematism because each patient

344 The “Felke law-suit” of 1909 caused quite a stir. Felke had to conduct eye diagnoses on several patients under supervision. He protested because he was not allowed to speak to the patients as he would usually do when taking their history. The court decreed that Felke’s method was wrong, but acquitted him nevertheless. Heyll’s verdict of this outcome was: “The legally highly questionable construction of not bringing a person to justice after finding him guilty of malpractice, showed, if anything, that the judges were not willing to treat the prominent defendant like any other charlatan.” Cf. Heyll (2006), p. 172. 345 Some homoeopaths also used iridology although it has essentially nothing in common with homoeopathy. Tischner (1939), p. 60. 346 Kramer (1986), pp. 70, 76. 347 The name goes back to the fact that the disease symptoms, according to this theory, appear most clearly on face and neck. For the study of facial expressions cf. Müller (1912), pp. 22–24. 348 The foreign substances would manifest in swellings, lumps, hardened and tense areas which would show mostly in the face or neck.

45 Emanuel Felke and his Therapeutic Concept: Homoeopathy and Naturopathy

should be treated as an individual.349 The patient’s frame of mind was of particular importance to Felke who was very critical of the “materialist approach” in orthodox medicine which, he thought, did not consider that human beings did not just have a body but also “a soul, mind, will and feelings”.350 Science forgot, so he argued, that all the curing was of no avail; homoeopathy had proved that the smallest and simplest measures had an effect on the human soul and mind.351

Felke’s Healing Approach Homoeopathy was the backbone of Felke’s method and he added to it the healing influence of light, air, water and earth as well as rules concerning nutrition and exercise. His theory was that the effects of homoeopathy went parallel with those of naturopathy.352 He also predicted that “homoeopathy would one day be the bridge on which the hostile brothers from orthodox medicine and natural medicine would meet, embrace and kiss one another.”353

Sitzbaths From one of Felke’s prefaces we learn that his first addition to homoeopathy were the cold sitzbaths.354 Hydrotherapy was the beginning of classical naturopathy which, during the 19th century, found more and more followers.355 At the beginning of the 19th century Vinzenz Priessnitz (1799–1851) had developed a complex water therapy system which resulted in a new height of popularity for hydro349 N.N. (no date), p. 18. 350 Kramer (1986), p. 58. 351 A homoeopathic remedy, he argued, could change the mood of a bad-tempered curmudgeon and induce him to light a cigar, have a beer, get out of his chair and go for a walk. Felke emphasized that there was evidence of such effects of homoeopathic remedies and that they were immensely precious. Kramer (1986), p. 58. 352 Felke in his letter to Max Vits (1899). Reproduced in: Kramer (1986), p. 54. For Felke and homoeopathy see p. 18 above. 353 Reproduced in: Kramer (1986), p. 54. 354 Preface to Felke’s 1913 calendar. Reproduced in: Kramer (1986), p. 68. For the cultural history of water usage in medicine in general cf. Hähner-Rombach (2005). Parallel to the sitzbaths Felke had used Kuhne’s diagnosis from physiognomy. 355 Jütte (2001), p. 387.

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therapy.356 Sebastian Kneipp as well as Emanuel Felke admired Priessnitz and his healing methods.357 As mentioned above, Felke considered the lower body to be a breeding ground for numerous afflictions from where foreign substances would spread through the whole body. If one rubs one’s hands with very cold water or snow they turn very red which is a sign that blood is streaming into the vessels. From this phenomenon Felke deducted that by using cold applications blood could be drained from all other organs, especially from the head, and concentrated in a particular part of the body.358 The cold application would not reduce the amount of blood in the body, as bloodletting did, but would just “relocate” it which means that over-supplied organs were relieved from excess blood – the cause of all inflammation – while the low temperature would alleviate the inflammation. With cold sitzbaths Felke wanted to stimulate metabolism and blood circulation and mobilize the body’s own defences. The sitzbaths were prescribed to suit the individual patient’s state of health.359 A massage was essential for maximising the effect of the sitzbath. 356 In Priessnitz’s lifetime there were between 70 and 80 hydrotherapy spas and in 1891 the number had risen to 131 naturopathy and bathing spas. Cf. Jütte (2001), p. 388. For Priessnitz cf. Heyll (2006), pp. 13–25 and Klatte (2005), pp. 137–161. 357 The “eye witness Dr Ed. Schnitzelein” who had been sent by the King of Bavaria, reported about the sitzbaths that, because the water temperature was higher at the top, “the upper stories of the body are freed from the excessive warmth by the emigration of the heat downwards”. The sitzbath was meant to draw blood from the head and chest. 358 Müller (1912), p. 69. 359 “How does one take a sitzbath? In order to answer this question we have to consider the various groups of users! There are firstly those who are not particularly sick, but want to heighten or retain their general wellbeing by using sitzbaths. They bathe twice daily: in the morning and in the evening. In the winter one bath a day is sufficient; and for those who have become used to the sitzbath it is also sufficient at other times of year to use the tub only once, best in the mornings. The sitzbath should be taken twice daily by otherwise healthy users who undergo a strict Felke cure of about four weeks in spring or autumn for their thorough refreshment and revitalisation. […] The healthy person uses water that is naturally cold or, at the most, has room temperature for a sitzbath. It is best to use the well known oval-shaped Felke tubs which are superior to the round ones in that they offer space for the feet. The water should be one handbreadth deep and the bath should take no longer than three to five minutes. During the bath which is always to be taken in front of the open window and in the nude, the user fills both hands with water and lifts it up to navel height, then rubs it along the abdomen with a downward stroke giving it a gentle massage. This can be repeated several hundred times,

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Felke was opposed to hot baths as prescribed by orthodox physicians against rheumatism or gout because the artificial induction of sweating, although it could alleviate the symptoms, was counterproductive in that it caused the excretion of beneficial fluids while the toxic fluids remained in the body where they were even further activated in the organs.360 They moreover exerted too much pressure on heart and brain, could stimulate an unnatural appetite and the body might lose its ability to produce heat.

Light-, Air- and Sun Baths Having introduced hydrotherapy Felke complemented his healing system by offering light and air baths.361 While travelling in the German Harz region in 1898 he had visited Adolf Just’s (1859–1936) Jungborn (fountain of youth) and became so enthused with the therapies applied there that he introduced them in his sanatorium in Repelen which opened its doors that same year.362 As mentioned above the skin as the main organ of perspiration was for Felke of central importance. If toxins could not be excreted through the skin the organs would suffer. He therefore recommended light-, air- and sun baths to stimulate the skin and thus metabolism. The air- and light baths were to be taken in the nude and not only on sunny days but also when it was rainy or cold. They were to be taken daily and each time last until one began to feel chilly. The healing power of the sun was also part of Felke’s therapy system. He had learned this from Arnold Rikli (1823–1906) who had founded the first sun bathing establishment in the world in the Swiss town of Veldes.363 Felke attributed a disinfecting and sterilising effect to the sun baths and found them indispensable in the treatment of gout and rheumatism as they helped ridding the body of

360 361 362 363

i.e. with knees bent and opened one gathers up water between them and strokes it downward along the abdomen. Without these strokes there is no sitzbath! Anyone who thinks it might be enough to just sit in the water and even read the newspaper must not be astonished if the hoped for effect does not materialize.” Reproduced in: Müller (1912), p. 72. Rheinfeld (1924), p. 5. Preface to Felke’s Calendar of 1913, reproduced in: Kramer (1986), p. 68. Heyll (2006), p. 169. With Just’s permission the Repelen establishment was also given the name Jungborn. Heyll (2006), pp. 83–86.

toxic metabolites.364 The use of sun baths was by no means restricted to the summer. Their effect was to be enhanced by exactly specified breathing exercises. Felke’s reservations about hot baths did not apply to the sun baths.

Clay Therapy Felke became famous under the name of “clay pastor”. Far beyond the post-war period his clay cures found enthusiastic followers among all parts of the population. It had, however, been Adolf Just who made clay popular as a cure.365 Felke not only prescribed clay compresses, poultices and mudpacks but also mud baths.366 His success led him to prescribe clay also as a drink, especially after he had read the works of two German professors of medicine who advertised the internal use of white clay powder.367 Because in death man returned to where he had come from, the earth was for Felke the element closest to him. In accordance with Genesis, 3:19, “… till thou return unto the ground; for out of it wast thou taken: for dust thou art, and unto dust shalt thou return’ Felke developed the leitmotif for his therapy: ‘we have to put man back into the earth from which he was created’.”368 Felke recommended clay poultices especially for external skin injuries and for swellings, bone damage, sprains, contusions or blood poisoning.369 The earth was to be mixed with cold water and spread onto the affected area;370 an ointment (such as Vaseline) could be applied first if the skin was broken.371 Festering sores or putrid wounds should be treated with powdered clay gained by drying clay on a hot stove and then scraping it off the block with a clean knife. Only in cases of severe pain, such as biliary colics,

364 N.N. (no date), p. 32. 365 Priessnitz and Kneipp had experimented with clay compresses even earlier. Cf. Jütte (1996), p. 139. 366 On clay treatment in general cf. Bachem (1922). 367 Jütte (1996), p. 139. 368 Müller (1912), pp. 60, 62 and Kramer (1986), p. 12. 369 Müller (1912), p. 63. 370 Only clean boiled water was to be used. Cf. N.N. (no date), p. 36. 371 To keep the clay in place that was applied directly to the wound it could be covered with a moist linen cloth and then wrapped with a wool cloth. According to Erna Bier other ointments could also be prescribed for the wound.

47 Emanuel Felke and his Therapeutic Concept: Homoeopathy and Naturopathy

the clay was to be applied warm.372 Felke thought that the clay absorbed the acrid secretions formed in the wound and prevented them from entering the blood stream. For internal application he recommended clay powder or clay water.373 Good quality clay as well as the right tools for its preparation and application could be procured directly from Adolf Just’s Heilerdegesellschaft (Society for Healing Earth) in the German town of Blankenburg in the Harz region; but the use of ordinary garden soil was also permitted374 as long as it was germ-free.375 Alfons Menschel, who had started off as a patient and had then been promoted to the position of assistant and air bath specialist in Felke’s establishment where he worked between 1921 and 1923, gave a description of the clay or mud baths taken in the mornings and evenings by the health spa patients at the Jungborn in Sobernheim.376 A hole in the ground was filled with two wheelbarrow loads of dry clay to which cold water was added and stirred into a pulp. The patient had to sit down in the pulp which reached up to the hips while his upper body was protected by screens against wind, rain or too much sun. After the bath the mud was scraped off with a wooden spatula. Any remaining clay was left to dry in the air and was then carefully removed with massaging strokes by hand or with a brush. The whole procedure was followed by a bath in the “Felke tub” and ended with a very cold shower. Many guests chose not to rub off the remaining clay because they believed that it had a healing effect on the skin. The ladies benefited from the “reform fashion” because they could just wear simple long muslin shirts on the skin that was still covered with mud.377 New guests were given an introduction to the right way of using the baths; but on the whole it was Felke’s unwritten law that guests should help each other and that no class distinctions applied. If a patient did not regularly sign in or did not attend without sending an apology Felke was informed. He would then have a serious word with

372 373 374 375 376

Bier (1925), p. 22. N.N. (no date), p. 35. Bier (1925), p. 22. N.N. (no date), p. 36. To be able to extend his cure, Alfons Menschel had been offered by Felke to run the Air-Bath Park for Men and use the facilities free of charge in return. Cf. Kramer (1986), p. 144. 377 For clothing see p. 44 above.

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the delinquent or refuse to see him in his surgery.378 Felke attributed his success to the strictness of his regime: each patient had to strictly follow instructions and apply the therapies as prescribed. As the most natural things had become alien to cultured man, Felke maintained that strictness alone could lead to success.379 The Felke Cure could be complemented by what was called “earth sleeping”. This also goes back to Adolf Just who had noticed that a patient felt extremely well in the morning after having spent the night sleeping on the ground in his air hut, wrapped up in sackcloth.380 Felke explained the curative effect of sleeping on the ground with the earth’s powers, because the closer the contact with the earth the more one would profit from the earth’s magnetism. His theory was that the ground drew morbid matter from the body while giving off healthy substances.381 Felke recommended choosing mild nights for sleeping outside to start with so that one would not be put off right away. One should lie on a sleeping bag and use one or more blankets for cover. To make the best of the earth’s energy Felke recommended barefoot walking.382

Nutrition and Exercise Felke thought that many diseases were caused by eating the wrong foods. The diets he prescribed were meant to help the diseased organism to cleanse itself,383 but he did not generally insist on a vegetarian diet or on abstention from alcohol or tobacco, only with particular illnesses or special treatments.384 Vegetables, fruit and salads ranked first in Felke’s dietetics as they had more goodness and energies than meat due to the mineral salts and vitamins they contained.385 Next on the list were potatoes, wholemeal bread and milk products. Meat, fish and eggs came last because of their high protein content. Felke 378 Kramer (1986), p. 144, p. 152. 379 From a speech given by Felke in Frankfurt, reproduced in: Kramer (1986), p. 80. 380 Heyll (2006), p. 166. 381 Müller (1912), p. 60. 382 Bier (1925), p. 3. 383 N.N. (no date), p. 21. 384 Stader (1930), p. 59. 385 N.N. (no date), p. 21.

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wholly rejected the protein theory advocated by many orthodox physicians as too much protein would lead to debilitating perspiration with the slightest of efforts, also to exhaustion, watered down blood, oedema and similar problems. The oxygen-deficient blood could not even properly burn out the metabolites, let alone the high amounts of protein which was known to use up a lot of oxygen.386 According to Felke’s theory strong spices such as the tropical flavour enhancers that had come into fashion were also injurious to health. He and his followers called them “blood killers” because they contaminated the blood. In order to revitalize the blood, the “bearer of life”, Felke prescribed a treatment therapy of five to six weeks which was best supported by eating raw vegetables.387 Fruit and vegetables were also recommended to reduce the uric acid that was so harmful for the organism.388 Felkeans considered it a great error to expect iron preparations to improve blood renewal as allopaths did in their treatment of anaemia and chlorosis. Only iron that could be assimilated by the body was able to revitalize the blood, in other words, iron in organic compounds as contained in fruit, vegetables and some herbs. Apart from iron-rich foods Felke recommended a diet rich in calcium salts for general physical weakness, consumption and rickets in children; for gout, diabetes mellitus, calculi etc. he suggested a high-sodium diet. Felke’s therapies also included medicinal herbs and various tea mixtures that were especially formulated for the individual patient.389 It was one of Felke’s principles that three meals a day should be eaten. The day was best begun with fruit and milk; nuts were also important because they were high in protein and thus a good meat replacement.390 In order to give the digestive system a rest Felke suggested to fast one day a week. He warned against hurried eating and insufficient mastication as the resulting lack of insalivation of foods overstrained 386 387 388 389

Müller (1912), p. 43. Stader (1930), p. 60. Stader (1930), p. 68. Particularly popular were his liver-kidney-bladder tea, cough tea, tea for gallstones, tea for gout and rheumatism, tea for nervous complaints, women’s tea, tea for haemorrhoids and tea to strengthen the stomach, but most important was his equisetum tea. 390 Stader (1930), p. 62. Müller (1912), p. 45.

the stomach and weakened the entire organism.391 The effects of malnutrition were not usually noticeable at first because the body would try to naturally excrete the unhealthy fluids that developed, via intestines, kidneys, lungs and skin.392 If the unhealthy lifestyle continued over years, however, the organs of excretion would slacken and become unable to cope with the imposed work load. The harmful juices, uric acid in particular, would increase and contaminate the blood more and more. If the patient did not change his lifestyle, calculi of kidney, bladder or gall would develop or fatty growth in the cells which would then lead to a thickening and gradual calcification of the internal tissues. Malnutrition would also result in the digestive process being prolonged which again would bring about a fever of the intestines. Excessive food intake together with insufficient excretion would increase the harmful fluids. Harmful gases would develop, especially ammonia, which would be absorbed by the blood. All these symptoms, whatever their names, were nothing but “outlets of the overall disease, the contaminated blood, and the body’s attempts to rid itself thereof by transforming the insidious, hitherto latent, chronic disease into excreting, hot, acute symptoms of illness”.393 Because modern culture had brought about abnormal conditions with less and less people doing physical work but earning their living by working intellectually instead, body and soul were no longer in balance. Felke’s aim was to re-establish harmony by introducing movement therapies. Like the Swede Per Henrik Ling (born 1776), who had developed a gymnastics programme based on his thorough knowledge of the musculoskeletal system, Felke was convinced that any movement affected the organism and thus inner organs, blood circulation and nervous system as well.394 Felke did not only set up an exercise programme, he also included apparatus gymnastics in his therapy system. A measured alternation between movement and rest was seen as particularly important.

391 392 393 394

Rheinfeld (1924), p. 2. Rheinfeld (1924), p. 3. Rheinfeld (1924), p. 4. Finger (1925), p. 10. Müller (1912), pp. 77–79. For “Swedish gymnastics” and their critics in Germany cf. Heyll (2006), pp. 74–79.

49 Hahnemann’s Dietetics

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Hahnemann’s Dietetics Contrary to common belief Hahnemann did not advocate an exclusive but a pluralistic approach to healing: next to his pharmacology, dietetics – the promotion of a moderate lifestyle – played an important part.395 In his writings we find instructions regarding nutrition, exercise, sleep and digestion based on the dietary concept of antiquity generally favoured at the time.396 His treatment system also included fashionable therapies such as mesmerism, magnet therapy and hydrotherapy.397 He also appreciated the ideas of Jean-Jacques Rousseau (1712–1778). Influenced by Rousseau’s naturism Hahnemann pleaded for simplicity, especially in nutrition.398 Hahnemann was not content with giving general dietary instructions, but applied the principle of individualisation. In his water applications and movement therapies he rejected any kind of schematism. His cures were tailored to the individual patient and his or her way of life. He was very critical of physicians who, when prescribing strengthening hydrotherapy applications, only suggested a half or full bath in the morning or evening without specifying either temperature or duration.399 It is characteristic for his dietetics that he warned against any kind of excess.400 He did therefore not support the intense water cures used by Priessnitz, but emphasized that any homoeopathic physician could use cold water as a “physical measure” for healing.401 “If there was one generally helpful remedy it would be water. Without a cold bath I cannot fully cure those of my patients who suffer from old tumours. The cold in itself seems not only to work in a strengthening, contracting way it also prevents putridity.”402

395 Busche (2003), p. 50. 396 Hahnemann not only saw himself as succeeding Hippocrates but also as completing his medicine. Tischner and Jütte (2001), p. 54. 397 Busche (2003), p. 50. On mesmerism cf. p. 8 above. 398 Tischner (1939), p. 153. 399 Tischner (1939), p. 126. 400 Moderation played an important part in the 18th and 19th century understanding of sickness and health. 401 Haehl (1922), vol. 1, p. 58. 402 Haehl (1922), vol. 2, p. 62.

Samuel Hahnemann (1755–1843)

Exercise was also an important part of Hahnemann’s dietetics403 and appropriate clothes necessarily belonged to a “sensible lifestyle”. He condemned tightly fitted, constricting clothes, corsets and garters in particular, as unhealthy.404 Hahnemann refers to nutrition in many publications and letters to patients, also in the Organon, the journal Freund der Gesundheit (friend of health) and in the annotations to Cullen’s Materia Medica. In his view any foods or stimulants could be of medicinal value. Because homoeopathy, as understood by him, was “medicinal monotherapy”, meaning that the treatment aims to avoid factors that would compromise the effect of a homoeopathic remedy, certain foods could have an unfavourable influence on the outcome of the homoeopathic treatment.405 According to Hahnemann the diet had to stand back, however, behind the medicinal treatment. The individuality of the patient which was subject

403 Busche (2003), pp. 54, 172. 404 Haehl (1922), vol. 1, p. 295. 405 Eppenich (1993), p. 68. A series of publications on nutrition based on Hahnemann’s work followed by the end of the 1860s. After that and up to the present time interest in homoeopathic dietetics has greatly decreased. Id. p. 69.

50 Chapter 2 · The Connection Between Homoeopathy and Naturopathy

to daily changes forbade a general nutritional law even though a few general guidelines should be observed.406 Coffee, tea and strongly seasoned dishes as well as some meats and vegetables such as parsley, celeriac, sorrel etc should be avoided or consumed with caution.407 Hahnemann did not object to meat in principle, but he thought that some meats such as pork, duck and goose were only suitable for healthy people and warned against their excessive consumption: “I recall here that no meat partakes so much of the animal nature as pork, or contains more unmixed animal bodies that so easily putrefy. In every case where there is an inflammatory tendency in the blood, as in intermittent and hectic fevers, in suppuration, tendency to erysipelas, disturbances of the bile, in skin diseases, and even in some forms of hysteria, it has proved harmful. It often aggravates the affection visibly or produces a recurrence. It is a very nourishing food for healthy people if eaten with great moderation, and when a good deal of physical exercise is taken it is quite harmless and easily digested. Any excess, however, has injurious consequences even for healthy people to a greater extent than any other kind of meat. […] The hunting of hare and deer produces in these animals a form of heated fever, and their flesh is then much nearer decomposition and therefore much easier to digest than that of animals who have been slaughtered in the ordinary way. That this tenderness of game can be brought about in another way by hanging in the air, steeping in vinegar and so forth, I leave to the kindly disposition of the cook to suggest to his employer. […] The preponderance of animal properties in the flesh of the duck brings it very near to that of pork. It owes its palatable and nourishing qualities to this, and also harmfulness similar to that existing in pork. This harmfulness arises from the exhalations of the already disintegrating animal particles which are injurious to the human body. The flesh of the duck approaches very near to that of the goose, yet there is a difference.”408

406 Eppenich (1993), p. 68. 407 Tischner (1939), p. 241. Numerous sources document the growing taste for coffee, for example, Haehl (1922), vol. 2, pp. 65–68. 408 Haehl (1971), vol. 2, p. 26

He always warned against the effects of drinking alcohol. His patients were generally only allowed to drink their wine watered down. He emphasized the harmfulness of alcohol in his Directions for curing old sores and ulcers.409 Hahnemann’s opponents tried to attribute his healing successes to his dietetic guidelines rather than to his medicinal treatment.410

Syntheses of the Healing Methods The history of medicine shows that the alternative approaches to healing were competing with one another as much as with orthodox medicine. Although they kept their distance or fulminated against each other, there were also frequent attempts at bringing the healing methods together and taking medicine further. It was Emanuel Felke who united the fundamental principles of two alternative healing systems and pleaded for the synthesis of different methods. Hahnemann had not restricted himself either to medicinal treatment, but had included dietetics in his therapy concept and had been open to new cures such as hydrotherapy. By the mid-1920s also orthodox physicians such as the renowned surgeon August Bier (1861–1949) postulated a complementary rather than hostile relationship between orthodox and alternative medicines. The new era of syntheses appeared to be dawning.411 The medical doctor Hans-Heinrich Reckeweg, who had known naturopathy and homoeopathy from childhood through his father and who stood in contact with August Bier, concerned himself with the integration and further development of the various healing concepts all his life. It was his endeavour also to “bring together homoeopathy and orthodox medicine”.412 We will now describe the motives that inspired orthodox physicians such as August Bier and HansHeinrich Reckeweg to promote the integration of different healing systems.

409 410 411 412

Haehl (1971), vol. 2, p. 394 Tischner (1939), p. 241. N.N. (no date.), p. 7. Doerper-Reckeweg and Maschke (1996), pp. 49, 58.

3 Homoeopathy as Part of a “Holistic Medicine”

The “Crisis” of Orthodox Medicine As described above homoeopathy looks back on a history of more than 200 years and is older than the cellular pathology developed by Rudolf Virchow (1821–1902) in the 1840s.413 Similarly, bacteriology, antisepsis, chemotherapy, serotherapy and radiology only began to flourish when homoeopathy had long been discovered.414 The development of chemistry and physics into empirical experimental sciences had decisively shaped the cognitive advancement of medicine from the second half of the 19th century and it was due to this that the scientific stream established itself as the orthodox medical system.415 It had become possible to allocate a place to the disease, an “anatomically definable place in the body.”416 This kind of localised pathology resulted in the emergence of new medical specialisations such as radiology, 413 Seidler and Leven (2005), pp. 201, 205–207. 414 Antisepsis goes back to Josef Lister (1867), chemotherapy to Paul Ehrlich (1890), serotherapy to Emil von Behring (1890) and radiology to Wilhelm Conrad Röntgen (1896). Cf. Schmidt (2007), pp. 45, 59. For the history of bacteriology and Louis Pasteur (1822–1895) and Robert Koch (1843–1910) in particular, cf. Ackerknecht and Murken (2002), pp. 121–131. 415 For the concept of orthodox medicine as opposed to therapies and practices that are not part of academic medicine cf. Eckart and Jütte (2007), p. 338. 416 Eckart (2005), pp. 184, 201.

orthopaedics or dermatology, while the holistic view of health and illness disappeared.417 The unity of soul and body was lost418 which led to “objectivation and mechanisation, the attention shifted from the sick person to the disease, and the social, individual and spiritual dimension of health and illness were neglected.”419 The scientific boom did, however, not happen without controversy with the result that numerous critics spoke of a “crisis in medicine” in the mid1920s. In almost all medical journals articles were printed that dealt with this topic.420 Behind the “crisis in medicine” stood the general discontent with the medical situation.421 Mostly physicians were involved in the debate, especially university professors, but also 417 The invention of new instruments had also played a part in establishing specialized areas, for example the specula for the examination of body cavities. “These endoscopes and cystoscopes, laryngeal mirrors, eye specula and urethral specula could only be used by specially trained experts” which required the specialisation of physicians. Non-medical factors, such as the population growth in big cities, also affected the way medicine developed. Cf. Ackerknecht and Murken (2002), p. 140. 418 Jütte (1996), p. 28. 419 Engelhardt (2006), p. 27. 420 Bothe (1991), p. 16. 421 Almost any development within the medical field that was perceived as negative was described as a “crisis” at the time. There was a “crisis of the medical profession”, a “crisis of the legal social insurance system” etc. The “crisis” was not a sin-

B. Blessing, Pathways of Homoeopathic Medicine, DOI 10.1007/978-3-642-14971-9_3, © Springer Medizin Verlag Heidelberg 2011

52 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

the occasional layperson.422 Among the prominent representatives, whose scepticism towards scientific medicine made a crucial impact, were the popular author, surgeon and gynaecologist Erwin Liek (1878–1935) and the leading surgeons August Bier (1861–1949) and Ferdinand Sauerbruch (1875–1951), the gynaecologist Bernhard Aschner (1883–1960), the immunologist Hans Much (1880–1932), a pupil of the bacteriologist and serologist Emil von Behring (1854–1917) as well as the internist and medical historian Georg Honigmann (1863–1930).423 Papers and monographs were written deploring the state of orthodox medicine and calling for an extended view; they spoke of the “dehumanisation of medicine” and the “abuse of scientific methods in medical practice”. Other works with similar titles were published which dealt with the “physician and his mission”, the “turning point in medicine” or “medicine at the crossroads”.424 While recognizing the achievements in science and medicine, they postulated a change of course with, above all, the integration of alternative approaches such as for example the inclusion of homoeopathy into the conventional healing system.425 Their main concern was the synthesis of the holistic approach and functional thinking. References to the philosophers and medical writers of antiquity were particularly popular, to Hippocrates for example, who over the centuries had come to be the ideal physician.426 A regular “Hippocrates cult” developed among the physicians.427 The debate about the various healing methods worked very much in favour of the alternative approaches; after World War I people became gener-

422 423

424 425 426 427

gular, but a general social phenomenon. People were looking for concepts that would help solve the social and economic problems which had arisen after the war. Bothe (1991), p. 18. Klasen (1984), pp. 1–3. The journal Hippokrates, founded in 1925, must be mentioned here as a forum for all those who were interested in overcoming the crisis in medicine. Cf. the list of numerous papers on this topic in Klasen (1984), p. 1 and for general aspects also Bothe (1991). Jütte (1996), p. 42. Klasen (1984), p. 1. For more recent research into the “crisis” in medicine cf. Dinges (1996). Aschner (1932), p. 6. Aschner (1932), p. 6. Klasen (1984), p. 93. The term “Neohippocratism” came into use. Klasen (1984) p. 21. Heyll (2006), p. 218. Cf. also p. 58 below.

ally more tolerant towards homoeopathy.428 After giving a lecture on homoeopathy before the Munich medical association – an absolute novelty in itself – the homoeopath and physician Rudolf Tischner (1879–1961) was able to publish an article of several pages about Hahnemann’s doctrine in the Münchener Medizinische Wochenschrift (Munich Medical Weekly).429 It was the first time an unbiased article on homoeopathy appeared in a leading medical journal. What was also new was that, after Rudolf Tischner’s lecture, the president of the Munich medical association conceded that one was willing to “learn” from homoeopathy.430 The articles that were printed two years later in celebration of Hugo Schulz’s 70th birthday followed along the same lines. Until then, Schulz had only reaped a few derogatory comments.431 Another two years later August Bier, one of the best known surgeons of his time, caused a great stir among the medical profession when he published an essay with the title What attitude should we have towards homoeopathy? A storm of protest broke out when he demanded that orthodox medicine should study homoeopathy without prejudice.432

August Bier (1861–1949) August Bier was born in 1861 in the German village of Helsen near Waldeck. He was the son of the sur-

428 “It is indicative of the present crisis in medicine that a lot is being said of homoeopathic treatment, that homoeopathic physicians are very popular and that many cures are effected with homoeopathic means. About 20, even 10, years ago homoeopathy was regarded as an old-fashioned oddity favoured by members of the landed gentry, the clergy and other more or less unworldly individuals. Today homoeopathic medicine is spreading from year to year. […].” Quoted from Aschner (1932), p. 288. The calls for change continued also after National Socialism had come in, but they were no longer referred to as “crisis”; the desire for new methods was now considered positive and one spoke of a “new direction in medicine” or a “medical revolution”. For the position of the “critical’ physicians and their attitude towards the National Socialism”, cf. Klasen (1984), pp. 3, 98. Generally to this question cf. also Heyll (2006), p. 216. 429 Tischner (1939), p. 758. (Münchener Medizinische Wochenzeitschrift, No. 7, 1921). 430 “Such words had never been heard before in the lecture hall of the Munich clinic.” Quoted from Tischner (1939), p. 759. 431 For Hugo Schulz cf. p. 68 below. 432 Schlegel (1939), pp. 40–72.

53 August Bier (1861–1949)

veyor Theodor Bier.433 His father was known to be an eclectic man with a vivid interest in the humanities and sciences.434 As a child August Bier was very close to nature; he loved his daily outings during which he explored the woods and, later on, went hunting. He kept up an enthusiastic interest in flora and fauna throughout his life. The birds, in particular, aroused his curiosity: he watched them closely, studied their plumage, their song, their food, their nesting and breeding sites. In order to find out more about the anatomy of animals he began to dissect them; and in order to gain more knowledge in this field he read the relevant literature.435 He passed his final school exams (“Abitur”) in the town of Korbach in 1891 and, after dismissing his initial plans to study forestry, biology and zoology, he went on to read medicine in Berlin, Leipzig and Kiel. Apart from having a special interest in the subject it was mostly for economic reasons that he chose medicine, as making a living from biology was considered difficult.436 With zoology August Bier feared that he might end up as a school teacher and forestry was not a promising choice either, despite the very expensive training, because there were too many applicants and therefore not much hope of finding a post. After starting medical school in Berlin, August Bier went to Leipzig for a year and a half where he studied under the anatomist Wilhelm His (1831– 1901) and the physiologist Carl Ludwig (1822–1898). Rudolf Leuckert (1831–1901), who, in line with the German Approbationsordnung (Medical Licensure Act), taught zoology also to medical students, made a particularly deep impression with August Bier. After 433 For a biography of August Bier cf. Vogeler (1941), Baldamus (1961), pp. 1–101. van’t Riet (1979), pp. 6–50. Waas (1982), pp. 72–74. Levacher (1986), pp. 4–35. Winau (1987), pp. 287–301. Zapel (1994). 434 Waas (1982), p. 72. van’t Riet, pp. 6, 45. In 1891 the brochure “Faith and Science” by Theodor Bier was published in Berlin and other publications appeared in the newspaper “Waldeckische Landeszeitung” in 1894/95. Between 1862 and 1887 Theodor Bier was head of the land-registry office in Korbach. 435 His parents tried to prevent his early morning forays into the forest, that he loved so much, but that at times proved to have a detrimental effect on his school work, by taking away his alarm clock. But he found a “biological” solution: he drank plenty of water in the evening so that he woke up early in the morning and continued his expeditions. Waas (1982), p. 72. 436 Bier (1951), p. 15.

3

August Bier (1861–1949)

passing his preliminary medical examinations in 1883 he moved to Kiel where he completed his studies. One of his teachers, who was to have a lifelong scientific influence on him, was the prominent Kiel surgeon Friedrich von Esmarch (1823–1908), who had achieved much in the field of asepsis and artificial anaemia.437 August Bier wrote about that time: “In the summer semester of 1883 I came to Kiel as cand. med., not for the sciences’ sake but for the sea and the navy. It was my intention to leave again after a semester or two. I found the conditions for learning so favourable, however, that I soon decided to complete my studies in Kiel. There were only few of us in the hospitals at the time, if I remember rightly, only 12 trainees. This meant we had the closest relationship to our teachers who, bar two, were truly excellent. If you applied yourself, you were allowed to carry out small operations, put on bandages and perform dissections in great numbers and, as an intern at the internal polyclinic, you could, just like a practitioner, visit and treat patients in town. If you were interested in microscopic investigation, the anatomical and 437 Cf. Bier (1935), p. 295.

54 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

pathological-anatomical institute were always open to you. At the latter especially, its director, Heller, and his assistant of many years, Dohle, whom we established Kiel students gratefully admired as our true teacher in pathological anatomy, tirelessly took each of the students under their wings. Of these truly wonderful schools the clinic for surgery fascinated me most; von Esmarch offered it five days a week. On Mondays and Wednesdays we only saw patients and discussed diagnosis, prognosis and treatment plans. On the other three days operations were carried out. Only the two presentation days were famous and well attended by Kiel standards. Here, von Esmarch was in his element and showed himself in the best light. He spoke before a limited number of listeners whom he all knew well and who did not disturb him, he was with compatriots whom he knew through and through. And finally, the theory was always accompanied by action here.”438 Their outstanding surgical skills did neither render von Esmarch, nor later Bier, blind to other kinds of treatment, such as the “conservative treatment method” which was en vogue at the time.439 For von Esmarch the influence of the soul on the physical symptoms was of the highest importance. Because he included this factor into his diagnosis and treatment he counts as one of the pioneers of modern psychosomatic medicine.440 His ability to look beyond the boundaries of surgery also shaped the views of his student August Bier. Due to his impartiality von Esmarch allowed his students and colleagues to put new ideas into practice, even if they did not correspond to his own medical view, such as Bier’s thoughts on hyperaemia. It was during the von Esmarch era that Kiel developed into a fashionable university.441 In 1886 August Bier passed his final state examination with distinction. After that he helped out in a small country practice in the village of Gettorf in Holstein and travelled twice as a ship’s doctor to South America where he was so struck with the virgin forest that he considered settling there.442 On his return in 1888, he gained his doctorate at Kiel University where he was employed as senior house 438 439 440 441 442

Bier (1935), p. 291. For the conservative treatment cf. also below. Levacher (1986), p. 7. Bier (1935), p. 293. Baldamus (1961), p. 17.

officer under von Esmarch.443 A year later he concluded his postdoctoral studies (Habilitation).444 As early as 1894 August Bier was appointed associate professor and deputy director. During his time in Kiel his scientific interest focused on hyperaemia and the reconstruction of amputation stumps. He also made a name for himself in the field of anaesthetics.445 Based on his scientific reputation the 38-year old August Bier was offered, in 1899, a professorship at the University of Greifswald which had, around the turn of the century, after Berlin the second biggest medical school in Germany.446 While in Greifswald he deepened the insights gained from his research in Kiel. There he met the pharmacologist Hugo Schulz (1853–1932) who taught him about the Arndt-Schulz Rule which was to have a decisive influence on his theory of stimulation. It was during this phase of his life that he began to study homoeopathy.447 In 1903 he received a call to the University of Bonn. August Bier’s position as a surgeon was not uncontroversial seeing that he supported conservative treatment and recommended surgery only as a last resort.448 With his view of inflammations as the body’s meaningful attempt to heal itself he also stood in opposition to the majority of his colleagues.449 He owed his appointment to the director of the Prussian science administration, Friedrich Althoff (1839–1908), who, contrary to common practice, did not simply consult the lists of names suggested for new appointments but made up his own mind after obtaining the relevant information.450 Because he was interested in new ideas he decided in favour of August Bier. While in Bonn August Bier concentrated primarily on his Hyperämie als Heilmittel (hyperaemia as a way of healing), a book for which he won the “KussmaulAward” of the University of Heidelberg. By and by, 443 Bier (1888) Contributions to the knowledge of syphilomas of the outer musculature. Med. Dissertation. 444 Bier (1889) On the circular intestinal suture. Professorial dissertation, Kiel. 445 During his time in Kiel he produced scientific papers on low spinal anaesthesia, first works on hyperaemia and amputations, also individual papers on the treatment of prostatic hypertrophy, on osteoplastic necrotomy and investigations into collateral circulation. Fryschmidt-Paul (1999), p. 5. 446 Levacher (1986), p. 12. 447 For Hugo Schulz cf. p. 68 below. 448 Fryschmidt-Paul (1999), p. 5. 449 For August Bier’s views on inflammation cf. p. 52 below. 450 For Friedrich Althoff cf. Brocke (1991).

55 August Bier (1861–1949)

his colleagues’ initial scepticisms abated.451 A great number of well-known physicians from renowned hospitals and also many practitioners came to Bonn to find out more about the hyperaemia techniques.452 In 1901, August Bier began with the transfusion of foreign blood.453 In 1905 he married Anna Esau, the daughter of a colleague in Bielefeld. She was 22 years his junior and the couple went on to have five children together. In 1907 August Bier became successor of Ernst von Bergmann (1836–1907) at the Friedrich-Wilhelms University in Berlin.454 His sponsor appears to have been Friedrich Althoff again.455 The university’s surgery department was considered the best in Germany and enjoyed international acclaim.456 As had been the case in Bonn, outer circumstances also made Bier’s life in Berlin initially difficult. His colleagues at the medical school felt left out because of his appointment by the ministry for education.457 There were also conflicts with Bergmann’s assistants whom he dismissed because they had turned against him in what became known as the “priority debate” on low spinal anaesthesia.458 The conflict even found mention in the newspapers. After these initial difficulties August Bier gained recognition in Berlin in a very short time and became a celebrity in his field. 451 One of his pupils wrote about that time: “But who was not under the influence of our mighty surgical seniors at that time who all cast a not very profound but disparaging judgment on our innovative outsider and who were ready to pronounce any kind of denunciation. With disapproval and often also mockery they tried to ignore his revolutionary ideas about fever and inflammation as natural healing powers as well as his rejection of antiphlogosis and his other fundamental views on the surgical infectious diseases.” Quoted from Baldamus (1961), p. 23. 452 Levacher (1986), p. 14. 453 Baldamus (1961), p. 24. 454 Von Bergmann is considered to be a pioneer of brain surgery. He was also interested in cancer, larynx surgery and skin transplants and was strongly influenced by war surgery. He was a “virtuoso surgeon” who, throughout his life, studied wound infection and revolutionized wound treatment by improving antisepsis and introducing asepsis. Weisser (2005), p. 166. 455 “He is 45 years old, a pupil of von Esmarch’s. The main concern of his scientific activity was the thought of using the congestion of blood in surgery. [ ..] Bier is without doubt a surgeon who feels the urge to go his own way. He will find something new in any material that attracts his attention. But many of his original ideas are seen as unfounded or even false by his critics.” Quoted from Winau (1987), p. 288, reference missing. 456 Levacher (1986), p. 16. 457 Levacher (1986), p. 16. 458 Fryschmidt-Paul (1999), p. 6.

3

Up to World War I Bier was mostly concerned with vein anaesthesia and abdominal surgery as well as with research into the regeneration of human tissues. In 1910 he was elected President of the German Society for Surgery for the first time and in the same year he received the Cameron Prize of the University of Edinburgh.459 In 1912 the famous surgery textbook edited by Bier, Braun and Kuemmel was published. At that time he also did research into the treatment of bone and joint tuberculosis.460 In 1914 building work began on his instigation for the sanatorium of Hohenlychen, where patients suffering from this particular complaint were to be treated. During this time Bier wrote his first medical-philosophical articles, such as the Festschrift “On the justification of teleological thinking in applied medicine”.461 August Bier served in World War I as brigadier general of the medical corps. In 1915 he was first sent to the Western front from where he had to return in 1916 because he was suffering from cardiomyopathy.462 His involvement in the war had led him to design a steel helmet together with the engineer Friedrich Schwerd (1872–1953), a professor at the Technical University in Hanover. It was based on the helmets worn in antiquity and was meant to prevent head injuries through shell splinters. The helmet was first worn in April 1916 by the troops who fought in the battle of Verdun.463 It was especially designed to protect the soldier’s skull, forehead, eyes and neck artery.464 During the war, Emperor William II offered August Bier, who had also operated on him, a knighthood for his merits, but Bier politely declined the honour.465 After the war the Deutsche Hochschule für Leibesübungen (German College of Physical Education) was founded in Berlin with August Bier as its first director.466

459 At the end of his life August Bier was a member of 15 national and international societies of medicine and forestry and held 5 honorary doctorates. Waas (1982), p. 73. 460 On surgical tuberculosis cf. p. 74 below, also Schlegel (1939), p. 13. 461 Bier (1910). Fryschmidt-Paul (1999), p. 6. 462 Fryschmidt-Paul (1999), p. 7. 463 Bier was the “intellectual father of the steel helmet, Professor Schwerd the designing engineer”. Cf. Baldamus (1961), p. 43. 464 Vogeler (1941), p. 46. Baer (1975). 465 Baldamus (1961), p. 43. 466 Cf. p. 74 below.

56 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

Prominent personalities from Germany and abroad came to consult Bier. But not just wealthy patients occupied the private ward in the Ziegelstraße. Often enough one met poor people there of whom there were plenty during and after the war. They received treatment there without having to pay extra fees. “The strangest guests were seen on this ward. High state officials and widowed, wholly impoverished women, famous sportsmen – often also penniless, German and foreign royalty, acquaintances of the privy councillor’s from the forestry, workers and farmers, old nurses and young students; they all came and looked up to him trustfully. I [Karl Vogeler] met people from South Africa, Finland and Greece, Tartars, Chinese and Japanese, noblemen and common citizens, merchants and skippers from the river Spree. Most extraordinary was a Tatar from the distant Asian steppe who did not speak or understand a word of any European language. He was a wild looking fellow who, in order to explain his presence there, stuck his tongue wide out of his mouth. It had a little ulcer on it.”467 In 1924 August Bier, who also ran a private hospital (the West Sanatorium in the Joachimsthaler Strasse, close to the Kurfuerstendamm in Berlin), where wealthy and prominent patients were treated, unintentionally hit the headlines.468 In the West Sanatorium, where only top surgeons operated, the industrial magnate Hugo Stinnes (1870–1924) had died, while in Bier’s care, after a gall bladder operation.469 Before he died, Stinnes had accused Bier of not treating him in the right way. The accusation had leaked into the public and brought the famous surgeon into disrepute, especially after he sent Stinnes’ family an invoice for 150,000 Marks for his own efforts and another 30,000 Marks for those of his assistant surgeon. Even Bier’s colleagues were taken aback by so much eccentricity.470 The death of Friedrich Ebert (1871–1925), first president of the Weimar Republic, who had been admitted to the West Sanatorium too late after suffering a ruptured appendix, was no less 467 Vogeler (1941), p. 70. 468 Jaeckel (1999), pp. 650–630. Apart from the major clinics in Berlin there were also a number of private hospitals which were often situated in specially adapted private houses. Winau (1987), p. 247. 469 For Hugo Stinnes’ biography cf. Feldman (1998). 470 Jaeckel (1999), pp. 630–642.

sensational. Again Bier was exposed to malicious taunting from the press. In Berlin, the rumour was spread that Ebert had fallen victim to Bier’s conservative approach. While Bier suffered greatly from these attacks he never offered a public explanation.471 In March a statement was published in the Münchener Medizinische Wochenschrift (Munich Medical Weekly), endorsed by the Ebert family, in which, among others, the famous pathologist Otto Lubarsch (1860–1933), director of the Institute of Pathology at the Charité University Clinic in Berlin, who had performed a biopsy on Ebert’s remains, put an end to the wild conjectures.472 In 1920, August Bier was again elected president of the German Society for Surgery and, in 1925, he became honorary member. In the same year, the 64year old published the paper that later was to become famous, “What attitude should we have towards homoeopathy”, and that alienated many of his colleagues. That the paper triggered such a violent debate was also due to the fact that a man of his standing could not simply be shrugged off.473 The reason why the paper appeared in the Münchener Medizinischen Wochenschrift (Munich Medical Weekly) was probably that the editors did not want to be seen as prejudiced. Also, August Bier had been co-editor of the journal since 1925 and was, as such, certainly in a position to exercise his influence.474 Encouraged by the controversial discussion about his paper on homoeopathy August Bier presented in 1926/27 his proposal for an inclusive medical system, which he had, in fact, prepared before 1925.475 Towards the end of his long professional life, in 1930, the Münchener Medizinische Wochenschrift published a series of essays in which he brought his considerations on homoeopathy and also on isopathy to a conclusion. The homoeopath and physician Oswald Schlegel (1887–1963), who worked with August Bier collected these essays in the volume Homöopathie und harmonische Ordnung der Heilkunde (Homoeopathy and the harmonious order of medicine), because the “master” did not find the time and had moved on 471 Levacher (1986), p. 24. Vogeler (1941), p. 49. 472 Jaeckel (1999), pp. 642–649. For Virchow’s famous and controversial successor, Otto Lubarsch, cf. Winau (1987), p. 279. 473 Doms (2005), p. 245. Planer (1926), p. 138. 474 Doms (2005), p. 245. Planer (1926), p 138. 475 Vogeler (1941), p. 50.

57 August Bier (1861–1949)

to new tasks. He published them in 1939 and a 2nd edition came out ten years later, the year of Bier’s death.476 The name of the famous surgeon Ferdinand Sauerbruch (1875–1951) is closely associated with that of August Bier. They maintained an amicable collegial relationship.477 Sauerbruch who was internationally acclaimed and already professor at the University Clinic in Munich, had been short-listed as successor to the surgeon Otto Hildebrand (1858–1927) at the Berlin Charité since 1925.478 The Department for Surgery at the Charité was, however, less prestigious than the Surgery Department at the University hospital where Bier was now approaching his retirement.479 Sauerbruch, who held an attractive position in Munich which he was not prepared to resign without good cause, asked for a double nomination that applied to the Charité as well as the University Clinic.480 This required the consent of the ministry and the medical faculty, and above all of Bier. Bier seemed to have favoured his Munich colleague already as his successor. In 1926, Sauerburch was not only invited as the successor of Hildebrand who was retiring from the Charité, but the university council and the government agreed by contract to offer him the chair at the Surgical University Clinic after Bier’s retirement.481 As a precondition for his acceptance Sauerbruch requested that both hospitals should be refurbished. When in 1930/31 the closing down of the Surgical University Clinic was being considered Bier’s colleagues suspected a scheme of Sauerbruch’s. When the tabloids got wind of this suspicion Sauerbruch felt obliged to defend himself in public. What had been agreed was that after the building work at the Charité was completed, the renovation, which August Bier had been promised 25 years earlier, would begin at the Ziegelstraße. In order not to disturb the daily routine in Bier’s clinic Sauerbruch had intended not to start with the building work before Bier’s retirement. But when the Prussian government had to 476 For Oswald Schlegel cf. Schroers (2006), p. 125. 477 For Sauerbruch’s position at the outbreak of the storm of protest against Bier cf. p. 60 below. 478 Genschorek (1986), p. 116. 479 Nissen (1969), p. 94. 480 Nissen (1969), p. 95. 481 Sauerbruch began lecturing in the summer semester of 1927.

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cut its budget Sauerbruch had taken up negotiations again. His efforts were unsuccessful in the long term and the clinic in the Ziegelstraße was closed down shortly after Bier had left, following a decision of the Ministry of State in 1932.482 The relationship between Bier and Sauerbruch did not deteriorate over the following years despite these outer events. In 1935 Bier was nominated for the Nobel Price in Medicine. When in 1936 Carl von Ossietzky (1889–1938) was awarded the Peace Nobel Prize for the year 1935 in retrospect, Hitler was so enraged that he forbade Germans to accept the Nobel Prize and introduced instead the 100,000 Reichsmark “German National Prize for the Arts and Sciences” to be awarded to three deserving Germans per year.483 When the Reich’s government asked Sauerbruch and Bier independently of each other whom they would suggest for this distinction they recommended one another. In 1937 the prize was then shared by August Bier and Ferdinand Sauerbruch.484 With the end of the winter semester 1931/32 August Bier retired from his university career. He withdrew to his beloved estate Sauen in the Mark Brandenburg where, within a few years, he transformed the local pine woods into a mixed forest. The prominent surgeon, university lecturer, director of several hospitals and institutes had not purchased his forest of 500 acres in 1912 and increased it to 800 acres in 1913 to use it recreationally or commercially, but to cultivate it on the basis of an “archetypal healing 482 It is said that Sauerbruch read about this in the press while on holiday. Despite the objections raised by the privy councillors Bier and Stoeckel the decision was maintained. Sauerbruch commented in the press: “Everybody can see that this hits me worst of all. A promise given me by contract has not been kept; a fact that I deplore most sincerely, because it renders my invitation to come to Berlin meaningless and the university loses a valuable faculty. That I accepted the invitation to come to Berlin shows how much I value tradition. But tradition is not a rigid term, but an idea that is alive. It is not bound to stones and sites, but it lives in the continuation of the spirit that brought about German surgery. It depends on achievements and personalities who can come together under varying conditions in any place.” Quoted from Genschorek (1986), p. 126. The university rector Wilhem His’s annual report for 1928/29 shows that there was no definite age at which professors had to retire from the university. His speaks of overaged lecturers who had become “part of the furniture”. His (1929), p. 6. 483 Levacher (1986), pp. 24, 26. Schlegel (1939), pp. 11–13. Bier (1949), pp. 248–264. 484 Cf., for instance, Freie Neue Presse of 8 September 1937, p. 4

58 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

principle”.485 August Bier predicted the dying of forests due to ignorant cultivation and rationalisation, which he successfully counteracted “by stubbornly adhering to the words of Heraclitus: opposites come together to create harmony”.486 Forest management on the Sauen estate did not simply follow the traditional principles of forestry but was based on philosophical considerations. As a physician Bier was a follower of Hippocrates, as a philosopher he was inspired by Heraclitus whom he revered as the greatest thinker of all times.487 In line with Heraclitus’ maxims Bier explicated: “Opposites find together in harmony. The Corpus Hippocraticum in medicine is based on the same principle for it teaches that the healthy state represents the right and disease the wrong combination of opposites. I tried to re-introduce the principles of ancient physiology and pathology into medicine and I believe that I succeeded. […]. Forestry is more apt than medicine to illustrate the harmony of opposites because the physician is forced to maintain what is inferior while the forester can ruthlessly eliminate it with saw and lopping shears and at the same time cultivate all that is of high value. Above all, foresters are truly familiar with the idea of the good mixture as they have often argued for mixed forest where softwood grows next to hardwood, shallow-rooted trees next to deep-rooted trees, trees that create humus next to those that consume humus. […].“488 His unconventional approach and openness to new procedures and methods had made it possible for August Bier to transform extremely poor pine stands with depleted soil into healthy, mixed woodland.489 His forestry was based on the endeavour to find the right mixture. It was not his aim to create a new forestry system, but to gener-

ate opposites in the monotonous pine stands and to bring them into a harmonious unity, a healthy mixed forest.490 During the last years of his life August Bier looked at medicine mostly through the eyes of a philosopher. After more than fifty years in his profession he wanted to carry “philosophy into medicine and medicine into philosophy” in keeping with the Hippocratic Corpus.491 Ever since antiquity, medicine and philosophy have been interrelated with physicians drawing their motivation and legitimation from “a preliminary philosophical understanding and thus from anthropology”; philosophers, on the other hand, made questions relating to life, suffering and death their main concern.492 This interrelationship underwent a complete change during the 19th century when medicine developed more and more into “biological technology”. The ensuing mechanised medicine had no room for philosophy. As has been pointed out above, the progress of scientific medicine also provoked a backlash.493 Its opponents referred to philosophical concepts and Hippocratic medicine.494 It was their aim to integrate other healing methods such as humoral pathology, biochemistry, naturopathy, anthroposophical medicine or homoeopathy into the medical system and to redirect the physicians’ gaze to the human soul.495 The Hippocratic concept in particular was drawn upon by a whole conglomeration of ideas that reflected the dissatisfaction with the scientific explanatory models. Towards the end of his life August Bier had also planned a trilogy based on the philosophies of Hippocrates and Heraclitus: in 1939 his book Die Seele (The Soul) was published, followed in 1952, posthumously, by Das Leben (Life).496 As a third volume

485 Cf. Schlegel (1939), pp. 11–13. Bier (1949), pp. 248–264. 486 Schlegel (1939), p. 12. 487 The philosopher Heraclitus of Ephesus (544–483 BC) thought that the world essentially consisted in the tension, but also the harmony of polar opposites that continually turned into each other. Halter (2008), p. 139. 488 August Bier in a lecture of 7 July 1933 to the Friends of Bärenthoren in (Bad) Saarow; reproduced in: Schlegel (1949), p. 249. [Baerenthoren is a district in Northeast Germany known for its pine forest management. Tr.]. 489 Ministerium für Landwirtschaft, Umweltschutz und Raumordnung (1994), p. 17.

490 Ministerium für Landwirtschaft, Umweltschutz und Raumordnung (1994), pp. 33. 491 Bier (1942), p. 8. It is assumed that the phrase which had been attributed to Hippocrates for a long time is of more recent origin. Engelhardt and Schipperges (1980), p. 7. 492 Engelhardt and Schipperges (1980), p. 2. 493 Cf. p. 51 above. 494 Bier rejected the word “crisis” which he thought was a “fashionable catchword”. Jütte (1996), p. 43. 495 Aschner (1932), p. 6. Klasen (1984), p. 92. 496 Bier (1942) and Bier (1951).

59 August Bier (1861–1949)

he had planned a treatise about the forest.497 August Bier died in 1949 at the age of 87 on his estate in Sauen.498 August Bier’s contemporaries confirmed that he used to speak his mind strongly and forcefully to anybody.499 Again and again he proved that he had the courage to swim against the stream of established ideas.500 He never tried to evade scientific arguments, on the contrary; as the example of homoeopathy below will show, he did not refrain from provoking a scientific éclat in order to challenge his colleagues’ way of thinking. The Berlin medical historian Rolf Winau (died 2006) described Bier’s character as follows: “His inner uprightness and charisma made a strong impression on anybody who met him. All his assistants verified this again and again, and it was even confirmed by his opponents. His uprightness might occasionally come across as brusque or rough, but it was never hurtful. His mockery and sarcasm, on the other hand, could be cutting. He had a crude sense of humour and wit that often also marked the tone of his lectures. There are many examples to which his students attested. It speaks for Bier that he could also make fun of himself.”501 With all this in mind we must not forget that August Bier was a brilliant surgeon.502 It was said about him that “he was one of those bold surgeons, not afraid of assuming responsibility, who were technically outstanding and used the scalpel with a sure hand. It was a joy to watch him operate”.503

August Bier’s Attitude Towards Homoeopathy August Bier described his interest in homoeopathy as a process of rapprochement. Just like his orthodox medical colleagues, he had first dismissed homoeopathy as “unscientific humbug from which any proper physician should keep his distance”.504 His 497 Cf. also Bier (1949), pp. 248–264. 498 An index of Bier’s writings is reproduced in Vogeler (1941), pp. 291–299 and also in Fryschmidt-Paul (1999), pp. 199–205. 499 Winau (1987), p. 293. 500 Levacher (1986), p. 13. 501 Winau (1987), p. 282. 502 Vogeler (1941), p. 27. 503 Killian (1980), p. 351. Fryschmidt-Paul (1999), p. 8. 504 Schlegel (1949), p. 40.

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Hugo Schulz (1853–1932)

change of mind was caused, as he said, on the one hand by the insights he had gained into stimulation therapy as a measure against inflammation which he found confirmed in homoeopathy and, on the other hand, by his contact with the pharmacologist Hugo Schulz (1853–1932), a researcher at the University of Greifswald.505 Inspired by Schulz’s work August Bier had first begun to study the original textbooks on homoeopathy in 1920.506 His intense studies taught him, as he himself put it, to separate “the wheat from the chaff ”. Bier was not completely won over by homoeopathy but he found that the “wheat harvest” was sufficient to justify taking a closer look at it. For him, homoeopathy was just one of several approaches and he continued to support the ancient principle of contrasts, while postulating the further development of medicine as not even in surgery Galen’s concept was always successful.507 Even if only the similarity principle remained from homoeopathy, and not even as the “eternal natural law” it had been for Hahnemann, this would still be scientific progress, Bier argued. Like Rudolf Virchow (1821-1902), Bier was 505 According to Hans Wapler, Bier had also been inspired to study homoepathy in 1914 by a paper he had published in the Allgemeine Homöopathische Zeitung under the title “Gebührt den Individualisten oder den Wissenschaftlern die Führung der Homöopathie?” [Is it up to individualists of scientists to lead homoeopathy?]. Cf. Mai (1996), pp. 72, 79. 506 Schlegel (1949), p. 40. 507 Schlegel (1949), p. 68.

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of the opinion that the sciences were wide enough to accommodate various directions, but, also like Virchow, he warned at the same time against making too many promises which would ultimately lead to ridicule and inflict damage on science.508 It was also not Bier’s intention to establish a hierarchy of healing methods. For him homoeopathy was “one of several possible” methods of treatment509 and allopathy, homoeopathy and isopathy each had their right to existence; with Heraclitus he stated that by excluding one of these approaches a “harmonious understanding” of medicine was no longer possible.510 What August Bier wanted was to make space for homoeopathy and isopathy where orthodox medicine failed.511 His presentation of homoeopathy is ultimately nothing but an appeal to science to study a terrain that had so far remained “scientifically” unexplored but that offered plenty of possibilities.512 With his famous 1925 paper August Bier set out to arouse “the spirits”, and he did. A few weeks after its publication the Verein für Innere Medizin und Kinderheilkunde (association for internal medicine and paediatrics) called a meeting in the auditorium of the Langenbeck Virchow House in Berlin. It was crowded to overflowing with colleagues keen to condemn the heretic.513 One year later Bier concluded that, with the heated arguments that divided allopathy and homoeopathy, a calm and factual discussion was not yet possible.514 The debate had sunk to an 508 “May the one seek to advance by anatomic investigation of diseases, the other by the clinical observation of processes, the third through pathology and the fourth through therapeutic experiment, the one through chemical or physical, another one through historical research, science is a wide enough field to offer enough space for all these directions as long as they don’t want to be exclusive and don’t go beyond their boundaries, if they don’t pretend to be able to achieve everything. Exorbitant promises have always been harmful, excessive pretensions have always injured, arrogance has insulted or been ridiculed”. Virchow (1854), p. 5. 509 Schlegel (1949), p. 68. 510 Schlegel (1949), p. 106 511 Schlegel (1949), p. 107. 512 Schlegel (1949), p. 109. 513 Vogeler (1941), p. 254. After publication of this paper numerous articles by opponents and supporters of homoeopathy appeared, not only in Münchener Medizinische Wochenschrift. For details of this discussion cf. Doms (2005), pp. 243–282 and the collection of essays in Planer (1926). Werner (1993), pp. 212–215. Lucae (1998), pp. 147–151. 514 Bier (1926), p. 555.

embarrassing level of mere bickering between the parties. Letters and treatises were ranging from the highest praise and base flattery to the roughest kind of mobbing and foul-mouthed vilification. Some saw in him a “great reformer”, others a “corruptor of medicine” or a “senile fool” and so on. Bier appeared to be undisturbed by all this, saying that anybody who had been a public figure in Berlin for any amount of time developed a thick skin. The debate also had the effect of promoting the cause of the “army of quacks and botchers”. The worst aspect for Bier was that the “trade and industry bandits” were making money by using his name. They had approached him offering him a share in their profit if he advertised their products.

Ferdinand Sauerbruch: “Taking up the Cudgels for August”515 When the protesters raged against Bier in 1925/26 Ferdinand Sauerbruch was not one of them. If we believe this famous surgeon, who wanted to be Bier’s successor, he had written to him expressing the view that most people did not understand the “essence” of Bier’s paper.516 In his memoirs which were published 30 years later Sauerbruch calls his colleague “an outstanding representative of exemplary medical practice” and admitted to often standing up for him when he was attacked in public lectures.517 In his reminiscences, Ferdinand Sauerbruch even devoted an entire chapter to August Bier with the title “Taking up the cudgels for August”. He quotes from a speech he gave, probably in direct relation to the events of 1925.518 515 516 517 518

Sauerbruch (1956), pp. 345–349. Sauerbruch (1956), p. 347. Sauerbruch (1956), p. 347. The cause was a lecture given on 15.7.1925 in the Ärztliche Verein [physicians’ association] in Munich by Professor Straub on ‘the mystery of the small doses’ in which he alluded to Bier’s paper on homoeopathy. Sauerbruch called his considerations intelligent and also moderate. The sheer number of pharmacological questions about the lack of efficacy of homoeopathic doses appear to have been so convincing that Sauerbruch had refrained from taking a stand in front of this audience. He was nevertheless firmly convinced that criticism of the lecture should not be suppressed and had therefore decided to bring the topic up again at a later time. No sources relating to this could be found. Sauerbruch (1956), pp. 345–349.

61 August Bier (1861–1949)

Sauerbruch judged the protests to Bier’s 1925 paper to be opinions of individuals that were not able to assault homoeopathy as a whole; the attackers were trying to defend a healing method that was in dire need of “refreshing”. The present – so he argued – was a time that was clearly ready for something new and August Bier had recognized this before others. By rejecting homoeopathy, orthodox medicine failed to see the positive sides of this doctrine and to draw inspiration from it while continuing to use chemical pharmaceutical preparations in a very careless manner: “It [orthodox medicine] is, above all, forgetting that practically applied pharmacology as practiced today, is even less of a science than what homoeopathy is doing. Chemical manufactories keep throwing innumerable remedies onto the market which are then used without reservation. And the vast amounts of chemical preparations that physicians prescribe today without using their own judgement, are sad proof of the fact that modern pharmacology despite all its admirable achievements in the field of experimental physiology and experimental pathology only registers modest success in the field of medical practice”.519 Furthermore Sauerbruch expressed his indignation at the attitude displayed towards a man of Bier’s rank who, with his originality and his fundamental achievements in surgery had done much more for this discipline and for medicine in general than anybody else. A personality like Bier’s was hard to find and his achievements alone justified his defence. Hahnemann also was, in Sauerbruch’s view, a man whose equal was not to be found in history. Although his Organon contained many errors, it also included many truths which especially the practitioner should know and appreciate. Much in the 100-year history of homoeopathy might have proved to be wrong and could therefore not be scientifically confirmed, but this did not speak against the method. Orthodox medicine had also committed many mistakes which were only discovered later, and it was still harbouring misapprehensions which only the future would bring to light. Sauerbruch felt particularly strongly about the orthodox physician’s disparagement of the small doses; homoeopathy had, after all, successfully treated 519 Sauerbruch (1956), p. 347.

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Ferdinand Sauerbruch (right) and August Bier

goitres with minute doses of iodine while orthodox medicine had only arrived at the same conclusion 100 years later and in a very roundabout way. About dosage he said: “[…] therefore the mystery of the small doses must not be entirely devalued and made to look false and ridiculous” as some pharmacologists did.520 As another instance of the efficacy of homoeopathic doses he presented the most up-to-date tuberculosis treatment which used dilutions that had so far only been known in homoeopathy. But the point was not, according to Sauerbruch, whether the principle of the small doses in particular applied or whether the “similia similibus” doctrine in general was false or in need of improvement; it was, as he emphasized, that one needed to study homoeopathy and its important proponents intensely. For this reason the sharp attack on Bier, who was certainly not above criticism in every respect, and on his paper was not justified. Bier had wanted to draw attention to the fact that allopathy could learn much from homoeopathy, which did not mean that they both were its followers. About homoeopathy he said: “We all know only too well how much commercial greed, untruthfulness, are concealed behind the veil of homoeopathy. But with August Bier I am convinced that we can also learn from it in various ways and that the homoeopathic approach anticipated and grasped many therapeutic principles, even if it did not provide scientific evidence, which we recognize today and which are part of our daily practice.“521 520 Sauerbruch (1956), p. 346. 521 Sauerbruch (1956), p. 348.

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Based on the sources examined so far it was not possible to establish whether Sauerbruch studied homoeopathy more deeply, for example by conducting his own experiments. He must have come across the fundamentals of Hahnemann’s doctrine, especially potentisation, and, during his time in Greifswald, he must have been introduced to the Arndt-Schulz Rule because he met Hugo Schulz there and Schulz’s daughter Ada became his first wife.522 Germany’s two leading surgeons, Bier and Sauerbruch, pleaded for changing the medical system.523 Sauerbruch’s argument was:524 “After it [orthodox medicine] had flourished in the 19th century a certain fatigue set in. The purely bacteriological and serological views of disease have brought us to a dead end. There are many indications for a change of course, such as the emphasis on function, the constitution theory, stimulation therapy, but we are still searching; the big, all-including idea is still missing.”525

Conflicts of Interest The public debate about August Bier in 1925 was by no means restricted to the reservations orthodox physicians brought forward against homoeopathy; there were other conflicts of interest concealed behind the argument. Representatives of medical specialisations feared for their “sole” competence status and closely guarded their domain which, according to August Bier, they thought was theirs alone.526 Because of his research outcomes Bier was faced with the question of whether they were only confirmed by surgery or by medicine in general, i.e. could they be generally applied.527 It was mostly pharmacologists, who were not closely involved with the medical practice, followed by the representatives of internal medicine 522 Genschorek (1986), p. 46. For Hugo Schulz see p. 68 below. 523 Aschner (1932), p. 36. 524 Sauerbruch thought that surgery, and medicine as a whole, were dominated by bacteriology and that important aspects such as the constitution of the body and of its tissues and fluids, as well as nutrition and other factors had been unduly neglected. Cf. Genschorek (1986), p. 98. 525 Quoted in Aschner (1932), p. 37, but without source reference. 526 Schlegel (1939), p. 82. For the development of specialisations in general cf. Eulner (1970), pp. 11–31. 527 Schlegel (1939), p. 82.

who saw “their rights” violated by Bier’s strivings. Bier described how he was asked in the rudest possible way to “keep his mouth shut” because he could not understand homoeopathy; its evaluation was up to internal medicine and pharmacology.528 He and his assistants had met with even worse spite when, in 1929, he had reported about remedies for Graves’ disease, tabes, paralytic dementia, sclerosis islets, neuralgia, liver and bile duct disorders.529 It had been pointed out to him that as a surgeon these illnesses were not his concern, as they belonged to the field of internal medicine.530 The conflict between the two specialist areas was nothing new: the surgeon Theodor Kocher (1841-1917) had pointed out, with a touch of irony, when the internal physicians and surgeons were arguing about whose realm gallstones belonged to: “Gentlemen, you are wrong; the gallstones belong to the patient.”531 But it was ultimately not just an argument about responsibilities that was at the root of the 1925 conflict, it was also about the hierarchy of the specialisations. Bier called surgery, even though it was past its climax and degenerating into technical shenanigans, the most efficient branch of medicine;532 it had, after all, not been the internal physicians nor the “physicotherapists” who had curbed the mutilating “surgical tuberculosis”, but fully qualified specialist surgeons.533 No doubt August Bier was also referring to himself when he described it as a sign of intellectual and moral “health” if the representative of a field that was in danger of going astray, implemented the necessary reforms rather than allow others to impose them on him. In Bier’s opinion surgery was almost fully developed while internal medicine was still facing numerous unresolved problems. He thought that internal medicine had allowed “specialists” to increasingly infringe on its realm, even though it had vehemently protested. Bier blamed internal medicine for having failed to follow the only possible path which would have been to do better than the “unbidden intruders”. He said: 528 Schlegel (1939), p. 82. 529 Schlegel (1939), p. 83. 530 For the history of internal medicine cf. Eulner (1970), pp. 180– 201. 531 Schlegel (1939), p. 83. 532 Schlegel (1939), p. 83. 533 Schlegel (1939), p. 84. For “surgical tuberculosis” cf. p. 74 below.

63 August Bier (1861–1949)

“This is largely due to the fact that it [internal medicine] had become too clever. It looked down on ancient, medical experience and believed it could practise medicine solely, or at least prevalently, with scientific precision and, in doing so, it gradually slid from the sick bed to the laboratory. And internal medicine had become more and more rigid. It lost its capacity of simple observation of the patient and of naïve thinking which both had distinguished the old physicians and which alone can lead to the goal.”534 August Bier did not fight the specialists – he saw himself as one of them – but he fought against their narrow-mindedness, the “narrow mind of specialisation which has indeed taken over”.535 Because natural medicine and homoeopathy smelled of quackery and the professional representations demanded specialisation in each field of medicine, he had offended the medical fraternity by establishing “special fields” in his clinic. In their opinion it was not up to him as a surgeon to pass judgment on other specialist areas.536 From the pharmacologists whose pharmacotherapy constituted one of the most important foundations for medical practice, Bier expected that they should also study the homoeopathic pharmacology, for example the testing of drugs on the healthy person.537 Hinting at the prestige enjoyed by this specialist field he remarked: “Where are the days when it [pharmacology] was the queen of all medical specialisations and surgery and physical healing methods only played minor parts? Now it is considered good form among physicians and laypersons to look down on medical treatment as having little effect and to get enthusiastic about drug free procedures.”538 While Bier did not share this view he still accused pharmacology of being responsible for its own one-sidedness. He had also been reproached by his university colleagues for employing staff for areas that were not taught at medical school as well as a large number of specialists for “all branches of medicine”, homoeo534 Schlegel (1939), p. 84. 535 Schlegel (1939), p. 90. 536 For medical specialisation in general and its institutional integration as well as the ensuing problem of over-aging cf. Schlegel (1939), p. 87. 537 Schlegel (1939), p. 63. 538 Schlegel (1939), p. 65.

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pathy among them, and, in doing so, turning the surgery department of the Berlin university clinic into a less respected, inferior faculty.539 The numerous independent medical departments in Bier’s clinic obviously evoked the envy of his colleagues because he took away patients from other hospitals. Considering the size of a city like Berlin this should not really have made a difference.540 Bier said to this: “To avoid becoming one-sided we had to establish a whole range of special departments led by specially trained physicians in our polyclinic which is attended by many patient with all kinds of afflictions, irrespective of the overall direction of this institution and irrespective of the full employment of clinical assistants. There are departments for orthopaedics, for disorders of the urinary tract, stomach, joints, skin, teeth, throat, nose and ears. Consultations for internal and gynaecological complaints are the task of the 3rd medical and women’s clinic next door, and for eye problems there is the eye clinic which is situated in the same area. Apart from the usual pathological anatomist and the necessary radiology personnel we employ in our clinic: specialists for tuberculosis, for gymnastics and other physical therapies, for massage, for drug treatment, temporarily also for psychotherapy, hypnosis in particular. Because the representatives of these fields are or used to be mostly assistants from other university hospitals that made them available to us and as they each maintain a connection with their mother hospital the whole procedure usually happens without arguments and friction. The few reservations expressed by representatives of professional associations, who nowadays poke 539 Schlegel (1939), p. 85. 540 Karl Vogeler offers a description, though not conclusive, about the numerous departments of Bier’s clinic: “On the right, just as we come in, are the two orthopaedics rooms, next to them the aseptic room, any other description, however, is hopeless. There is a stomach room, a tuberculosis room, a department for sufferers from joint problems, an x-ray department, a septic room; above the door of a small room we read the proud inscription: ‘Skin department of the surgery of the University Clinic’. Apart from these labelled departments there were others that were situated outside the polyclinic as such, such as the very extensive urological department, the metabolism department led by Dr Zimmer, who later was also given a special department for rheumatism research, the department for massage and gymnastics led by Dr Kohlrausch; with its associated school for massage and remedial gymnastics. Behind the polyclinic was the large x-ray department of Prof. Hintze, who had put much effort into developing and shaping the work in this field in an exemplary way.” Id. (1942), p. 92.

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their nose into everything, we were able to dispel so far. If I was younger I would also employ a physiologist because it is a great pity that the enormous wealth of physiological observations made by an attentive surgeon during his operations, are not being used by an expert.”541 Bier had designed his clinic as a “small medical town”.542

The Similarity Principle August Bier’s interest in homoeopathy had been awakened by the outcome of his research into stimulation therapy. Whereas inflammations had so far been treated in accordance with Galen’s contraria contrariis principle, Bier chose to physically aggravate the inflammation and admitted that this convinced him of the truth of the similia similibus principle.543 He saw inflammations and fever as useful remedies which meant that they often had to be artificially induced.544 “Curative inflammations”. Up to the turn of the century inflammations were generally seen as an illness in themselves which one had to fight with all conceivable means.545 Bier, however, defined inflammation as a reaction to “any harmfulness” and said that the reaction needed treating.546 The inflammation affected the body in one place, damaging and dissolving part of its tissues. As a result the decayed substances would stimulate the body to fight them, enter the blood stream and provoke an inflammatory reaction.547 The reason why chronic inflammations did not heal was that the activity of the focus of inflammation had 541 542 543 544

Quoted from Vogeler (1942), p. 93. Uhlmann (2004), p. 82. Schlegel (1949), p. 40. Inflammation plays a central part in Bier’s scientific writings. “[...] there is no problem that, in the long term, captivated me as much as inflammations, I did not invest as much effort and time into any other problem and I do believe that posterity will grant me one day that I have worked successfully in that field”. Bier (1933), pp. 407–549. Fever is for Bier similarly important. In his writings he concentrated on inflammations, because he was, as he said, not able to supply the reader with the same kind of evidence for fever as for inflammation. Schlegel (1949), pp. 26, 19. 545 Waas (1982), p. 73. 546 Schlegel (1949), p. 26. 547 Bier (1933), p. 541.

decreased or expired. If one rekindled the expired activity of the debilitated cells with a stimulant a renewed healing process could be induced that would at least improve the complaint.548 Because all inflammations – whether traumatic, rheumatic, gouty, gonorrhoeal or tuberculous – basically produced the same symptoms which differed, if at all, only in degree, Bier decided to treat them with the same or similar means, but he did not only use drugs to aggravate the inflammation. From his descriptions we gain the impression that he did not develop his treatment on the basis of Hahnemann’s doctrine, but that it was his experiences with stimulants that led him to homoeopathy.549 He was convinced that his research results were in line with the fundamental principles of homoeopathy: “No doubt, the stimulant therapy as we use it, which is the way we consider most appropriate, is a kind of homoeopathy as originally understood by Hahnemann.”550 Stimulants. Bier treated inflammations in the limbs and in the head and trunk with physical measures.551 In order to increase the hyperaemia that accompanies any inflammation, he tried to generate increased blood flow by using heat and skin stimulants.552 He also designed suction and constriction devices to generate hyperaemia. In order to reach places inside the body Bier injected foreign blood, at first only intravenously.553 He did not find the dreaded side-effects of blood transfusions disadvantageous, but saw them as a stimulus that affected body and cells and especially the focus of inflammation.554 For Bier, the blood transfusion therefore did not serve to replace blood as had been believed for 250 years, but the transfusion reactions caused by decomposition, such as shortness of breath, dry cough, red and hot skin, increased peristalsis and fever he thought to be 548 Schlegel (1949), p. 28. Bier points out that the theory of stimulants was not entirely new and refers to John Brown (1735–1788) and Rudolf Virchow (1821–1902). Brown saw the stimulant as a passive, Virchow as an active disposition to change. Cf. Levacher (1986), p. 51. 549 Schlegel (1949), p. 43 550 Schlegel (1949), p. 43. 551 Schlegel (1949), p. 19. For a complete outline of Bier’s fields of research cf. also Simon (1980). 552 Heyll (2006), p. 206. 553 Schlegel (1949), p. 19. 554 Schlegel (1949), p. 206.

65 August Bier (1861–1949)

very similar to inflammation reactions and therefore suitable for aggravating and thus healing the inflammation.555 According to Bier the decomposition also stimulated the generation of new healthy blood which, if the dosage was right, also had a positive influence on weight gain or loss.556 The stimulation which was sparked off by the injected animal blood worked, as he said, in the whole body, but not evenly: the reaction was stronger in the focus of inflammation, which was the purpose of the treatment.557 Bier thought that the “foreign” blood represented a stimulus for the body to which it had to react by mobilising its defences.558 At the beginning of the 1920s Bier pointed out with regard to the proteinbody therapy which had come into fashion that he had been the first to use protein-body therapy with his targeted injection of animal blood.559 Concerning the homoeopaths’ disapproval of the injection of substances he replied that, while their opposition to the exaggerated injection craze might be justified, they must not forget that many substances could only unfold their effect in this way.560 In order to use the inflammation in a remedial way, August Bier had tried a number of other measures. He described them in his book Hyperämie als Heilmittel (“Hyperaemia as remedy”) stating: “[…] that the most diverse measures, the so-called derivatives (i.e. the immense number of rubefacients which are used close to the focus of inflammation) and 555 “He also injected sheep blood from healthy animals very slowly into the veins. He injected enough blood to provoke a medium strong transfusion reaction (approx. 15 to 25 cc). Because of the sensitisation the amount could be reduced for the following injections. Bier used this method for 11 patients with the most severe, often final tuberculosis. In all of them he observed an obvious improvement of their general condition as well as improved appetite and weight gain. Definite healing processes he observed, however, only with lupus. Unlike ordinary fever, the transfusion fever did not adversely affect the patients.” Fryschmidt-Paul (1999), p. 154. 556 Bier (1929), p. 1027. 557 Schlegel (1949), p. 22. Bier pointed out that the healthy organs probably also reacted differently to the stimulants. 558 Fryschmidt-Paul (1999), p. 155. 559 Fryschmidt-Paul (1999), pp. 154, 156. In later years, Bier recommended to refrain from the intravenous injection of animal blood because of the side effects and the complexity of the process and suggested to inject it into the muscle instead. Schlegel (1949), p. 39. For injection see also p. 84 below. 560 Bier (1933), p. 542.

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revulsives (i.e. similar measures used away from the focus of inflammation), red-hot iron, ropes of hairs, fontanels, moxae, heat (hot sand, water, peat, heating pad, cataplasms, hot air), foreign bodies (bougies for the treatment of strictures), even ordinary water (by soaking), light, above all tourniquets, decomposing body parts, foreign and own blood or, as we now say, protein-body, intravenously injected drugs, antiseptics etc, all work in the same way which means that they aggravate the remedial inflammation (and the remedial fever).” 561 The effect of the chosen stimulant was, he said, subject to the Arndt-Schulz Rule.562 According to August Bier chronic inflammations were the incomplete attempt of the “physis” – or natural healing power – to remove the “harmfulness”, which was really the illness.563 Through activation of the inflammation the natural healing power was sparked off which then aimed at overcoming and removing the “harmfulness”.564 Once the harmfulness was overcome the inflammation would also abate as it was no longer needed.565 In cases of acute inflammation it was, as a rule, not necessary to support the physis as it did the right thing of its own accord. But as this was not always the case the physis might need to be supported with the help of a physician.566 Bier’s inflammation theory was also teleological in that he suggested that the inflammation was a reaction of the body that had the purpose to remove the damage.567 To the physicians of the late 19th and early 20th century, when orthodox medicine was dominated by mechanistic thinking and only interested in cause and effect, teleology was like a red rag.568 Bier described his past as a time when any kind of teleology was frowned upon, while any roughly mechanical explanation was sure to be applauded even if it arrived at the same conclusions.569 As a student in Kiel he had already been uncomfortable with the 561 562 563 564 565 566 567 568 569

Schlegel (1949), p. 30. See p. 67 below. For the physis in general cf. Bier (1951), p. 66. “The inflammation does not eliminate the inflammation but the harmfulness.” Schlegel (1949), p. 265. Schlegel (1949), p. 265. Schlegel (1949), p. 261. Schlegel (1949), p. 33. For teleology cf. Bier (1951), p. 17. Levacher (1986), p. 47. Schlegel (1949), p. 33.

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motto proclaimed in the lecture halls of internal medicine: Search for knowledge and do not ask for its purpose.570 For him, healing was the central purpose of medicine.571 Over and above that, Bier followed the teachings of Hippocrates who had postulated not to counteract the natural physical reaction, but to support it effectively.572 In the analogy between the reaction to inflammation and to stimulants he also found a confirmation of the homoeopathic principle of similes which he called the cornerstone of homoeopathy.573 Referring to his stimulant method he said: “Therefore I declare that the greatest support for the simile principle can be found in a place where neither Hahnemann nor his successors would expect it; I even maintain that the rule can be based on procedures which Hahnemann vehemently rejected as allopathic and nonsensical. Supporting nature’s great healing forces, fever and inflammation, is the most homoeopathic procedure, because it meets all the main conditions Hahnemann had stipulated for such a procedure in his best years: the remedy is chosen according to the similarity principle, with all symptoms being taken into account, so perfect as no other remedy. I maintain furthermore that there are no exceptions.” 574

570 “I found this saying in this place very odd, because I had entered the lecture hall in the naive and innocent belief that they taught here how to make sick people better and that one considered here what served this purpose and what did not serve it, which means that one – always and as a matter of principle – asked what our knowledge was good for. I noticed later that Quincke actually worked in this way which I find very praiseworthy. I made enquiries as to who this man Bartels was and my astonishment grew when I heard that he was professor ordinarius of internal medicine, an excellent physician and researcher and Quinke’s predecessor who had taught in the same room. I asked myself: How can such an important physician choose such an absurd motto for himself? Well, if a philosopher or a so-called ‘pure’ natural scientist did this, one might understand it; but a medical practitioner, whose entire striving and searching should aim at helping his patients, seemed to me to be very much on the wrong track with this attitude. One could say that what Bartels had in mind was that one could not know in advance whether knowledge served a purpose and that any important result that one could gain in any way served a purpose.” Bier (1951), p. 64. 571 Levacher (1986), p. 48. 572 Levacher (1986), p. 52. 573 Schlegel (1949), p. 40. 574 Schlegel (1949), p. 209.

Drug Proving Bier was also convinced of the importance and irreplaceability of drug proving on the healthy person as postulated by Hahnemann, because it was the only way to learn something about the physiological effect of medicinal substances.575 In the long term, pharmacology could not forbear from recognizing what homoeopathy had established and what the stimulant therapy had confirmed: that many substances provoked different effects in the healthy and the sick person, and, with the latter the effect differed again for chronic and acute conditions.576 This certainly did not mean that there should be no animal testing, which in various respects provided much more accurate findings. What they did not provide were subjective criteria which could be of the greatest importance. Bier argued that animal tests did not convey information about the effect of small doses, and the means were much too crude to supply evidence of minimal changes in the animal. Symptom Complex. Bier’s criticism of homoeopathy was that it lacked a methodical pharmacology. He was sceptical about the finding of the right remedy. The similia and simillima listed in the homoeopathic repertories were, he thought, superficial and arbitrary.577 Although a great many homoeopathic remedies as well as countless symptoms had been gained from drug provings, their correctness was, with a few exceptions, doubtful.578 Apart from the fact that most provings stemmed from Hahnemann’s times, there had been little research into the remedies since then.579 Even if the drug picture was unambiguous, there were considerable discrepancies between it and the natural disease picture. The homoeopathic physician, moreover, used in practice the remedy which he thought to be the simillum, but did not adhere to Hahnemann’s indications; just like in orthodox medicine he prescribed a certain number of drops to be taken once to three times a day or even more frequently. If they showed no effect, he would simply move on to the second 575 576 577 578 579

Schlegel (1949), p. 140. Schlegel (1949), p. 163. Schlegel (1949), p. 194. Schlegel (1949), p. 197. Schlegel (1949), p. 197.

67 August Bier (1861–1949)

“simile” and so on. Occasionally he would give an interim remedy, often without taking the interval into consideration. As a result, the polypharmacy which was rife in orthodox medicine had spread even more relentlessly in homoeopathy.580 Bier also criticized that, although Hahnemann had carefully registered all the symptoms found in drug provings in different people and had categorized and listed them according to body parts, he and his successors’ “proven materia medica” failed to supply a critical evaluation of the recorded symptoms and whether they really matched the relevant drug pictures. In Bier’s view all investigations were based on entirely unreliable observations. Although there had been countless requests for exact proving pictures homoeopathy had rarely taken the necessary steps in that direction. In order to illustrate that an index of characteristic symptoms was needed, Bier referred to one of the best drug pictures, that of mineral sulphur, for which Hahnemann had recorded, on 37 pages, 755 symptoms observed in healthy people. Bier commented on this magnitude as follows: “Who is, as I am, engaged in surgery, which consists of much action and few words, where we usually know exactly what works and what does not, and where, in the great majority of cases, the correctness of a diagnosis can be tested by autopsy in vivo, knows that it is always a sign of great uncertainty if a great number of hardly characteristic diagnostic symptoms are listed. He equally knows that it looks very foul indeed if, for one disorder, half a dozen or more reliable operating methods are registered instead of just one or two. Once one has gained real knowledge and competence all that is uncertain and irrelevant will swiftly fade away.”581 The only scientific homoeopathic trial, according to Bier, was Hugo Schulz’s work on the treatment of diphtheria with cyano-mercury because Schulz had carried out drug provings on the healthy and the sick as well as tests on animals.582 Bier also disapproved of the fact that the symptoms listed were founded more often on subjective than on objective aspects. In his drug provings, Hahnemann’s main concern had been the subjective symp580 Schlegel (1949), p. 197. 581 Schlegel (1949), p. 200. 582 Using the example of ether, Bier shows how difficult it is to decide on one reliable drug picture. Schlegel (1949), pp. 197–200. For Hugo Schulz cf. p. 68 below.

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toms, which was understandable seeing that at the time little was known about the objective criteria.583 It was greatly to its disadvantage that homoeopathy did not take sufficient notice of the “outstanding results” that orthodox medicine was achieving with its accumulation of objective symptoms.584 Hahnemann’s great maxim never to choose a remedy based on the diagnosis of a disease, but only according to the similarity of symptoms was also rejected by Bier.585 He also contradicted Hahnemann’s view that each disease presented a specific for which one had to find a specific remedy based on the similarity principle; stimulants, for instance, were entirely unspecific.586 Animal blood, just like thousands of other substances, would induce focal reactions that were accompanied by chronic inflammation. He argued that it did not matter which inflammation or fever inducing remedy was chosen, because the effect and success of a treatment depended solely on the dosage in the individual case and the interval.587 In his opinion there was no disease that fully corresponded to the “totality of symptoms” of a drug picture and vice versa. In reality, one had to pick a group of symptoms from the drug picture and the choice of a remedy was always a compromise. The methods applied by homoeopaths were largely arbitrary.

Posology Bier found dosage more important. It had been one of his main reasons for turning to the Arndt-Schulz Rule and to homoeopathy in the first place.588 The Arndt-Schulz Rule. Rudolf Gottfried Arndt (1835–1900), a biologist and psychiatrist at the University of Greifswald, first phrased the “biological fundamental law” and Hugo Schulz believed he was able to prove it in the laboratory which is why it has become known as the Arndt-Schulz Law or Arndt583 Schlegel (1949), p. 183. 584 Schlegel (1949), p. 184. 585 Hahnemann himself had to make allowances in this respect. Schlegel (1949), p. 209. 586 Schlegel (1949), p. 207. 587 Schlegel (1949), p. 207. 588 Bier (1933), p. 538.

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Schulz Rule.589 It states that weak stimulants excite vital activity, medium stimulants promote it, strong stimulants hinder it and the strongest stimulants eliminate it.590 Hugo Schulz had studied the effect of amino acid on the fermentation of yeast and discovered that the fermentation process was hindered or prevented with a high acid concentration, while it was enhanced by smaller amounts of acid.591 Trials with arsenic and other substances showed the same results.592 Hugo Schulz concluded from this that small amounts of remedy stimulated organic activity and thus promoted the body’s own healing forces, while high dosages annihilated them. He also thought that the majority of medicines did not have a neutralising, dissolving or disinfecting effect, but stimulated particular organs and were therefore organ specific.593 It was August Bier in particular, who regarded Hugo Schulz’s experiments as a reliable, scientific basis for the similarity rule and who, from 1903, had publically advocated the Arndt-Schulz Rule.594 In his book Hyperämie als Heilmittel, which was published in 1903, he had already put great emphasis on the rule, but it was only properly perceived after the publication of his Heilentzündung und Heilfieber (1921). Later on, Bier said about the Arndt-Schulz Rule: “I was probably the only person, who immediately recognized the outstanding significance of the ArndtSchulz Rule when I came across it more than 20 years ago. I thought it was so important that I included it right at the beginning of the second chapter of my book Hyperämie als Heilmittel (p. 248), which is about treating diseases with hyperaemia. I tried to inspire an interest in this rule in many an internal physician and in more than one pharmacologist and convince them of its importance, but it was in vain. Their response was always: Schulz is half a homoeopath, or: he is an outsider. I do admit, however, that this ‘outsider’ has 589 590 591 592 593 594

Schroers, pp. 4, 130. Arndt (1885), p. 28. Doms (2005), p. 247. Schulz (1926), p. 289. Schlegel (1949), p. 44. Bier had first met Schulz in Greifswald where Schulz explained the “fundamental biological law” to him in detail. Vogeler (1942), p. 35. That Hugo Schulz was unprejudiced towards homoeopathy does not mean, that he did not look on it with the critical eye of the scientist: he expressed reservations about the homoeopathic high potencies.

had a great impact on my medical and therapeutic thinking and doing in general. That this influence was of benefit I can see from the fact that in the last two decades all the so-called new discoveries in this field have become second nature to me.”595 According to August Bier only few diseases could be cured with drugs. In principle, they only helped the diseased organ if they supported the natural healing process.596 The Arndt-Schulz Rule found little interest among orthodox physicians; it was mostly supported by homoeopaths, but there again only by those who wanted to use the “biological fundamental law” to give homoeopathy a scientific underpinning while classical homoeopaths rejected any such attempt arguing that scientific analysis could never do justice to homoeopathy.597 Next to August Bier it was particularly Hans Wapler (1866–1951) who, as director of the homoeopathic hospital and the homoeopathic polyclinic in Leipzig, again and again referred to the theoretical and practical importance of the Arndt-Schulz Rule. Yet, some of the scientifically minded homoeopaths, such as Ernst Bastanier (1870–1953), Hugo Dammholz (1865–1951) and Friedrich Gisevius (1867–1946), were critical of the Arndt-Schulz Rule. They saw it as an essential pillar of homoeopathy, but found that it was too narrowly defined.598 In this connection the homoeopath Elias Altschul (1797–1865) of Prague should be mentioned. He described the reciprocal effect of weak and strong stimulation as the “law of polarities”.599 He juxtaposed gravitation and light development as archetypal phenomena and assumed that this polarity could be found in all of nature, in the various forces and counterforces. The same polarity he detected in the effect of drugs on the organism. From among the orthodox physicians it was mainly the professor and pharmacologist Wolfgang Heubner (1877–1957) who, following Bier’s publication of 1925, sharply criticized the Arndt-

595 596 597 598 599

Schlegel (1949), p. 29. For the natural healing force cf. p. 65 above. Böhme (1986), p. 101. Werner (1933), p. 255. Altschul had been private lecturer for homoeopathy in Prague and director of the Homoeopathic Polyclinic there. Cf. Schroers (2006), p. 2, and Böhme (1986), p. 97.

69 August Bier (1861–1949)

Schulz Rule.600 The fact aside that very highly dosed stimulants tended to damage or completely paralyze vital processes, he thought, that it was “rather difficult to find laws of overall validity where the effects of poisons were concerned”.601 The observations made by Arndt and Schulz only related to certain medicinal drugs, certainly not to all of them. Even with trials carried out by Schulz, which seemed to confirm the law, one could not say that the converse effects worked on the organ, i.e. that the important organ specificity was warranted. It is more likely that the various stimulant dosages worked in different places. Potentisation. The tests with stimulants Bier had conducted also confirmed for him that too high a dosage resulted in the deterioration of the patient’s condition. The example he used was that of rheumatoid arthritis, where it had turned out that patients who still had limited mobility became incurable cripples within a very short time if they received high dosages.602 While in Bier’s way of thinking there had to be at least one reaction, he had by and by that, if there was chronic illness, a violent reaction was not desirable when using stimulants, as it often led to an “aggravation” that could then not be reversed again. August Bier also explained that small, as opposed to large, doses of stimulants not only had no harmful effect, but lost their non-specificity at the same time. This meant that according to his theory they had a specific effect on the chronically inflamed tissue that 600 When a few weeks after publication of Bier’s paper of 1925 the association for internal medicine and paediatrics called a meeting in the auditorium of the Langenbeck-Virchow House, the pharmacologist Professor W. Heubner was among the his fiercest opponents. Style and tone of Heubner’s attack on Bier were inappropriate and disrespectful. There was no hint of collegiality. His behaviour might have been caused by his professional situation. From a note of his father, the paediatrician Otto Heubner, one can assume that his son had been invited to Berlin in order to speak up against Bier who had suddenly become all enthusiastic about homoeopathy. The father expressed his astonishment that his son had accepted the invitation, because “they had boycotted him again when appointing a successor for Heffter”. But in the end, Heubner was appointed director of the Pharmacological Institute in Berlin. Winau (1987), pp. 287–301. Planer (1926), p. 138. Engelhardt (2002), p. 278. 601 Quoted from Werner (1933), p. 253. Bier did however refuse to call it Arndt-Schulz “Law” because there were no established laws in nature, if anything, then only “rules”. 602 Schlegel (1949), pp. 42, 48.

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they stimulated, while the rest of the body showed no discernible reaction.603 As a follower of Heraclitus, Bier saw the non-specific and the specific as belonging together. Besides the predominant unspecific effects, stimulants therefore also sparked specific ones, especially when administered in small doses.604 Bier’s investigations and especially those of his assistant Arnold Zimmer also confirm Hahnemann’s findings that the sick person responds to much smaller dosages than the healthy.605 Bier did not want to see Hahnemann’s techniques of drug preparation and dynamisation of substances denounced as illogical, because the small doses did not work chemically, but they were stimulants that activated the organism. He called Hahnemann’s discovery a “first-rate medical achievement”, but nevertheless thought that Hahnemann had, in this case, made his usual mistake of falling into exaggerations. He had, for example, come to the conclusion that Drosera in decillion-fold dilution (C30) after shaking twice would cure whooping cough, while one drop of the same dilution with 20 or more “succussions” could bring about a life-threatening conditions.606 Even though Bier respected Hahnemann’s way of preparing and dynamising drugs, he rejected his infinitesimal (extremely high) potencies as fantasies; this was also clear from the fact, that homoeopathy had not managed yet to supply scientific proof of how high potencies worked. It had not even made the first step in that direction neither had it defined yet where the high potency started.607 Like Theodor von Bakody (1825–1911) and Hans Wapler (1866–1951) Bier did, as a matter of principle, not prescribe anything beyond D6 or D12 at the most.608 But, with Alfons 603 Bier also pointed out that there were exceptions. 604 “Nobody would dream of doubting the predominantly nonspecific nature of derivatives, revulsives and other stimulants. We can speak of general remedies here for the simple reason that inflammation and fever, stimulation and paralysis are elementary, recurring events in the world of organisms and symptoms of all kinds of diseases, to whose appearance they are contributing. The rule of similars applies to them in the greatest measure.” Schlegel (1949), p. 208. 605 Schlegel (1939), p. 41. Arnold Zimmer wrote the first systematic textbook on rheumatism in the German language and was strongly involved in establishing the German society for rheumatology of which August Bier was to become an honorary member. www.dgrh.de/75jahredgrh.html 606 Schlegel (1939), p. 109. 607 Schlegel (1939), pp. 180, 182. 608 See p. 16 above.

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Stiegele (1871–1956), he agreed that higher potencies could be efficacious stating that in orthodox medicine adrenalin, which was given in a D15 dilution, caused specific effects. Although Bier was, like Hahnemann, against polypharmacy and in favour of simple remedies, he, like Bürgi, often considered it necessary to give several medicines at the same time in order to improve the efficacy.609 Bier by no means restricted himself to theoretical presentations in his essays, he also showed his colleagues experiments or asked them to verify his treatment suggestions.610 He demonstrated to them the effect of sulphur on the skin, which in strong dosage and taken internally would induce skin ulcers, rashes and furunculosis, but, if one followed Hahnemann’s law of similars for dosage, could be used to successfully treat persistent furunculosis with small doses, such as D3 or D6.611 Bier claimed to have cured 34 cases of furunculosis in all.612 There had been a few patients who, despite treatment with quartz lamps, yeast, arsenic, stimulants, their own blood etc., had repeatedly relapsed, but had remained symptom-free after the sulphur treatment.613 He saw his treatment of acne and staphylomycoses as similarly successful. Surgical removal he only recommended for large carbuncles because they did not respond to sulphur treatment. The sulphur treatments taught Bier that a correctly chosen and rightly dosed internal remedy did more for an internal infectious disease that did not respond to any other internal remedies, than other healing methods, especially immunising, physical and surgical ones.614 He saw this example as proof that small homeopathic dosages of sulphur could cure persistent diseases better than any other remedies. He said that the sulphur cured by helping the skin to eliminate the disease through its own activity. If the remedy was very carefully triturated in adherence to 609 610 611 612

Schlegel (1939), p. 221. For Bürgi cf. p. 21 above. Schlegel (1939), p. 62. Schlegel (1939), p. 53. Bier also saw his treatment of acute furuncles as successful, even though the success was not as convincing as with the old, persistent furunculosis. Schlegel (1939), p. 54. 613 Before the sulphur treatment, Bier had used quartz lamps (or “sunlamps”) in combination with X-ray light to cure persistent furunculosis. The sulphur treatment was in his view more promising, simpler and cheaper. Schlegel (1939), p. 55. 614 Schlegel (1939), p. 56.

Hahnemann’s instructions it would attain a state that was most suitable for reaching the afflicted organ in order to unfold its effect there.615 According to the natural philosophical stream of homoeopathy the remedy did not work as coarse matter, but like an enzyme or colloid. Efficacy did not dependent on the amount but on the fine dispersion of the substance. For the prevention of colds Bier recommended iodine which he had tested on himself following the principle of similars.616 Knowing that greater amounts of iodine would induce a runny nose and inflammation of the mucous membranes he had taken this in homoeopathic doses without being aware of the fact that it was used in homoeopathy. About the successful outcome he wrote: “I mostly only needed one drop in order to prevent the onset of the illness; rarely, especially when I have not taken the remedy at a very early stage, I have to fight the illness for several days and take one drop daily for up to a week. I always succeeded in preventing my old cases, however, and I have been free from the troublesome complaint for six years now. The iodine did not prevent an attack of influenza during an epidemic, but the attack was only light if I took just one drop of the dilution per day.”617 Ether injections also confirmed the principle of similars for Bier.618 As a prophylactic against postoperative bronchitis and the pneumonia into which it often developed, he had discovered the right remedy by “naïve” observation that ether, which was, as far as he knew, not used in homoeopathy, was most dangerous in case of lung disease. Homoeopathically dosed, the same substance would, however, incite the diseased lungs. This was strictly speaking isopathy, as it was based on the “aequalia aequalibus curantur” principle which Hahnemann had rejected, but as it worked in small dosage he regarded it as homoeopathic in Hahnemann’s sense.619 With regard to the ether he admitted that he was proud of his discovery even though his colleagues disagreed because they did not think it was “scientific”.620 As it was not based on animal testing and chemical examinations in the 615 616 617 618 619 620

Schlegel (1939), p. 56. Schlegel (1939), p. 58. Schlegel (1939), p. 58. Schlegel (1939), p. 59. Schlegel (1939), p. 60. Bier (1933), p. 542.

71 August Bier (1861–1949)

laboratory, and founded on false beliefs, his therapy concept did, according to the orthodox physicians, not comply with scientific medicine. Because one could not possibly deny its usefulness, ether was often used for acute bronchitis, but one kept silent about the fundamental significance of its effect. Bier also declared that these insights were highly important for homoeopathy, because the ether did not only cure bronchitis caused by ether, but also bronchitis that had been caused in other ways. For homoeopathy which was anyway to a large extent orthodox religion or confession, this was, as he thought, uncomfortable, because one of its maxims stated that one must not treat all cases of one disease with the same remedy; which meant, that as far as he was aware, the treatment with ether was prohibited for bronchitis: “This does strike one as very strange seeing that the magic effect of this remedy, even with common acute bronchitis, is the best example known to me for the law of similars. But that is what a hierarchy is like. If one attacks its maxims it takes it amiss, especially in medicine if it happens with remedies that actually help.”621 Bier thought that sulphur for furuncolosis and ether for bronchitis were two “homoeopathic” remedies that allopathy could not equal.

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aemia, Priessnitz compresses and other measures that showed how important the interval for allowing the reaction to subside. Bier explained that nobody who used physical measures or protein bodies in treatment could fail to notice the importance of dosage and interval, but that Hahnemann had been the first to point this out in connection with medicines.624

Hahnemann’s Homoeopathy as a System

Intervals. Like Hahnemann, Bier found it particularly important that medicines were given in certain intervals of time.622 He himself had encountered the problem of the interval when he used hyperaemia at the end of the 19th century and, from then on, had spent more than ten years studying the question intensely on the basis of the Arndt-Schulz Rule. Based on the remedy used, the disease and the patient he worked out a rule for the application time and interval. As an example, Bier referred to his intravenous animal blood injections against infectious diseases, malignant tumours and nutritional deficiency, which he initially injected about once a week and then reduced the application. As a rule of thumb he recommended to wait with injecting blood as long as there was improvement which was best established by observing the weight gain.623 Other examples he mentioned were exposure to sunlight and hot air, constriction hyper-

Bier suggested that, when passing judgment on Hahnemann, one had to clearly differentiate between his excellent acute ability to observe, the resulting discoveries and his dogma.625 The “ingenious observer’s” biggest shortcoming was what Bier described as his “obsession with the system of homoeopathy”. Homoeopathy as seen by its founder had not become a means to an end, but an end in itself. Hahnemann had declared homoeopathy to be a universal system or law of nature while rejecting other rules and considerations.626 According to Bier, this attitude had even been beneficial in promoting the fast establishment of the homoeopathic school because people were keen on systems and the systems worked even better on them once they had become dogma or religion, be it Christianity, socialism, homoeopathy or allopathy. But the further development of homoeopathy in particular had shown that its all too narrow system presented “heavy chains for the spirit”. Hahnemann had often cast off these chains by moving beyond his system in practice although he remained rigid and unbending in theory.627 One of Hahnemann’s weaknesses was in Bier’s eyes his constant change of mind to which he refers in the following critical passage: “First he most emphatically points out that names and types of diseases are nonsensical and confusing, then he uses them himself. In one instance there is no specific for groups of illnesses, in another he warmly recommends belladonna against scarlet fever and camphor against cholera. While he usually rejects etiological classification, he recognizes it again at other times: ‘As the various protracted complaints of body and soul, that appear to be entirely different conditions

621 Bier (1933), p. 542. 622 Schlegel (1939), p. 146. 623 Schlegel (1939), p. 147.

624 625 626 627

Schlegel (1939), p. 188. Schlegel (1939), p. 164. Schlegel (1939), p. 157. Schlegel (1939), p. 164.

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in different patients, are partly only symptoms of that one ancient condition scabies miasm, their cure has to be attained with the same remedies, just as with the typhus epidemics where one patient presents this, the other that symptom while they all suffer from the same disease and where the chosen remedy or remedies cure the whole typhus and are therefore specific’. Passionately, he fights against any treatment that does not follow the rule of similars and against the so-called ‘allopathic’ doses, but then he goes and recommends the selfsame therapies and remedies as his recommendation of camphor against cholera shows. This Hahnemann neither chooses for all cases according to the law of similars, nor does he give it in the high potencies which he declared to be absolutely necessary for that time. I could supply scores of similar examples which I, in fact, did in this treatise. Now, I do believe that only fools and incorrigible pigheads never change their mind in the course of a long life, because it is important that one learns new things and casts off what one has recognized to be erroneous. In Hahnemann’s case, however, theory and practice are often in severe conflict with one another.”628 For August Bier, homoeopathy had been dogmatic right from the beginning which had made its further development impossible.629 He granted that it had flourished in Hahnemann’s lifetime and beyond and that a number of clever people had been involved with it. It had also been esteemed to a degree among orthodox physicians, many of whom had tried, in collaboration with some outstanding homoeopaths, to reconcile homoeopathy with orthodox medicine so that the first could complement the latter. August Bier suggested two main reasons why homoeopathy nevertheless sank in the eyes of orthodox physicians.630 The first reason had to do with homoeopathic literature where Hahnemann himself had set a poor example. Apart from the insulting tone in which he referred to allopathic colleagues his writings were full of contradictions, arbitrariness, one-sidedness and exorbitant exaggerations. While Hahnemann’s early writings had been free from such errors, they became increasingly pre628 Schlegel (1939), p. 164. 629 Schlegel (1939), p. 166. 630 Schlegel (1939), p. 169.

dominant as he grew older. Still, Bier was sufficiently convinced of Hahnemann’s homoeopathy to explore it intensely despite a very full work schedule. He declared: “I do understand […]that an excellent pharmacologist, after telling me that he found Hahnemann indigestible, asked me: ‘How can you take upon yourself the effort of studying these writings, of which you say yourself that more than half of it is irrelevant and nonsensical?’ I replied: ‘Because the smaller half which one has to work out for oneself is so precious, it makes all the effort worthwhile’.”631 The second reason which, in August Bier’s view, brought homoeopathy into disrepute among orthodox physicians was its fast descent to the level of quackery and lay healing.632 He also criticized that Hahnemann, just like orthodox physicians, outsiders and sectarians, had not embraced the Heraclitean spirit that looked at all things from all sides and knew that opposites unite to bring about harmony.633 Bier thought that Hahnemann’s contemporaries had behaved in a more insightful way than their successors, although they had been attacked and insulted by their master in the most severe and unwarranted way. Hufeland, for instance, had praised the founder of homoeopathy and let him write in his Journal der praktischen Heilkunde, just as orthodox physicians wrote in homoeopathic journals. He mentioned as an example the well-known obstetrician and gynaecologist Eduard Martin (1809–1875), professor in Jena and later Berlin. He wrote at length about Hahnemann’s doctrine in the homoeopathic journal Hygea whose editor was the homoeopath Philipp Wilhelm Ludwig Griesselich (1804–1848).634 Eduard Martin, a dyed-in-the-wool orthodox physician, had studied homoeopathic writings intensely and even founded a society for the examination of homoeopathy students. The work of Wilhelm Ameke illustrated to what extent many orthodox physicians had used homoeopathic remedies.635

631 632 633 634

Schlegel (1939), p. 169. See p. 12 above. Schlegel (1939), p. 221. To Eduard Martin cf. Tischner (1939), pp. 531–533 and Engelhardt (2002), p. 397. 635 Ameke (1884); Cf. annex for his list.

73 August Bier (1861–1949)

Although homoeopathy had come up against severe criticism as early as the first half of the 19th century, Hahnemann’s observations and discoveries were only dismissed by orthodox medicine in the second half:636 “Orthodox medicine turned entirely against homoeopathy and banished it, treated homoeopathic physicians as charlatans and quacks and did not allow them access to the notable medical journals.”637 As a result homoeopathy was shunned and because it was not able to assert itself and win through of its own accord, anybody who only showed the slightest interest in it was branded a heretic by the medical fraternity. But, Bier continued, this disdain was not the fault of orthodox medicine alone, homoeopathy itself had to bear most of the blame itself because it had never moved beyond words and theories.638 It might be right in reproaching orthodox medicine for ignoring valuable and promising homoeopathic teachings, but orthodox medicine was justified in asking: “Why did you, with all the beautiful laws at your disposal, not find what we managed to find without them?”639 The best role models for a scientifically based homoeopathy were, as Bier pointed out, Theodor von Bakody (1825–1911), Hans Wapler (1866–1951) and Alfons Stiegele (1871–1956).640

636 637 638 639 640

Schlegel (1939), p. 167. Schlegel (1939), p. 167. Schlegel (1939), p. 169. Schlegel (1939), p. 169. The medical doctor Theodor von Bakody held the chair for comparative homoeopathic pathology and therapy in Budapest. Apart from being a lecturer he was also head of the homoeopathic wards in a municipal and a private hospital. Hans Wapler, who was also called “leader of the scientific stream” was also a medical doctor. It was his endeavour to help homoeopathy to gain scientific recognition and free it from the taint of charlatanism. For a very short time Wapler was director of the Leipzig homoeopathic hospital and, from 1901 to 1943, director of the homoeopathic polyclinic in Leipzig. He also worked for the Allgemeine homöopathische Zeitung where he was chief editor from 1922 to 1944. For Stiegele see p. 15 above. Bier also felt indebted to Stiegele because he had employed Bier’s pupil Arnold Zimmer as medical assistant in Stuttgart for half a year. Schlegel (1939), p. 171. Schroers (2006), pp. 7, 156. Lucae (1998), pp. 200, 218.

3

August Bier and the “World’s Biggest Natural Healing Institute” August Bier was not only attacked by orthodox physicians for his attitude towards homoeopathy, but also for introducing naturopathy into his clinic.641 Among the treatments favoured by him were therapies that used light, air, water and physical exercise. The establishment of non-surgical specialist fields within the surgery department was also based on his motto of bringing opposites together to create harmony. In order to bridge and connect the polarities of the specialist fields Bier wanted to learn as much as possible about them.642 Bier called his clinic the biggest “natural healing institute” in the world.643 Apart from the light and air sanatorium for the treatment of bone and joint tuberculosis in Hohenlychen which he had founded in 1914 and which, by 1925, had grown to 250 beds, there was an exercise square in Berlin which offered 300 places for light, air and movement therapies. In the polyclinic, Rudolf Klapp (1873–1949) treated 270 children with malformations on average per day and Dr Wolfgang Gustav Theodor Kohlrausch (1888–1980) treated numerous other abnormalities.644 Unlike the classical naturopaths, Bier did not forego pharmacotherapy. He also approached naturopathy from a teleological point of view.645 641 Bier (1930). Reproduced in: Schlegel (1939), p. 85. 642 Bier was, in fact, also self-critical and modest: “I am also convinced that not everything I present here in the wide field in which I work can be correct; considering the novelty of the thoughts involved this is not possible. But I do believe that I can supply sufficient experiential material to prove that the foundations on which I am building are good and that is enough for me.” Bier (1930). Reproduced in: Schlegel (1939), p. 86. 643 Bier (1930). Reproduced in: Schlegel (1939), p. 86. 644 Schlegel (1939), p. 67. Rudolf Klapp had joined Bier during his time in Greifswald and accompanied him to Bonn and Berlin where for many years he was head of the polyclinic. Dr Kohlrausch was head of the department for curative gymnastics to which a school for physical exercise and massage was attached. Vogeler (1941), pp. 90, 92, 94–96. The physician Wolfgang Gustav Theodor Kohlrausch is thought of as the father of German physiotherapy. 645 “At several occasions I had professed myself to be a teleologist which at the time was equivalent to being wholly unscientific. I had stood up for what is called natural healing despite my status as a surgeon and had thought out and published methods that were clearly naturopathic.” Quoted from Baldamus (1961), p. 21.

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Movement in “light and air” was particularly important for Bier. He demanded that physical exercise should be taken in the nude throughout the year. Because air, wind and sun and also the occasional shower of rain, strengthened the body like no other therapy, and because they were also healthier than the popular hydrotherapies – building up protection against colds and their effects as well as against “surgical tuberculosis” – August Bier introduced the relevant therapies in his clinic.646 At the beginning of the 20th century surgical treatment consisted in removing the foci of tuberculosis by excision, resection and amputation.647 Although the tuberculous focus was eliminated in this way, the treatment often led to mutilation and functional impairment. Gradually, various conservative treatment methods began to establish themselves. Next to immobilisation, stimulation therapy and local iodoform and tuberculin injections – of which the latter could aggravate a patient’s condition or even prove fatal – the sun treatment introduced by Oskar Bernhard (1861–1939) and August(e) Rollier (1874–1951) also gained popularity.648 In accordance with the generally growing esteem for conservative treatment methods Bier agreed that in most cases of “surgical tuberculosis” an operation was not necessary.649 Bier’s treatment consisted in a combination of sun baths, constriction hyperaemia and exhibition of iodine.650 In keeping with natural healing principles he argued: “By treating tuberculosis with light and air we learnt how carefully pampered humans have to be inured again to these natural influences before they can unfold their full potential.”651

646 Bier (1920), p. 6. 647 Fryschmidt-Paul (1999), p. 140. 648 The surgeon and bacteriologist Theodor Billroth (1829–1894) and Oskar Bernhard and August(e) Rollier had introduced the sun therapy which was intended for use at high altitude and had initially only been accepted very reluctantly. Bier put great emphasis on sun therapy also being used in the lowlands. Fryschmidt-Paul (1999), pp. 140–144. For Oskar Bernard cf. Engelhardt (2002), p. 49. 649 Sharp controversies had also arisen at the congress of surgeons in 1921 where Bier had given a presentation on the conservative treatment of bone and joint tuberculosis. Vogeler (1941), pp. 203–205. 650 Bier had first used hyperaemia for bone and joint tuberculosis. Vogeler (1941), p. 199. Fryschmidt-Paul (1999), p. 144. 651 Bier (1920), p. 6.

His commitment to physical exercise for the prevention and healing of disease had led to his appointment as principal of the German Hochschule für Sport.652 Games and sports, in his words, should serve to make the young body, especially that of academic students, a “strong vehicle for the male spirit. […] Each student should consider it his patriotic duty to steel his body so that he is able to serve his country to the best of his strength.”653 August Bier was a confirmed monarchist and, as such, deeply affected by the breakdown of the German Empire. He feared that the abolition of military service – “the greatest physical education in the world” – would result in the physical as well as moral decline of society.654 As the conditions of the peace treaty prohibited the re-introduction of military service, Bier postulated a compulsory physical training year for all young men during which they would devote themselves entirely to physical exercise.655 Bier wanted everybody to receive the training that suited their physical constitution. His ideal was the harmonious stature of the ancient Greek athlete;

652 Bier had not been the first choice for this office as we learn from a letter of the Sports League of the German Reich. It should have been Max Rubner (1854–1932), physician, director of the Berlin Physiological Institute, vice-president of the Reich Health Council and member of the war committee for the people’s nutrition. Rubner had declined, however, because he had too many other commitments. Bier held an honorary position as rector. Voigt (2006), p. 64–66. The German University for Physical Exercise had been founded on 15 May 1920 in Berlin. It was the first Sports university in the world. Bier was rector there until his retirement and his successor was Ferdinand Sauerbruch (1932–1934) who served as rector from 1932–1934. The actual leader of the university was Carl Diem who was general secretary and, from 1931, prorector. After 1933, gradual changes were implemented because the training concept did not comply with Nazi ideology. It was dissolved in 1936 and later succeeded by the Imperial Academy for Physical Exercise which closed down as well in 1939/40. Bier had always represented the university internally and to the outside. He had admitted students, supervised staff and chaired the meetings of the senate. The minutes of the meetings show that Bier was familiar with almost all university business. Up to the present time the “August-Bier-Badge” is awarded at the Sports University in Cologne to the best student of a semester. www.dshs-koeln.de/who is who/rektoren Berlin. 653 Bier (1920), p. 4. 654 Bier (1920), p. 4. 655 Bier found heavy physical exercise inappropriate for women, a view he saw confirmed by the fact that heavy physical work which did no harm to men, made women age fast and look ugly. Bier (1920), pp. 5, 16.

75 Establishing Homoeopathy at the University of Berlin

sport was to work against human “disharmony”.656 In his youth Bier himself had been an enthusiastic sportsman eager to strengthen and steel his body.657 He also thought that a healthy lifestyle had to be based on healthy nutritional values.658 The former military institutions he found to be ideal examples: the food served there had been excellent in terms of simplicity, well composed and highly nutritional.

Establishing Homoeopathy at the University of Berlin It was thanks to August Bier’s efforts that a chair for homoeopathy was established at Berlin’s Friedrich Wilhelm University in 1927 and a homeopathic polyclinic in 1929.659 But he does not seem to have been personally involved in the debate about the academic establishment of homoeopathy.660 The German Central Association of Homoeopathic Physicians had tried before to obtain a statement regarding a professorship from the Prussian universities. They decided unanimously against it, however, and the association addressed a similar application to the Prussian parliament.661 On 2 November 1925, the Prussian Ministry of State received an appeal “that professorships should also be granted to representatives of homoeopathy and other biological approaches to medicine, when they appointed chairs for internal medicine, so that the medical students could familiarize themselves with the principles of 656 Levacher (1996), p. 23. 657 Baldamus (1961), p. 9. 658 Bier (1920), p. 5. Bier had also studied nutrition in connection with severely infected wounds and high fever. Baldamus (1961), p. 52. 659 This, at least, was Fritz Donner’s opinion who had been employed in the homoeopathic polyclinic in Berlin from 1931. Donner (1955), p. 76. On Fritz Donner see p. 15 above. 660 Lucae (1998), p. 149. Bastanier (1944), p. 64. 661 Lucae (1998), p. 150. As early as 1920 the Berlin Homoeopathic League had submitted a petition to the National Assembly, the Prussian State Assembly and to the Prussian ministries with the aim of gaining recognition of homoeopathy as a fully accepted healing method. They demanded a professorship for a homoeopathic physician who would also be director of an internal clinic. Homoeopathic physicians should, moreover, have the right to dispense drugs once they had passed the relevant examination. They further requested that homoeopaths should no longer be disadvantaged because of their convictions, which also meant that they should be accepted by the health insurance companies. Mai (1996), p. 71.

3

these treatment methods in a scientifically correct manner.”662 It was mostly thanks to the conservative member of parliament and life reformer Professor Dr Martin Fassbender (1856-1943) that this chair was established in the end.663 It is worth mentioning in this context that the president of the Reich’s Health Department, Professor Carl Hamel (1870-1949), commissioned the pharmacologist Professor Dr Rost (life dates not known) to prepare a thorough evaluation of homoeopathy.664 Thanks to Bier’s paper the mood among university physicians had changed to an extent665. Their attitude was now: “We should have a look at what there actually is to homoeopathy. If a man like Bier has shown interest in it, it can no longer be seen as beneath our dignity.”666 As a result of this scientific curiosity, consultants, registrars and assistants began to look around homoeopathic hospitals and attended ward rounds and surgery hours in order to be able to draw their own conclusions. Fritz Donner reported: “This was completely unprecedented in homoeopathy, because so far only those colleagues had been seen in homoeopathic hospitals and polyclinics who seriously intended to learn about homoeopathy in order to apply it in practice. They came to homoeopathy for totally different reasons and they were given, according to their wishes, an introduction into the theory of homoeopathy, into the homoeopathic doctrine, into the special homoeopathic ideology and into 662 Minutes of the meeting of the Prussian Landtag [government], 2nd legislative period, volume 4, p. 5 6002. Quoted from Mai (1996), p. 73. For the establishment of homoeopathy at the University of Berlin in general cf. also Werner (1993), pp. 212–215 and Fassbender (1926), pp. 22–34. 663 The Privy Councillor Professor Dr Martin Fassbender lectured on financial and social economics at the University for Agriculture in Bonn and Berlin. He was particularly interested in population policy and public health and supported the life reform movement. From 1907 to 1908 he was a member of the Reichstag and from 1907 to 1918 a member of Parliament in Prussia. People referred to him as the “leader of Catholic life in Berlin”. He was also president of the Berlin charity “Caritas”. Lucae (1998), p. 203 and Biographisch-Bibliographisches Kirchenlexikon www.bautz. de/bbkl. On the occasion of Fassbender’s death Ernst Bastanier wrote: “It is certainly only due to Fassbender’s untiring intermediation that the government ever decided to establish a professorial chair and a homoeopathic polyclinic at the University of Berlin. As a sign of their appreciation of his efforts for homoeopathy the Central Association of Homoeopathic Physicians made Fassbender an honorary member.” Bastanier (1944), p. 64. 664 Donner (1955), p. 77. 665 Donner (1955), p. 76. 666 Donner (1955), p. 77.

76 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

Ernst Bastanier (1870–1953)

the homoeopathic views concerning the use of drugs. The entire homoeopathic literature and everything that had been taught in training courses and in the homoeopathy schools had for many years been tailored to this group of physicians who were so keen to learn. All of this was changing now. The colleagues who came were not so very interested in the homoeopathic party ideology and party platform – to use an expression from politics; they did not really want to know why and in which form this or that remedy was chosen for this or that disease. No, they simply wanted to know what actually happened when Dr X or Dr Y implemented a homoeopathic treatment.”667 The parliamentary decision provoked strong opposition from the university professors. Alfred Grotjahn (1869–1931) regarded the establishment of a chair for homoeopathy as a “first and therefore alarming step towards the intrusion of a pseudo-medical sectarianism into the faculty”.668

667 Donner (1955), p. 77. 668 Alfred Grotjahn, a social hygienist, was at the time dean of the medical faculty at the University of Berlin. Lucae (1998), pp. 150, 206.

In 1928 the chair for homoeopathy was offered to the Berlin physician and homoeopath Ernst Bastanier (1870–1953), who took up his professorship in the winter semester of 1928/29.669 In his inaugural address on 6 November 1928 Bastanier emphasized with an obvious aside to Virchow, that medicine did not need hostile schools and parties. What it needed was a competition for the same goals with different means. He also pointed out: “It is now up to us homoeopathic physicians to seize the moment and convince all scientists who are of good will and not prejudiced that homoeopathy is based on valuable, scientifically founded ideas and indubitable experiential facts, the closer examination and practical application of which can also enrich modern medicine. The chances of this succeeding are much higher today than before, because we all have moved to a higher level of scientific critique: homoeopathic physicians no longer believe, like Hahnemann, that homoeopathy can replace all other approaches in medicine, and our opponents know better than previous generations that they are not infallible. [...] It will be the purpose of my future lectures to show where homoeopathy is superior to today’s medicine, i.e. where the latter can gain from it.”670 Because there was no polyclinic to start with and therefore no possibility for clinical case demonstrations, Bastanier concentrated on the history of homoeopathy.671 As, contrary to the requests of the Central Association, Bastanier had not been given the possibility to carry out clinical demonstrations in His’s Clinic, the professorial commission of the homoeopathic central association declared towards the Prussian Ministry of Education that it could only accept the professorship if its members were guaranteed com-

669 Ernst Bastanier was born in Berlin. After his medical studies he worked for three years at the anatomical and pathologicalanatomical institute in Koenigsberg. He had come across homoeopathy in the writings of Hugo Schulz. His teachers in homoeopathy had been Rudolf Windelband, Victor Schwarz and Hans Wapler. In 1903 he settled down as medical practitioner in Berlin. Lucae (1998), p. 200 and Schroers (2006), p. 9. Mai (1996), p. 74. 670 Bastanier (1928), p. 3. For the – largely positive – public response cf. Lucae (1998), p. 153. 671 Donner (1955), p. 78.

77 Establishing Homoeopathy at the University of Berlin

3

plete independence and freedom of movement.672 If these conditions were not met, the association would prefer to run private hospitals and further training courses as before. The commission maintained furthermore that “the professorship is tied to a clinic or a clinical department. The lecturer in charge receives the title of ‘professor’ as did the lecturers in physicaldietetic therapy (natural medicine) in Berlin and Jena.”673 Fassbender had to renew his efforts in the following year before a homoeopathic polyclinic could be established. In the winter semester of 1929/30 Bastanier began with his lectures and exercises. He was supported by Dr Karl Kötschau (1892–1982) and Dr Rall (life dates not known) from the Stuttgart hospital.674 When Kötschau left for America after a year and Rall continued his medical specialisation in a hospital in Esslingen, Fritz Donner, specialist registrar at the homoeopathic hospital in Stuttgart, was invited to come to Berlin. From 1931–1940 he was specialist registrar at the homoeopathic clinic of the University of Berlin.675 Despite the frequent staff changes at the polyclinic, Berlin, just as Stuttgart, became an important training centre for homoeopathic physicians.676 While the Berlin chair for naturopathy came with an associate professorship and, as a training centre, also with what was called the “Hydrotherapeutic University Institute”, i.e. a comfortably furnished, publically financed hospital well staffed with physicians, nurses and balneotherapists, similar requests for the setting up of the homoeopathic chair were rejected. Bastanier was employed as a “Dozent” (lecturer), “a

term that was not in the least equivalent to the position of a professor with habilitation, who belonged to the faculty staff. In our case, the title ‘Dozent’ rather described somebody who practiced outside the faculty. […]. At least the title ‘Dozent’ looks and sounds better.”677 Establishing a homoeopathic polyclinic meant for Bastanier that he himself had to find suitable rooms for his out-patient clinic that was to be called “Homoeopathic University Polyclinic”. He also had to pay the rent himself and the costs of heating, light and medical, technical and cleaning staff.678 The Prussian Ministry of State merely supplied 100 Reichsmark for instruments, examination chairs, books, journals, laboratory equipment such as microscopes and apparatus for the determination of blood sugars. Rooms were rented close to the Charité in the ambulatory of the heart specialist Professor Dr Rosin (life dates not known), which were only used in the late afternoons.679 The building was owned by the pharmacist Koplowitz who paid the rent for 15 years. He had his pharmacy with dispensary in the same house and the polyclinic used his secretary and technical assistant as well as the polyclinical “factotum”. Staff costs had to come out of the income from patients. An assistant physician was paid for by the Schwabe Company in Leipzig.680 When the number of patients increased Madaus in Dresden paid for a second assistant.681 As the polyclinic kept growing it was decided to put the bursaries for the two assistant physicians into one pot and “in a truly ingenious way” split it into three salaries.682 The clinic gradually prospered. In a report to the Reich’s Ministry

672 Wilhelm His (1863–1934), whose father’s lectures on anatomy August Bier used to attend, had made a name for himself as a young private lecturer, among other things by discovering the atrioventricular bundle named after him which lies between atrium and ventricle and transmits impulses. In 1928/29 he was rector of the Friedrich Wilhelm University in Berlin. During the discussions about a university chair he had often spoken up in favour of homoeopathy, while insisting on the establishment of homoeopathy as a science. Lucae (1998), p. 208 and Winau (1987), p. 284. 673 Quoted from Mai (1996), p. 75. 674 Karl Kötschau was director of the university clinic for biological medicine in Jena from 1934 to 1935 and, from 1937 to 1945, head of the second department for Internal Medicine and naturopathy at the Municipal Hospital in Nuremberg. Schroers (2006), p. 78. 675 To Fritz Donner see p. 15 above. 676 Mai (1996), p. 75.

677 Donner (1955), p. 79. Before the opening of the Hydrotherapeutic Institute in 1905, an institute for light therapy and one for massage had been founded at the university. Werner (1993), p. 205. In May 1920 the first German chair for naturopathy was established which was occupied by Franz Schoenberger. 678 Donner (1955), p. 79. 679 Donner (1955), p. 79. Mai (1996), p. 75. 680 For Schwabe see p. 25 above. It is possible that the social democratic member of parliament and physician Julius Moses (1868–1942), who also supported the project, played an important part in the financial model because he was friendly with Koplowitz and the company owner Gerhard Madaus. Mai (1996), p. 75. 681 For Madaus see p. 20 above. 682 Donner (1955), p. 80.

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of Education from the beginning of 1933, Bastanier spoke of 30 to 40 patients per day a third of whom were new admissions.683 The training, on the other hand, developed more sluggishly probably due to the fact that homoeopathy did not count as an examination subject. The “theoretical-homoeopathic lectures” presented by Bastanier in the main building of the University Unter den Linden were attended by 30 students from different faculties.684 Their number seemed to dwindle considerably as the semester went on.685 In the polyclinic two-hour lecture courses with case studies were also offered twice a week. Their low attendance was explained by Fritz Donner with the fact that the times coincided with numerous other special medical presentations. He reckoned that, had homoeopathy been taught at a smaller university with fewer lecture courses on offer, Bastanier would have had more students. Whether Bastanier’s style of lecturing had anything to do with the falling student numbers is not known.686 As long as Bier was still in office, it was also possible to do a doctorate in homoeopathy: Walter Abegg (born 1905) did his in 1931 on “The Indications for Sulphur”.687 In Bier’s clinic he had investigated for which patient type and which “form of illness” sulphur worked successfully. One can assume that the dissertations were agreed with the homoeopathic polyclinic, although it is doubtful that Bastanier as lecturer was considered qualified to act as doctoral supervisor. Compared to other institutions, the homoeopathic polyclinic was quite neglected by the university. It was almost entirely third-party funded because the Prussian state, as mentioned above, only paid a monthly contribution of 100 Reichsmark which hardly justified the term public funding.688 Bastanier was only a physician, who had been granted a “lectorship” at the university, a function which he fulfilled on an honorary basis.689 No wonder, therefore, that the Homoeopathic University Polyclinic was lacking essential equipment. They could not use 683 684 685 686 687 688 689

Mai (1996), p. 76. Donner (1955), p. 81. Mai (1996), p. 76. Lucae (1998), p. 156. Donner (1955), p. 116. Abegg (1931). Mai (1996), p. 76. Donner (1955), p. 80.

that of other institutes, because they were neither part of the Charité nor of the Ziegelstraße Clinics, to which the above mentioned University Institute for Naturopathy belonged.690 They did have personal contacts to the institute for constitutional medicine, but the physicians there were so overburdened with work that they did not have the time to observe the patients at the Homoeopathic University Polyclinic although they were interested in them.691 The financial expectations of pharmacist Koplowitz also remained unfulfilled because half of the patients did not buy their homoeopathic remedies in his pharmacy. Because of the strong influence of the principles of Stiegel and Schieder, only single remedies were prescribed in the polyclinic. Patients usually received 100 tablets in an original pack for 62 Pfennig which means that if they took one tablet twice a day they lasted for 50 days. Pharmacist Koplowitz mentioned as exemplary a few renowned homoeopathic physicians who had six, eight or ten substances mixed in one bottle which brought in not 62 Pfennigs, but 10 Marks.692 Madaus in Dresden promised to fund a further assistant position in return for efficacy tests on their complex remedies. Manufacturers of complex remedies also sent large parcels with their products unbidden to the polyclinic offering to pay for an assistant if their profit was increased by prescription of their medicines and advertisements in the relevant specialist journals. The chair for homoeopathy as well as the polyclinic had been set up against the will of most university professors in Berlin. Only few of them, among them Wilhelm His (1863-1934), had been in favour of the polyclinic.693 As early as 1925 His had asked for a scientific commission of clinicians and pharmacologists who, as part of a state institute for experimental therapy, should look into the questions that had arisen from homoeopathy. Homoeopathy and its potential had to be examined by scientists who were equally well versed in the principles of homoeopathy and the exact investigation methods of the laboratory.694 Like August Bier, Wilhelm His 690 691 692 693 694

Donner (1955), p. 85. Donner (1955), p. 116. Donner (1955), p. 83. For His see p. 76 above. Lucae (1998), p. 156.

79 Hans-Heinrich Reckeweg’s Pathology and Therapy Concept

thought that nothing was more desirable than that the truths inherent in homoeopathy be unveiled and substantiated.695 As long as this was not the case, homoeopathy could merely expect research posts at the universities, but no professorships. The internist Gustav von Bergmann (1878–1955), who had been appointed head of the second medical department at the Charité, also assumed a more moderate attitude towards homoeopathy and its concerns. Bergmann had come to be convinced that the sciences were not able to explain all medical phenomena.696 In 1930 Fassbender explained in the Allgemeine Homöopathische Zeitung why the establishment of a chair for homoeopathy had met with such vehement opposition from the university professors. It was due, he said, on the one hand to the physicians’ fanaticism with regard to homoeopathy and, on the other, to the critics who insisted that homoeopathy could only be taught once pharmacology had supplied a foundation for it, based on experiential evidence from clinical experiments.697 He referred to the wide-spread accusation from orthodox medicine that homoeopathy put the practical application of its methods first and was incapable of carrying out the theoretical verification of its maxims demanded by the scientifically minded physicians. But Fassbender also mentioned the scientific homoeopathic stream represented, for instance, by Hans Wapler who even endorsed animal testing as a means for putting homoeopathy on a scientific footing.698 He quoted Wapler as saying: “The goal we envisage is that our method of research and healing should find a permanent place in the universities so that it can gain more supporters among the physicians. [...] We need university institutes and we also need sympathetic colleagues among the university lecturers so that homoeopathy

695 His (1932), p. 367. 696 Werner (1993), p. 214. Gustav von Bergmann, son of the surgeon Ernst von Bergmann (1936–1907) and Bier’s predecessor at the University in Berlin was employed at the second Medical Clinic of the University Berlin from 1903 to 1912. In 1920 he transferred back to Berlin, this time to the second Medical Clinic of the Charité where he became director. For Gustav von Bergmann cf. Engelhardt (2002), p. 48. 697 Fassbender (1930), p. 3. 698 Lucae (1998), p. 157.

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can fully unfold its potential and render Hahnemann’s great reformatory thoughts useful to the general public.”699 But the homoeopathic clinic flourished despite these adverse conditions. In January 1931 new premises were considered at Schiffbauerdamm 31–32 and funding was discussed with Robert Bosch. These plans were dropped, however, when even bigger premises with 220 beds were found at the Lietzensee.700 In the autumn of 1938 Bastanier retired from his lectorship because of his age. On 30 January 1939 Hitler awarded him the title of professor for his special merits in the field of homoeopathy. After the war Bastanier settled again as a medical practitioner in Berlin until he was granted an “honorary salary” from the City of Berlin following an application of the Berlin association of homoeopathic physicians.701

Hans-Heinrich Reckeweg’s Pathology and Therapy Concept After the war Hans-Heinrich Reckeweg (1905–1985) was among the physicians who advocated a holistic medical concept.702 He, on the one hand, intensely researched and collected a vast amount of scientific material thus laying the foundation for a synthesis and, on the other hand, applied alternative healing methods, homoeopathy in particular, in his therapies. He amalgamated the insights of generations of scientists, as Karl Kötschau (1892–1982) expressed it with reference to August Bier, into a “harmonious order of medical knowledge”.703 While studying in Berlin, Reckeweg attended the lectures of Ferdinand Sauerbruch and August Bier.704 It was August Bier, 699 Lucae (1998), p. 157. 700 It is not clear why the project was not further pursued. Mai (1955), pp. 76, 79. 701 Lucae (1998), p. 200. 702 The terms Neue Deutsche Heilkunde (new German medicine), Biologische Medizin, synthesis of Hochschulmedizin und Naturheilkunde (university medicine and naturopathy) were mostly replaced after 1945 by the term holistic medicine due to their political connotations. Jütte (1996), p. 56. For HansHeinrich Reckeweg cf. p. 22 above. 703 Cf. Karl Kötschau’s preface in Reckeweg (1957), p. VIII. 704 After Hans-Heinrich Reckeweg had spent two years in Berlin, he returned again to study at the Friedrich Wilhelm University in summer 1928 and in winter 1928/29. It can be assumed

80 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

however, who made the deepest impression on him and of whose lectures he did not miss a single one although they started at seven o’clock in the morning.705 Reckeweg regarded it as his life’s task to bring together homoeopathy and orthodox medicine.706 His research led him to found homotoxicology and introduce it in 1952 in a leading German medical journal (Münchener Medizinische Wochenschrift) in which August Bier had once also published his essays on homoeopathy.707 Like August Bier, HansHeinrich Reckeweg had a teleological view. He saw in the processes commonly referred to as disease biological i.e. natural “purposive processes”. For Reckeweg the concept of “disease” encompassed the question concerning its cause.708 His leading thought, which he saw later confirmed by molecular biology, was based on the insight that all life processes are due to chemical conversion; and this meant, according to Reckeweg, that the key functions of the physiological and pathological manifestations of life were based on chemical reactions.709 Referring to the concept of the biologist and systems theorist Karl Ludwig von Bertalanffy (1901– 1972) Hans-Heinrich Reckeweg suggested that the organism was a flow system that strove to maintain or restore its flow balance at any rate. According to this theory, substances stream into the body and are converted, used, restructured and eliminated by the organs of the flow system.710 As long as the substances fed to the flow system are “adequate”, in other words if they are substances that are needed and capable of being processed and then eliminated, the flow balance remains intact and the body is in a “state of

705 706 707

708 709

710

that he attended the lectures of Ernst Bastanier during that time although there are no sources to confirm this. After his second stay in Berlin he changed to the university of Bonn where he sat his state examination and completed his doctoral dissertation in 1930 on “The History of the dietary therapy for stomach ulcers” under Professor Carl Hirsch (1870–1930). Reckeweg (1930), p. 69. Doerper-Reckeweg (1993), p. 10. Doerper-Reckeweg (1993), p. 10. Doerper-Reckeweg (1993), p. 10. He established the foundations of homotoxicology as early as 1947/48. In 1955 he published a book on the fundamentals of homotoxicology. Reckeweg (1975), p. 142 and id. (1955). Reckeweg (1955), p. 3. Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 7, and Reckeweg (1975), p. 625. Although the history of molecular biology goes back to the 1930s, it did not gain recognition until the 1950s. Rheinberger (2005), pp. 1001–1003. Reckeweg (1975), p. 625.

health”.711 If substances enter the body, or are present in the body, which put the flow system under stress or disturb it, they act as poisons.712 Reckeweg calls these poisons “homotoxins”.713 They can be contained in food or stimulants (exogenic homotoxins), but they can also develop in the body as part of physiological metabolic processes (endogenic homotoxins).714 As a consequence reactions set in to counteract the effect of the toxins and restore the flow balance. Reckeweg defined the physiological and pathological reactions as a combat against the toxins. As a result the body would either render the toxins harmless or be damaged by them to a greater or smaller extent, and sometimes also succumb to them. While Hermann Georg Fühner (1871–1944), a pharmacologist and professor in Bonn, described poisonings in his “Medical Toxicology” as diseases which had to be treated accordingly, Reckeweg arrived at the opposite conclusion and interpreted all diseases as reactions to the threat of poisoning.715 The founder of homotoxicology rejected the view that diseased organs were the cause of numerous diseases and established the theory that they were simply the consequence of pathological conversions that were due to excessive stress or permanent damage.716 One finds similar concepts also in naturopathy as was mentioned earlier. Felke, for one, pointed out that in the view of humoralism there was no such thing as diseases of individual organs, but that each disease was a sign that the whole body was contaminated with pathogenic substances.717 In naturopathy the theory was widespread that almost all diseases were caused by foreign substances that could also be called poisons. The healthier a person was, claimed the proponents of this alternative medical approach, the more energy he possessed to excrete

711 Reckeweg (1975), p. 625. 712 For detoxification and toxification cf. p. 82 below. 713 Reckeweg (1975), p. 140. Reckeweg referred to the poisons as “homotoxins”, or human toxins, as there are also poisons that are not toxic for some animals, but for humans. Reckeweg (1975), pp. 141, 626. 714 Reckeweg (1959), p. 2. 715 Fühner (1943), p. 1. Reckeweg (1975), p. 53. Fühner was one of Reckeweg’s teachers at the university in Bonn. DoerperReckeweg (1993), p. 10. 716 Reckeweg (1975), p. 142. 717 Cf. p. 43 above.

81 Hans-Heinrich Reckeweg’s Pathology and Therapy Concept

the foreign substances; if the body was not able to eliminate them they were deposited and caused damage. According to Hans-Heinrich Reckeweg a cure consisted either in the neutralisation of homotoxins or in their excretion.718 Detoxification in the homotoxicological sense means that two or more toxins are “coupled” into a new chemical body and are neutralised. In contrast to the homotoxins these primarily non-toxic substances are called homotoxons i.e. homotoxins are poisons and homotoxons are neutralised poisons.719 Reckeweg thought that the latter were found in pus, mucus and other exudates, but also in ordinary bodily secretions such as sweat, urine and faeces. Disturbances of the homotoxon couplings are due to the inhibition of “fermentation” which usually ensures unhindered detoxification processes. When the homotoxons are excreted the biological “purpose” comes to expression: “All excretions are important for the biological detoxification process; one could say that they serve as valves.”720

Fever and Inflammation Just like Bier, the founder of homotoxicology did not see fever or inflammations as futile reactions, but as signs of a heightened defence reaction.721 According to Reckeweg the connective tissue plays a central part in inflammations: after having been broken up in the intestines and absorbed into the blood stream, numerous homotoxic substances, nutrients in particular, are deposited, first in the liver and then mostly in the connective tissue where they can remain for a long period of time without causing any noticeable 718 Reckeweg (1958), p. 4. As the article “On the foundations of homoeopathy” was slightly revised for the volume on homotoxicology published by Reckeweg in 1975, we refer to the 1958 edition. 719 Reckeweg (1959), p. 3. 720 The term “ferment” used to denominate the cell’s metabolic function. According to Reckeweg, homotoxon secretions serve to keep the skin supple, for instance. The mucous membranes are kept moist by the secretion of mucosa, i.e. of homotoxonic substances; in all excretions homotoxons, i.e. detoxified waste products, are eliminated. Reckeweg (1959), p. 4. 721 Reckeweg (1958), p. 4. In his paper “On the purpose of inflammations” Hans-Heinrich Reckeweg merely referred to August Bier with regard to his blood constriction or red-hot iron applications as examples for the similarity rule. Reckeweg (1959), pp. 1, 8.

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symptoms. Reckeweg also thought that all cellular waste products collected in the connective tissue. If there was additional contamination with homotoxins or if a certain homotoxin concentration was reached, inflammatory processes would set in.722 Referring to the pathologist Robert Rössle (1876–1956), who saw inflammations as a “digestion in the tissue”, Reckeweg spoke of the “digestion of homotoxins in the tissue”.723 He thought that the connective tissue was primarily a big storage place for numerous exogenous and endogenous toxins that came from the cells or were funnelled by the blood through the connective tissue to the cells. The connective tissue is always the interim organ that has an important storage and detoxification function.724 If too much waste gathers in the connective tissue the physiological function is no longer sufficient for its transportation and self-help measures become necessary. These consist in cleaning processes that manifest as inflammations. In their course, after or parallel to liquidation, the toxins are bound into homotoxons through the activity of the connective tissue cells. This process can emerge as an efficient curative fever and is often characterised by a crisis after which the inflammation abates and harmless homotoxons leave the organism as secretion, pus, mucus, exudates etc. The symptoms of the inflammation must therefore not be suppressed, instead the treatment must aim at supporting the body during this process; the homotoxins have to be rendered harmless by detoxification or excretion.725 To this end, mostly homoeopathic remedies are used.726 As was shown above, August Bier also thought that chronic inflammations have to be stimulated in order to effectuate a cure.727 Bier saw parallels between the effect mechanism of his stimulant therapy and the principles of homoeopathy.

722 Reckeweg (1959), p. 8. 723 Rössle had taken over the chair for pathology in Berlin in 1929 and was also director of the pathological institute at the Charité hospital. Biographische Enzyklopädie deutschsprachiger Mediziner, p. 505. 724 Reckeweg (1959), p. 8. 725 Reckeweg (1959), p. 9. 726 Cf. p. 80 above. 727 Cf. p. 64 above.

82 Chapter 3 · Homoeopathy as Part of a “Holistic Medicine”

Phases of Poisoning Homotoxicology defines disease processes either as the organism’s general defence reactions to poisons or as an expression of damage through poisons.728 According to Reckeweg the extent of the poisoning depends on whether the poison is outside the cell or has penetrated it.729 He presented a six-phase model to illustrate the body’s attempts at maintaining or restoring the flow balance that had become unbalanced by homotoxins.730 In the first three phases (humoral phases: excretion phase, reaction phase, deposition phase) the flow balance is fully restored. The disease is curable. In phases four, five and six (cellular phases: impregnation phase, degeneration phase, neoplasm phase) the cell structures are increasingly damaged and become more or less dysfunctional, i.e. the last three phases are the result of chronic disease processes. Reckeweg described the transition from one phase to the next as progressive or regressive vicariation.731

Homoeopathy and Homotoxicology Already before World War II Reckeweg had tried to find out why, under the influence of homoeopathic remedies, one disease disappeared while another one emerged instead.732 He was not convinced by Hahnemann’s explanation that the actual disease was eliminated by the secondary disease which was artificially induced by the homoeopathic remedy, and thought that the scientific insights of chemistry, physiology and medicine had progressed beyond that.733 He explained the effect mechanism of homoeotherapy with his doctrina medica: accord-

728 This does not signify that for each disease there is a clearly defined underlying homotoxin. The disease diagnosis can conceal a complex process that takes place at several levels and involves a number of homotoxins. Herzberger and Reinhart (2007), p. 84. Reckeweg (1958), p. 5. 729 Reckeweg (1958), p. 5. 730 For more detail cf. Herzberger and Reinhart (2007), pp. 11–21. 731 Reckeweg (1975), p. 627. 732 See p. 23 above. 733 Reckeweg (1975), p. 43.

ing to homotoxicology the secondary disease that Hahnemann had noticed was a secondary defence action against the toxins.734 Reckeweg considered homoeopathic preparations to be suitable for combating toxins as they stimulated the “Greater Defence System”.735 Based on his observations he had established the “Greater Defence System” as a foundation for the various detoxification processes. This system he subdivided into five subsystems which he linked up with each other to express their close interaction. The detoxification processes underlying the disease are enhanced by the homoeopathic remedies and are given a particular direction and this accelerates bonding and elimination of the toxins. The effect of the Greater Defence System manifests after the application of homoeopathic remedies especially in regressive vicariations which are identical to natural healing if they proceed up to the physiological excretion phase.736 As the homotoxin that caused the disease is, in most cases, not known, a similar homotoxin has to be used to stimulate the defence system according to Reckeweg: the homoeopathic simile. The simile excites the disturbed life force which explains the impressive defence effect that is often observed after application of the right homoeopathic remedy. The body is given a mirror-image toxin in a potentised form. Homotoxicology also confirms the ArndtSchulz-rule: diluted active agents, i.e. homoeopathically diluted homotoxins, excite life processes in a specifically antihomotoxic way.737 Because the dilutions are no longer toxic, no additional disease symptoms or toxin defence processes are provoked by the antihomotoxic remedy. The causative homotoxins can be neutralised by the newly mobilised defence mechanisms and this happens via the Greater Defence System.738 According to homotoxicology the homoeopathic remedies do, however, not target the disease symptoms. These symptoms are basically the mirror image of an internal toxic situation and the defence reactions it sets off. They are signs of the organism’s fight against 734 735 736 737

Reckeweg (1975), p. 591. Reckeweg (1975), p. 590. Reckeweg (1975), p. 589. For vicariation see above. Reckeweg (1958), p. 6. For the Arndt-Schulz Rule cf. p. 67 above. 738 Reckeweg (1975), p. 554.

83 Hans-Heinrich Reckeweg’s Pathology and Therapy Concept

the toxins that are now confronted with an antidote in the form of the simile.739 The symptoms are therefore expression of a defence reaction against the toxins. Reckeweg explained the fact that the symptomatology described in homoeopathic textbooks and pharmacopoeias in some cases only occurred intermittently or not at all with the result that the therapy remained without effect, by pointing out that a homoeopathic single remedy worked differently depending on the phase during which it was applied.740 If given in the reaction phase it was usually able to improve the condition and lead it back to the excretion phase. If it were given in the impregnation phase regressive vicariation would also occur, but possibly only down to the reaction phase which might mean that an entirely different remedy was now required.741 In the degeneration phases the homoeopathic remedy could usually only bring temporary relief. Characteristic for the treatment in the cellular phases was, according to Reckeweg, that the same preparations were given continuously because of the intermediary homotoxins that constantly emerged due to the “inhibited fermentation” typical of these phases and that were only temporarily abolished by the homoeopathic remedy which was in fact not strong enough to remediate the “inhibited fermentation” responsible for the ongoing emergence of intermediary homotoxins. This is particularly true for treatment in the neoplasm phases where suitable homoeopathic remedies need to be applied long-term. Antihomotoxic therapy works on the basis that, in cases of disease, the organism’s natural self-healing aspirations are supported by biological, and therefore natural, toxin-bonding and excretion processes.742 Even if a permanent cure was no longer possible, as in phases four to six, Reckeweg recommended the use of homoeopathic remedies next to other measures for an ongoing detoxification, as homoeopathic remedies mainly stimulated, enhanced and induced detoxification and excretion processes.743

739 740 741 742 743

Reckeweg (1975), p. 591. Reckeweg (1975), p. 592. Reckeweg (1975), p. 592. Reckeweg (1975), p. 701. Reckeweg (1958), p. 7.

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As several toxins were often present at the same time or following each other and stimulated complex defence processes, the simultaneous use of several indicated remedies was justified, with the sum total of effects being subject to Bürgi’s synergism principle.744 Reckeweg assigned a detoxifying function to the single remedy as well as to the combination preparation, while pointing out that numerous toxins and retoxins were present during the cellular phases and they had to be the main target of the antihomotoxic remedy combinations.745 As with the ongoing recovery, i.e. detoxification, the symptoms gradually disappeared, the final healing impulse could often be achieved with a single remedy in high dilution.746 Reckeweg was also open to the concept of potentisation or dynamisation which Hahnemann had only introduced later in his life.747 He felt that the effect of high potencies which had been confirmed by hundreds of honourable, knowledgeable and convincing scientists and physicians should not be called into question just because it had not been possible yet to supply chemical-physical evidence. He thought in general that one should make use of the whole range of available therapies in order to achieve lasting results. Considering the multiple possibilities offered by biology it would be very narrow-minded indeed to use only low or high potencies or nothing but mixed remedies. He also recommended not to use single remedies only in low potency, but also in high potency and to apply them parenterally as well as orally.748 Reckeweg was a proponent of potency chords.749 They are based on the principle that different potencies can address different defence systems and that by giving higher and lower potencies simultaneously potential drug reactions might be avoided.

744 745 746 747 748

Reckeweg (1975), pp. 553. For Bürgi’s principle see p. 21 above. Reckeweg (1975), p. 556. Reckeweg (1958), p. 7. Reckeweg (1975), p. 611. He appealed to the practising homoeopaths: “Always remember that the patient’s symptoms are exhortations of the cybernetic vegetative organisation which we call the Greater Defence System, and that homoeopathy is applied toxicology that takes effect in the reciprocal action and the simile principle.” Reckeweg (1975), p. 611. 749 Reckeweg (1975), p. 595.

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Lower potencies can cause drug reactions which the reciprocal effect of the high potencies is able to reduce or eliminate. “Using potency chords contained in one and the same remedy, for instance D4, D6, D12, D30, D1000 or others, considerably widens a drug’s scope of efficacy. Homoeopaths know that the D4 dilution of a drug addresses entirely different aspects of a condition from the D30. Giving all potencies in one accord ensures a very broad effect with different potencies probably addressing different defence systems. The principle seems of particular value for the wheal-inducing intracutaneous segment therapy of the ‘Injeels’, but also for mixtures of several homoeopathic remedies where the mixtures contain only few homoeopathic remedies but in several potency grades.”750 After World War II the polyclinic of the Robert Bosch Hospital in Stuttgart, for instance, used combination preparations with different potency grades of one homoeopathic remedy.751 In contrast to orthodox medicine, which had undergone a number of changes since Hahnemann’s times, and its medicines, which had been continuously transformed and adapted in line with the progress made in pharmacological research, the homoeopathic principle was based on a natural law which meant that a homoeopathic remedy once established by drug proving was final. For Reckeweg this was another argument in favour of homoeopathy. He did point out, however, that plants could be subject to changes caused by environmental influences such as radioactive radiation.752 Reckeweg was convinced that his homotoxicology could explain how homoeopathic remedies worked. While in Hahnemann’s view the homoeopathic remedy provoked a secondary disease which cancelled out the underlying primary one, Reckeweg held that it acted antihomotoxically, i.e. it induced an additional defence mechanism against the toxins.753 According to homotoxicology the body’s defence reaction to the toxins that cause the disease must not be hindered. The therapist must endeavour to support or activate the body’s defences. Chemical medicines are not considered appropriate to these requirements as they are 750 751 752 753

Reckeweg (1957)/Special publication. Cf. p. 16 above. Reckeweg (1975), p. 591. Reckeweg (1975), p. 333.

seen as constituting additional stress factors for the organism that block the natural specific and unspecific defence mechanism as a result of which the reaction capacity might be permanently lost.754 Homotoxicology as well as homoeopathy apply weak stimulants to support the defence system. Combinations of substances or combinations of different potency grades of the same substance or of different substances play an important part in antihomotoxic therapy. Because disease is seen as a multifactorial process it is necessary, according to Reckeweg, to treat it with a remedy complex which works in a regulatory way on different levels.755 Reckeweg who had also studied orthodox medicine spent much of his life exploring and researching homoeopathy. He studied its fundamental literature and thought – like August Bier – that its wealth of documentation was promising. In his Ordinatio Antihomotoxica et Materia Medica he quoted Bier as saying: “I only gained real insight into homoeopathy when I began, from 1920, to study its fundamental literature. Then I learned to separate the wheat from the chaff and realised that the wheat harvest was sufficient to make the considerable workload worthwhile. I had to concede that I could have saved myself many errors and deviations if I had embarked on this research 30 years earlier.”756

Injection Therapy with Homoeopathic Remedies Injections were not popular initially, in homoeopathy as little as in orthodox medicine.757 The Englishmen John Wilkins (1614–1672) and Christoph Wren (1632–1672) were the first to experiment with intravenous injections on humans.758 Richard Lower (1631–1691) and Jean B. Denis (1625–1704) performed the first successful transfusions. Lower trans754 Herzberger and Reinhart (2007), p. 59. 755 Herzberger and Reinhart (2007), p. 60. 756 He chose this quotation also as his motto in the introduction to his paper ‘On the fundamentals of Homoeopathy’ (1958). Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (e.g. 1959, 1967), Introduction. Reckeweg (1975), p. 11. Schlegel (1949), p. 40. 757 For the history of intravenous injections cf. Buess (1946). 758 Eckart (2005), p. 116.

85 Hans-Heinrich Reckeweg’s Pathology and Therapy Concept

ferred animal blood to another animal and Denis first introduced the transfusion of animal blood to humans. Injections as well as transfusions presented a considerable risk for the life of patients: the outcome often proved fatal and the procedures were soon prohibited. In the 19th century they came back into fashion but again led to the death of patients.759 The method was only developed into a safe therapeutic procedure in the 20th century. August Bier was, as we have seen, among those who injected animal blood intravenously,760 but not, like orthodox medicine, as a substitute but in line with the simile principle in order to stimulate the focus of inflammation to react and to enhance the healing process. Reckeweg was convinced that injection preparations were particularly effective and promising of a quick success as the antihomotoxic remedies were supplied directly to the defence mechanism.761 The chemical pharmaceutical factory in Göppingen, for one, advocated the use of injections in homoeopathy in the 1930s. Injections were recommended when patients were unable to ingest homoeopathic preparations.762 Reckeweg prepared his own injections with sea water to enrich them with mineral trace elements.763 He called all his ampoule preparations that were made up of potency chords of single substances “Injeels” (Injectiones Heel).764 All Injeels and ampoule preparations could also be taken orally: diluted in a cup of water they should be drunk over a period of two days.765 Reckeweg also gave his patients blood, but did not use animal blood but the patient’s own blood.766 In contrast to the usual own-blood therapies he administered it in a diluted and potentised form as through potentisation the homotoxins in the blood stream would be detoxified in accordance with the Arndt-Schulz rule. Blood was taken from the patient and then homoeopathically potentised over several 759 760 761 762 763 764 765 766

Eckart (2005), p. 117. Cf. p. 65 above. Cf. p. 82 above. For Carl Müller cf. p. 32 above and Chemisch-Pharmazeutische Fabrik Göppingen (1938), pp. 5–10. Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 241. Herzberger (1995), p. 52. E.g. Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), pp. 17, 241, 278. Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 10.

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stages before it was re-injected. Reckeweg did therefore not use the procedure in the sense of the simile, but isopathically. By adding suitable homoeopathic injection preparations such as nosodes or suis-organ preparations he wanted to further enhance the effect of the potentised own-blood injections in line with Bürgi’s principle.767 Reckeweg also used nosodes to combat homotoxins.768 The 2000 official German Homoeopathic Pharmacopoeia (HAB) defines nosodes as “preparations gained from human or animal disease products, derived from pathogens or metabolic products or from decay products of animal organs”.769 For the production of nosodes the raw material is first sterilised and then tested for sterility. 770 This substance is then made into a mother tincture. Nosodes are homoeopathic because they conform to the simile principle. The symptoms are therefore often not explored through homoeopathic drug provings. The preparations are usually applied as homoeopathic potencies. The concept traces back to Constantin Hering (1800-1880) who also introduced the term “nosode”.771 “In the autumn of 1830 he collected the content of scabies pustules from a young black man who suffered from scabies with large vesicles. Hering opened all the mature pustules and mixed the pus in a vial with spirit of wine. With the potentised substance he carried out drug provings on healthy subjects. In 1833 he also succeeded in taking the infected saliva of a rabid dog. The drug proving testified the efficacy of the preparation and he used it to cure rabid dogs as well as ulcers of patients who had been bitten by rabid dogs. His prophylactic attempts were also suc-

767 Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 10. Herzberger (1995), pp. 79–81. For Bürgi’s Principle see p. 21 above. 768 Reckeweg (1975), p. 226. The term “nosode” comes from the Greek and means disease-related. Lanninger-Bolling (1997), p. 9. Cf. also her historical survey on pp. 9–13. 769 Homöopathisches Arzneibuch (hab) (2000), vol. 1, chapter H 5. 2. 5 (3 / 4). 770 For the safety of medicines cf. the detailed information in Herzberger and Reinhart (2007), p. 74. For the different nosode groups cf. Lanninger-Bolling (1997), pp. 16–20. 771 Constantin Hering was an enthusiastic follower of Hahnemann who tried to develop his own concept of homoeopathy. He emphasized that the homoeopathic materia medica needed to adjust its principles. Cf. Tischner (1939), p. 497.

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cessful. Hering wrote: All those who had been bitten by dogs thought to be rabid and to whom I had given the hydrophobin did not fall ill”.772 Johann Wilhelm Josef Lux (1773/6–1849) must be mentioned in this context. He was one of the founders of veterinary homoeopathy.773 Lux is best known for his 1833 paper “Isopathy of the contagions” with which he founded modern isopathy.774 When asked by a Hungarian estate owner to supply remedies for the treatment of his mangy and glanderous animals, Lux had tried to replace the lacking simile by an “aequale” by taking a drop of blood from a mangy dog and potentising it to C30. He did the same with the nasal mucosa of an animal that suffered from glanders.775 Reckeweg’s nosode therapy is based on the idea that nosodes excite specific stimuli that activate the defence system directly. On returning from the war he immediately began with the nosode therapy and he produced nosode preparations from 1946.776 Homotoxicology assigns a deep constitutional effect to nosodes.777 They are mostly used to reverse the cellular phases back to humoral phases, but also in humoral phases when there is risk of the disease becoming chronic.778 As part of his antihomotoxic therapy Reckeweg also used animal organ preparations.779 “Suis-preparations” are homoeopathically produced organ preparations derived from the organs of healthy (nowadays controlled) pigs.780 The ampoule preparations are only sterilised after potentisation. “Thus the material retains the character of the living tissue during potentisation and the preparations have a direct protein link to the diseased organ.”781

772 www.leo-willin.de/essais/nosoden.htm. 773 Schroers (2006), p. 91. For Lux cf. also Kannengiesser, pp. 228– 248. 774 Tischner (1939), p. 316. 775 Julian (1994), p. 7. 776 The first nosode preparation was “Psorinoheel”. Reckeweg (1975), p. 373. 777 With regard to his nosode preparations Reckeweg referred to Julian (1994). Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 284. 778 Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 284 and Herzberger and Reinhart (2007), p. 76. 779 Reckeweg (1975), p. 615. 780 Herzberger and Reinhart (2007), p. 77. 781 Herzberger (1995), p. 64.

Whether the founder of antihomotoxic medicine was influenced by Bier who also gave his patients organ preparations cannot be established from the sources. We can assume that Reckeweg was familiar with the research outcomes of the famous clinician especially as he was studying in Berlin in 1929, the year in which Bier’s paper “On organ hormones and organ therapy” was published in the Munich journal Münchener Medizinische Wochenschrift. Bier hoped that the organ therapies would reduce the need for surgical interventions.782 In his hospital in the Ziegelstraße organ preparations were mostly used to treat the liver and the nervous system.783 To treat the hepatic duct they used porcine organ segments as their source material.784 Patients suffering from tabes, a nervous disease, could buy an organ preparation called “Promonta” which contained, among other things, substances derived from the central nervous system.785 In order to exert an effect an additional irritant was needed (Bier’s associate chose strychnine) to help the diseased organism to absorb the organ preparation.786 To explain this combination, Bier referred to a Hahnemannian principle which said “that certain remedies change a person’s constitution in such a way that his disease is cured by other substances which would usually remain without effect. It [the rule] calls these kinds of substances ‘constituents’.”787 Bier reckoned that the organ preparations did not address the disease directly but that they strengthened and regenerated the organ that had lost its power of resistance so that it was enabled to help itself. This view was confirmed in Bier’s view by the fact that the remedy worked for different afflictions of the same organ.788 He argued that the treatment as such consisted in supporting the physical organism by stimulating the “natural healing force”. For him the question was if organ preparations substituted components that were lacking in the diseased organ or if they served purely as stimulants that activated the “malfunctional” organ to fully function again. Bier assumed that it was a case of both but found the 782 Bier (1929), pp. 1031, 1035. 783 Bier’s colleagues also had organ preparations manufactured for kidney, stomach, duodenal diseases. Bier (1929), p. 1031. 784 Luetkens and Gehrke (1929), p. 1035. 785 Gehrke (1929), p. 1042. 786 Bier (1929), p. 1031. 787 Bier (1929), p. 1031. 788 Bier (1929), p. 1032.

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latter possibility more desirable because that was the only way to cure diseased organs. Substitutes would only work temporarily and would require continuous or at least frequent application.789 Bier also pointed out that, apart from some references to organ therapies in the Hippocratic writings, ancient oriental documents also advocated the use of blood, liver, brain, testes, uterus and adherent glands (ovaries), lung, spleen, kidney, urinary bladder, mammary gland, salivary gland, oral mucosa, stomach, skin, hair and feathers, isopathically i.e. against diseases of the same organ, as well as against other or “general diseases”.790 Not only organs were used as remedies but also excretions such as bile, milk, urine, faeces. In antiquity organs were also administered in the raw state. Bier procured industrially processed organ preparations because the use of raw organs had proved to be very difficult. He thought, however, that it might be possible in the future to use whole organs again. He considered it advantageous that organ preparations could be taken orally, because – next to the specific pharmacological effect, an unspecific stimulant also played a part with injected medicines and this was much rarer and weaker with oral applications. Bier also saw the possibility that one would differentiate between male and female organs in the future, or that it might be indicated to treat men with female organs and vice versa. He postulated: “I urge those who test these remedies to use them as exclusively as possible and keep away from the truly horrible polypharmacy of our contemporary medicine. It has again become as widespread as it was in Hahnemann’s times and one can only wish for another Hahnemann to appear and crush the serpent’s head as successfully as the former had done. Only in very special circumstances is it permissible or necessary to give several remedies with the organ preparations, such as, for instance, with heart medications given to Graves’ disease patients who suffer from serious heart problems.”791 Reckeweg was in favour of the suis-organ preparations. Homoeopathy uses porcine preparations in accordance with the simile principle, as the tis789 Bier (1929), p. 1032. 790 Bier (1929), p. 1033. Treatment with animal organs was also known in ancient Chinese medicine. 791 Bier (1929), p. 1035.

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sue structure of pigs is similar to that of humans, although it is considered to be inferior.792 When using cell extracts there is a risk of damage so that the homoeopathic dilution of organ preparations is paramount if one wants to achieve the reciprocal effect specified by the Arndt-Schulz rule, especially as porcine tissue contains additional toxins, according to homotoxicologists: the sutoxins.793 The organotropic use of suis-organ preparations is primarily recommended for the cellular phases, for instance in chronic cases, so that the tissue that is in the deposition phase can also benefit from the treatment.794 Reckeweg produced suis-organ preparations as potency chords for parenteral organ therapy.795

Nutrition and Sutoxins The concept of homotoxicology implies the necessity for a poison-free lifestyle to remain healthy. This means, among other things, that one should not take in poisonous substances (homotoxins) with one’s food. Reckeweg studied nutrition in depth and it ranked highly in his therapy system.796 He advocated a “biologically sensible diet”. In his Ordinatio Antihomotoxica et Materia Medica he recommended a mixed diet as most suitable for humans.797 Apart from avoiding harmful substances one should pay particular attention to how the food was taken in, as thorough insalivation was crucial for a healthy digestion. Reckeweg pleaded above all for a varied diet using only superior, fresh and natural foodstuffs such as vegetables, fruit, salads and suitable meats; these should, however, not be served in one meal. As in Felke’s nutritional programme it was considered best to start the day with fruit, but while Felke recommended a maximum of three meals per day, Reckeweg thought it best to spread seven meals over the day. He said that one should never feel full after 792 Reckeweg (1975), p. 615. 793 Reckeweg (1975), p. 616. For sutoxins cf. below. 794 Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 278. 795 Heel (ed.), Ordinatio Antihomotoxica et Materia Medica (1967), p. 278. 796 Hans-Heinrich Reckeweg’s father, Heinrich Friedrich Reckeweg, had been very particular about the right diet for his children. Doerper-Reckweg (1993), p. 10. 797 Reckeweg (1967), p. 307.

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eating. Immediately after waking up one should eat a fruit and then have a first breakfast before starting work between 7 and 8 o’clock followed by a second breakfast some time later. Lunch should be taken between 12 and 1 p.m., afternoon tea between 3 and 4 p.m., a snack between 5 and 6 p.m. and supper between 7 and 8 p.m.798 Reckeweg also warned against foodstuffs that contained colorants.799 Since the 1850s the “arsenal” of additives had grown considerably due to the development of the chemical sciences. In order to feign higher quality, vast amounts of artificial colours, for example lead chromate and verdigris were added to sausages, pasta and confectionary. Bread contained special bleaching agents as well as baryte, gypsum or potatoes; beer was mixed with alum, coffee with chicory and tea with graphite, rubber solutions and green vitriol.800 In 1975, nutrition legislation was reformed and stricter controls were introduced as a protection against health risks and deception.801 Reckeweg considered the consumption of pork to be particularly unhealthy. As mentioned earlier, special poisons (sutoxins) were said to be present in pig meat according to homotoxicology which the body could not break down and which were therefore deposited.802 According to Reckeweg sutoxins were not excreted in the excretion phases but only in the reaction phases, which meant that they manifested as

798 Monika Doerper-Reckeweg describes in her reminiscences how, after the war, they used to pick dandelion leaves with their father in the spring and turned them into a tasty salad in order to get fresh vitamins. The aromatic watercress was also used to prevent the deficiencies so common at that time. From the time when Bircher muesli became known, though it was not yet fashionable, porridge from oat flakes mixed with fresh blueberry compote was part of Hans-Heinrich Reckeweg’s daily menu. He considered oat flakes to be one of the most important foodstuffs because they were rich in vitamins, minerals, protein, fat and carbohydrates which meant they contained almost everything the human organism needed. Doerper-Reckweg (1993), p. 44. 799 For the history of the adulteration of foodstuffs and for food chemistry, since the mid-19th century in particular, cf. Wiegelmann and Teuteberg (1986), pp. 371–377. 800 Wiegelmann and Teuteberg (1986), p. 374. 801 “This reform amended and abolished 16 earlier laws and 40 statutory orders which partly stemmed from the 19th century.” Wiegelmann and Teuteberg (1986), p. 371. 802 Reckeweg (1975), p. 419.

boils, eczema, fluor albus etc.803 Because pig meat had a high energy density it would first be stored in the connective tissue if eaten excessively. In Reckeweg’s opinion this led to the obesity (adiposity) typical in pork eaters. Eating too much pork would also result in raised cholesterol levels which could cause high blood pressure, arteriosclerosis or circulatory disorders, myocardial infarction etc.804 The sulphur-rich mucous substance of the connective tissue presented a particular risk, Reckeweg warned. Homotoxicology blamed amino sugars, hexosamines and sulphurous substances such as chondroitin sulphuric acid and mucoitin sulphuric acid for the mucous swelling of the connective tissue.805 Reckeweg found the deposition of mucous substances in tendons, ligaments and cartilage particularly dangerous. It could lead to rheumatism, arthritis and arthrosis as well as invertebral disc degeneration, as the coarse connective tissue substances became mucous and soft and therefore less resistant. Reckeweg explicitly referred to August Bier who had injected test animals with sulphur.806 This had led to a mobilisation and elimination of the tissue sulphur which had made the cartilage firmer and poorer in sulphur. Reckeweg explained the effect of sulphur baths in the same way: cartilage, he said, was firmer and more resistant the less sulphur it contained. Reckeweg was also opposed to the consumption of pork because pigs were fed growth hormones which caused inflammations and tissue swelling in humans.807 Because of its histamine content he also thought that pork caused itching which could induce inflammatory processes such as furuncles, carbuncles, appendicitis, gall disorders, phlebitis, but also fluor albus in women as well as skin disease. Referring to Richard Shope’s (life dates unknown) work at the 803 Reckeweg also saw a danger in the fact that these reaction phases that served the purpose of detoxification and elimination of the sutoxins were hindered by highly effective remedies and that the waste products were forced back as retoxins to the area of their origin, a process equivalent to retoxic impregnation. Reckeweg (1975), p. 99. 804 Reckeweg (1977), p. 10. 805 “This leads to the characteristic swelling of the connective tissue to Rubenesque opulence only encountered in eaters of pig meat. It absorbs water like a sponge and gives the pork eater his typical cushion-like enlargement of the connective tissue.” Reckeweg (1977), p. 10. 806 Reckeweg (1977), p. 11. 807 Reckeweg (1977), p. 12.

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London Virus Research Institute he put forward the theory that the influenza virus survived the summer in the lungs of pigs.808 Hahnemann, by the way, had also been cautious with regard to the consumption of pork and he had advised sick people in particular against it.809 He assumed that due to substances that were very close to decay, disorders such as “inflammatory tendencies of the blood”, suppuration and skin rashes could deteriorate or recur.

Homoeopathy as the “Mother of Medicine” Just like homoeopathy, antihomotoxic medicine postulates the setting up of an overall treatment plan: in order to be able to select the right homoeopathic remedy or remedies in a given case, the toxin situation had to first be established in detail. Thorough case taking was part of this as it took into account previous illnesses, how they were treated and how the diseased organism had reacted to the treatment.810 The symptom picture needed to be clearly delineated and the course of the present, acute or chronic, disorder investigated. In homotoxicology, every toxic situation has its particular symptom picture on the basis of which the antihomotoxic remedy is selected.811 The preparation chosen in this way supports the organism by stimulating the immune forces against the homotoxins. The choice of remedy complies with Hahnemann’s similarity rule. If there is no clearly matching drug picture for the constellation of symptoms it is, according to Reckeweg, a matter of several toxins putting strain onto the organism with their interference rendering it impossible to identify one definite drug picture.812 In these cases he recommended a therapy concept with combination preparations in which the state and course of the disease in relation to Reckeweg’s table of phases played an important part. Depending on the disease phase, different remedies had to be combined so that

808 809 810 811 812

For Shope’s work cf. www.jem.org/cgi/content/full/203/4/803 Cf. above. Herzberger and Reinhart (2007), p. 83. Herzberger and Reinhart (2007), p. 84. Herzberger and Reinhart (2007), p. 85.

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one toxic layer after the other would disappear and ultimately only one remedy would be necessary to achieve a full recovery. One maxim of homotoxicology is that acute conditions require lower potencies while for chronic cases the strategy was different: the patient had then, according to homotoxicologists, reached of the three cellular phases and the immune forces were no longer able to deal with the homotoxins. Because those homotoxins were now so numerous and the defence system already weakened it was not advisable to choose the potencies too low, because of the risk of further aggravating the homotoxin situation. The mild stimulants would gradually reactivate the organism’s defences. In phases four to six especially, it could come to “inhibited fermentation” and damage to the cell structure. Reckeweg preferred suis-organ preparations in these situations to achieve a stronger stimulation of the cell structures.813 Reckeweg regarded homoeopathy not as a complementary method, but as the basis of all drug therapy; for him it was “the mother of medicine”814, a fact which did not prevent him from considering other remedies to be also useful for detoxification. Biological remedies were for him in tune with nature and supported the organism’s own healing forces. They characteristically aimed at effecting regressive vicariation, in other words, at moving the symptoms towards a more favourable phase, always with regard to the physiological excretions. It seems only logical therefore that Reckeweg favoured the methods of naturopathy as well. He was particularly enthusiastic about clay therapies.815 According to homotoxicology – and we have met the same ideas in naturopathy and in Felke’s concept – secretions such as sweat, mucosa, pus and pruritus must not be suppressed as this would hinder the excretion of pathogens and encourage renewed toxification.816 813 Herzberger and Reinhart (2007), p. 87. 814 Reckeweg (1975), p. 589. 815 Biological therapies, according to Reckeweg, included diet, fasting, massage (gymnastics, sports, physical exercise), hydrotherapy, acupuncture, chiropractic, correction of posture, treatment with leeches and cupping, urine therapy, non-specific protein therapy, haematogenic oxidation therapy, oxygen insufflation, cellular therapy, hormone therapy, antibiotics therapy (elimination of homotoxins), inoculations, surgical measures, cytostatics, roentgenotherapy, neural therapy. Reckeweg (1975), pp. 667, 582. 816 Reckeweg (1958), p. 8.

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Instead, Reckeweg recommended washing, bathing, poultices, compresses, external “healing earth” applications etc. in order to rinse off, draw out and divert the homotoxins directly.817 It was Felke who had complemented homoeopathy, the “backbone” of his healing system, with healing factors such as light and air and who had included guidelines on nutrition and exercise. Hahnemann also did not

817 Reckeweg (1959), p. 11. After the war, Hans-Heinrich Reckeweg had spent two weeks in the “Pastor-Felke Bath” in Diez on the river Lahn taking mud baths and doing exercises. He was so enthusiastic about the clay therapy that he went on to recommend clay compresses and mud baths to many of his patients after returning to Triberg where he had settled down. His father, Heinrich Friedrich Reckeweg, had also been enthusiastic about the Felke Bath. Cf. Doerper-Reckeweg (1993), p. 45.

claim exclusivity for homoeopathy and did not restrict himself to drug therapy, but included dietetics and hydrotherapy in his treatment plans. Reckeweg advocated other “biological” healing methods next to homoeopathy and saw it as his life’s task to bring about the union of orthodox medicine and homoeopathy.818

818 Doerper-Reckeweg (1993), p. 10.

4 Summary

Homoeopathy as founded by Samuel Hahnemann is based on medicinal therapy. Classical homoeopathy does still not select remedies on the basis of diagnosis, but applies the principle of the similarity of symptoms. It is this similarity alone that determines the choice of remedy. The earlier, classical naturopathy, in contrast, was a drug-free therapy and availed itself of the healing influence of light, air, water, earth as well as a healthy diet and exercise. Hahnemann did not claim exclusivity for his concept but welcomed a pluralistic medical approach. He also employed dietetics in his treatments as well as hydrotherapy and mesmerism, both fashionable at the time. In all of this, he did, however, insist on the principle of individualisation. Influenced by naturalism, the founder of homoeopathy called for a natural life style with a simple diet, but saw both as measures that supported the medicinal treatment. In contrast to classical homoeopathy, classical naturopathy entertained a disease concept that was based on humoral pathology. According to the naturopathic view, any disease could be reduced to foreign substances or defined as poisoning. Naturopathy did not classify diseases, though, nor did it rely on detailed diagnoses. In contrast to orthodox medicine, the older naturopathy did not acknowledge clearly delineated organ diseases.

It was Emanuel Felke who, at the turn of the 20th century, brought homoeopathy and naturopathy together. He based his concept of disease on naturopathy but modified it in some respects. He declared homoeopathy to be the backbone of his healing method while including the curative measures favoured by naturopathy. He saw the effects of homoeopathy and naturopathy as running parallel to each other. As the foreign substances were not only wrongly imported into the body, but also remained their because of faulty elimination, he recommended the use of baths in light, air and sun, sitzbaths and clay applications. Their foremost purpose was to draw the poisonous substances out of the body. He complemented his treatment system with guidelines on nutrition and exercise. Felke did not restrict himself to the analysis of symptoms, but used eye diagnosis and facial analysis to find the cause of a disease. Felke’s work gave rise to a critical mass movement around the turn of the century. In the mid-1920s, August Bier, the prominent surgeon at the Berlin University Clinic, brought homoeopathy to new fame. He postulated a complementary relationship of orthodox and alternative medicines and, in the face of much resistance, pleaded for the union of orthodox medicine and homoeopathy. Yet, homoeopathy was for him just one of many medical approaches and he supported isopathy and naturo-

B. Blessing, Pathways of Homoeopathic Medicine, DOI 10.1007/978-3-642-14971-9, © Springer Medizin Verlag Heidelberg 2011

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pathy as well. His endeavour was the advancement of medicine; his interest lay in scientific progress rather than the establishment of a hierarchy of medical approaches. He followed the Heraclitean principle of the union of opposites creating harmony and argued that by excluding homoeopathy, isopathy or orthodox medicine a “harmonious concept” of medicine could not be attained. His considerations on homoeopathy were ultimately an appeal to science to not come to a standstill but to continue to research a yet unexplored field. Hans-Heinrich Reckeweg, who had been familiar with naturopathy and homoeopathy from early childhood and whose teachers included August Bier, was among those physicians after World War II who proposed a healing concept that was based on holistic thinking. Throughout his life he strove to bring together homoeopathy and allopathy and therefore did all he could to further the development of the healing systems. From the plethora of scientific material and knowledge he created the foundation for a synthesis which he used in order to explain the mechanism of efficacy of the homoeopathic materia medica. Antihomotoxic medicine, which he founded, defines pathological processes as the organism’s defence actions against toxins, or as the damage induced by toxins. Homoeopathy was for Reckeweg the basis of all drug therapy, but he also made use of other biological remedies and therapies. Nutrition and exercise also played a major part in his approach. Homoeopathy is more than 200 years old now and for many people it has remained an attractive medical system.819 What its supporters appreciate mostly is to have efficacious remedies that do not cause any side effects.820 Generations of homoeopathic physicians and patients as well as homoeopathic 819 In a representative survey of 1100 Germans published in 2004, 62.3 per cent specified that they had used at least one alternative method within the previous 12 months. 14.8 per cent used homoeopathy. The demand is also reflected in the numbers of physicians who choose specialist training. In 2004, 15,970 physicians held additional qualifications as chirotherapists, 13,502 as naturopaths and 5,538 as homoeopaths, according to a report of the federal association of medical practitioners (Kassenärztliche Bundesvereinigung). With regard to acupuncture, where the additional official qualification was only introduced in 2004, the estimated number of medical practitioners is between 20,000 and 50,000. Weidenhammer (2006), p. 2929. 820 Sahler (2003), p. 160.

associations, journals, institutions and lay organisations have kept homoeopathy alive since Hahnemann’s times.821 Since its first beginnings, numerous variations and different opinions have evolved within homoeopathy. Conflicts were ultimately due to the fact that, after Hahnemann’s demise, classical homoeopaths considered his doctrine as final and complete. This means that progress and new findings of the biological, chemical and medical sciences have remained unconsidered by some, while others have included the scientific knowledge, even though critically, into their homoeopathic approach and endeavour to adjust homoeopathy to contemporary standards. Hahnemann’s and classical homoeopathy’s main tenets included – next to the drug provings on the healthy subject, the similarity principle and the giving of smallest doses – the principle of the single remedy. It was still in Hahnemann’s lifetime that an alternative approach established itself which went against the dogma of the single remedy. As science never stood still but continued to evolve, the scientific-critical stream of homoeopathy developed new concepts based on various explanatory models. Despite their differing views, all complex homoeopaths and proponents of spagyrics mentioned here were committed to Hahnemann’s simile principle. Hahnemann himself had been attracted to the idea of the double remedy for a short time. It was in the end his fear of being accused of practising the kind of polypharmacy popular among orthodox physicians around 1800 that kept him from authorising the double remedies. He moreover considered the preparation technique to be too complicated and laborious to enable him to establish the relevant guidelines. The founder of homoeopathy was concerned also because most homoeopaths found it extremely difficult in any case to find a remedy that matched the characteristic symptoms. Despite of his having conducted only a few tests, Hahnemann did not deny the efficacy of the double remedy in exceptional cases, but, like many critics after him, he thought that the mixtures were of inferior quality. Dogmatic single remedy homoeopaths were not only concerned that the dual remedy approach constituted a deviation from Hahnemann’s doctrine, but that it might divide the homoeopaths and thus strengthen 821 Schmidt (no date), pp. 15–29.

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the allopathic camp. Complex homoeopaths countered that patients who had been treated unsuccessfully with homoeopathy would be driven into the arms of the allopaths. Classical homoeopaths also argued that not enough scientific knowledge about the single remedies was as yet available and that one could not foresee their effect. There was a danger, they thought, that it was more difficult to find the right remedy and that, the less experienced practitioners were, the more remedies they would mix together. Keeping the composition of mixed preparations secret constituted a particularly severe offence in the eyes of classical homoeopaths. A new chapter in the history of homoeopathy was opened around 1900 with the first industrial production of complex remedies. It was mostly pharmacists and physicians who founded factories for homoeopathic remedies. While classical homoeopaths had already rejected mixed preparations that were hand prepared for the individual patient, they were even more incensed about their industrial production. They accused the remedy manufacturers of omitting the drug proving on the healthy subject and of trying to save themselves the time and trouble of searching for the right simile, thus violating the individualisation principle. They moreover criticized that clinical results, if there were any, were not published. Lay practitioners attracted criticism from all sides with the homoeopathic orthodoxy accusing them of merely seeking commercial profit with their homoeopathic combination remedies. To start with, the proponents of double remedies had only permitted their use in cases where a single remedy showed no effect or did not correspond to the symptom picture. They also believed that drug mixtures worked faster and more efficiently. But soon there were supporters who intended to use the double remedy as a matter of principle in chronic cases of disease. Trials in Italy were said to have shown as early as 1840 that certain double remedies elicited symptoms that were assignable to both remedies, while others could be assigned to the one or other; at the same time there were symptoms that were a result of the combination of both drugs. The argument that the double remedies were based on arbitrary mixing was invalidated by the “renegades” insisting that all drugs were selected in keeping with the simile principle and that they could

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therefore not be put on a par with the mixtures of the allopaths. In any case, one could only speak of mixtures when coarse substances were concerned, not with high dynamisations where a dematerialisation had taken place. The complex homoeopaths rejected qualms about remedies possibly cancelling each other out if too many of them were mixed together. Some even thought that the mixing of remedies could reduce the unwanted side effects of single remedies. It was generally believed that the substances were composed to enhance each other; there was neither antagonism between them nor assimilation, while there was the danger with alternating homoeopathic single remedies that they would interfere with each other, if they were given in too quick succession for instance. The scientifically minded homoeopaths supported their preference for homoeopathic drug mixtures by arguing that naturally occurring substances could also be compounds: remedies gained from one and the same plant could feature a variety of chemical compositions. It was therefore the task of the physician or pharmacologist to find out the substances that were thus related or complemented each other and mix them in a way that no mutual elimination of active agents could occur. Another justification presented to classical homoeopaths was that the remedies were in any case subjected to chemical transformation processes in the body. Since the beginning of the 1990s there has been a differentiation between naturally occurring “complex remedies” and the man-made “combination remedies”. Accusations that they were ignoring Hahnemann’s symptomatology were countered by some complex homoeopaths with the argument that orthodox homoeopathy overrated them, while others thought that the diversity of symptoms in fact asked for the combined effect of different remedies. Another argument put forward was that it was hardly possible to find one remedy that provoked exactly the desired symptoms, while, by adding other substances, one could target the disease symptoms with much greater certainty. Not to use combinations meant, moreover, to exclude valuable and potentially successful options as diseases were often caused by a number of damaging influences and a complex of remedies was therefore indicated. There was consequently widespread agreement that a complex of symptoms

94 Chapter 4 · Summary

required a complex of remedies. The proponents of homoeopathic mixtures, on their part, criticized that the number of symptoms registered in the homoeopathic repertories had grown to such an extent over time that it had become very difficult to find the right remedy at all. They were also sceptical about the lists of registered symptoms because of their not having been observed in one person but in several. It was also claimed that trials had shown that the same remedy did not necessarily have the same effect when absorbed by two different organisms. As the drug mixtures were becoming established it was also suggested that the organism was able to choose from the substances administered to it the ones it needed for its recovery, while it eliminated those that were of no use to it; they would not cause any aggravation because they exerted no medicinal effect whatsoever. Just as the healthy organism needed various nutrients to retain its balance the sick organism could take in several remedies. According to August Bier only very few diseases could be cured with drugs; in principle, drugs supported the natural healing process. Homoeopathic remedies were for him stimulants that activated the physical organism directly to remediate any damage. Hahnemann had used a similar argument when, in the last third of his 60-year career, he tried to define disease as the result of an unbalanced spiritual life force and healing as the direct effect of the medicinal power on this life force.822 Five years before his death Hahnemann had declared that the homoeopathic remedy had the effect of holding up an augmented image of the disease as an enemy to the life force which would ultimately induce it to summon up its own energy to regain full command over the organism.823 Hahnemann’s great dogma that the choice of remedy must never be based on the diagnosis of a disease, but only on the similarity of symptoms was also rejected by the complex homoeopaths. They argued that their comprehensive drug therapy took into account the diseased organs that were responsible for the disorders, in other words, they no longer, or not exclusively, combated the symptoms but also the cause of the disease. Some proponents of spagyrics held 822 Schmidt (1993), p. 1087. Hahnemann was well aware of the speculative character of his explanation and did not intend to use it in defining the fundamentals of homoeopathy. 823 Schmidt (1993), p. 1087.

that any malaise had its origin in the lymph or in the blood. They agreed with Hahnemann in saying that one single remedy was capable of exerting a simple effect, but only with regard to one particular aspect. There was, however, always a complex of underlying causes for a disease and they could not be removed with one remedy if other organs were affected. This led to the theory that the single remedy combated the symptoms while homoeopathic drug combinations exerted an organ-specific effect. It was still thought that, with disease processes that were restricted to one organ, several remedies had to be prescribed because the symptoms did not always relate to one single remedy. It was assumed that any disease generally manifested itself in several organs. With reference to Bürgi, most complex homoeopaths and proponents of spagyrics claimed that the effects of remedies with the same target merely added up, while those with different targets potentised, in other words the overall effect exceeded the sum total of individual effects. Complex homoeopaths rejected the accusation that they were ignoring the principle of individualisation with the argument that the application of homoeopathic single remedies relied largely on the patients’ subjective considerations and particularly also on the wider or narrower knowledge of the practitioner, in other words the individualisation was not at all based on reliable criteria. As the complaint did not behave in a “rigid” way and the organism was subject to subtle changes such as climate and diet, the single remedy homoeopaths had to face unexpected developments, a problem that did not present itself with complex remedies. The position of complex homoeopathy and spagyrics with regard to drug provings on the healthy person was ambivalent. Often their representatives argued that empirical bedside experience was sufficient to judge the efficacy of combination preparations or they relied on clinical outcomes. But there was also the theory that some remedies only worked with sick people while the healthy person would eliminate them. August Bier was adamant as far as the importance of the drug proving on the healthy was concerned as it was the only way to gain insight into the effect of individual remedies; his stimulant therapy had shown that many remedies exerted different effects in healthy and sick people, and, from the latter, there was a difference again depending on

95 Hans-Heinrich Reckeweg’s Pathology and Therapy Concept

whether they were acutely or chronically ill. Bier’s investigations had also confirmed that the sick person responded to much smaller doses than the healthy person. Opinions also differed with regard to homoeopathic potentisation grades. A number of complex homoeopaths rejected the immaterial effect of high potencies and preferred low or medium potencies. At the Stuttgart Robert Bosch Hospital or in August Bier’s surgical university clinic, potencies did generally not exceed D6, or occasionally, D12 or D15. Often low potencies were used for acute cases and high potencies for chronic disease. Especially August Bier, but also some of the complex homoeopaths, supported Hugo Schulz’s view that weak stimulants excited life processes, medium strong ones enhanced them, strong stimulants inhibited them and the strongest terminated them. The proponents of spagyrics preferred fermentation which they thought yielded higher efficacy than homoeopathic potentisation. Like Hahnemann, Bier’s school of thought arrived at the conclusion that the strong reactions elicited by very high potentisation were not desirable. Bier also claimed that his stimulants, unlike high dosages, not only avoided damage but also lost their nonspecificity. This meant that the stimulants worked on the chronically inflamed tissue, while the rest of the body did not show any noticeable signs of stimulation. He thought moreover that the small dosages had no chemical effect, but acted as stimulants to the organism. It became a habit to prescribe single remedies of various potency grades as well as combination preparations consisting of single remedies of various potency grades. The founder of antihomotoxic medicine also took blood from his patients which he homoeopathically potentised over several stages and then re-injected. Although the potentisation process in this procedure is homoeopathic, the treatment itself is isopathic.

4

However varied the views of the homoeopaths, all proponents of complex homoeopathy and spagyrics mentioned here were committed to Hahnemann’s similarity principle. The orthodox physician August Bier regarded the establishment of the similarity rule as Hahnemann’s most important achievement. Based on Hahnemann’s insight that a natural disease can be cancelled out by another, similar, drug-induced disease, Bier carried out stimulation therapies. He did not restrict himself to the use of medication, however, but applied physical measures, to enhance inflammations for instance, and found that they confirmed the similia similibus principle. Fever and inflammation were in Bier’s eyes effective curative agents which he therefore tried to induce artificially. Because the symptoms of inflammation are in principle always similar, he treated them isopathically as well as homoeopathically. In accordance with Hippocrates Bier postulated that natural bodily reactions should not be suppressed but effectively supported. Like August Bier, Hans-Heinrich Reckeweg also activated inflammations by stimulation. According to his doctrine the purpose of inflammations was to eliminate homotoxins. Against the homotoxins, which in his view were responsible for a disease, he used homoeopathic remedies. In 1928 Ernst Bastanier, lecturer for homoeopathy at the Berlin university, underlined in his inaugural lecture, with explicit reference to Virchow, that medicine could do without hostile schools. He appealed to scientists to explore homoeopathy in order to make it accessible to a modern medicine. In 2008 this goal seems to move closer again. At Europe’s biggest university Clinic, the Berlin Charité, a foundation endowed chair has been installed for the research into complementary medicine.824 Homoeopathy, naturopathy and acupuncture are at the centre of this scientific endeavour.825

824 Ärzte Zeitung of 20/05/2008 (www.aerztezeitung.de/extra). The growing interest in complementary medical therapies had already led to the foundation of a forum of university work groups for naturopathy and complementary medicine in 1998. Weidenhammer (2006), p. 2930. 825 www.charite.de/epidemiologie/german/pkomplement.html.

Archives

▬ Archives of the German Homoeopathic Association

(DHU)  Illustrierte Preisliste ‘B’ (issue 103) 1927, (issue 105) 1929, (issue 107) 1930, (issue 112) 1935, (no detail) 1936, Dr. Willmar Schwabe Leipzig.  Illustrierte Preisliste ‘A’ (issue IV) 1929. Dr. Willmar Schwabe, Leipzig.

▬ Heel Archives  Firmenarchiv Heel/Bibliothek – Heel’s Tropfen.

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