Homœopathy (homoion, 'like; pathos, 'disease'), a medical doctrine, which teaches that diseases should be treated or cured by drugs capable of producing similar symptoms of disordered health to those presented by them; or, as it is commonly phrased, 'likes should be treated by likes,' or let likes be cured by likes—similia similibus curentur.
The earliest mention of this doctrine occurs in one of the books attributed to Hippocrates, who taught that some diseases were cured by similars and some by contraries. He illustrated the former by pointing to mandrake as a cure for mania; 'give the patient,' he says, 'a draught made from the root of mandrake in a smaller dose than is sufficient to produce mania.' Reference is also made to the doctrine of similars by several medical authors during the centuries that followed. In 1738 Stahl, a Danish army surgeon, wrote that 'the rule generally acted upon in medicine to treat by means of oppositely acting remedies is quite false, and the reverse of what ought to be; I am, on the contrary, convinced that diseases will yield to and be cured by remedies that produce a similar affection.' The celebrated Von Stœrck, in 1762, urged the same rule as a reason for using stramonium in insanity. Though impressed with the importance of this doctrine, these writers took no steps towards rendering it available in the practice of medicine. To do this was reserved for Samuel Hahnemann (q.v.), who, in 1796, in an essay entitled 'Suggestions for ascertaining the Curative Powers of Drugs,' published in Hufeland's Journal, then the leading medical periodical of Europe, showed, as the result of a series of researches and experiments extending over six years, that in this doctrine lay the key to the selection of specifically acting medicines; of medicines, that is, which cure by exercising a direct influence upon the parts diseased, as distinguished from those which relieve by what is termed their 'derivative' action. For example, it was then, and is now, customary to endeavour to control congestion of the brain by purgatives, by medicines operating not on the brain but upon the bowels. Hahnemann, on the other hand, asserted that congestion of the brain was most quickly and certainly cured by prescribing small doses of a medicine which previous experiment had proved to have a special influence upon the circulation in that organ—a direct method. The nature of this influence, he further showed, must be one of similarity. This similarity was, he pointed out, recognised by the symptoms indicating the nature of the disease-process on the one hand, and those marking the action of the drug when taken by persons in ordinary health on the other.
This doctrine, then, applies solely to that part of the treatment of disease which relates to the use of medicines; and further, it is restricted to prescribing medicines in diseases which are not dependent for their existence on some mechanical cause, such as the presence of a mass of undigested food in the stomach, or of a stone in the bladder. To those parts of treatment which are concerned with nursing, dietetics, hygiene, the use of water in various ways, electricity, massage, &c., homœopathy, as such, bears no reference; though those physicians who have adopted it attach great importance to these therapeutic measures. Homœopathy has solely to do with the selection of drugs when these are needed for directly curative purposes—a sufficiently wide range truly! Hahnemann's claims to distinction as a therapist rest not merely on his having recognised this doctrine as a rule of drug-selection in a wide range of diseases—this had been done to some extent by others, as he himself has admitted—but upon his having rendered it possible to apply it in practice; as he wrote in 1810, 'no one has as yet taught this homœopathic therapeutic doctrine.' If it were true that the symptoms evoked by a drug should regulate its employment in disease, the symptoms which drugs will cause must needs be ascertained. Hence the study of drugs by making experiments with them upon healthy persons—drug-proving, as it is termed—became a cardinal point in the teaching of Hahnemann. It forms, indeed, the first maxim of homœopathy.
Further, if a medicine is to be used that will produce a condition like that which it is intended to cure, it is obvious that it must be prescribed in a dose smaller than that in which it is capable of producing such a condition. This much was clear to Hahnemann when he first applied homœopathy at the bedside. During the first three or four years of his doing so he used doses of from three to four grains of such medicines as mx vonica and veratrum powder; of arnica powder he gave 'a few grains;' of ignatia, from three to seven grains, and so on. As his experience in the use of medicines upon this basis increased he found that far more minute doses than these were all-sufficient, and in 1806 he writes of his giving hundredths, thousandths, and millionths of the quantities required to obtain the antipathic or allopathic action of a drug. In graduating his doses Hahnemann followed where his experience seemed to lead him, his one desire apparently being to give no more medicine than was absolutely necessary for the cure of disease.
What is the safest, surest, and best dose in which to prescribe a homœopathically chosen medicine is a question upon which there is a great difference of opinion among those who have studied the subject. The only principles upon which there is any unanimity among them are that the dose to cure must be smaller than that which will produce a condition like that to be treated, and that different persons are susceptible to the influence of widely differing doses. The necessity for the dose being a small one is the second maxim of homœopathy. The third is that medicines must be prescribed in the form in which they were taken when 'proved'—i.e. when the experiments were made which revealed the kind of action they have upon healthy persons. This is essential, because, however well acquainted such experiments may render the physician with medicines individually, they teach him nothing of what the action of such medicines will be when combined with one or more others. He has no means of ascertaining what would be the influence exercised upon the action of his 'base' by the 'corrective' or the 'adjuvant' of the ordinary prescription combination of drugs.
To account for or explain the modus operandi of a homœopathically selected medicine several theories have been advanced. Hahnemann put forward one which, however, he at the same time declared that he regarded as of no importance. So far no explanation hitherto attempted has met with any general acceptance from those who admit the truth of the doctrine. It is as an ultimate fact in therapeutics, the reality and value of which can only be ascertained by putting it into practice at the bedside, that homœopathy has always been regarded, rather than as a speculative idea to be demonstrated or refuted by theoretical discussions or a priori arguments. Hence it is to the results of experience in employing homœopathically selected medicines, especially in epidemics notoriously attended by a great mortality under the usual methods of treatment, that those who advocate this method appeal to sustain their position.
For example, in 1836 cholera was devastating Austria, when a petition was presented to the government to allow homœopathy to be tested. Dr Fleischmann was accordingly ordered to fit up a hospital in the Gumpendorf suburb of Vienna for the reception of cholera patients to be treated homœopathically. The result showed that whereas 70 per cent. of those treated in the ordinary way died, Dr Fleischmann lost only 33 per cent.
Again, in yellow fever, in 1878 the American Institute of Homœopathy appointed a commission, consisting of physicians who had had experience in dealing with this disease, to ascertain the number of cases treated homœopathically during the epidemic of that year, and the rate of mortality amongst them. The report showed that in and around New Orleans 3914 cases were treated, with a loss of 261, being a mortality of only 6.6 per cent. in this singularly fatal form of disease.
Lastly, in the city of Melbourne typhoid fever recurs in epidemic form every year. The Melbourne Herald of April 20, 1889, gave the following hospital statistics of typhoid for three seasons. During these three epidemics the Melbourne hospital, with 318 beds, received 1182 cases of typhoid, of which 181, or 15.31 per cent., died. The Alfred Hospital, with 144 beds, admitted 998 cases; of these 135, or 13.52 per cent., were fatal. The Homœopathic Hospital, with 60 beds, received 554 cases, of which 49, or 8.84 per cent., died.
Another argument in support of the contention that homœopathy affords a real basis on which to select a medicine is drawn from the fact that Hahnemann, when appealed to in 1832 to suggest the medicines most likely to be useful in cholera, without ever having seen a case, but merely from studying the symptoms of some that were reported to him, and comparing these symptoms with those produced by medicines he had experimented with, named camphor, copper, and white hellebore as the remedies; and these, with the single addition of arsenic, have since been found to be more serviceable in checking the disease than any others. It is consequently urged that for a principle of drug-selection to enable the physician to indicate beforehand the appropriate remedy in an entirely new form of disease is a strong proof of its truth, and evidence of its value.
Finally, homœopathists contend that the unacknowledged adoption of many of the practical results of their teaching by physicians who professedly repudiate homœopathy is an additional proof that this teaching is sound. The text-books on Materia Medica which are now most popular in the medical schools, the Handbook of Therapeutics, by Dr Sidney Ringer, and Dr Lander Brunton's Materia Medica, Pharmacology, and Therapeutics, abound with recommendations for the use of medicines in diseases in which they were first known to be of service through homœopathy. Of these, the use of aconite in inflammatory fever is one of the most conspicuous. That it would be found capable of reducing the fever with which acute inflammations are usually ushered in was an inference drawn by Hahnemann from the experiments that he had made with it; and, when publishing his conclusion, he foretold that it would entirely supersede the necessity for blood-letting, then so constantly employed in such cases. It was the endorsement of this statement by Dr Uwins—who had to some extent tested the worth of homœopathically selected medicines—at a meeting of the London Medical Society in 1836 that so shocked the members present as to induce them to pass a resolution precluding all reference to homœopathy at any future meeting. To use aconite in small doses in acute inflammatory fever is thoroughly homœopathic, and is at the same time a very common practice now among those who deny that homœopathy is of any value to the physician. Many other medicines there are that are very generally used by opponents of homœopathy in conditions to which they are homœopathic, and in which they were originally made known to be useful by those who practise homœopathically; such, for example, as arsenic in gastric irritation, ipecacuanha in vomiting, corrosive sublimate in dysentery, belladonna in quinsy, &c.
While homœopathists accept these appropriations as so many tributes to the truth of their doctrine, and look upon them as important advances in therapeutics, at the same time, in the absence of any knowledge on the part of those who use them of the doctrine which led to their employment, they regard them as calculated to give rise to disappointment in some instances. They do so for the reason that all cases of a given form of disease are not so precisely similar as to admit of cure by the same medicine. Thus, to give belladonna in all quinsies, while of advantage in many, would be useless in some, because all cases of quinsy do not resemble that produced by belladonna. Some are more like that occasioned by mercury, others that of the poison of the honey-bee, or of one of the serpent poisons, others that of the Phytolacca decandra, and so on; and it is, the homœopathist argues, only when the doctrine of homœopathy is strictly adhered to in each individual instance of a disease that that success which he contends will follow his method can be looked for.
From the date of the publication of Hahnemann's first essay on Homœopathy the opposition this doctrine has met with from the great majority of the profession in Great Britain has been of the most determined and persistent character. Of late years the intensity of the bitterness of feeling which this controversy aroused has been somewhat mitigated, or perhaps the influence of public opinion has prevented its indulgence to the same extent as formerly. The last attempt to deprive a physician of his hospital appointment on the ground that he was treating his patients homœopathically failed, while several open adherents of this doctrine are to be found holding public health and poor-law appointments. The number of those who in Great Britain admit that they practise homœopathy has never at any one time exceeded 300. The chief hospital where homœopathy is practised is the London Homœopathic (1850), with ninety beds and a large out-patient department. There are similar institutions at Birmingham, Liverpool, Bath, Plymouth, Bournemouth, Eastbourne, and Bromley; and a convalescent home in connection with the London Hospital has recently been opened at Eastbourne. In addition to these there are about a hundred homœopathic dispensaries in different parts of the country.
In the United States of America, where public opinion is more powerful than professional feeling, homœopathy has spread rapidly and widely, and it is estimated that nearly one-fourth of the qualified practitioners of medicine in that country have adopted it. There are over fifty hospitals and nearly as many dispensaries; and the journals devoted to homœopathy exceed a score in number. It is taught in thirteen medical colleges and in three of the universities. In Europe there is only one university where there is a chair of Homœopathy—viz. at Budapest.
Though Hahnemann is denounced by many as a 'fanatic' and a 'knave,' and notwithstanding that homeopathy has very generally been set aside as a 'fraud,' no one can study the history of medicine during the 19th century without perceiving the powerful influence it has had on the general practice of the medical profession. While, during the first fifty years of the century, homeopathy was gradually becoming more frequently practised, the weapons commonly used against disease were of the most formidable character. Bleeding by lancet, leeches, and cupping-glasses, mercurialism, purgatives, &c. were in constant use. The progress of homeopathy in Austria, and the assumption on the part of some physicians that it was a purely negative mode of treatment, the success of which was due to the omission of all drugs, led to that scepticism in medicine which, originating with Sköda in Vienna, prevailed throughout the profession during the next twenty years. 'Placebos' took the place of the lancet, bread-pills formed a substitute for purgatives, and 'ptisans' did duty for mercury. As the literature of homeopathy increased a revival of interest in the use of drugs followed; and during the last twenty years the method of studying the actions of drugs originally suggested and carried out by Hahnemann has been adopted to a very large extent, under the designation of pharmacology; while, for practical purposes, the uses of drugs proposed by homeopaths, and set forth in their journals and published works, have, as has already been stated, been very largely followed. See the article MEDICINE.
The chief authorities on homeopathy are: The History of Homeopathy: its Origin and Conflicts, by Dr Ameke, translated by Dr A. E. Drysdale; Lectures on Homeopathy, by Dr Dudgeon; Homeopathy: its Principle, Method, and Future, by Dr Pope; Fifty Reasons for being a Homeopath, by Dr Burnett; A Manual of Therapeutics, by Dr Hughes; A Manual of Pharmacodynamics, by Dr Hughes. The Homeopathic Review and The Homeopathic World are published monthly.