Myth and reality


At Hahnemann's death his doctrine had already spread widely in spite of opposition, and homeopaths felt confident that it would not be long before they had achieved recognition as practitioners of the one rational form of medicine. Homeopathy was to be found not only in Germany and France, the two countries where Hahnemann had practised, but also in England, Italy, Spain, Scandinavia, Poland and Russia; it had crossed the Atlantic to both Americas and it had taken root in India, still the country where it flourishes most successfully although little is known about how it came there.

At this time homeopaths were not content to rest upon the labours of the Master; many of them took up various aspects of his teaching and developed them in new directions. In the next chapter I shall look at what happened to the potency idea but here I am concerned with the new provings that were undertaken by some of his more adventurous disciples, sometimes at considerable personal risk.

In spite of their fundamental importance for homeopathy both of Hahnemann's major contributions to pharmacology - The Materia Medica Pura and The Chronic Diseases - had serious flaws. The Materia Medica Pura was so arranged as to make it almost unreadable, consisting as it does of mere lists of symptoms arranged anatomically, so that, in the words of Richard Hughes, an eminent British homeopath of the day, the would-be reader of Hahnemann's article on Aconite begins with Vertigo and ends with Rage. As for The Chronic Diseases, it suffered from the same problems of arrangement and in addition, as we saw in the last chapter, there were doubts about its reliability.

Many homeopaths, therefore, while not questioning Hahnemann's genius or importance, felt that there was a need to re-prove his medicines to see whether the symptoms he had found could be reproduced. They also wanted to test new medicines for their possible application to disease. For these reasons the second half of the nineteenth century saw an astonishing spate of provings, especially in Germany, Austria, and the USA. Some of the most interesting and extensive provings of the later nineteenth century were carried out by the Austrian Homeopathic Society, which re-proved a number of Hahnemann's medicines and also some new ones. The narrative accounts of the nineteenth-century provings are often extraordinarily dramatic. The provers often went to lengths that can only be called heroic, and their records provide striking evidence of their homeopathic zeal. It is certain that work of this kind will never be repeated, which makes it of unique historical interest if nothing else. And yet the surprising fact is that today all these original reports remain locked away in nineteenth-century tomes, gathering dust and almost unread even by homeopaths. Later we shall see how this has come about but for the present let us look at what happened to some of these pioneers.

The medicines that were tested fall into three broad categories. First, there are substances that are definitely poisonous if taken in adequate dosage - mercury, phosphorus, and arsenic, for example. Not surprisingly, provers who took these substances often made themselves quite seriously ill. Second, there are substances that, although certainly capable of making people ill, seldom cause death even when taken in fairly large doses. In this second group we find, for example, nutmeg, hashish, and poison ivy. Third, there is a group of substances that would ordinarily be thought of as more or less inert or harmless; here we find common salt, charcoal, and quartz sand. This group offers special difficulties to a modern reader, in that it is particularly difficult to decide how far the symptoms attributed to the medicines may really be due to something else. There is of course a certain amount of overlapping among these three categories but in what follows I shall treat them separately.

Dangerous poisons

The nineteenth-century homeopathic literature contains many alarming reports of people taking appallingly large doses of poisonous substances. Hering, for example, took a lead preparation until his moustache and eyebrows fell out and his teeth decayed. A Dr Spence also took lead in increasing doses over three weeks; his gums became spongy and he suffered other well-known symptoms of lead poisoning such as colicky abdominal pain and paralyses of his limbs. Knowing what we do today about the persistence of lead in the body and its long-term effects, we must assume that these provers would have continued to suffer from lead poisoning long after the end of the experiments.

Another poison that attracted a great deal of attention from provers was phosphorus. This was used at the time in the manufacture of matches and was well known as an industrial poison; workers in the industry suffered loss of teeth and destruction of their jaw bones ("phossy jaw"). Provers who took phosphorus duly suffered pains in their teeth and facial bones. Some of them also experience interesting psychological symptoms. Dr Heath, an American, took five drops of phosphorus tincture and then dismissed the matter from his mind. At about 10 p.m. he went to bed but was unable to sleep.

My mind was greatly oppressed with melancholy; tears would start without cause; a feeling of dread, as if awaiting something terrible while unable to resist or move, overcame me. Sometimes it seemed as if I were beginning to bloat, and then I could hear a multitude of voices saying, in high glee: "Fill him up a little more and he will burst", followed by demoniacal laughter ... When I attempted to walk my legs seemed glued to the floor; the slightest motion caused great pain...

It took Heath more than two months to recover fully from this alarming experience.

Sometimes provers took matters to the point where their health was permanently impaired. This occurred during the provings of arsenic in America, in which some of the provers took doses of a tincture of arsenic for long periods - fifty days or more. They experienced a variety of symptoms, some of which lasted for over two years.

Toxic but non-fatal substances

This group contains some of the most interesting accounts, since the provers often took large doses over long periods. This comes out particularly clearly in the case of Thuja occidentalis, the Tree of Life. One hardy experimenter took 42,260 drops of tincture over 155 days; some others took nearly as much. Not surprisingly an enormous variety of symptoms ensued, which it is quite impossible to summarize. Thuja was for Hahnemann the principal anti-sycotic (anti-wart) medicine, and in fact a number of provers, including three children (the apparent willingness of some enthusiasts to experiment on children and even babies is remarkable) developed warts, and in adults a gonorrhoea-like urethritis was also seen. Dr Robert Dudgeon, a prominent English homeopath of the time, had in this connection an embarrassing experience which I give in his own words.

On 10th July, when taking a walk, I happened to pass a [Tree of Life] laden with green cones. I plucked one, chewed it a little, and thought no more about it. That same evening I observed a very disagreeable scalding on making water, which continued all next day; and I was horrified to observe on undressing that my shirt was spotted all over in a manner extremely repugnant to one's notion of respectability ... I had quite forgotten the circumstance of having chewed the Thuja cone and could not imagine what could have produced in me, a decent paterfamilias, such a very incongruous complaint. The following year the discharge had become yellow ... I now remembered the cone-chewing and regarded the malady with more composure. [The disease lasted until the 16th.] The symptoms ... were precisely those of an ordinary attack of gonorrhoea, but their medicinal origin was evidenced by the short duration of the attack. I should add that two colleagues who, at my suggestion, chewed a cone as I had done were unaffected by it.

There are no reports of fatalities from accidental overdosage with Thuja, and from the large doses taken by some of the provers it would not seem to be a dangerous substance. However, the symptoms often lasted a long time, sometimes for a month or more after the last dose was taken.

Another interesting substance is poison ivy (Rhus spp.). This is a plant that grows wild in North America. People become sensitized to it easily and then suffer severe skin reactions whenever they come into contact with it. Hahnemann introduced the herb as a homeopathic medicine in the 'Materia Medica Pura' and it has always remained an important homeopathic medicine, being used for the treatment of skin disorders and also certain kinds of muscle and joint pains.

The American provers experimented with Rhus quite extensively. For the most part they used extracts of the leaves, either neat or in low dilutions. Most of them experienced the expected skin and muscle symptoms but the details of some of the narratives are curious. One prover, for example, became so exquisitely sensitive to the plant that in subsequent years he was unable to pass a swamp in which the plant was growing without suffering renewed symptoms. An unusual feature was that at this time his wife would experience vaginal burning after intercourse.

Another prover, a Dr Clary, held a stick of Rhus in his hand for half a minute and just touched his tongue with the tip of it. Nothing happened for a week; then while sitting at dinner he suddenly felt a scalding sensation in his tongue, and this grew rapidly worse and spread over his whole mouth and throat. Over the next few days he became very ill; a severe rash spread all over his body, his whole intestinal tract was affected, and his muscles ached so much that he could barely walk. It was more than two weeks before he recovered.

Other drugs in this group include those taken up as psychedelic agents by later generations, such as nutmeg and hashish. Hallucinations and other bizarre mental symptoms are reported surprisingly seldom by provers, who seem mainly concerned with bowel disturbances, aches and pains, and various strange physical sensations. (This is true of the proving literature taken as a whole.) But at least one prover experienced a bad trip after taking hashish.

I felt myself mounting upwards, expanding, dilating, dissolving into the wide confines of space, overwhelmed by a horrible, rending, unutterable despair. Then, with tremendous effort, I seemed to shake this off, and to start up with the shuddering thought, Next time you will not be able to throw this off, and what then?

Apparently inert substances

This group is in some ways the most puzzling to evaluate. It is very difficult to understand how taking common salt or charcoal could produce genuine symptoms, yet these and similar apparently inert substances were extensively proved by the early homeopaths. According to Hahnemann they would not have had any effect in their crude form but must first be activated by dynamization. Even homeopaths were sometimes sceptical about this, which makes their eventual conversion through personal experience all the more interesting. A good example is provided by the Austrian provings of common salt.

Some provers were in fact insensitive to salt. Others had well-marked symptoms and there are pages and pages about them. One of the most interesting reports is that of Dr Watzke, who on 2 March 1843 began to take salt in various doses. At first nothing much seemed to happen, but then he began to suffer pains in his joints of such severity that he could hardly walk. The symptoms continued until the end of May. Reflecting on his experience, Watzke wrote:

It could not be easy for anyone to show themselves less susceptible to small as well as large doses of common salt than I showed myself at the beginning of my experiments ... And yet the medium doses, used continuously for a longer period, developed the salt disease in me almost to complete cachexia; and of all the medicines which I have hitherto proved, none created ultimately such a deep penetrating tenacious action in me as common salt.

This is certainly a curious account and it does not stand alone; numerous other provers reported something similar. Watzke appears to have been a sceptical and objective observer and it is difficult to dismiss his account as the result of error or self-deception.

This is not true of all the substances in this group. The provings of several of the major homeopathic medicines, such as Silicea, Sepia, and Lycopodium are less convincing. A great many symptoms are attributed to these medicines but they are mostly rather indefinite and I at least am left with the suspicion that many of them are really due to suggestion or other factors.

A case in point is provided by a report of the supposed effect of musk. This substance, used in the manufacture of scent, is derived from a special gland possessed by the musk deer and was supposed to have aphrodisiac properties. It had been proved by Hahnemann and other researchers, but the most startling description of effects comes from Hromada and concerns the experiences of an unspecified number of people engaged in grinding (triturating) musk.

A man aged 52 spent an hour at the task. In the first five minutes he had 'a kind of rush of blood to the head, with staring eyes and spasm in his mouth, so that he could not answer when asked what was the matter, though he understood what was said'. He then began to speak but rapidly and confusedly, and he would not stop when asked to do so. He became pale and sweaty and staggered as if drunk. His eyes rolled upwards, his jaw moved as if chewing, and he was unable to answer questions coherently. All these symptoms disappeared half and hour after he was taken into the fresh air.

Rather surprisingly he then resumed his grinding duties. All went well for half and hour, but then the symptoms came back with greater force than before. He lost consciousness and suffered a hallucination of big black figures pressing in on him.

Other musk grinders had symptoms that were almost as alarming. One woman aged 45, for instance, lost consciousness, but before this happened everything seemed to round in a circle, at first slowly, then faster and faster until at last it seemed as if she were hovering in the air and then falling from a great height.

It seems surprising to say the least that grinding musk should have had such striking effects as these. What can have been going on? A clue, I think, is provided by the occurrence in one musk-grinder, a woman aged 60, of sexual desire. We are assured by Hromada that she had never in all her life had such a sensation before, but it is permissible to wonder whether she can have been quite so immune from the desires of the flesh as this.

It seems much more likely that many of the symptoms supposedly due to the musk were really caused by a combination of collective hysteria (assuming that all these people were doing their grinding together, which is implied though not stated) and suppressed sexual awareness heightened by associations to musk. The phenomena described by Hromada are remarkably similar to those that occurred in Anton Mesmer's groups. Mesmerism was fashionable at this time and there are numerous accounts of trances with a strong sexual element during Mesmeric sessions.

Support from this idea comes from an interesting case reported by Dudgeon.

An unmarried lady of about 40 mentioned to me that she was extremely sensitive to the odour of musk. She would faint if she merely opened a note highly scented with musk. A doctor who was unaware of this peculiarity prescribed for her a pill containing 1/4 grain of musk. Soon after taking this she became unconscious, was violently convulsed, and this state lasted nearly a week, with short intervals of consciousness. She said her life was despaired of.

Lest it appear that I am being unduly sceptical about some of these provings, in Chapter 11 I describe the results of a modern proving of Pulsatilla, in which the participants produced so many symptoms in response to placebo that many of them withdrew from the trial.

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