166 T H E B R I T I S H H O M ( E O P A T H I C J O U R N A L

IMPLICATIONS OF HAHNEMANNIAN HOM(EOPATHY

By E. K. LEDERMA:NN, M.D., F.F.Hom.

THE OBJECT OF THE PAPER

Mr. President, ladies and gentlemen, the theme of this Congress is the demonstration of the value of Hahnemannian Homceopathy. Any discussion of the value of a method must rely on an understanding of the scope and limitations off this method. l i t is further essential to realize how the method is related to others which are in competition with it. These considerations apply to a very marked degree to Homoeopathy; the latter is a school of medicine which is different from the rest, is faced with great prejudice and practised only by a small minority o f doctors. These have to a large extent given up the practice of pure, i.e. Hahne- mannian Homceopathy and have compromised with the dominant school. I understand tha t this Congress aims at reversing such trends and strengthening the homoeopathie school as it was founded by Hahnemann and as it has survived in Great Britain. The clarification of two of its most difficult and most important problems is the aim of this paper---in the hope tha t this clarification will help, in achieving the high aim which the Congress has set itself. The problems are: (a) teleology, and (b) the high potency.

DEFINITION AND TYPES OF TV, LEOLOGY

Teleology is a "doctrine of final causes, a view tha t developments are due~ to the purpose or design tha t is served by them".* We must distinguish two forms of final causes as understood by Henri Bergson. The first is radical finalism. This view is par t of the mechanistic conception and follows from the presupposition of determinism. A machine shows the feature of purposefulness. In all its parts, the teleological design manifests itself in their working together. The feature of self regulation is found in machines which can adjust themselvea to new conditions, for instance machines with a feed-back. These have become models for the understanding of living organisms, bodies and minds.~ I t is. possible to look upon a living organism from the point of view of a design which determines its various processes. In tha t case, these follow necessarily from the design which is the overall feature. A watch is an illustration. Every wheel in it. serves the purpose of the watch. In the human body, we find numerous regulative. processes in the blood, the nervous system, and the glandular system which can be considered from the point of view of radical finalism, expressing a mechanistic view.

Mechanistic explanation does not allow for creativeness. The latter means. that something unforseeable, new, and unique arises. The purposeful processes are not conceived in an automatic manner. Growth of living organisms and adaptation to the innumerable external and internal conditions which character- ize them can only be accounted for by means of creative teleology. All t rea tment of illness relies on it, the success being manifest by the response of the whole patient to the stimulus of the drug, by the healing power of the tissues occurring after an operation etc. These responses are not only found locally where the physician or surgeon aimed at healing the disease, but are total responses of the whole patient, as any change occurring in a par t must lead to changes in m a n y parts to safeguard the continuation of life. There is no way of calculating or foretelling creative teleology; in medicine, its power is gauged by the doctor when choosing the t reatment and assessing the prognosis of an individual patient. Creative teleology can account for individuality, as it allows for uniqueness.

* The Concise Oxford Dictionary. Reference is made here $o the so-called science of cybernetics and Cannon's homceo-

stasis.

IMPLICATIONS OF HAHNENIANNIAN HO]VI(]~OPATHY 167

THE METAFHYSICAL CHARACTER OF MECHANISTIC AND CREATIVE TELEOLOGY

The term "metaphysics" is used with different connotations. They have the character of absoluteness in common. The German philosopher Dilthey spoke of the metaphysical urge referring to the human desire to penetrate into the kernel of the given world, to know what is fundamental. I t is the business of science to gain knowledge of the world. Kan t has shown that metaphysics, a science of the absolute, the fundamental, does not exist. Modern philosophers have accepted Kant ' s view, but they have not given up the term metaphysics. The absolute and fundamental has been found in the subjective, in the at t i tude with which a person approaches the world (W. Dilthey) and in the irrational, tha t aspect which is not amenable to logical treatment, to scientific under- standing, to a solution (N. Hartmann) . P. Matussek speaks of metaphysical problems in this sense and maintains tha t every science contains such problems which are fundamental. Medicine which includes biology and psychology as the two sciences on which it rests, contains metaphysical problems. Life itself is one. The feature of creativeness implies the element of inscrutability, irrationality.

The two types of teleology illustrate these points. Mechanistic teleology is based on the metaphysical theory of materialism. This assumes that the universe is made up fundamentally of a homogeneous substrate, tha t this can be divided into equal units which follow in their movements the laws of physics. They are predictable in principle although it may be impossible to apply the law to one particular particle of microdimension. The characteristic of purposive- ness is ignored, as its acceptance would involve the acceptance of a non- mechanistic principle.

Creative teleology, on the other hand, accepts a whole+making "holistie"* force as the fundamental principle in the universe and derives the phenomena of inorganic and organic nature from it. The so-called vital force is one of its manifestations. As pointed out, it is taken for granted by all doctors, but is omitted in scientific literature. I t is, however, entailed in such terms as "res- ponse" and "adaptat ion".

The adherents of mechanistic and creative teleology respectively show themselves as metaphysicians by their convictions tha t they have discovered the fundamental feature of the universe. They show the typical intolerance and fanaticism. Doctors are trained to be scientifically minded. They believe in mechanistic metaphysics. I shall show later on how this metaphysical prejudice can be removed by investigating the nature of scientific knowledge, by an enquiry into epistemology.

TELEOLOGY IN PHARMACOLOGY

As Homceopathy is a form of drug treatment, it is obviously important to consider in what respects it differs from the ordinary use of drugs, from pharma- cology. This science follows mainly the specific-analytical approach which is characteristic of science. The body is subdivided into organs, and a disease is defined as a change in one of them. The drug is given to influence the particular disease, digitalis for the abnormal heart, penicillin against the abnormal micro- organisms wherever they happen to be. In tha t treatment, the creative holistie power of response is taken for granted but not considered.

There are, however, exceptions to this approach in pharmacology. Protein shock, convulsion t reatment by means of cardiazol, metrazol, or insulin are measures which affect more than one organ, which are not specific for one particular disease and which can only be understood by assuming that they affect regulative processes which themselves are a manifestation of creative teleology.

* See J. C. Smuts's Holis~n and Evolution, Macmillan & Co., Ltd., 1936.

168 THE BRITISH HOlYI(EOPATHIC JOURNAL

TELEOLOGY IN HOM(EOPATHY Hahnemannian Homceopathy is based on two works byits founder, The Orga-

non of the Rational Art of Healing and Chronic Diseases, their Nature and Homceo- pathic Treatment. In the Organon, Hahnemann established an unspecific approach implied in the law of the simillimum. Patients are classified according to drug pictures and not according to diseases. In the provings, a method was found to show up types of people who respond to drugs as total personalities. In the Chronic Diseases, Hahnemann introduced a specific approach through his antimiasmic drugs and through the nosodes. Modern Homceopaths have in many instances modified his teaching, especially with regard to psora, and have added to Hahnemann's list of nosodes by making use of modem bacteriology. The dose employed is as a rule very small or infinitesimal. The effect of the drug is not considered in proportion to the dose and no attempt is made to achieve a continuous level of the drug in the body in order to keep up the effect. The latter depends on the release of the integrative bollstic power, as Hahnemann put it, on the release of the "life force".* He formulated his view of the body as a whole very clearly in the Organon as follows "the human body is, in its living state, a unity, a complete and rounded whole. Every sensation, every manifestation of force, every inter-relation of the material of one part, is intimately concerned with the sensation, force-manifestations and inter-relations of all the other parts; no part can suffer without involving all the rest in suffering (greater or less) and in alteration." t i n the following paragraph, he drew the conclusion that there is no local disease, and that no remedy confines its effect to one part. Both disease and drug action have to be considered from a general point of view. He was also aware of other general effects such as those arising from diet and a person's mode of living.

THEORETICAL EXPLANATION OF MECHANISTIC TELEOLOGY

The human mind needs an explanation to understand complex phenomena. The theory fulfils this task in science. Modern physics formulates its theory largely in mathematical language, but the other sciences are not in that position. They use a pictorial language illustrating the functioning of the phenomena and their nature by means of models which may be built up o f material corpuscules or waves. Sir James Jeans has pointed out that it is due to the nature of the human mind and not to the phenomena which it investigates that mechanical pictures are used. "There is only one type of model or picture which could be intelligible to our restricted minds, namely one in mechanical terms."+ +

Mechanistic teleology, as was shown, explains living organisms by means of machines and claims to bridge the gulf between inorganic and organic nature in that way. Machines can be taken to pieces and their mechanism completely understood. They function in a calculable manner, every phase of their action is determined.

THEORETICAL EXPLANATION OF CREATIVE TELEOLOGY The foregoing enquiry implies that creative teleology does not allow of

such satisfactory treatment. Hahnemann admitted that he could not offer any explanation of the workings of the body, "the essential nature of the medicinal powers of drugs, vitality, the inner invisible working of the organism in health and the changes of this hidden inner working which constitute disease in other words, the inner nature and essence of illness."w He stated that the understand- ing of life was beyond human intelligence, which means that we are confronted with a true limitation of knowledge which is not due to its present state of in-

* The Organon, 1st edition, paragraph 227. t The Organon, 1st edition, paragraph 42.

Physics and Philosophy, Cambridge University Press, 1942, p. 175. Organon, lsb edition, paragraph 13.

I M P L I C A T I O N S OF H A H N E M A N N I A N H O M ( E O P A T H Y 169

completeness but is permanent and fundamental. Hahnemann implied this by referring to the life force which embodies the element of creativeness with its character of inscrutability.

I t is obvious tha t science .does not accept creative teleology, as it is intent on formulating laws to account for phenomena in a deterministic predictable manner. The dominant medical school thus ignores or at tacks the school of Homceopathy as unscientific.

These attacks are directed particularly against the use of high potencies which brings us to our second problem.

THEORETICAL EXPLANATION OF THE NATURE OF THE H I G H POTENCY

Homceopathy is and can be practised with low and medium potencies. Their action can be explained as chemical agents which are powerful because of the large active surface of the drug which has been ground up with sugar or is held in suspension in a colloidal state. I f the quantities are very minute, the explanation can still be tha t they act as catalysts.*

The action of the high potency, however, cannot be explained by means of any such theories, as it does not contain any material particles of the particular drug. High potencies are widely used and form part of Hahnemannian Homceo~ opathy.

W. E. Boyd has proved tha t a high potency of mercuric chloride had a definite effect on the action of diastase on starch.~ In another paper, he offered as a theoretical explanation the assumption that the high potency contained "some unknown immaterial energy" which he connected with "the actual stuff of reality of which the material body and the immaterial mind both consist".,+ This explan- ation cannot be accepted as a scientific theory, it is a metaphysical statement, as "the actual stuff of reali ty" refers to the structure of the universe itself.

We have to admit that the action of the high potency cannot be explained scientifically. Homceopathie physicians must face that fact and must be prepared for the hostility against their system on the par t of those who insist that the t ruth of science depends on the availability of a theory. This vital point must now be clarified.

AN EPISTEMOLOGICAL INVESTIGATION

Kant ian epistemology maintains that we can never gain scientific know- ledge of reality as such. Science is systematized knowledge which is built up of concepts ready in the human mind. Kan t examined those which are funda- mental. In addition, he showed tha t others which he called Ideas, are only regulative, they do not form par t of our scientific knowledge, but they guide the scientist. Purpose is such an Idea, necessary for the accounting of biological phenomena. I t is borrowed from the realm of human motivation and is used by the biologist "in analogy".w The two types of causality, the mechanistic and teleological, can be combined in the theoretical explanation of biological pheno- mena if we avoid the mistake of hypostatizing (i.e. making into something real) the Idea of purpose. Creativeness disappears, as purpose is considered as a guiding principle and not in its true sense as present in the mind of the Creator who is thought of as designing living organisms in a purposeful manner.

Creativeness must remain outside the boundaries of scientific knowledge, as it contradicts the presupposition of science which demands tha t the phen- mena are governed by determinism and are thus in principle predictable.

When we realize the true nature of science and the fact that knowledge

* O. Leeser, "Die Dosierung in der HomSopathie", Der Landarzt, September 20th, 1951. ~f "Biochemical and biological evidence of the activity of high potencies", The British

Homeeopathic Journal, January 1954 "The Biophysical Relationship between Drugs and Disease", The British Homeeo.

pathic Journal, March, 1946. w See Critique of Pure Reason and Critique of Teleological Judgment, w 4.

170 THE B R I T I S H HOM(EOPATHIC J O U R N A L

consists of something which the mind has built up as an abstract structure, the absence of a scientific theory for certain phenomena loses the power of turning down such phenomena; we become immune against prejudices based on ignorance of the true nature of science and we can deal with those who have such prejudices and who are ignorant.

TH~ NEED FOR AN EMPIRICAL PROOF

Modern science is empirical in the sense tha t it does not rely on specula- tion but only on evidence. In medicine, any method of t reatment has to be proved effective. Homceopathy is in particular need of such proof, as it differs so fundamentally from other methods. The facts tha t it relies on creative tele- ology and tha t many of its adherents use the high potencies for which no scientific theory is available show up the difference most markedly.

The International Homceopathic League should organize control experi- ments which should include the use of high potencies in order to establish an empirical proof for the efficacy of Hahnemannian Homoeopathy. Details of such a plan were outlined in a previous paper.* An effort was made to establish the proof by treating a number of patients suffering from surgical tuberculosis homceopathically with high potencies and comparing the results with another number treated with Placebo.~ Further extensive tests on these lines are imperative.

CONCLUSIONS

Hahnemannian Homceopathy implies the acceptance of a theory and practice, different from the rest of medicine. I t requires clarification of its principles. This is a philosophical task. Teleology is the central philosophical problem.

The efficacy of the method does not, however, depend on theory or philo- sophy. I t must be proved by scientifically conducted experiments, i.e. with controls.

* "Homceopathy 's Way to Recognit ion" by E: K. Ledermann, The British Homeeo- athic Journal, July, 1949.

t "Homceopathy Tested Against Controls in Cases of Surgical Tuberculosis", The British Ho~nceopathic Journal, April, 1954.