Medicine of Experience :: The Forerunner of Organon

Dr. Samuel Hahnemann's magnum opus, his fundamental masterpiece, "Organon of Medicine" was not a fortnight saga neither was it the prize of serendipity. Organon was the result of Hahnemann's keen observation and profound experimentation utilized with an analytical brain. All must concede that but few medical writers have appeared since the days of Hippocrates, whose opinions have stood the test of centuries so triumphantly as those of our Master. Hahnemann's experiment with Cinchona had been like Newton's apple implanting in his mind the first seeds of Homeopathy.

After the Cinchona experiment and the first insight of the principle of Similia Similibus Curentur the indefatigable rebel strived harder to search for the " Truth slightly covered o'er by the Allwise". Constant experiments and keen analytical observation led to the production of masterpiece such as Homeopathy.

That was the year 1790 and in 1796 Hahnemann published his article Essay on a new Principle for Ascertaining the Curative Powers of Drugs in Hufeland's journal wherein he first explained the principle of Similia similibus and advocated the proving on healthy human beings. "...and employ in the disease we wish to cure, that medicine which is able to produce another very similar artificial disease, and the former will be cured; similia similibus"

This was soon followed by different other articles where he tried to explain and fine-tune his new found principle. Moving in and out of Leipsic and Dresden expanding his knowledge on Homeopathic principles Dr. Hahnemann wrote in 1810 the first Edition of his Organon, " Organon of Rational Healing Art". This was later revised, augmented, enhanced into 5 editions in his life time and the 6 th posthumous edition about which he wrote the 6 th edition of my Organon which is the most complete existing edition of my book.

Thus we see that from imperfection to perfection his theory removed its multilayered shroud gradually and completely to glorify the world with its outcomes. If the principles of Homeopathy have withstood the assault of centuries it is because they were subjected to profound criticisms and scrutiny remodeling them and perfecting them. Hahnemann has laid the foundation of the true healing art on a firm and incontrovertible basis - the principles of Homeopathy have been thoroughly tested for over two centuries with the most gratifying results.

Among the harbingers of Organon are numerous literary works of the Master which paved the way for this masterpiece. These include:

1. Essay on a New Principle for Ascertaining the Curative Power of Drugs with a few glances at those hitherto employed, 1796. As discussed above, it laid the foundations of Experiment on healthy human beings and Law of Similia.
   
2. On the Power of Small Dose of medicine in general & of Belladona in particular, 1801 wherein he talks about the powerful effect of the infinitely small doses of medicine on the morbid state. " The nearer the disease approaches the acute character, the smaller are the doses of medicine".
   
3. Aesculapius in the Balance , 1805 which questioned the then prevalent medical system about the lack of progress in the science. "In the centuries since Aesculapius lived, the art of medicine has made little or no progress other than searching for an undiscoverable source of disease".
   
4. Medicine of Experience, 1805 which is considered the precursor of Organon
   
5. On the value of Speculative System of Medicine especially as viewed in connexion with the usual methods of practice with which they have been associated , 1808. This work questions the efficacy of the conventional systems of medicine and their artistically compounded recipes.

Among the above medical writings it is the Medicine of Experience which is chiefly considered as Organon's precursor. It is because though all the early works had some theories or principles which were to be later presented in Organon it was only this article (Medicine of Experience) which had close resemblance to Organon both in its content and format. Going through M.E exhaustively exhibits the crude and primitive form of different aphorisms of the later version of Organon.

Medicine of Experience was first published at Berlin, 1805 in German language. It commences with, " Man, regarded as an animal, has been created more helpless than all other animals." Dr. Hahnemann wrote this to explain that Nature compensated for man's lack of congenital weapons of defense by giving him the powerful mind which he can use to discover remedial agents for his protection from maladies and accidents. These can be discovered by not imitating nature's method of removing disease but by discovering medicines to eradicate diseases. " Medicine is a science of experience; its object is to eradicate diseases by means of remedies. The knowledge of diseases, the knowledge of remedies and their employment, constitute medicine"

This as we remember has been again repeated in § 3 and later in §71 of Organon. Dr. Hahnemann considers the above three points as necessary for every physician to acquire for it is on these that cure depends. Some of the other subjects which were discussed first in Medicine of Experience and were later presented in Organon of Medicine either as improved version or with some minor changes include:

Rapid, Gentle and permanent Cure: Aesculapius' criteria of ideal cure Cito tuto et jucunde (meaning thereby speedily, safely and gently) impressed Hahnemann to such an extent that he signified Ideal Homeopathic Cure as Rapid gentle and permanent cure in §2 of his Organon. In The Medicine of Experience, Dr Hahnemann writes that "... in order to cure the diseases we wish to remove, certainly, quickly & permanently".

Importance of External Exciting Cause: He explains that in spite of researching for so many years the knowledge of diseases and its related internal changes is still incomplete. So instead of wasting their time and energies on disease processes the judicious method is obtaining knowledge of causation, chiefly exciting and predisposing cause. This assertion on exciting and fundamental cause was again seen in §5 of his Organon.

Cure: In M.E, Hahnemann writes that Cure means removal of patient's symptoms along with exciting causes achieved by an improved regimen to prevent relapses. We find the same view in §7 and §8 of Organon where Hahnemann explains cure as removal of totality of symptoms.

Symptom presentation: Dr. Hahnemann wrote in his M.E that " Internal essential nature of every malady expresses itself by symptom". This unisons with §11 of Organon where Hahnemann explains that the primarily morbidly deranged vital force expresses its sufferings by morbid symptoms.

Modus operandi of Homeopathy : Further, the Maxims of Experience listed in M.E about what happens when two abnormal irritations (of dissimilar or similar nature) act on the body. The result would be either suppression of the weaker or its removal as in the latter case. Then the inference that he gives is the glimpse of Modus operandi of Homeopathy, " It is only by this property of producing in the healthy body a series of specific morbid symptoms, that medicines can cure diseases, i.e. to say remove and extinguish the morbid irritation by a suitable counter-irritation." This was later expressed in detail in §26 of Organon giving Homeopathic law of Cure, " A weaker dynamic affection is permanently extinguished in the living organism by a stronger one, if the latter (whilst differing in kind) is very similar to the former in its manifestations " . 1

Primary action and Secondary Action: Dr. Hahnemann explains in his M.E that medicinal substances possess a positive (primary) & secondary action and this secondary action is the exact opposite action of the first process. Though not up to the mark or lacking the finesse of his later work § 63 of his Organon where he clearly explains primary and secondary action and their role in homeopathy; but still this shows that Hahnemann had started thinking and experimenting on the matter and the result was indeed evidenced in his Organon.

Artificial Disease: In M.E Dr. Hahnemann mentions that if large doses of medicine are administered Artificial diseases result which are difficult to cure; " greatest most formidable & most incurable diseases..". He again mentioned the same view in §74-75 of Organon ".. commonly met with, artificially produced in allopathic treatment by the prolonged use of violent heroic medicines in large and increasing doses ,.."

Types of Diseases: Dr. Hahnemann classified diseases into:

• Miasmatic maladies or specific diseases or diseases of peculiar character that arise from same contagious principle, pursue same course and have same essential character. E.g hydrophobia, small pox, measles.
• Non-miasmatic maladies or diseases that arise from single unvarying cause or confluence of several definite causes. E.g. marsh ague, gout etc.
• Other diseases arising from combining of several dissimilar causes, varying in number and differing in nature & intensity. These diseases never occur in the same manner or under same circumstances e.g. dropsy, scrofula, rheumatism etc.

This classification was the beginning of the elaborate disease classification which was to come later in Organon §77. Though not exactly similar but it shows that the foundation had been laid for miasmatic and non miasmatic maladies.

Case taking: In M.E, Hahnemann writes about forming accurate picture of disease by questioning patient and his attendants. He also advises to avoid all conjectures, leading questions, suggestions during interrogation and also to refrain from any interruption in between. This being a beginning we find more luxuriant directions in §83-104 of his Organon. But the mere mention of the subject heralds M.E as forerunner of Organon.

Dr. Hahnemann also suggests carefulness in observing and fidelity in copying symptoms during interrogation. It is astonishing to see the same direction in §83 of Organon.

Importance of Objective Symptoms: " When the physician has completed this examination he notes down what he has silently observed in the patient". This view of Dr. Hahnemann was explained further in his Organon in §90 where he writes " When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient". Thus we see that before he wrote his magnum opus Dr. Hahnemann gave an insight of its aphorisms in Medicine of Experience.

Constructing patient picture in cases with history of previous treatment: In the cases which had previously taken treatment for their complaints Dr. Hahnemann advises in his M.E to inquire about the last medicinal treatment for construction of an unmodified picture of the patient. This was again written by Dr. Hahnemann in his § 91 of Organon wherein he changed the language but the essence continued to remain the same. " those symptoms and ailments which he suffered from before the use of the medicines, or after they had been discontinued for several days, give the true fundamental idea of the original form of the disease.." Hahnemann's views and rationale on Homeopathy can be first seen in M.E which later came in the form of Organon.

Drug proving on Healthy Human beings : In his M.E, Dr Hahnemann mentions that " each plant, animal & mineral effect an alteration in our state of health in a peculiar, determinate manner... for knowing there exact character we administer these medicines experimentally the weaker as well as the stronger....to healthy individuals. As discussed earlier after the Essay on a New Principle for Ascertaining the Curative Power of Drugs with a few glances at those hitherto employed, 1796 Hahnemann explained the need to prove drugs on Healthy human beings and to record their exact symptoms. This view was improved, expanded and applied to present to the profession the aphorisms of Drug Proving §105-145 of his Organon.

Characteristic Symptom: In his M.E Dr. Hahnemann gives most importance to the symptom most singular, most uncommon signs, most constant, most striking and most annoying to the patient. Similarly in § 153 of his Organon he lays importance on the more striking, singular, uncommon and peculiar signs and symptoms of the case. This shows that the major issues explained in both these works were not very different.

Homeopathic Aggravation : Dr. Hahnemann mentions in his M.E that, " If we have not only selected the right remedy, but also hit upon the proper dose (& for a curative purpose small dose) the remedy produces within the first few hours after the dose has been taken a kind of slight aggravation (seldom lasts so long as 3 hours) - nothing more than primary symptoms of medicine which are superior in intensity to disease" This mention of slight intensification of symptoms just after intake of medicine is quite similar to his mention of Homeopathic Aggravation in §157-160 of his Organon of Medicine.

One-sided Disease: Dr. Hahnemann also mentions in his M.E about those diseases wherein"..... only one or couple of severe symptoms are observable..". This special group of diseases were later named One-sided diseases by Hahnemann and given under §172-184 of his Organon.

Repetition of Doses : ".. not repeating the dose until after the medicine has exhausted its dose.." were the words of Hahnemann in M.E to express the need of status quo before second prescription. Later Hahnemann adhered to the same view while writing his Organon of Medicine and gave §245-251 explaining that second prescription should not be made until the first medicine has ceased its action.

Doctrine of Doses : Regarding the administration of doses/medicine to the patient Dr. Hahnemann mentions in his M.E that "... a single simple remedy is always calculated to produce most beneficial effects.." and later ".. smallest possible dose of a positively acting medicine will suffice..". This employment of single simple medicine was proposed by Hahnemann in § 272-274 of his Organon of Medicine. Though undoubtedly the advice for the potency to be employed changed in later editions but the Doctrine of Single simple dose remained the same.

Animal magnetism : Hahnemann also mentions about the Heroic powers of Animalism in his Medicine of Experience. It is though amazing to see that though mentioned in M.E (1805) it was only later in the 3 rd edition of1824 that Hahnemann first placed paras of Animal magnetism or Mesmerism in his Organon. This shows the high honor that is deserved by M.E for it was in truest sense the harbinger of Organon of Medicine.

Other than the insight of above mentioned themes Medicine of Experience also has further citation for Medicinal Aggravation " new, violent symptoms during the first few doses of medicine"; Improving Diet and Regimen; Palliative treatment etc.

The author of Homeopathy, throughout the whole of his glorious career, was remarkable as a man of facts. Ignoring the theories prevailing at his time and fighting the criticism of his contemporaries he endeavored for truth alone and it was the result of his untiring efforts that we received this rich heritage of Homeopathy- first with Medicine of Experience and later with Organon of Medicine..

Is it not surprising to know that most of the principles and aphorisms enlisted in Organon share their birth in Medicine of Experience? As with evolution of Organon (from 1 st to 6 th Edition) some concepts but mainly language and explanation changed so we can see that it was exactly the same case with transition from Medicine of Experience to Organon of Rational Art of Healing. Apart from its name and lack of aphoristic style of writing this book if critically reviewed seems like the oldest version of Organon of Medicine. In short, if merited on the basis of its content we can so rightly call Medicine of Experience to be a forerunner of Organon of Medicine.

N.B: The abbreviation M.E in the above text stands for Medicine of Experience.

Bibliography:

1. Samuel Hahnemann, Organon of Medicine, 5 th Edition. (Dudgeon's Translation)
2. The Lesser Writings of Samuel Hahnemann translated by R.E Dudgeon.