OMEOPATHY. — From ὅμοιος = similar, πάθος = suffering: a therapeutic system founded on the law
of similars (similia similibus curantur), conceived by Hippocrates, confirmed by Paracelsus, and definitively formulated and developed by Samuel Christian Friedrich Hahnemann (born in 1755, died in 1843), doctor of medicine of the University of Erlangen (Germany).
To dispel whatever may appear paradoxical in the concept that diseases are cured by means of similar diseases, there are numerous clinical observations of cures occurring when, in the same patient, a morbid affection very similar to the one already present supervenes. But the best commentary on the law of similars is found in the constitutional and synthetic conception of disease, which Hippocrates was the first to formulate, which Hahnemann placed at the foundation of o., and which modern clinical medicine has taken up, updated, and developed through the work of A. De Giovanni, G. Viola, and N. Pende in Italy, and abroad above all through that of the Frenchman L. Lévy and the Spaniard G. Marañon. The Hippocratic idea refers above all to the general and constitutional causes of diseases; without denying importance to external pathogenic agents, it seeks above all to recognize the characteristics of the morbid «terrain»; and it considers the patient’s symptoms not as harmful disturbances that the physician must in any event remove, but as the genuine expression of a natural defense of the organism. It follows that rational therapy will not be directed toward combating the patient’s symptoms, but, in a certain sense, toward favoring and strengthening them, in order to assist the effort of nature in restoring health.
It is Hahnemann’s merit to have understood that drugs can usefully be prescribed according to this criterion and employed in such a way as to reproduce in each patient a symptomatic picture, a small artificial disease, which, by superimposing its symptoms on the natural ones through virtue of a perfect similarity, intensifies them sufficiently to strengthen the salutary reaction to the greatest possible extent.
Cases of morbid affections whose cure could not be explained without the intervention of the law of similars, perhaps applied unconsciously, are extremely frequent and were known to clinicians even before o. Thus, for example: the observations of Muralto and Wedel concerning the beneficial action, in certain colics of children, of jalap, which, at the usual dosage, produces colic and intestinal evacuations in healthy subjects; the cure of certain conjunctivitides by means of euphrasia, which in normal doses tends to inflame the mucous membrane of the eye (Murray); the hemorrhages which Baglivi, Barbeyrac, and Dalberg saw cease under the action of ipecacuanha, a remedy notoriously capable, in certain doses, of producing hemorrhagic states; the treatment of seasickness with tobacco, which in turn can provoke characteristic syndromes of nausea and violent dizziness; and the beneficial results observed by Whistling in certain varieties of epilepsy through the use of agaricus muscarius, which, in cases of poisoning, essentially produces tremors, convulsions, and loss of consciousness, in a picture exceedingly similar to that of an epileptic attack. In all these cases, the beneficial intervention of an artificially produced disease caused by the «similar» drug is apparent: it has acted in the same direction as nature, as an additional and specific stimulus to the reactive powers of the organism.
To make it possible to seek the remedy best suited to producing the similar disease, it is necessary to know precisely the effects of individual drugs on healthy human beings.
When conducted with the requisite scientific rigor, these investigations have, among other things, demonstrated that the action of a drug always tends to unfold in two clearly distinct stages: the first, which Hahnemann called «primary action» and attributed to the toxic action of the drug, hence, practically, to the dose employed; the second, or «secondary effect», which Hahnemann identified with the organism’s effort to free itself from the disturbances caused by the drug. It is therefore essentially to the secondary effect, that is, to the vital reaction, that the salutary action of the remedy must be attributed; and since the vital reaction is excited by small stimuli, while it remains suppressed and even annihilated by excessively strong stimuli (the Arndt-Schultz law of fundamental biology), a correct dosage must re-
duce the primary action to a minimum, and thus reduce the doses to a minimum. This is the principal reason why o. preferably employs its drugs in minimal and often imponderable doses; but this should be regarded only as a logical corollary of the law of similars, and not as a fundamental pillar of the system, as some have erroneously believed.
In any case, the minimal dose of homeopathic medicines is not the result of simple attenuation. When Hahnemann, in fact, progressively reducing the doses in the course of his experiments, had gone beyond the limits of the imponderable, he began seriously to fear that he had also gone beyond the limits of reason. His doses, by then negligible, were no more than highly diluted solutions; without any other aim than to ensure a uniform distribution of the remedy in the solvent, he then adopted the practice of diluting systematically according to a progressive scale (decimal or centesimal) and of giving the bottles a certain number of shakes at each transition from one concentration to the immediately lower one. Following this system, he observed that the therapeutic action of his solutions persisted not only specifically, but even to an increasing degree; and, on the other hand, this intensification of the drug’s activity did not occur when the solutions were not shaken. Hahnemann gave this procedure the name «dynamization», to indicate that by means of it one seeks to liberate from matter the immaterial forces contained within II. In reality, the daily confirmation provided by biological control authorizes the view, together with Hahnemann, that the practice of dynamization may reveal in drugs specific energies and latent biochemical affinities, perhaps through a modification and disintegration of their original physical structure.
Apart from every hypothesis concerning the physical state that the drug may attain through Hahnemannian dynamization, it has been demonstrated that the infinitesimal dose proves active only when the remedy is perfectly «homeopathic» to the clinical case, that is, when the picture of the symptoms it can provoke in the healthy organism is very similar (similimum) to that of the patient. It is therefore indispensable that the patient be examined thoroughly, not only through careful inspection of the affected organs and functions, but also through study of his subjective sensations and mental symptoms, assigning particular value above all to those peculiar and individual facts which, being characteristic of his manner of reacting, define his morbid personality more precisely. The homeopathic physician cannot make use of the pathognomonic symptoms of the disease, which serve solely for clinical diagnosis, but only of the patient’s pathognomonic symptoms, the only ones useful for the purposes of psychophysical diagnosis, which in o. is identified with the diagnosis of the remedy. Homeopathic practice therefore requires a dual diagnosis, and confronts disease not with one remedy for each symptom (as is done in symptomatic treatments), but by administering the remedy that alone reproduces the entire morbid syndrome, with the greatest possibilities of polyvalent action, and therefore specific action in the most ideal sense of the word.
Scientific advances, new means of clinical investigation, and the overall development of medical science and therapy have not merely left the edifice constructed by Hahnemann intact, but in many cases have strengthened it with authoritative confirmations. New theories and new therapeutic systems appear and disappear every day; Hahnemann’s doctrine, perhaps the only one to have known the danger of opposition and criticism from its very beginnings, appears to be among the very few that have preserved their vitality and improved their efficacy.
matière médicale, 3 vols., Ginevra 1948; L. Vannier e J. Poirier, Précis de matière médicale homéopathique, Parigi 1948.