Marketplace of the Marvelous (21 page)

Hahnemann had a particular problem with coffee. He drew clear distinctions between “food” and “medicine.” “Medicinal things are substances that do not nourish, but alter the healthy condition of the body,” wrote Hahnemann. Medicine taken unnecessarily by healthy people “deranges the harmonious concordance of our organs, undermines health and shortens life.” For Hahnemann, coffee fell squarely into this category of medicinal food. Worse, many people drank coffee daily and certainly in amounts far larger than a safe infinitesimal dose. Hahnemann came to blame the beverage for nearly all chronic suffering and general ill health.
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Two decades later, in 1828, Hahnemann changed his mind. He realized that perhaps he'd been too hasty in his condemnation of coffee, as his observations revealed the inadequacy of homeopathy in treating chronic sufferers, even among the coffee abstainers. Rather than discounting what he witnessed or rationalizing his data to fit his theory, Hahnemann altered his hypothesis to account for his observations: a very scientific approach to the problem. While he wasn't ready to fully embrace coffee, he would allow that maybe it wasn't the principle cause of suffering. Chronic diseases, Hahnemann now explained, stemmed from deep disturbances of the body's vital forces known as “miasms.” Contagious and hereditary, these miasms surfaced when people lived in unhealthy states for extended periods of time, and their presence pointed to a more fundamental problem in the body than the current illness. Hahnemann's miasms bore much in common with the ancient idea of contagion from miasma, or bad air, filled with malodorous and poisonous particles much discussed by Hippocrates. Hahnemann divided his miasms into three primal types: syphilis, sycosis, and psora. Syphilis caused many diseases of the nervous system and sycosis many sexual diseases and joint infections. Hahnemann labeled psora the “oldest, most universal and
most pernicious,” having existed for thousands of years and causing seven-eighths of all chronic illnesses. Characterized by skin eruptions that reflected the inner diseased state, Hahnemann blamed psora for hysteria, epilepsy, gout, cancer, impotence, mania, and countless other afflictions. Because of the deep-seated nature of these miasms, treatment could take weeks longer than acute cases and required patients to take short whiffs of diluted remedies so as to not overwhelm their severely debilitated systems.
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Hahnemann's new theory of miasms did not sit well with many of his followers. Encouraged to think critically by homeopathic theory and Hahnemann himself, homeopaths demanded that Hahnemann further clarify its principles before they would incorporate it into their treatment regimen. Hahnemann refused. “He who does not walk on exactly the same line with me is an apostate and a traitor, and with him I will have nothing to say,” declared Hahnemann in a pompous tone not unlike that of Thomson before him. These hostile remarks led some homeopaths to split with him, declaring their old leader, now in his seventies, past his prime. But they did not abandon homeopathy. Followers pledged to stick with their original convictions and to ignore what they saw as Hahnemann's more irrational claims.
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These internal divisions did nothing to slow homeopathy's rapid colonization of Europe. Regular doctors from across the continent, many of them young and just starting out in the field, flocked to Hahnemann to receive personal tutorials in homeopathic therapy. They returned home and set up clinics of their own and taught homeopathy to colleagues. Homeopathy also caught on with the European aristocracy, who hungered for the newest and most scientific innovations. Members of the German and British royal families patronized several homeopaths, including Hahnemann himself.
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Though it was created to wipe out sickness, it was, ironically, epidemic disease that enhanced homeopathy's reputation and contributed to its explosion in popularity. During an outbreak of cholera in Europe in 1831, Hahnemann advised sufferers to take homeopathic doses of camphor (from the camphor tree), cuprum (copper), and veratrum (a plant commonly known as false hellebores). He also prescribed fresh air and frequent baths for the healthy, and advised the quarantine of those who had already contracted the disease. Since the primary treatment for cholera is rehydration, Hahnemann's watered-down
cures likely helped to replace some lost fluids while isolation and his hygiene recommendation prevented its spread. These relatively benign remedies contrasted sharply with treatments by regular doctors, whose harsh and largely ineffective heroic response with purging and bleeding likely only hastened dehydration and did little to heal or win the confidence of people seeking relief. Although Hahnemann knew no more about the cause and proper treatment of cholera than regulars, the relative success of his method and higher survival rate of his patients played a major role in winning homeopathy additional friends and supporters on both sides of the Atlantic in the 1830s and 1840s.
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Late in his life, Hahnemann surprised his followers by marrying French artist Marie Melanie d'Hervilly and moving from his German home in Kothen to Paris in 1835. Hahnemann established a lucrative practice in an elegant mansion and taught homeopathy to his new wife, who soon began practicing by his side. Controversial until the end, even with his aristocratic clientele, Hahnemann found himself defending his theory and his method until his death in 1843.
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Homeopathy arrived in the United States with Hans Burch Gram in 1825. Born in Boston but trained in Europe, Gram first learned of homeopathy while studying medicine at the Royal Medical and Surgical Institute in Copenhagen. Returning to the United States, Gram established a successful homeopathic practice in New York City and created an apprenticeship program to train the first generation of American homeopaths. But Gram's New York City enterprise was soon eclipsed by activity in Philadelphia, which emerged as the first true center of American homeopathy thanks largely to the efforts of several German immigrants.
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By far the most influential of these immigrants was Constantine Hering, who became known as the father of homeopathy in America. Hering first learned of homeopathy as a medical student at the University of Leipzig in the 1820s, where he received a commission to write a book refuting Hahnemann and his theories. Rather than disagree with Hahnemann, though, Hering found himself impressed with Hahnemann's work and homeopathy's potential. His convictions strengthened after he contracted a severe infection in his finger after an autopsy. The wound became so bad that amputation seemed all but necessary until a friend persuaded Hering to try a homeopathic
dose of arsenic as a last resort. His infection resolved and led Hering, grateful for his ten fingers, to declare, “The last veil that blinded my eyes to the light of the rising sun was rent and I saw the light of the new healing art dawn upon me in all its fullness. I owed to it far more than the preservation of a finger. To Hahnemann, who saved my finger, I gave my whole hand and to the promulgation of his teachings not only my hand, but the entire man, body and soul.”
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He soon abandoned regular medicine for homeopathy and joined a zoological expedition to South America, where he carried out provings on a variety of plants and animals on the side, including a particularly risky trial with snake venom.
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Hering first heard stories about the bushmaster, the largest poisonous snake in the New World, while encamped in the Amazon Basin in Suriname in 1828. A zealous convert to his new system, Hering reasoned that the snake's lethal venom might be beneficial in infinitesimal doses, so he paid locals to capture a snake so he could collect its deadly saliva for observation. The venom was so toxic that even the process of preparing and diluting the poison for homeopathic dosing made him delirious. Hering mixed the venom with lactose and conducted a proving on himself while his poor wife recorded the results. He woke up the next morning lucky to be alive. Fever, delirium, and a “frantic struggle for breath” were just a few of the symptoms she listed. The venom Hering collected became the first snake poison ever researched for medical purposes. Even today, doctors and researchers continue to study the usefulness of snake venom and poisonous animals in medicine.
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Hering and his alcohol-preserved bushmaster arrived in Philadelphia in 1833. Finding a handful of like-minded immigrant homeopaths in his new city, he quickly organized the Hahnemann Society, the nation's first homeopathic medical organization. Two years later, he became president of the world's first homeopathic medical school, the North American Academy of the Homeopathic Healing Art, in Allentown, Pennsylvania. Instruction, conducted entirely in German, included lectures on medical botany, dietetics, surgery, obstetrics, anatomy, physiology, and the history of medicine. Financial difficulties forced the school to close in 1842, but not before sending out a host of evangelistic graduates eager to carry the homeopathic faith to the rest of the country.
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Hering went on to found several other homeopathic schools, including the Homeopathic Medical College of Pennsylvania in 1848, which became the national leader in homeopathic education. Twenty years later, in 1869, the school merged with another homeopathic school to become the Hahnemann Medical College of Philadelphia with Hering as dean and chair of materia medica. Homeopathic instruction continued at the school into the 1950s, a lasting vestige of the school's origins and a reflection of the strength of homeopathy as a medical practice into the twentieth century. Besides his educational endeavors, Hering continued to experiment with remarkably risky provings. In 1849, he experimented with the newly discovered explosive nitroglycerine, curious about its possible therapeutic value for headaches after learning of Italian scientist Ascanio Sobrero's observations that it produced throbbing, violent head pain when placed on the tongue. He confirmed the effect in his volunteers with dilutions of less than one three hundredth of a drop. Hering also reported changes to the pulse, observing that nitroglycerin caused “contraction” and “oppression” of the chest. Decades later, regular doctors adopted nitroglycerine as a treatment for the chest pains associated with heart disease, for which it is still widely used today. Hering also wrote more than forty books on homeopathy, the most important of which was the popular home-health manual
The Homeopathic Domestic Physician
. The book found a wide audience among regular doctors interested in learning about homeopathy as well.
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The number of homeopaths in the United States expanded rapidly. By 1860, the nation had more than two thousand practitioners. They formed local and state organizations and in 1844 established the first national medical organization, the American Institute of Homeopathy (AIH), to improve the quality of the field. Constantine Hering became its first president. It surely wounded many regular doctors' pride to see one of their supposedly unscientific rivals forming an organization to implement standards and improve medical practice before they had organized to do the same.
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Three years later, in 1847, regular doctors established their own national organization, the American Medical Association.

While the AMA may not have explicitly formed to fight homeopathy, it's not hard to imagine that motivation behind the organization's actions. One of the AMA's first orders of business was to effectively ban homeopaths from ever becoming members by rejecting a homeopathic
education as unscientific and inadequate to the task of training doctors. This despite the fact that the content of homeopathy's two-year training program was nearly identical to that of regular medicine. Homeopaths' understandings of bodily function and how to find and study disease did not differ from those of their regular peers. Even more, before 1860, the majority of homeopaths were regulars who had converted or those who offered a mixed practice of heroic and homeopathic therapies.
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Education was a serious matter for homeopaths, who organized the American Institute of Homeopathy in part to improve training and standards. They particularly wanted to reign in “physicians from pretending to be competent to practice homeopathy who have not studied it in a careful and skillful manner.”
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Homeopathic schools opened all over the country, more than twenty by the end of the nineteenth century. The majority also admitted women, unlike regular medical schools, though some homeopaths did share the conviction of regulars that women were better served by female medical colleges. Only a year after its founding, the AIH resolved to admit only members who had completed a “regular course of medical studies,” homeopathic or regular, and who had passed an examination, far stricter criteria than existed for membership in the AMA.
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Soon after forming, the AMA passed a code of ethics barring members from even consulting or associating with homeopaths at the risk of expulsion from the organization. It was no idle threat. “No one can be considered as a regular practitioner, or a fit associate in consultation, whose practice is based upon an exclusive dogma, to the rejection of the accumulated experience of the profession,” read the code.
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One Connecticut doctor was ousted from his local medical society after talking over a case with his wife, who was studying to become a homeopath. One observer wryly noted that his error might have been overlooked “had he consulted with another man's wife upon topics not purely medical.” Another was expelled for purchasing milk sugar, a standard dilution ingredient, from his local apothecary.
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Anyone calling him- or herself a homeopath was deemed “unfit” for consultation on patient care, even if it came at the patient's request. At the same time, no regular doctor could serve a patient under the care of a homeopath until the homeopath was dismissed, no matter how desperate the situation and need for assistance. Local and state medical societies held meetings to determine if regular doctors
who had converted to homeopathy should be allowed to retain their membership; most voted no. The Medical Society of the County of New York, which had gone so far as to give Hahnemann an honorary membership in the organization, rescinded the honor a few years later as homeopathy's ideological and financial threat to regular medicine grew more apparent.
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From the 1850s onward, medical societies used the consultation clause to successfully keep homeopaths from practicing in publicly funded medical institutions, medical schools, and the medical departments of the military.
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