Much more is now known about the “exciting or maintaining cause” of many types of illness than was known in Hahnemann’s time. This is speculation and extrapolation of course, but IMHO §7 seems to be saying that if you have evidence that the “manifest cause” of a disease is colonisation by bacteria [see my footnote], then Hahnemann would support an attempt to eliminate the bacteria from the body.

In fact, Hahnemann himself only propounds his methods as being suitable after “manifest causes” have been successfully treated, and so the Organon effectively predicts that homeopathic methods will become less and less useful as scientific knowledge of manifest causes improves.

[Footnote - a bacterial infection, in modern terminology; but in 1810 the word had a different meaning so I've avoided using it here]

The risk of dying from a case caught in the wild (the most common wild strain was highly lethal) was much higher than that from deliberate inoculation with a mild strain (about 30% as opposed to 3%). Incidentally this is why Jenner’s experiment was reasonably ethical, he would have inoculated with a mild form of smallpox even if he hadn’t first inoculated with cowpox.

I actually kinda like Hahnemann. It’s not his fault for being wrong, nor for not having the same standards we have today. Good scientists are wrong often, but they are still good scientists. Of course, it’s something else when you stick to something that has been proven wrong. H didn’t do that, today’s homeopaths do.

Comment by Elennaro — January 15, 2008 @ 9:38 pm

I was thinking about that this morning, and how infinitely worse are today’s homeopaths compared to Hahnemann. At least he had the excuse of working in the dark, so to speak, in the absence of any knowledge of germs, antibiotics, vaccinations, insulin, genes, the immune system, epidemiology… He also had no knowledge anything at the atomic level (atoms were only postulated by Dalton in 1803 and not confirmed until Rutherford came along), so no knowledge of x-rays or anything like that. Compared to what is known today Hahnemann knew very little indeed. But he was not entirely blameless because it seems he was prone to making stuff up without any scientific foundation. All he had really found was a way to keep some people away from the conventional medicine of the time, which was very crude and often worse than the diseases it aimed to treat. And in the process anyone with a self-limiting ailment got better – which they would have done anyway without seeking any medical help. He wasn’t very clever because he didn’t realise what was really happening.

Modern homeopaths however do not live in such ignorant times, and their persistence in perpetuating Hahnemann’s thoroughly discredited ideas (for profit I might add), all the while slandering modern medicine (of which Hahnemann has nothing to say because he was ignorant of it), it’s practitioners and researchers. Whereas Hahnemann’s ignorance was a product of the age in which he lived, the modern homeopath’s ignorance (if it is real) is wilful and mostly unforgivable.

The former (distal cause) refers to innate/developed susceptibility (e.g., a genetic inability to produce an immune response to a disease) or lifestyle/habits (e.g., unprotected sex) that increase someone’s chances of developing a disease. Whether these can be remedied or not, it is good advice that they should be noted. Nowadays we’d say that it is good advice because changing behaviour, for example using condoms, reduces the chances of re-infection. Hahnemann appears to say that they should be noted because they may indicate a “chronic miasm”, exactly what this is (apart from a placeholder term for “susceptibility”) remains unclear.

The latter (proximal cause) refers to the recent distinct event that has caused this acute stage of the disease. Hahnemann explicitly says that any doctor with half a brain will remove this cause, if possible, and that this will generally relieve the symptoms; so the splinter will be removed from the eye, the poison expelled with the help of an emetic etc. Again this is all very sensible advice and not in dispute. However, it is at this point that the advice falls down in the light of more recent knowledge. We now know that pathogens can be detected independent of symptoms and that they can remain in the system after the symptoms subside (e.g., malaria) i.e., the footnote to section 8 is wrong in every particular, there are indeed diseases that remain in the system and “burst forth at [their] pleasure with [their] material presence.”

I don’t know whether Hahnemann was aware of germ theory in later life, but it strikes me that the removal of the pathogen by modern medicine (e.g., antibiotics) is entirely in line with his previous advice; the only difference is that an antibiotic for removing bacteria is slightly more subtle than an emetic for removing poison. However, given that we are now aware of germ theory it strikes me that the obvious gap in homoeopathy is that it fails to deal with what we now know are the proximal causes of disease (H4H, I’d be interested to hear your view). This is fairly clearly demonstrated by the fact that homoeopathy’s “success” appears to be restricted to those cases in which we would defeat the proximal cause anyway (e.g., colds, flu) and is absent in those cases in which the proximal cause would defeat us (e.g., anthrax, rabies).

Finally, it’s most interesting to note that Hahnemann eerily foreshadows one common feature of pretty much all discussions of homoeopathy:

“When a patient has been cured of his disease by a true physician, in such a manner that… all the signs of health have permanently returned, how can anyone,… affirm in such an individual the whole bodily disease still remains interior? And yet the chief of the old school, Hufeland, asserts this in the following words: “homoeopathy can remove symptoms, but the disease remains.” … This he maintains partly from mortification at the progress made by homoeopathy to the benefits of mankind, partly because he still holds thoroughly material notions respecting disease.”

Not only does Hahnemann make an appeal to a mysterious, non-material cause of disease (energy, vibrations, miasms, quantum) but he also says that he (big pharma) rejects homoeopathy, not through a consideration of th eevidence and logic behind it, but because he is frightened at just how wonderful it is compared to “old school” medicine.

Apologies for loser-length post

Verse 9 is kinda fair enough, but it’s a bit of a mumbo jumbo way of saying that if you’re well then your body wil self-regulate and you’ll stay well. By extension, this does suggest that he thinks there’s no need for prophylactic medication, which is not so good, but since he didn’t know about vaccines, it’s understandable in the context of the ignorance of the time.