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Hahnemann - The Real Pioneer Of Psychiatry
by Peter Morrell

"Hahnemann was less keen to explore the psychological or psychic
causes of sickness and he seemed to play down the significance of such
factors. Moreover, in homeopathy, that still remains a more or less
blank sheet even to this day." [Morrell, 2001/2, JAIH]

Reflection upon this point has prompted me to consider this matter
further.

This short survey attempts to explore Hahnemann's treatment of
mentally ill patients, his aphorisms in the Organon on the same
subject and finally the uncomfortable position 'mental illness'
occupies within the conceptual fabric of homeopathy as a whole.

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As Dudgeon tells us, Hahnemann "settled for a time in 1792," [Dudgeon,
xxiii] in Georgenthal, and it was while residing there that he
"accepted an offer of the reigning Duke of Saxe-Gotha to take charge
of an asylum for the insane," [ibid.]. In a letter of May 1792,
Hahnemann states that the Duke would soon be "handing over to me his
hunting castle in Georgenthal," [Haehl, 2, 32], and it was here that
Hahnemann was able to "pursue his painfully interesting
investigations," [Dudgeon, xxiii], eventually establishing a dramatic
cure of a patient, Herr Klockenbring. The account of this cure was
published in 1796 [see Lesser Writings, 243-49] and this proves
Hahnemann was "one of the earliest, if not the very first," [ibid.] to
advocate a "treatment of the insane by mildness rather than
coercion," [ibid.]. In fact, it was on 2 September in the year 1793,
that "Pinel made his first experiment of unchaining maniacs in the
Bicêtre," [ibid.], which was some fifteen months after Hahnemann had
commenced treating Klockenbring.

This single incident undoubtedly provided Hahnemann with some
pioneering ideas about the nature of mental disease and how sufferers
ought to be treated. Whether it gave him any conception of mental
illness, as a separate category of sickness seems unlikely, because
such an idea clearly flies in the face of the holistic views inherent
to homeopathy itself. These events also lie close to the years when
Hahnemann was conducting his first provings and just before he
published what might be termed his 'first sketch' of materia medica in
the Fragmenta de viribus medicamentorum positivis, published in 1805.
Therefore, this incident actually occurred at a very busy and
important time when Hahnemann was consumed with his formulation of the
homeopathic system for the first time.

Johann Christian Reil (1759-1813)

There seems little doubt that Hahnemann "possessed an extraordinary
understanding for the nervous and mental activities of his patients…
and [possibly] considered psycho-therapy in certain cases to be more
important, more applicable than the use of homeopathic
medicines," [Haehl, 1, 272-3]. He also seems to have been "far in
advance of his time in this province," [Haehl, 1, 273]. Everyone seems
to be agreed that he exhibited a "fine understanding…for the
unfortunate victims of mental derangement," [Haehl, 1, 272] and he
acquired a reputation for the same, attracting many patients with
mental problems. This was in the 1790s before homeopathy was yet
established and during which time he was not a regular medical
practitioner. His cure of Klockenbring "caused a sensation," [Haehl,
1, 41] at the time and certainly reveals him as the originator of
"entirely new methods in the treatment of mental patients,
independently of his famous contemporaries Pinel and Reil," [Haehl, 1,
272]. "'We lock up these unhappy beings like criminals in cells,'
exclaims Reil in 1803," [Haehl, 2, 31]

The anatomist and psychiatrist Reil (1759-1813), was "a friend of
Goethe and publisher of various medical journals, who was the first to
use the term "psychiatry;" warned against the indiscriminate
administration of drugs and, instead, emphasized the use of
psychogogics, occupation? playing music, and acting in his therapeutic
program, "Rhapsodies" on the application of emotional cures on rain of
the mind." The treatment of melancholy included pleasing physical
stimuli such as heat, studying esthetic paintings, strolling, and
swinging." [ http://mineralconnection.com/stjohn-3.htm]

Philippe Pinel (1745-1826)

Phillippe Pinel [1745-1826], a French physician, "M.D. Univ. of
Toulouse, 1773. After moving to Paris in 1778, he was appointed (1793)
director of the Bicêtre hospital and shortly thereafter of the
Salpêtrière. His Traité médico-philosophique sur l'aliénation mentale
(2d ed. 1809), based on observations in both these hospitals,
advocated humane treatment of mentally ill persons, then called the
insane, and a more empirical study of mental disease. He further
contributed to the development of psychiatry through his establishment
of the practice of keeping well-documented psychiatric case histories
for research."

[http://www.slider.com/enc/42000/Pinel_Philippe.htm]

Treatment of Klockenbring

The chief resource that is alluded to by others in support of
Hahnemann's superior and prophetic views on mental illness is his
treatment of Klockenbring in Georgenthal in 1792. This event was
certainly critical in formatively creating his own views on this
subject.

At the time in question, Hahnemann declared that he had "been for
several years much occupied with diseases of the most tedious and
desperate character in general…" [Bradford, 52], including several
cases of hypochondria and insanity. Hahnemann then wrote of
establishing "a model asylum for the treatment, by gentle methods, of
the insane of the higher classes of society," [Bradford, 53].
Publicity for the new asylum was given in a local journal, The
Anzeiger, in March 1792 [Haehl, 2, 20] yet "in spite of the clear
intention to restrict its use…to persons of…good social standing…the
document breaks out compassionately into a plea for a rational
treatment of the countless victims of insanity who were kept in
confinement in the asylums," [Hobhouse, 85-6].

Hahnemann's entry into the psychiatric field "was four years before
William Tuke, the English Quaker had finally established the Retreat
in York…and a year before Pinel reformed the Bicêtre Asylum in
Paris," [Hobhouse, 85].

William Tuke
(1732-1822)

William Tuke, "was head of the Quaker family that founded the York
Retreat in 1792…located in a rural setting, provided humane
institutional care of people with mental illness. Its reduced use of
restraints and confinement, and therapeutic use of occupational tasks,
especially farming chores, were duplicated in scores of later
institutions." [Street, 1994]. Tuke [1732–1822], was an English
merchant and philanthropist, who succeeded at an early age to the
family business at York in wholesale tea and coffee. Apart from
founding the York Retreat, he also spawned a whole family of
individuals, all with pioneering links to humane treatment of the
poor, the destitute and the mentally ill. The York Retreat was "an
influential early institution for the intelligent and humane care of
the insane," [http://www.infoplease.com/ce6/people/A0849646.html]

At the time of Hahnemann's incursion into this field, the insane were
"treated like wild animals…chained in dungeon-like cells," [Cook, 62].
The usual treatment at the time was "by violence…whipping and
dungeons," [Bradford, 54]. Haehl states that Hahnemann "acquired a
knowledge of psychiatry…greater than Pinel…[upholding] the cause of
humane treatment," [Hobhouse, 93], Hahnemann additionally laying out
"the foundations of a new medicinal treatment of mental
illness," [ibid. 93]. Hahnemann also appreciated the importance of the
'law of similars' when he referred to a cure "by Hippocrates of his
friend's mania by the use of Hellebore…[which can] produce the
symptoms of mania," [Hobhouse, 92]. Apparently, this observation
provided one confirmation for his idea of the central importance of
similars in medicine.

During the two years following his translation of Cullen's Materia
Medica, and the epochal Cinchona bark proving in 1790 that derived
from it, Hahnemann "continued to experiment upon himself and on his
family and certain of his friends with different
substances," [Bradford, 52], but he had not yet "tested the truth of
this new principle on the sick. The insanity of Klockenbring gave him
the opportunity," [ibid, 52]. However, for the first few weeks
"Hahnemann simply observed Klockenbring without giving him any medical
treatment," [Hobhouse, 89].

Klockenbring had been "Hanoverian Minister of Police and Secretary to
the Chancellery…[and] in his fast life, he developed great
eccentricity," [Bradford, 53], but he became the subject of a satire
claiming he was a close associate of drunken brothel keepers and that
he had "the most dangerous venereal disease and moral vices ranging
from drunkenness to fraud," [Cook, 62]. As a public figure and family
man who could not stand such accusations, he "became violently
insane," [Bradford, 53].

"In June 1792 he was brought to Georgenthal," [Haehl, 2, 33], being
"so violent that he was escorted by two well-built men to keep him
under control," [Cook, 63]. His face was "covered with large spots,
was dirty, and imbecile in expression. Day and night he raved. He was
afflicted with strange hallucinations…would recite Greek…actual words
of Hebrew text…he destroyed his clothing and bedding, took his piano
to pieces…and exhibited the most perfect forms of excitable
mania," [Bradford, 54]. Yet, Hahnemann had succeeded in curing him by
"March 1793," [Bradford, 55]. As Cook suggests, it seems likely that
his ravings were indeed "those of the tertiary stages of
syphilis," [Cook, 63], as his cruel satirist had suggested in the
first place.

In the Organon, Hahnemann on so-called ‘mental diseases’

Several things are apparent to anyone who reads about "mental and
emotional maladies," [Aph. 229] and "mental and emotional
disease," [Aph. 230], in the Organon. For example, Hahnemann is
consistently very careful indeed not to fall into the allopathic trap
of classing them as a separate category of sickness. He very
specifically qualifies his reference to them as diseases, preferring
to allude to them as mental symptoms of the whole person. For example,
he states that "what are termed mental diseases…do not, however,
constitute a class of disease," [Aph. 210], and employing various
phrases, he refers to them as an "altered state of the disposition and
mind," [Aph. 212], "the so-called mental and emotional
diseases," [Aph. 215], "the state of the mind and disposition," [Aph.
213], "the symptom of the mental disturbance," [Aph. 216], etc.

Hahnemann refers to "derangement of the mind and disposition," [Aph.
215], to "insanity or mania (caused by fright, vexation, the abuse of
spirituous liquors…" [Aph. 221]; "attack of the insanity," [Aph. 223];
"a real moral or mental malady," [Aph. 224]; "furious mania…doleful,
querulous lamentation…senseless chattering…disgusting and abominable
conduct…" [Aph. 228]; "destruction and injury of surrounding
objects," [Aph. 228]; "the violent insane maniac and
melancholic," [Aph. 229]; "an acute mental or emotional
disease," [Aph. 222]; "periodic or continued mental
derangement," [Aph. 223]; "mental or emotional disease of long
standing," [Aph. 222]; "there are incredibly numerous varieties of
them," [Aph. 230]. Taken together, these observations clearly
demonstrate the amount of careful attention he had personally directed
towards such cases.

From the depth and detail of his knowledge of emotional disorders,
Hahnemann then reveals a clear familiarity with patients who are
"obstinate, violent, hasty…intolerant and capricious, or impatient…
lascivious and shameless," [Aph. 210]; cases of "insanity…melancholia…
mania," [Aph. 216]; disease states resulting from "faults of
education, bad practices, corrupt morals, neglect of the mind,
superstition or ignorance," [Aph. 224]; "the melancholic…the spiteful
maniac…the chattering fool," [Aph. 224]. All such references suggest
Hahnemann’s minute observation of many cases and the thoughtful and
compassionate attitude that such experiences must have inspired in him
towards "such unfortunate beings," [Aph. 222] who possess a "clouded
spirit," [Aph. 229], for he sees in each of them "the soul that pines
or frets in the chains of the diseased body," [Aph. 229].

He himself is clearly one he calls "the accurately observing
physician," [Aph. 211], that such disorders "can only be detected by
the observation of a physician gifted with perseverance and
penetration," [Aph. 216]. Being very empathic towards such patients in
whom "the emotional and mental state, constituting the principal
symptom of such a patient," [Aph. 230], he also makes vague attempts
at explanation of mental illness based upon his own extensive
observations. He proposes that they "originate and are kept up by
emotional causes, such as continued anxiety, worry, vexation, wrongs
and the frequent occurrence of great fear and fright," [Aph. 225];
"emotional diseases…first engendered and subsequently kept up by the
mind itself," [Aph. 226]; and that they require a "carefully regulated
mode of life," [Aph. 228].

Hahnemann also condemns outright the fact that the mentally deranged
patient of his day all too "often witnesses the occurrence of
ingratitude, cruelty, refined malice and propensities most disgraceful
and degrading to humanity, which were precisely the qualities
possessed by the patient before he grew ill," [Aph. 210] and which are
very clearly uncurative and injurious that only aggravate the
condition of the patient. He insists that the physician should adopt
an "appropriate psychical behavior towards the patient," [Aph. 228],
employ "an auxiliary mental regimen,", "without reproaching the
patient for his acts" [Aph. 228]. This should not include "corporeal
punishments and tortures" [Aph. 228] or "the employment of
coercion," [Aph. 228]. He is astonished and appalled at "the hard-
heartedness and indiscretion of the medical men," [Aph. 228] for
"torturing these most pitiable of all human beings with the most
violent blows and other painful torments," [Aph. 228], which he
condemns as a "revolting procedure," [Aph. 228].

Such physicians he says "debase themselves…[by]…their uselessness,
[Aph. 228]. He denounces "harshness towards the pitiable, innocent
sufferers," [Aph. 228] and proclaims that "they are equally pernicious
modes of treating mental and emotional maladies," [Aph. 229]. And he
advises physicians in general that "I can confidently assert, from
great experience, that the vast superiority of the homoeopathic system
over all other conceivable methods of the treatment is nowhere
displayed in a more triumphant light than in mental and emotional
diseases of long standing," [Aph. 230], acknowledging the general
point that "the disposition of the patient often chiefly determines
the selection of the homoeopathic remedy," [Aph. 211], as examples of
the key feature of mentals in remedy selection, he then furnishes us
with some examples - "Aconite will seldom or never effect a rapid or
permanent cure in a patient of a quiet, calm, equable disposition; and
just as little will Nux vomica be serviceable where the disposition is
mild and phlegmatic, Pulsatilla where it is happy, gay and obstinate,
or Ignatia where it is imperturbable and disposed neither to be
frightened nor vexed," [Aph. 214].

Always emphasising that "a homoeopathic medicinal pathogenetic force -
that is to say, a remedy which in its list of symptoms displays, with
the greatest possible similarity, not only the corporeal morbid
symptoms present in the case of disease before us, but also especially
this mental and emotional state," [Aph. 217], for "a disease of the
mind and disposition," [Aph. 218], or "disorder of the mind," [Aph.
220], Hahnemann then identifies remedies like "Aconite, Belladonna,
Stramonium, Hyoscyamus, Mercury," [Aph. 221], as being especially
useful for such patients, but though "a lucid interval and a transient
alleviation of the psychical disease" [Aph. 219] may be obtained, that
they can only be "cured by antipsorics," [Aph. 223], that "mental and
emotional diseases…can only be cured by homoeopathic antipsoric
medicine," [Aph. 228], that one must select "the antipsoric remedies
selected for each particular case of mental or emotional
disease," [Aph. 230], and administer "a radical, antipsoric
treatment," [Aph. 227] as being "the only efficacious mode of curing
such disease," [Aph. 228].

This short account provides an accurate survey of what Hahnemann says
in the Organon regarding emotional disorders.

Discussion

Although Hahnemann, in the Organon, and most homeopaths since, do
consider the mental symptoms - the "always predominating state of the
mind and disposition" [Aph. 217] - as being very important and
significant in defining the disease or selecting a remedy, yet nowhere
in homeopathy is there any coherent theory of mind or mental illness
in the same sense that is found in allopathy. Indeed, mind is merely
regarded as another part of the whole person: "the almost spiritual,
mental and emotional organs, which the anatomist has never yet and
never will reach with his scalpel" [Aph. 216]. In other words, all
homeopaths since Hahnemann have predominantly ignored mind as a
separate field of disease causation, except insofar as it is merely a
field wherein symptoms make themselves manifest either as a product of
the drug or of a disease and always when viewed holistically - in the
round.

Hahnemann does however acknowledge that such mental disorders do give
an impression, an apparition of being a separate class of disease: "as
though it were a local disease in the invisible subtle organ of the
mind or disposition," [Aph. 215], but because homeopathy fails to take
cognisance of mental illness as a separate entity, apart from any
other holistic disease entity, then it seems to ignore all theories of
mental disease in exactly the same way that it ignores all
allopathically construed theories of physical disease, as being
largely irrelevant to its 'modus operandi' or worldview. It adopts
this position because all disease is construed as a "dynamic
aberration of our spiritlike life," [Close, 67]; "a perverted vital
action," [Close, 70]; "disease is the suffering of the
dynamis," [Close, 72]; "disease is primarily a morbid disturbance or
disorderly action of the vital force," [Close, 74]. Close is most
emphatic in insisting that disease is "not a thing, but only the
condition of a thing," [Close, 70]. Because homeopathic drugs correct
the vital force, so, after which, by domino effect [so to say], the
entire organism automatically becomes corrected - including mind. We
might therefore ask where is the concept of mental illness in
homeopathy? There is NO such concept - there is no concept of mental
illness per se in homeopathy.

Clearly, the Organon's conception of 'mental illness' does not
dovetail too easily with the conventional definition of mental illness
or, the way it is applied by modern practitioners. In this sense,
homeopathy clearly has no separate category of 'mental illness'. Even
though, the symptom of the one-sided illness may involve mental
illness [in the conventional sense] an obsession, illusion, delusion,
hallucination, fear [phobia?], suicidal impulses, depression, etc., to
homeopathy it is only an illness of a deeply deranged vital force,
deranged at the most fundamental level, never of the mind itself in
isolation from the whole person.

The essence of this view is peppered throughout the Organon and in
Kent and Close and Boger - it states simply that mind and body
comprise one holistic unit [conventionally regarded as two arenas] in
which symptoms make themselves manifest. It depicts a "functional
unity of the psychic state…and somatic state," [Verspoor, 103].
Boenninghausen also repeats this dual unity of Aphorisms 224-226
[Verspoor, 118]. However, Hahnemann is clear that the ultimate source
of all symptoms is derangements in the "life force." A view
incidentally he shared with Paracelsus, Stahl, and van Helmont.
Remedies remove these derangements and so the flow of symptoms - to
whichever arena - is slowed and then ceases. These views are stated
repeatedly by Close and Kent, for example, and obtain ample repetition
by all ‘the greats’.

Jean-Baptiste Van Helmont (1577-1644)

Hahnemann leaves no doubt that the fundamentally holistic nature of
homeopathic philosophy, rails repeatedly against materialistic and
allopathic constructs, which seek to slice the person up into organs
or systems and he condemns any ‘treatment of parts’ that always flows
from such a reductionist perspective. Kent likewise condemns this
approach in his own emotional manner. The only option therefore is to
regard all ‘disease’ so-called as an expression of an internal
disorder resident in the life force, which remedies reach and
eliminate, and then the flow of symptoms ceases. Clearly, the remedies
must be chosen based on their totality and similarity to the entire
person, rather than upon the disease as an entity -- which was
originally an idea of Paracelsus interpreted differently in the
material school leading to allopathy from the view in vitalist schools
including van Helmont [Paracelsus’ chief interpreter] and Stahl. This
stream leads directly to Hahnemann - even though he never states that
overtly.

‘Disease as entity’ was a spiritual concept of invasion of the life
force - this concept was created by Paracelsus, but poorly described
by him, receiving much clearer expression by Van Helmont. This point
was also amplified extensively by Kent in his idea that the cause of
disease invades the vital force first, as a spiritual entity, and then
outflows its bad effects into the entire organism 'from within
outwards'. This view comes close to that of some modern homeopaths who
believe in "the all-encompassing state of mind," [Verspoor, 125].

Paracelsus (1493-1541)

Whether this is truly "Hahnemann's conception of the 'highest disease'…
those that are 'spun and maintained by the soul' but ultimately rooted
in the arch beliefs of the human spirit [Aph. 224]," [Verspoor, 130],
is very hard to say. It almost suggests "the idea of disease as a
delusion," [Verspoor, 268], which again sounds like Hahnemann as a
disease "first spun and maintained by the soul," [Verspoor, 299].
However, it is hard to see to what extent such modern ideas about the
significance of mind or mental symptoms in homeopathy truly derive
from the words of Hahnemann. One suspects that his own words have been
hammered on an anvil of modern psychology into very distorted word
shapes, belonging to a lexicon of concepts that would have been
entirely alien to Hahnemann himself. This clearly remains a matter of
opinion and debate.

Sources

Boericke, W & Dudgeon, R E translation, The Organon, combined 5th/6th
edition, 1925

Bradford, Thomas L, Life and Letters of Hahnemann, B Jain, 1895

Close, Stuart, The Genius of Homeopathy, Lectures and Essays on
Homeopathic Philosophy, New York, 1924

Cook, Trevor M, Samuel Hahnemann, the Founder of Homeopathic Medicine,
Wellingborough, Thorsons, UK, 1981

Dudgeon, Robert E, Lectures on the Theory & Practice of Homeopathy,
London, 1853

Haehl, Richard, Samuel Hahnemann His Life and Works, 2 volumes, 1922

Hobhouse, Rosa W, Life of Christian Samuel Hahnemann, Harjeet, India,
1933

Morrell, Peter, The Secretive Hahnemann and the Esoteric Roots of
Homeopathy, JAIH, Winter 2001, and Similia, Australia, Winter 2001

Street, W. R., A Chronology of Noteworthy Events in American
Psychology, Washington, D.C.: American Psychological Association,
Addenda, 1994, http://www.cwu.edu/~warren/addenda.html]

Verspoor, Rudi & Steven Decker, Homeopathy Re-Examined, Heilkunst,
Canada, 1999

Homeopathe International
http://www.homeoint.org/morrell/articles/psychiatry.htm