– On the cutting edge of extinction : how the quest for modernity led to the erosion of identity in american homeopathy from 1865-Craig Repasz (Craig Repasz)

Adolph Von Lippe,

Homeopathy by the 1860s had its identity affected by many different influences: loss of a common enemy, the easing of professional standards, and the pursuit of a scientific identity that was at odds with strict Hahnemannianism. By the 1860s orthodox homeopaths would begin a fight, as the old guard, for the protection of Hahnemann’s homeopathy. This fight at first arose as a personal conflict and existed along personal lines. The personalities involved were strong enough to divide homeopathy into defined camps of conservative and liberal. These opposing camps defined the schism. The camps debated the essential issues of the definition of homeopathy, how should it be practiced, and what should be the role of science in homeopathy. Until this point the issues were between individuals. By the 1880s they were between professional homeopathic organizations.
 According to the sentiments voiced in the AIH founding charter, the majority of homeopaths in the 1840s were conservative followers of Hahnemann and needed to protect their ranks from inept practitioners. The AMA shared a similar sentiment towards its ranks, therefore, there existed a need to raise the professional standard.
 The AMA, when it was founded in 1847, recommended that the traditional medical schools adopt higher standards of education by teaching anatomical dissection and mathematical sciences, and requiring a good education in English. xxxv Inherent in the recommendation was the hope that by raising educational standards the personal qualities of the physician would also be raised. The AMA’s emphasis on medical education echoes the prevailing sentiment in antebellum America that a physician’s personal character was his greatest asset. Personal character was considered a more important asset then the particular medical system to which a physician had identified.
 Medical schools during this period were numerous and non-standardized. Many of the schools would recruit as faculty members physicians who had studied in France. xxxvi The worldliness and scientific training of these men gave the educational institutions a sense of prestige that was necessary to attract new students. If a medical school could not attract such physicians, it would, by the late 1840’s, adopt the new empirical sciences from France into its curriculum.
 …the line of the schism had been drawn between personalities, not actual issues that would be points of contention in the decades to follow.
 The Homeopathic Medical College of Pennsylvania was no exception. In 1848, its first year in existence, the courses offered included chemistry, pathology and physiology. xxxvii In addition, it boasted of having a Parisian-trained Physician on its faculty. xxxviii To strict orthodox homeopaths, pathology was considered irrelevant because they emphasized Hahnemann’s totality of symptoms as the only true indication of understanding disease. While pathology would coexist with orthodox homeopathy peacefully for 19 years in one medical school it would eventually be the catalyst for a conflict that would tear the school apart, and sowed seeds for setting up formal camps on both sides of the schism in final decades of the nineteenth century.
 The Homeopathic Medical College was competing with all other medical schools. In 1849, the college was run by a twelve-member board of managers, none of whom was a physician. xxxix The board may have seen the need to keep the college competitive with other medical schools and hold the college out to be modern and prestigious by offering courses in the new sciences.
 However, in 1867, the college was ripped apart over the issue of whether or not pathology was indeed compatible with homeopathy. The dispute occurred between Dr. Adolph Lippé, professor of materia medica, and Dr. Charles Raue, professor of pathology. Dr. Lindsay Bradford, an early historian of the college wrote:
 As may be remembered, the new charter really made the institution a sort of joint stock company, in which the person holding the majority of the stock could control the entire college. At the close of the session of 1866- 1867, Dr. Adolph Lippé thus held the ruling power and most of the stock, and could virtually control the destinies of the college. After the close of the session he said that the chair of pathology and diagnostics was unnecessary, that it was contrary to pure homeopathy, that the homeopathic physician did not need pathology but only the power to prescribe according to the methods of Hahnemann from the totality of the symptoms. But when it came to a question of overthrowing the chair of Dr. Hering’s bosom friend, Dr. Raue, of cutting off the very necessity study of pathology and diagnostics from the students, Dr. Hering said: “No, I will leave the college if Dr. Lippé is to have his own autocratic way in this matter.”xl
 Regardless of the reason for the argument-personal, political, financial or principal-the excuse was quite clear. Pathology had no place in homeopathic education, according to Lippé. The indication that Hering and Raue are unorthodox was not substantiated in later writings. Further events would, however, establish Lippé as a spokesman for the conservatives. Seemingly, the line of the schism had been drawn between personalities, not actual issues that would be points of contention in the decades to follow.
 Hering and Raue immediately withdrew from the college with many of the faculty, and established the Hahnemann Medical College. In the first Annual Announcement the founders of the college stated the reasons for establishing the enterprise and justifying the curriculum. “A large number of Homeopathic physicians are in the habit of recommending their students to attend one or all of their courses of lectures at the Alloeopathic schools; alleging that general medical science, as well as surgery-in short, all except the bare matter of Homeopathy itself-can be successfully acquired only in that way.”xli They saw a need to retain students or lose them to other schools if the modern sciences were not offered. The trustees also ranked the sciences beneath pure homeopathy. “The high standard of scientific attainment requisite to constitute a thorough medical education demands most careful attention: for Homeopathy, however pure, if not based upon general medical science, must, in common with all other modes of practice, end only in quackery.”xlii It is clear that Hering and the other founders of Hahnemann University felt that a homeopath, no matter how orthodox, needed to appear modern and well-versed in the sciences. The homeopathic instruction at Hahnemann continued along the lines of the Hahnemannian tenets and the faculty continued to use Lippé’s textbook on Materia Medica. xliii
 The two colleges existed as rivals until 1869, when Lippé assigned his stock in the college to Dr. Henry Guernsey who, in turn, transferred the 185 shares to Hering. This happened unbeknownst to Lippé, who immediately resigned. The colleges were then merged under the new name. xliv
 Pathology could be interpreted as a clear violation of Hahnemann’s Organon § 6. “The disease consists only of the totality of its symptoms. Note the old school’s futile attempts to discover the essential nature of disease, prima cause.”xlv Many of the conservatives felt pathology had some value but the Hahnemannian view of the totality of symptoms was still of utmost importance. In 1874 Raue stated in his book Special Pathology and Diagnostics with Therapeutic Hints:
 This book does not pretend to be a special Theriapia, because, as v. Grauvogel already remarks: ‘It is impossible to prepare a complete, special Therapia for any so-called disease; just as impossible as to describe all human beings of all times, because the conditions of getting sick change constantly in the course of time.’ What the genius epidemicus requires, for example, in an epidemic of whooping- cough at his season may now answer at all for a like epidemic of next year. Hence, my only intention has been to give therapeutic hints. This book does not give any prescriptions in regard to the dose, because that is still an open question, and must be left entirely the free judgment of the practitioner. My hints are collected from all sorts of observations, with low, middle, high and highest potencies. I myself prefer the highest potencies: and it is possible that the more accurately we individualize the more we may become inclined to choose the highest. Others may think differently. So much is certain, that there are undoubted facts which seem to favor both sides of the question. Cases are recorded in which low potencies were given in vain, and a higher one of the same remedy at once effected a cure, and viceversa. Judge for thyself.”xlvi
 Raue clearly showed he could be ranked among the conservatives according to his methods. However, his leniency and acceptance of a different opinion would rank him among the liberals. One can interpret the above quote as a crack in the dam: he stated that pathology cannot be a foundation for prescribing but could point to the proper remedy. It could, however, lead to the use of remedies as specifics. The use of a specific remedy for a specific disease is a clear violation of Hahnemann’s law of similia.
 Earlier in the introduction to his book, Raue presented a list of sources he consulted. He stated that “I have made free use of all of them as far as they suited my purpose, but have not followed anyone exclusively.” His lists contained prominent homeopaths: Hahnemann, C. Dunham, Hering, Boenninghausen, Jahr, as well as Virchow, Müller and Bähr. By grouping Hahnemann with other physicians and scientists, Raue shows that Hahnemann had not been turned into an icon.

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