THE PROVING, POTENTISATION AND THE LAW OF SIMILARS: SOME HISTORICAL PERSPECTIVES – Peter Morrell

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“From the earliest beginnings until now, the materia medica has
consisted only of false suppositions and fancies, which is as good as no materia medica at
all.” [The Organon, v.110]

“He had now confirmed his earlier suspicions….that medical
practice was crude, barbaric, unhygienic and ineffective.” [Cook, 1981, p.52]

As far as Hahnemann was concerned, there was virtually no certainty in the
whole of medicine. No certainty about drugs and no certainty about how to use them. It was
completely riddled with irrational confusion, conflicting ideas and argument. And no-one
seemed bothered enough to do anything about this appalling state of affairs.

“He had followed the orthodox training of the day, with its
insistence on powerful drugs, bleeding, blistering, but he soon grew first disillusioned,
then appalled by the failure of these methods.” [Griggs, 1982, p.177]

“After I had discovered the weakness and errors of my teachers
and books, I sank into a state of sorrowful indignation, which had nearly altogether
disgusted me with the study of medicine.” [opening lines of ‘Aesculapius in the
Balance’, 1805, in ‘Lesser Writings’, p410]

At this point we observe a doctor trained in a system of medicine which he
had come to despise for its irrationality and total ineffectiveness. In Desau in 1781 he

“…takes rather a desponding view of medical practice in
general, and of his own in particular, as he candidly admits that most of his cases would
have done better had he let them alone.” [Dudgeon, 1853, p.xx]

“Hahnemann was so disillusioned with the state of medical
practice and knowledge that, soon after his marriage in 1782, he totally refrained from
practising medicine…so deep was his belief that the tools he had been given would do
more harm than good.” [Danciger, 1987, p.5]

It will be recalled that Hahnemann in the early 1780’s “..was
becoming disenchanted with his chosen profession” [Cook, 1981, p.52] and gave up the
practice of medicine at an early stage in his career, both out of severe disappointment with
its results and to make sufficient cash from translating to support his large and growing
family.

“For 18 years I have departed from the beaten track of medicine. It
was painful to me to grope in the dark, guided only by our books in the treatment of the
sick…In an 8 years’ practice, pursued with conscientious attention, I had learned the
delusive nature of the ordinary methods of treatment…” [from ‘Letter upon the
Necessity of a Regeneration of Medicine’, 1808, in ‘Lesser Writings’, pp511-3]

His translation work

When he started all his translation work he was also searching for some
guiding principles, some certainty, some predictable patterns to emerge from his reading.

In the 1780’s in Dresden

“… he published many chemical works.. [then]…retired
disgusted with the uncertainty of medical practice and devoted himself to chemistry and
literature.” [Dudgeon, 1853, p. xxi]

Throughout the 1780’s, therefore, he was poised in a frustrating no-man’s
land, detesting what he could not and dare not use (allopathy), haunted by what he wished to
use (similars), but unable to utilise the advice of his medical forebears for want of a
homeopathic ‘modus operandi’.

Without doubt, this translation work opened up for him a rich and
inspiring world of medical data, therapeutic hints, clinical observations and notes about
drug actions, which must have enormously enriched his medical thinking and which practically
no-one else was party to. So Hahnemann must have been imbibing a wealth of clinical and
therapeutic ideas from his many translations and historical researches, during those years.

“The truly prodigious output of Hahnemann is demonstrated by the
fact that these translations totalled no less than 1780 pages” [Cook, 1981, p.51]

The standard idea at the time was that drugs should be used on the basis
of contraries and this idea stretches back to Avicenna (980-1037), to Galen (c130-201), and
even to Hippocrates (c460- 359BC). Paracelsus (1493-1541) had questioned it and tried to
change it, but no-one questioned it in Hahnemann’s day. Drugs were also prescribed almost
entirely in complex mixtures, very rarely as single drugs. The method of ascertaining the
clinical usefulness of a drug was decided mainly upon the dictates of tradition from old
herbals and apothecaries’ formularies. Ultimately, the accepted view was that any drug
reveals its sphere of action through its colour, taste, appearance, place of growth, etc,

This was often called the ‘doctrine of signatures’, a system by which
information about their healing properties had been supposedly inscribed by God into the
plants of the earth and which could be conveniently identified and interpreted by
physicians.

“Lily of the valley…is under the dominion of mercury, and
therefore strengthens the brain…” [Culpeper, 1652]

“Paracelsus was also a firm believer in the doctrine of
signatures, and in illustration of it explained every single part of St John’s Wort
(Hypericum perforatum) in terms of this belief “…the holes in the leaves mean that
this herb helps all inner and outer orifices of the skin…the blooms rot in the form of
blood, a sign that it is good for wounds and should be used where flesh has to be
treated.” [Griggs, 1981, p.50]

Yet Hahnemann soon gave this notion short shrift:

“The… virtues of medicines cannot be apprehended by…smell,
taste, or appearance… or from chemical analysis, or by treating disease with one or more
of them in a mixture…” [The Organon, v.110]

In accounts of cures from the past, Hahnemann often noticed that
‘similars’ and ‘single drugs’ cropped up at least as often as contraries and mixed drugs as
‘guiding principles’ for the practise of medicine. It is also highly likely that the
‘historical imperative’ of his day would have pushed him more in the direction of single
drugs, in keepingwith the general rush towards reductionism typical of his age.

“…a pattern emerges of ideas, influences, cultural realities
and historical momentum behind his discoveries…” [Danciger, 1987, p.1]

After Descartes (1596-1650) and Newton (1642-1727), scientists were very
busy slicing things up into smaller fragments, giving them names and then analysing
phenomena into causal mechanisms (see Tarnas, Russell, Rogers, Berlin). This was the main
business of the 18th century. Two of the best examples of this tendency were the taxonomic
classification of animals and plants introduced by Linnaeus (1707-1778) in 1735, and the
development of a Periodic Table of the Elements by contemporaries of Hahnemann, like Dalton
(1766-1844) and Berzelius (1779-1848) (see also Davies, 1997, pp.596-9). Hahnemann was no
exception. He yearned to place medicine itself upon just such a rational footing.

He started with a vast and disorganised mass of materia medica and a truly
chaotic system of therapeutics, plus the ‘annals of medicine’ (published cases in various
languages) which revealed to him even more chaos and confusion. This confusion was about
methods, about drugs, about dosage and about case histories –all of which varied from place
to place and time to time with no common agreement in sight. It seems immensely curious to
us today, but nevertheless it is true to say that physicians at that time disagreed, and
often furiously, about virtually every aspect of their craft. Hahnemann was the first to
seriously try and reduce this confusion and map out some certainty about these central
problem areas.

Single drugs and similars

“Undeterred by the magnitude of the task, Hahnemann set about
creating a materia medica which should embody the facts of drug action upon the
healthy.” [Close, 1924, p.147]

While engaged in his translation work, he was also searching through the
annals of medicine for specific effects of single drugs. He was looking out for single drugs
in cures as opposed to polypharmacy. He was trying to make sense of toxic effects of drugs
in medical history, and to ascertain how we should decide upon the use of a drug, whether
upon similars or contraries, signatures, old wives tales or what? And he was also looking at
the whole problem of dosage. These were the types of things he was looking out for and
making a note of in his translation work.

As a result of all this searching, at some point in the 1780’s he made an
important and very decisive choice: he chose similars and single drugs as forming a sounder
basis for the whole of medicine, as opposed to contraries and multiple drugs, which he felt
had caused more than enough confusion in medicine right through from ancient times. He made
this choice because the system was so confusing and unworkable that the then current methods
must in themselves be somehow responsible for the confusion.

“Many before Hahnemann, from Hippocrates down, had glimpses of
the law [of similars], and some had tried to make use of it therapeutically; but all had
failed because of their inability to properly graduate and adapt the dose.” [Close,
1924, p. 215]

“Paracelsus’s system…was a rude form of homoeopathy..but it
was not equal in value to Hahnemann’s system…” [Dudgeon, 1853, p.14]

His studies eventually generated a list of questions rather like this:

1. What is the most reliable basis for drug action, is it similars or
   contraries?
2. How is the toxic nature of a drug related to its therapeutic power?
3. Should low or high doses have a better healing effect?
4. Should drugs be used singly or in mixtures?
5. If in mixtures, how does one know which one in the mixture cures which
   specific symptom?
6. Do plants truly have ‘signatures’ which reveal their healing
   properties?
7. What is the optimum dose for any drug?
8. How can one determine scientifically and with certainty the healing
   powers of a drug?

There is also an historical imperative to what he was doing. Once he had
generated his list of questions he then had to decide on methods to establish some certain
answers in order to build a rational system of therapetutics. Like any other ‘man of
science’ in the 1780’s he chose experimentation as the most sure and valid method. That
places him alongside other contemporary giants of chemistry such as Priestley (1733-1804),
Lavoisier (1743-94) and Scheele (1742-86), who were also testing old dogmas and new ideas
through purely experimental methods [see Tarnas and Russell; also Rogers, 1935, pp.
351-375].

Isaiah Berlin, the late historian of ideas at Oxford, provides a
wonderfully luminous portrait of eighteenth century rationalism when he says they believed
in

‘…the autonomy of reason and the methods of the natural sciences,
based on observation as the sole reliable method of knowledge, and the consequent
rejection of the authority of revelation, sacred writings and their accepted interpreters,
tradition, prescription, and every form of non-rational and transcendent source of
knowledge…’ [Berlin, 1997, p.1]

And that

‘…a logically connected structure of laws and generalisations
susceptible of demonstration and verification could be constructed and replace the chaotic
amalgam of ignorance, mental laziness, guesswork, superstition, prejudice, dogma,
fantasy… [which had been]… largely responsible for the blunders, vices and misfortunes
of humanity.’ [Berlin, 1997, p.1]

This is an almost perfect description of Hahnemann’s contemptuous attitude
towards the chaos that was allopathy, and also of how he truly believed that a rational and
scientific system of therapeutics could be formulated through a combination of
experimentation and clear thinking.

Provings and potentisation

By around 1785, Hahnemann had established both single drugs and similars
as the soundest guiding principles of his work. He then had to choose a method of
therapeutics based upon some other guiding principle to decide what the toxic or therapeutic
effect of a drug actually is. He is actually standing right on the ‘doorstep’ of the proving
as such, but he arrived there through the idea of similars, because once you accept the idea
of a similarity between the toxic and the therapeutic action for a single drug, and you have
rejected signatures, then it follows through very close reasoning that the only way to
ascertain its curative (or toxic) power is to give it in small dose to a healthy person.
That was a most revolutionary and original step; all the rest can be seen as mere lead-ups
to that.

Thus we can trace the proving to his decision to favour similars over
contraries and to his general search for clarity about toxic and therapeutic actions of
drugs. And potentisation came in later simply as a means to moderate the dose in clinical
use.

Thus, for example, his observations about Mercury and Syphilis or
Belladonna and Scarlet Fever, while being good, clear examples of the law of similars, also
show the way the toxic and therapeutic action depend upon the same power within the drug,
adjusted in a see-saw fashion, only through dosage. And also that by dose adjustment one is
able to change a toxic effect into a therapeutic one. Then his experiment with Cinchona
after reading the ‘Materia Medica’ of William Cullen (1710-90), shows clearly that the fever
of Malaria can be caused (in the healthy) through taking a drug which has been shown many
times throughout medical history, to be a specific cure for Malaria. These examples also
clearly illustrated to him the superiority of the law of similars.

The turning point is generally acknowledged to have occurred in 1790 while
he was translating Cullen’s ‘Materia Medica’ into German. Sometime in the 1790’s he stumbled
across what he termed his ‘new principle’ in an essay of 1796. The ‘new principle’ being the
practical application of the law of similars via the proving. The reduction in doses came
much later, c1798.

This ‘new principle’

“…was to him what the falling apple was to Newton, and the
swinging lamp in the Baptistery at Pisa was to Galileo.” [Dudgeon, 1853, p. xxi]

The fact that a larger dose of Cinchona would increase the fever of
malaria, strongly implied that a curative medicine can cause what it will cure. It
established a clear link between the toxic action of a drug and its therapeutic effects. He
disagreed with Cullen’s theory of the action of Cinchona upon the stomach and so resolved to
test it on himself.

Although Dudgeon says, “from this single experiment his mind appears
to have been impressed with the conviction that the pathogenetic effects of medicines would
give the key to their therapeutic powers.” [Dudgeon, 1853, p. xxi], yet as we have
shown, he was already tending towards the proving idea directly from the law of similars
itself.

Thus, by way of summary, we can identify in the person of Hahnemann
several threads which were essential to his task and which, in the whole of medicine, no-one
else possessed at that time. These are his astonishing linguistic and translation skills,
his abandonment of allopathic drugging, his encyclopedic knowledge of drugs and of the
annals of medical history –in 8 different languages. That sets the scene. Then there is his
18th century penchant for experimentation as the soundest basis for making decisions and
establishing clear principles. Taken together he was the ONLY person at that time who
possessed all these qualities and thus the only one who could reach the truth.

Having amassed all the data he had, Hahnemann was left with only two
problems: how to adjust dosage and how to investigate the powers of similar drugs on the
healthy. He then set about solving both in his usual systematic manner.

In terms of the proving and potentisation, these both derive from reaching
a position where single drugs and similars are regarded as the ONLY reliable ‘guiding
principles’ for a rational system of medicine. Once having reached this point, then the two
questions become:

1. What dosage to use?
2. How do you know the drug picture?

“A hint of his growing conviction that remedies should be
prescribed in high dilution was given in… [an article]..published in 1788.” [Cook,
1981, p.51]

“…I found from the toxicological reports of earlier writers
that the effects of large quantities of noxious substances ingested by healthy
people…largely coincided with my own findings from experiments with those substances on
myself or other healthy people.” [Hahnemann, 1810, v.110]

It is of great interest that he included the data from poisonings as it
shows very clearly his belief in how the ‘toxic’ and the ‘therapeutic’ sit very closely
together. This fascination Hahnemann had with the data from poisonings is in fact pretty
crucial to our understanding the origins of the proving. The proving is in fact merely a
mild and subtle form of poisoning, during which the power of the drug ‘takes hold’ of the
prover and so reveals its therapeutic ‘sphere of action’. Now we can see how that relates to
the rest of his ‘gameplan’ for the creation of homeopathy. While Hahnemann derived the law
of similars from the contraries of Old Physic, so he also derived the single drug from the
complex mixtures of Old Physic. Likewise, we can see that he derived the proving from the
records of poisonings, and he derived the infinitesimal dose from the mighty doses of Old
Physic. In this way it is clearly apparent how Hahnemann based homeopathy upon the
underlying principles of Old Physic as a ‘creative template’ for building up the alternative
plan for homeopathy.

Again, we are permitted to lay bare the lines of argument, the logic and
the choices which must have run through Hahnemann’s mind during the process of his
formulation of homeopathic methods. In every case he was inspired to choose the very
OPPOSITE of the rules of Old Physic quite simply because of his certain conviction of the
total ineffectiveness of that system. So in this way we can gaze directly into the mental
processes of Hahnemann, just as if he were still with us today, and see very clearly the
path of his reasoning in the formulation of homeopathy as a system.

Thus we can see that Hahnemann was led to provings and potentisation via
the law of similars and the flow of his own experimentation. These techniques stem directly
from the position he found himself in, and were not therefore ‘taken out of thin air’ as
many have previously supposed.

Conclusions

We can now come to make a summary of the whole matter. We can say that in
order to make sense of the confusing medicine of his day, Old Physic, Hahnemann set about
condensing it down into its basic principles and isolating from it a series of discrete
questions. He wanted to know whether to choose drug mixtures or single drugs. He chose
single drugs. He had to know whether similars or contraries was best. He chose similars. He
had to decide between tradition and signatures or the proving: he chose the proving –guided
there, as we have seen, from the effects of poisonings. In relation to the subject of
dosage, he chose to reduce doses. This is not only his ‘gameplan’ for the creation of
homeopathy from allopathy, it is also the exact sequence he followed chronologically. A
logical and systematic plan of action which is a triumphant illustration of the rationalist
instincts of his other contemporary scientists.

“He instituted “provings” of drugs upon himself,
members of his family, friends, students and fellow practitioners, keeping all under the
most rigid scrutiny and control, and carefully recording every fact and the conditions
under which it was elicited. This work continued for many years, parts of it being
published from time to time, until the mass of material reached enormous
proportions.” [Close, 1924, p.147-8]

“There is no other possible way of correctly ascertaining the
characteristic action of medicines on human health – no single surer, more natural way –
than administering individual medicines experimentally to healthy people in moderate
doses…” [Hahnemann, 1810, v.108]

Let us now return to the events surrounding the Cinchona bark experiment,
which, probably more than any other event, so beautifully illustrates the creative process
he followed and everything we have thusfar said. We can analyse this single event into its
component parts, some ideological and some historical. It shows a physician adopting an
experimental method to solve a problem regarding similars versus contraries. He deliberately
pitches experimentation (the new) against tradition and dogma (the old). It also illustrates
a person adopting the exact method favoured by all his contemporary scientists. It shows the
background for his dissatisfaction with and abandonment of tradition and dogma in favour of
direct real-world experience. It shows a scientist who has chosen the single drug over the
mixture and who is investigating its action upon a healthy person. It shows a person
allowing a mild poisoning of his own system specifically to observe in detail the effects on
his health. In other words, it is the first proving. Being the first proving makes it
significant from all these different angles.

“In the last three thousand five hundred years, not one single
physician, to my knowledge… has come upon this so natural, so absolutely necessary, so
uniquely valid proving of the pure, characteristic action of medicines…”
[Hahnemann, 1810, v.108]

The final problem he solved was about dosage. As we mentioned at the
start, he was led logically through his own investigation into a series of experiments with
provings 1789 to 1796 (approximately) and then later into a series of experiments with dose
reduction from 1798 onwards.

‘We cannot fail to be struck by the sudden transition from the
massive doses he prescribed in 1798 to the unheard-of minuteness of his doses only one
year later, and we can but guess the causes for this abrupt transition.’ [Dudgeon, 1853,
pp.395-6]

“Hahnemann’s idea at first was simply to reduce the
“strength” or material mass of his drug, but his passion for accuracy led him to
adopt a scale, that he might always be sure of the degree of reduction and establish a
standard for comparison.” [Close, 1924, p.216]

Again, I think it is clear from its preceding chain of events, that the
idea of potentisation follows on very logically and is not as surprising as it first seems.
The main aspect that is surprising and apparently original is the use of succussion at each
stage of dilution. And where he got that idea from is still a mystery.

I suspect that the idea of succussion arose from something he had read,
maybe in some obscure journal. His use of succussion seems so utterly alien and yet at the
same time so complete and sophisticated, just as if he had crafted the technique to
perfection, but that it had originated from some hint or suggestion he had come across
elsewhere. It seems scarcely credible, at least to me, that he discovered directly that
well-shaken remedies work better than unshaken ones, as that would require the type of long
and systematic comparison which such a methodical man would surely have mentioned in
extenso. The fact that he never claims any personal credit for the technique also suggests
that he originally obtained it from someone else.

Hopefully, I have shown that crystallised in this single event –the
Cinchona experiment –is condensed the whole background to what Hahnemann was doing and it
illustrates the search he had been engaged in since the early 1780’s: to make some sense of
the irrational and confusing allopathy of his day, Old Physic, and to develop from it a new
system, based entirely upon clear guiding principles. With the advantage of hindsight, we
can see that he created a system based upon the single drug, upon similars, upon provings
and upon the reduced dose. That is homeopathy, and it was created entirely by Samuel
Hahnemann.

In conclusion, we might even go so far as to say that
Hahnemann&Mac226;s rigorous and relentless pursuit of truth in medicine can probably
withstand close comparison with the experimental work of Priestley and Lavoisier on the
nature of air and oxygen. Historically and scientifically the parallels are most striking.
In both cases that eighteenth century combination of detachment from dogma, devotion to
experiment and clear thinking generated new and exciting truths.

“If one has tested a considerable number of simple medicines on
healthy people in this way… then one has for the first time a true materia medica: a
collection of the authentic, pure, reliable effects of simple medicinal substances in
themselves; a natural pharmacopoeia…” [The Organon, v.143]

Acknowledgement

My sincere thanks are due to the Swiss homeopath, Alain Jean-Mairet, for
his numerous helpful suggestions about the early drafts of this article, and also for ideas
and general encouragement. I also thank Julian Winston for some clarification about the
origin of succussion.

Sources:
Berlin, Isaiah, 1997, Against The Current: Essays
in the History of Ideas, Pimlico, London
Close, Stuart, 1924, The Genius of Homeopathy, Lectures and Essays on Homeopathy, 1986
reprint, Jain, India
Cook, Trevor, 1981, Samuel Hahnemann The Founder of Homeopathy, Thorsons
Culpeper, Nicholas, 1652, The English Herbal
Danciger, Elizabeth, 1987, The Emergence of Homoeopathy, Alchemy into Medicine, Century
Hutchinson
Davies, Norman, 1997, Europe — A History, Pimlico, London
Dudgeon, Robert E, 1853, Lectures on the Theory & Practice of Homeopathy, Jain
Griggs, Barbara, 1981, Green Pharmacy — A History of Herbal Medicine, Blond & Briggs,
London
Hahnemann, Samuel, 1796, Essay On A New Principle For Ascertaining the Curative Powers of
Drugs
Hahnemann, Samuel, 1810, The Organon, Kunzli & Naude translation, 1978
Hahnemann, Samuel, The Lesser Writings, edited by Dudgeon
Rogers, Arthur K, 1935, A Student’s History of Philosophy, Macmillan, New York
Russell, Bertrand, 1943, A History of Western Philosophy, Unwin, London
Tarnas, Richard, 1996, The Passion of the Western Mind, Pimlico, London

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