Part I of this blog† summarized the origin of homeopathy, invented in 1790 by Samuel Christian Hahnemann. It discussed Hahnemann’s first two “homœopathic laws of nature,” similia similibus curantur (like cures like) and the “law of infinitesimals,” and showed that his rationales for each have long been refuted. Hahnemann proclaimed a third doctrine, the “law of psora” [“itch”], said by him to be “the mother of all true chronic diseases except the syphilitic and sycotic.” Oddly, it seems to have been forgotten.
Part II gives Hahnemann the opportunity to explain his assertions more thoroughly, as is his due. It considers those assertions from the vantage point of modernity, as is ours.
“Leave None of them Uncured”
According to Hahnemann, homeopathy is a panacea:
“Now, however, in all careful trials, pure experience, the sole and infallible oracle of the healing art, teaches us that actually that medicine which, in its action on the healthy human body, has demonstrated its power of producing the greatest number of symptoms similar to those observable in the case of disease under treatment, does also, in doses of suitable potency and attenuation, rapidly, radically and permanently remove the totality of the symptoms of this morbid state, that is to say, the whole disease present, and change it into health; and that all medicines cure, without exception, those diseases whose symptoms most nearly resemble their own, and leave none of them uncured.”
How might this happen?
“Dynamic Deranging Irritations of the Vital Force”
Hahnemann proposed that if two diseases with similar symptoms strike a patient, the “stronger” disease will invariably cure the “weaker.” Moreover, “the human body is much more disposed to let its state of health be altered by medicinal forces than by natural disease.” Thus, by simulating the symptoms of a disease, homeopathic medicines “substitute themselves for the natural morbid affection, and thereby deprive the latter of all influence upon the vital force.”
Hahnemann and most of his contemporaries believed in a supernatural “vital force.” “Vitalism” was the explanation for life itself, which was thought not to conform to the same physical and chemical principles that appeared to govern non-living processes. According to Hahnemann, “during health a spiritual power (autocracy, vital force) animates the organism and keeps it in harmonious order.” Diseases, he believed, “are purely dynamic deranging irritations of the vital force.” Thus “to regard those diseases that are not surgical as a peculiar distinct thing residing in the human frame is an absurdity which has rendered allopathy so pernicious.” In other words, diseases other than surgical (few, at the time) were not to be explained by material processes.
Again, Science Intervenes
The sweeping discoveries of the century or so following Hahnemann’s epiphany rendered “vitalism” obsolete. Among these were advances in physiology, chemistry and biochemistry demonstrating that biological processes conform to the same physical laws that govern non-living entities, and the refutation, by Louis Pasteur in 1861, of “spontaneous generation.” The Germ Theory of disease, discovered by Pasteur, Koch and others, and advances in pathology, pathophysiology, biochemistry, nutrition, pharmacology, toxicology, genetics, and immunology have proved beyond any doubt that diseases are entirely explicable as “peculiar distinct thing[s] residing in the human frame,” even if not all diseases have yet been explained. In summary, there is no need to invoke supernatural theories to account for either normal biological processes or diseases.
The great 19th century French physiologist Claude Bernard understood this by 1865, when he wrote:
“When an obscure or inexplicable phenomenon presents itself, instead of saying ‘I do not know,’ as every scientific man should, physicians are in the habit of saying, ‘this is vitalism'; apparently without the least idea that they are explaining darkness by still greater darkness…. Vitalism is nothing but a word that means ignorance, and when we characterize a phenomenon as ‘vital,’ it amounts to saying that we do not know its immediate cause or its conditions.”
Homeopathy vs. “Allopathy”
As suggested in Part I, Hahnemann’s first law (“like cures like”) was nothing new. The second law (“infinitesimals”) was certainly the basis for the early, apparent success of homeopathy, when the practice contrasted with the harsh, frequently toxic ministrations of contemporary European medicine. Hahnemann himself called attention to the difference:
“…homœopathy sheds not a drop of blood, administers no emetics, purgatives, laxatives or diaphoretics, drives off no external affection by external means, prescribes no warm baths or medicated clysters, applies no Spanish flies or mustard plasters, no setons, no issues, excites no ptyalism, burns not with moxa or red-hot iron to the very bone, and so forth, but gives with its own hand its own preparations of simple uncompounded medicines, which it is accurately acquainted with, never subdues pain by opium, etc.”
“Allopathy” was the term coined by Hahnemann to dramatize the contrast between homeopathy and its competition. According to Hahnemann, “allopathic” medicine sought to give only medicines that suppressed symptoms:
“In order to give a general notion of the treatment of diseases pursued by the old school of medicine (allopathy)… Whenever it can, it employs, in order to keep in favour with its patient, remedies that immediately suppress and hide the morbid symptoms by opposition (contraria contrariis) for a short time (palliatives), but that leave the disposition to these symptoms (the disease itself) strengthened and aggravated.” (parentheses in the original)
That assertion was not really applicable to the medicine of Hahnemann’s time (bloodletting, purging and many other treatments derided by Hahnemann were used because they supposedly drew the causative pernicious humours from the body—not in an attempt to “suppress and hide the morbid symptoms”). It has even less to do with modern medicine, although homeopaths still denigrate drugs that ameliorate unpleasant symptoms (pain, for example), and frown on any class of agents whose name includes the prefix “anti-,” whether the root word refers to a symptom (antidepressant) or not (antibiotic).
Hahnemann considered nothing other than symptoms—albeit “symptoms” that competent physicians then and now would find preposterous, as we shall see—because “If all the symptoms be eradicated, the disease is always cured internally also.”Thus it is ironic that his statements about “allopathy” appear to be the basis for the now-common claim among homeopaths, naturopaths, “integrative” physicians, and others that they “seek to identify and remove the underlying causes of illness, rather than to eliminate or merely suppress symptoms.”
The term “allopathic” is of historical interest only; it has no role in describing modern medicine. Its use by modern “CAM” advocates is usually pejorative, as it was when used by Hahnemann himself. It is naïve when used by legitimate physicians, who appear unaware that they are misrepresenting their profession. The misnomer is especially regrettable when found in the language of state medical boards and agencies of the federal government, betraying the ignorance of those presumed by the citizenry to be experts.
“Provings” and “Symptoms”
Determinations of the type of substance and the dose (that is, the dilution) used in homeopathic preparations are made by “provings”: a homeopath-‘investigator’ gives a preparation to one or more healthy subjects (“provers”), who each keep a detailed diary of every sensation, feeling, mood change, physical change, and anything else that may occur to them over the next several days to months. These “symptoms” are then compiled; their aggregate is presumed to have been caused by the “remedy” that preceded them, and the result is published in a Materia Medica. The practicing homeopath, after eliciting a litany of “symptoms” from a patient, then determines the correct “remedy” by finding the most closely-matching group in the MM. 
Shortly before Hahnemann died, Oliver Wendell Holmes, Sr., one of the innovators of modern medicine and a critic of homeopathy, considered “symptoms”–as the term is used by homeopaths:
“The following list was taken literally from the Materia Medica of Hahnemann, by my friend M. Vernois, for whose accuracy I am willing to be responsible. He has given seven pages of these symptoms, not selected, but taken at hazard from the French translation of the work. I shall be very brief in my citations.
“ ‘After stooping some time, sense of painful weight about the head upon resuming the erect posture.’
“ ‘An itching, tickling sensation at the outer edge of the palm of the left hand, which obliges the person to scratch.’ The medicine was acetate of lime, and as the action of the globule taken is said to last twenty-eight days, you may judge how many such symptoms as the last might be supposed to happen.
“Among the symptoms attributed to muriatic acid are these: a catarrh, sighing, pimples; ‘after having written a long time with the back a little bent over, violent pain in the back and shoulder-blades, as if from a strain,’—‘dreams which are not remembered—disposition to mental dejection—wakefulness before and after midnight.’
“I might extend this catalogue almost indefinitely. I have not cited these specimens with any view to exciting a sense of the ridiculous, which many others of those mentioned would not fail to do, but to show that the common accidents of sensation, the little bodily inconveniences to which all of us are subject, are seriously and systematically ascribed to whatever medicine may have been exhibited, even in the minute doses I have mentioned, whole days or weeks previously.
“To these are added all the symptoms ever said by anybody, whether deserving confidence or not…”
Are today’s homeopaths as liberal in their use of the term as was Hahnemann? Yes, as we shall see next week.
 Hahnemann SC. Organon of Medicine. 5th Edition (1833) translated by Dudgeon. 6th Edition (1842?) translated by Boericke. Available at: http://www.homeopathyhome.com/reference/organon/organon.html
 Pasteur L. 1861. Memoire sur les corpuscles organizes qui existent dans l’atmosphere. Examen de la doctrine des generations spontanees. [On the organized bodies which exist in the atmosphere; examination of the doctrine of spontaneous generation]. Annales des sciences naturelles, 4th series, vol. 16, pp. 5-98. Excerpt translated in: Brock TD (translator and editor). Milestones in Microbiology. Englewood Cliffs, NJ: Prentice-Hall, Inc.; 1961. pp. 43-48
 Bernard, Claude. An Introduction to the Study of Experimental Medicine. Translated by Greene HC. New York: Macmillan; 1865 [Reprinted in 1927, p. 201]. Quoted in “Medicine in quotations online.” American College of Physicians website. Accessed 2002 at: http://www.acponline.org/cgi-bin/medquotes.pl?subject=Vitalism (no longer available online)
 Borneman JP, Field RI. Regulation of Homeopathic Drug Products. Am J Health-Syst Pharm. Vol. 63 (2006): 86-91. Available at: http://nationalcenterforhomeopathy.org/articles/regulation_of_homeopathic_drug_products.pdf
 Holmes, OW. Homeopathy and its Kindred Delusions. Two Lectures to the Boston Society for the Diffusion of Useful Knowledge (1842). Available at: http://www.quackwatch.com/01QuackeryRelatedTopics/holmes.html
†The Homeopathy Series:
- Homeopathy and Evidence-Based Medicine: Back to the Future – Part I
- Homeopathy and Evidence-Based Medicine: Back to the Future – Part II
- Homeopathy and Evidence-Based Medicine: Back to the Future–Part III
- Homeopathy and Evidence-Based Medicine: Back to the Future Part IV
- Homeopathy and Evidence-Based Medicine: Back to the Future Part V
- Harvard Medical School: Veritas for Sale (Part III)
- The Dull-Man Law
- Smallpox and Pseudomedicine