Sue Ieraci: Time to move on

IN a way, and for a man of his time, Samuel Hahnemann was partly right.

“Samuel who?” you ask. Hahnemann (1755–1843) was a German physician and polymath who became dissatisfied with the therapeutic methods of the time, which included purging, bloodletting and emetics.
    
While translating A treatise of the materia medica, by Edinburgh professor William Cullen, one of the 18th century’s leading medical theoreticians and educators, Hahnemann started to develop the idea that substances that caused certain symptoms in healthy people could cure the same symptoms in the unwell.

This principle – “like cures like” – became the basis of homeopathy.

Now you are asking if I am seriously suggesting that the originator of homeopathy was on the right track. Well, in his own context, his suggestions made some sense.

Hahnemann was a contemporary of the early advocate of disinfection, Joseph Lister, and the pioneer of vaccination, Edward Jenner.

At the time, many of the diseases that plagued Europe were infectious, but the principles of “germ theory” and vaccination were yet to be fully developed.

Hahnemann took the principles of vaccination and applied them across the spectrum of symptoms and substances, using an early form of the scientific method to test proposed therapeutic substances through “provings”. Having no other method of attenuating the offending pathogens, he diluted them. He diligently catalogued his findings in publications that are still in use today.

His biography suggests Hahnemann was a leading thinker and innovator. Prior to the development of sophisticated technology, research could only be conducted through direct observation and deduction.

There was no electron microscopy to reveal microcellular structures, or assays to measure serum electrolytes. The body was yet to reveal the intricacies of the alveolar space or the renal tubule. Scientists of the time had not defined the electrical pathways of the heart, or the pathophysiology of asthma. There were no antibiotics and no insulin.

As an innovator, Hahnemann struggled to improve the knowledge and methodology of his time, and was dissatisfied with contemporary medical practice. He was, in fact, the antithesis of those who apply his (now discredited) model today.

How ironic 21st century followers of Hahnemann ignore nearly 2 centuries of innovation, and cling to his 19th century approach.

I suspect Hahnemann himself would be rolling in his grave.

In all areas of human endeavour, knowledge and understanding grow in increments — rarely by revolution. Evidence builds upon previous evidence, old models are tested and updated, they are occasionally discarded or reworked. Cognition and reasoning work hand-in-hand with technology.

We are no longer limited to what we perceive with our human senses, but can image and test phenomena from subcellular to population levels. We have moved on from humours, demonic possession and phrenology, just as we have left behind the horse and cart and smoke signals for motorised travel and the internet.

Some people indulge in a form of nostalgia that both endows the past with a sense of purity and idealism, as well as casting suspicion on the new.

We don’t know everything about how the human organism works — far from it — but we have a good enough understanding to know that Hahnemann’s model was wrong — it was considered reasonable for a man of his time, but has, in the meantime, been superseded.

And yet his followers, who are content to fly internationally and use the internet, remain stuck in his outdated model.

Cognitive dissonance — a great topic for another article.
 

Dr Sue Ieraci is a specialist emergency physician with 30 years’ experience in the public hospital system. Her particular interests include policy development and health system design, and she has held roles in medical regulation and management.