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SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
The Hahnemann Casebooks Part 2 - Continuity and Change
“he bequeathed...to his youngest daughter Louise, the books which contained the cases of all his patients, carefully and elaborately written with
his own hand, forming perhaps the most interesting work for Homœopathy that could possibly be.”(1)
“the lost treasures of his works were discovered long after his death. They were with Hahnemann’s second wife in Paris. They consisted of 54
case books containing the records of all patients treated by Hahnemann from 1799 to 1843 (four large volumes of about 1500 pages each) with
alphabetically arranged repertories, none of which had been published before.” (2)
Peter Morrell
Abstract
Having recently bought a range of Hahnemann’s transcribed Casebooks (2), I realise what a treasure they have turned out to be!
This article gives the reader an introduction to what the Casebooks contain and what their contents reveal about Hahnemann’s
methods, his consultation style, prescribing habits and thus some insights into his ideas and his reasoning. In addition, of
course, one can also see how these methods and ideas change and evolve across the entire span of his medical career. This
article serves merely as a brief introduction to the Casebooks, and in a future article, I intend to explore in more detail further
aspects of Hahnemann’s cases and methods.
• • • • • • •
This article continues my exploration of Hahnemann’s Casebooks
(Krankenjournal) and attempts to bring their interesting contents
to a wider homœopathic audience. It hopefully begins to place the
casebooks into the life history of Hahnemann, and also to reveal in
greater detail the evolution of his medical practice.
By way of introduction, some general data about the numbers
of Casebooks and their dates can be organised into a table and
converted into a bar chart (see Chart 1 below). In brief, this
shows that Hahnemann was gradually using more casebooks per
year as time went on. This supplements and reinforces the data
supplied in the previous article (Similia volume 29, number 2)
which showed that Hahnemann was gradually devoting more
written lines to each patient as time went on. Taken together, the
data indicate that as time went on Hahnemann was writing longer
notes for each patient and his Casebooks were getting longer and
so he needed to write more of them.
Period Years Ds No Years No Ds ratio
Early 1799-1805 D1 - D5 6 5 0.83333
Torgau 1805-1811 D5 - D10 6 5 0.83333
Leipzig 1811-1821 D10 - D21 10 11 1.1
Coethen 1821-1835 D20 - D38 14 18 1.28571
Paris 1835-1843 D38 - DF17 8 16 2
Chart 1: Casebooks per year/city produced by Hahnemann
Early Practice
“Now a period of happy creative work began
for Hahnemann. He had the key: the door
stood open. It was his task to bring order,
to assemble proofs, and to weld his healing
instrument out of unholy chaos.” (3)
The irstcasebookscovertheperiod1799-1805,duringwhichtime
Hahnemann resided in Königslutter (1796-99), Altona (1799),
Hamburg (1800), Mölln (1800), Machern (1801), Eilenburg
(1801) and Schildau (1804) before he moved to Torgau in January
1805. These years include the casebooks D1 to D4. However, D1
from 1799 has never been found. In this early period Hahnemann
was still very much in his wandering intellectual phase working
on his ideas and practice, which was evolving in its early stages.
Four of the main features of these early casebooks can be stated
from looking through them. First, they contain extremely brief
patient notes. Second, he is still using some conventional drugs.
Third, he changes the remedy and the potency quite often. Four,
he uses some very strange dilutions. Here are some examples (4):
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
10
The D4 Casebook contains “all the idiosyncrasies of Hahnemann’s
way of setting down day-to-day observations, down to the dialect
and exact colloquial speech used by his patients ... Most of the
ailments complained of by the people of Eilenburg near Leipzig
from autumn 1802 to summer 1803 were minor ones and provided
an excellent opportunity for trying out the effect of drugs on a
practically healthy body before experimenting with the sick one.
Hahnemann records not only the objectively observed symptoms but
also the patients’ utterances allowing us an insight into their view of
the situation, as for example p. 207 ‘butter tastes bitter’, or on p. 85,
‘when she gets out into the open air it drives her nuts’ (will sie aus
der Haut fahren).” (5)
“Krankenjournal No.4 is ...a diary with clinical histories extending
from October 1802 until July 1803. These records were personally
written by Hahnemann during his three-year residence at the small
town of Eilenburg, near Leipzig. The journal deals with the illnesses
of about 300 patients seen over the ten-month period ...often age
and sex are not recorded ... the complaints elicited from the sick
inhabitants of Eilenburg were set down in telegraphic fashion.
Written partly in German and partly in Latin, these miscellaneous
symptoms form a conglomerate whose relevancy was difϔicult
to discern. Next to the patient’s intestinal spasms, we read that
he snores at night, cannot yawn nor belch, etc... the patients
consulting Hahnemann complained mainly of digestive symptoms,
such as anorexia, constipation, and intestinal cramps. Others came
with insomnia, headaches, dizziness, weakness, and peripheral
paraesthesia. During the winter months there were abundant
respiratory ailments, and the women had backaches, menstrual
irregularities, leucorrhoea and menopausal hot ϔlashes ... thus
the reasons for composing the “Krankenjournal” become clear:
he wanted to preserve for his own future reference the successful
correlations he was obtaining between the presenting symptoms
and his therapy.” (6)
Part of the above quote by Risse is very revealing: “these
miscellaneous symptoms form a conglomerate whose relevancy
was difϔicult to discern. Next to the patient’s intestinal spasms,
we read that he snores at night, cannot yawn nor belch, etc.” (7)
The relevance may be hard for an allopath to comprehend but
let us just remind ourselves what was really happening here.
The ‘miscellaneous symptoms’ Risse refers to, along with the
snoring, belching and yawning are of course not just what patients
experience but they are also the material of the provings; they
are aspects of the patient totality, a concept entirely absent from
allopathy. What Hahnemann was doing was viewing his patients
through the ‘lens’ of the proving symptoms of his single drugs and
then making correlations in order to ind the best match between
the two. And so, put bluntly, what we are looking at in these early
casebooks is the very birth of the ‘homœopathic gaze.’ (8) Far from
being irrelevant, this was in fact a remarkably ground-breaking set
of circumstances.
Summary of early prescribing 1801-7 (%)
Remedies
D2
(1801)
D3
(1802)
D4
(1802-3)
D5
(1803-6)
D6
(1806-7)
Belladonna 3.6 4.2 4.7 4.4 3.3
Chamomilla 18.9 19.7 22 14 10
China 4.6 2.5 1.9 4.2 3.9
Cocculus 5.8 6.8 3.7 3.7 5.7
Ignatia 5.4 3.2 3.5 3.9 1.8
Ipecac 4.9 1.3 0.6 2.9 4
Ledum 1.5 5.8 5.1 1.8 0.9
Nux vomica 14.4 11.7 9.9 13.3 19.7
Pulsatilla 10.1 18 23 21.3 23.7
Veratrum 4.1 4.4 4.4 3.2 1.9
sum 73.3 77.6 78.8 72.7 74.9
No presc. 1102 1104 1071 1733 1597
No Rx 59 40 41 73 47
This table shows that in his early practice roughly three quarters
of his prescribing work was covered by just the ten remedies
listed. We can see from this summary of the remedies he was
using that they consist mostly of what we today might regard as
quite super icial acute remedies. Presumably this re lects not only
the relative paucity of well-proven remedies at his disposal at this
time, but also the types of acute conditions he was mostly called
upon to treat. However, it is clear that he got much of his work
from Chamomilla, Nux vomica, and Pulsatilla, all of which have
stood the test of time and are still in widespread use today.
Hahnemann’s Use of Potency
Hahnemann’s use of potency varies through time. In general, and
as might be expected, he used higher potencies as he matured
in age and experience. However, in the early casebooks (D2 to
D6) his use of potency is highly variable and is clearly still at a
very experimental stage. We know this because he tends to use
all sorts of different dilutions for the drugs in use; there seems to
be no really consistent pattern. This variability in itself suggests
uncertainty and continued experimentation.
In the early casebooks he uses a system of fractions that signify
how much he has diluted the remedy. These tend to be quite
speci ic for each drug and this fraction only rarely changes. For
some drugs it never changes, while for others it changes a little.
Examples include 1/384 for Chamomilla, 1/40 for Cocculus, 1/16
for Aconite and 1/20 for Ledum. He then varies these fractions by
increasing them. Examples include 1/384  1/3840 or 1/384000
for Chamomilla; 1/16  1/160 and 1/1600 for Aconite. In the
early casebooks he was clearly using greater and greater dilutions
of the drugs. He increases these dilutions many times such that
some of the fractions become huge such as 1/384000000000 for
Chamomilla. He therefore starts to use m for million, b for billion
and tr for trillion to make writing them out easier.
In the table we can also see he starts to simplify these fractions
by writing 1/384m meaning 1/384000000; the ‘m’ signi ies a
million times smaller, or a millionth. One assumes he did this as
a shorthand to make writing down the remedies easier. In D2, D3,
D4, and D5 he uses a small m = millionth, b = billionth and tr =
trillionth to signify the further dilutions as some of his fractions
have gotten so big. In Hahnemann’s time a billion was a million
million and a trillion was a million million million. Only in the
last 100 years or so have these been supplanted by the modern
versions.
He also uses a sign towards the end of D5: § (= Section Sign), which
apparently signi ies placebo or sugar of milk. I have counted all
the m’s, b’s and tr’s in D2 to D5. The results are shown in the table
below, and show how much diluting he was doing 1801-1806
11
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
and he was already using big dilutions even in 1801 (D2). The
approximate centesimal potency is indicated.
Number of times listed
D2 D3 D4 D5 potency
millionth 230 546 480 229 3c
billionth 2 62 274 347 6c
trillionth 4 1 0 10 9c
One of the main dif iculties in assessing his use of potency in the
early casebooks is that it is hard to translate some of them into
modern centesimal scale potencies that we today understand. The
table below shows some examples of this.
Remedy Typical fractions
Chamomilla 1/3840m, 1/85, 1/8500, 1/3840000
Nux vomica 2/220000, 1/12m, 2/2400, 1/20, 1/120m
Pulsatilla 1/800m, 1/16, 2/16000m, 2/80m, 1/400
Veratrum 1/12m, 1/4800m, 2/24m, 1/20
Ledum 1/2000, 1/200m, 3/2000, 1/200000
Belladonna 1/12m, 5/12, 1/126, 1/72m, 1/600000, 1/12tr
Cocculus 1/1500m, 1/7680000, 1/300000m, 1/768
Aconite 1/1800000m, 1/18000, 1/180m
Arsenicum 1/48, 1/46b, 1/4000, 1/500
Hyoscyamus 3/16, 1/200, 2/10000, 1/20000
Regarding the fraction denominators, it seems likely that he
began by using the standard doses in common allopathic use as
his starting point and some would naturally be much higher doses
than others. And then he could dilute them down from there.
This would explain why the denominators vary so much between
remedies, like 1/384 for Chamomilla, 1/1500 for Cocculus or
multiples of 1/20 for Ledum.
What is also clear, and which remains unexplained, is why Cocculus
seems to be his remedy of choice when it comes to permutations
of potency; he seems to dilute that one remedy much more than all
therest,followedcloselybyNuxvomica,PulsatillaandChamomilla.
Is it such a deadly poison? Well, so too are Aconite and Belladonna,
but he doesn’t seem to potentise them as much as Cocculus. This
mightsuggestthathisdilutionofdrugswasdrivennotsolelybythe
natural toxicity of a drug—as one would expect—but also by how
aggravated a patient became from taking it: the more aggravated
their condition became, the more he diluted the drug in question.
Hahnemann noted very early on that the sensitivity of a patient to
the similimum is far greater than for a person for whom it is not
the similimum. Therefore, it is perfectly possible that he reduced
his doses due to the patient’s sensitivity to the similimum more
than because of the raw toxicity of a drug, to which all people are
broadly subject.
From around page 260 in D5 he changes his potency notation
system yet again. He now starts to use a number system, e.g.
Pulsatilla No.1, Nux vomica No.3, Chamomilla No.4, etc. In spite
of prolonged study of them, it is still not very clear what these
numbers actually refer to. Logically, and based on the changes
he made in the fractions, one might imagine, that No.1 means
millionth, No.2 means billionth and No.3 means trillionth. But at
no point is this ever stated and also the situation is made more
complicated when he uses No.7, No. 13, etc. And so we are left
more or less completely in the dark about his use of potency from
D5 through to D16 when he starts to use the Roman numerals I, II,
III, IV, V, to signify the centesimal potencies, in which, for example,
III = 9c, V = 15c, VIII = 24c and X = 30c
We can thus identify a sequence of changes in his system of
potency notation forming a series like this:
the fractions -> fractions + m’s, b’s and tr’s -> numbers -> Roman
numerals -> centesimals
We search in vain for his hidden reasoning and the smooth
methodical low of his logic; we want to see that and we expect he
himself must have followed it, for that is the truly methodical man
we know him to have been. But in the early years he seems to have
indulged a phase of unbridled experimentation, which also seems
to be quite loose, ad hoc and lacking rigour. Although we like to
think of Hahnemann as rigorous and systematic yet in this early
phase he seems to have been literally experimenting continuously.
He experimented with potency again when in Paris.
In studying his use of potency in the early Casebooks what is very
interesting is what might have derived from his use of million,
billion and trillion dilutions. These igures all increase in powers
of 6 and thus a millionth dilution is equivalent to the centesimal
3c; likewise, a billionth is equivalent to 6c and a trillionth to 9c.
Once you adopt and use this series, which forms a sequence rising
in 3 centesimal gaps like this, it is not a very big step to then reach
the dilution sequence he adopted later, namely: 3c, 6c, 9c, 12c, 15c,
18c, 21c, 24c, 27c and 30c. One therefore wonders if his use of
the sequence millionth, billionth and trillionth eventually led him
much later to use the centesimal dilution system that eventually
became a trademark feature of homœopathy worldwide. It is
also of interest that the metre of 100 centimetres was invented in
France in 1793. With the centesimal scale could he perhaps have
been following that trend, of which he might have been aware?
Beyond the above points it is not possible at this point to compile
and present any accurate data of his use of potency for the early
casebooks as they are not presented in an easily intelligible form.
The middle period of his prescribing i.e. 1806-21 includes his
residence irst in Torgau (1805-11) and then in Leipzig (1811-
21). The Casebooks reveal this period as involving both continuity
and change. Continuity, in the sense that he continues in much
the same way as before; change, because he introduces many new
remedies and continues experimenting with potency. In many
ways, it is a phase of consolidation of previous work combined
with the introduction of new developments.
Leipzig
“In the year 1811 he returned to Leipsic, where he was
appointed ‘magister legens’...at Leipsic he had an extensive
practice, and was assisted by a great number of friends and
pupils in the proving of medicines. The apothecaries of that
city, however, rose against him...” (9)
Records show the steady progress Hahnemann made when
residing in Leipzig 1811-21 and teaching at the university. This
phase includes Casebooks D11 to D22. Here he was seeing 2-14
patients per day (averaging at 7.4) according to the data displayed
in Schreiber. He was also making more extensive patient notes,
roughly 2-3 patients listed per page of the Casebooks. This is
equivalent to 12-18 lines per case.
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
12
Year Cons/m Cons/day
1811 59.2 1.973333
1812 85.6 2.853333
1813 149.8 4.993333
1814 263.3 8.776667
1815 263.3 8.776667
1816 228.9 7.63
1817 172.1 5.736667
1818 190 6.333333
1819 426.4 14.21333
1820 432.5 14.41667
1821 173.4 5.78
Avg 222.2273 7.407576
Hahnemann’s time in Leipzig (1811-21) is characterised by the
steady expansion of his medical practice and his work at the
university. He was also engaged in conducting new provings and
publishing works. It is very clear from the data given in Schreiber
(10) that the number of his consultations increased substantially
towards the end of his stay in the city. He had approximately 200-
300 consultations per year for the irst 6 years and then in 1819
there is a sudden increase to 420 and in 1820 to 583. This means
he saw roughly 20 patients per month up to 1819, then 35 and
then 49 in 1820. This sudden increase in his patient workload
might have been stimulated by the publication in 1818 of the
second edition of his Organon. And some of the volumes of his
Materia Medica Pura: volume 2 (1816), volume 3 (1817), volume
4 (1818) and volume 5 (1819). (11) He also published a series of
articles while residing in Leipzig. (12)
Throughout his time in Leipzig he tended to see more male than
female patients, averaging 56% male to 44% female, but in some
years it was almost a 50:50 split (e.g. 1811 and 1818). However,
in 1821 the ratio had risen to 65% male and 35% female. No
explanation for this pattern seems to be very clear. The average
age of his patients varies very little. It is generally around 30 years
of age. It was 29 yrs in 1813-16 and between 33 and 34 yrs 1819-
1821. The age range of his patients is also fairly constant averaging
between 1 year and 73 years of age. The oldest patients he saw
were aged 83 and 84 years (in 1820 and 1821) and the youngest
recorded overall was a 3 month old baby.
The data above have been extracted from Schreiber (pp.202-266)
and processed to give the table showing key changes in gender,
number of consultations and age range during his Leipzig practice.
The occupations of many of his patients are given throughout the
casebook notes and basically they fall into two main categories:
irstly, ordinary craftspeople and secondly clerics, lawyers,
administrators and clerks. In Graphik 25 (13) these are groups 2
and 5. These seem to have formed the vast bulk of his patients
throughout the Leipzig period. The commonest patients listed
were theologians, lawyers, merchants, cobblers, pastors, printers
andaverywiderangeoftradespeopleofeverydescription.Further
examples include: carpenters, saw sharpeners, schoolteachers,
printers, soap makers, tailors, bookmakers, hairdressers, a
telegraphist, a tinsmith, publicans, fruit sellers, basket makers,
soldiers, actors, clerks, locksmiths and butchers. (14) Graphiks 22
and 23 (15) show that in 1801-3 44.9% of his patients were group
2 labourers and 24.9% were group 6 admin/clerks. In 1811-21
labourers accounted for 32.6%, church, educators and academics
21.6% and group 6 lawyers, court workers and administrators
15.4%. This change strongly re lects the greater religious and legal
nature of Leipzig as compared to his residence in the more rural
parts of Altona, Gotha, Mölln, Machern, Eilenburg then Dessau in
the years 1801-3. (16)
Schreiber’s Graphs 22 and 23 (p.156) show the occupations of the
majority of his patients:
 1801-3 labourers 44.9%; and 24.9% were admin, clerks, law/
managerial total > 60%
 1811-21 labourers 32.6%; church 21.6% and admin clerks,
law 15.4% total = 68%
Schreiber has also collated some information about the distances
his patients travelled to consult him. Graphik 21 on p.155 shows
that 27% of his patients were local to Leipzig and were travelling
less than 25km to see him. 19.5% were coming from up to 50km
distant, while 31.7% were travelling over 100km to visit him. Only
21% travelled between 50 and 100km to consult him. Compared
to modern doctors today one imagines these distances are much
further than usual. It would be useful to have some comparisons
for other physicians of the same period.
The sudden increase in the success of his medical practice in the
years 1819 and 1820 might also have laid the foundations for
the prosecution brought against him by lawyers acting for the
physicians and apothecaries of the city, who wanted him put out
of business for making and dispensing his own medicines and for
thusinfringingthesolerightofapothecariestodispensemedicines
on behalf of physicians. For example, his increasing popularity and
success as a physician had perhaps attracted the wrong sort of
attention from the city medical authorities. This could have been
a signi icant factor lying behind the drafting of the lawsuit against
him and his eventual downfall at trial early in 1821.
Bradford described very well what had happened twenty years
earlier: “The physicians of Königslutter became jealous of his rising
fame, and they incited the apothecaries against him, and these
brought an action at law against Hahnemann for dispensing his own
medicines, and thus encroaching upon their rights. It was decided
against him; he was forbidden to give his own medicines, and this, of
course, rendered his further stay impossible. He could not remain in
Königslutter, and in the autumn of 1799, with his family, he departed
from the ungrateful city.” (17)
13
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
What happened in Leipzig was but a repeat of the same old
process. “Dr Schwenke says that the reason why Hahnemann ϔixed
upon Coethen as his residence, after the persecutions of the jealous
physicians and apothecaries had driven him from Leipsic ... (was) to
practice according to the dictates of his own conscience.” (18) But
Haehl adds that attacks upon homœopathy increased dramatically
after the death of Prince Schwarzenberg in October 1820 and the
privileges previously enjoyed by doctors dispensing their own
drugs came under the scrutiny of the state government. (19)
However, in any case, Hahnemann did not wait to hear his fate,
for he left Leipzig at the end of May 1821, several months before a
decision was announced by the Saxon government about the self-
dispensing of homœopathic pills. (20)
By collecting data from the Casebooks we can see the trends in his
prescribing for the Leipzig period, shown below.
Summary of Leipzig Period Prescribing (%)
summary
D16
(1817)
D19
(1819)
D22
(1821)
Volkmann
(1819-31)
Aconite 0.3 0.2 1.2 3
Acid vitriol 0.7 0 0 3
Ant. crud. 0 0.1 3.5 1.5
Arsenicum 2.8 1.6 2.5 1.5
Aurum 4.9 1.7 1.3 2.07
Belladonna 1.5 4 0.1 1.8
Bryonia 5.8 2 0.1 0.3
Calomel 6.9 1.3 0.8 1.5
Chamomilla 0.9 0.4 0.1 2.4
China 3.2 2.3 0.1 2.1
Cocculus 2.2 1.2 1.9 1.2
Digitalis 2 1.5 0 0.3
Ferrum 0.5 0.4 0.04 2.1
Graphites 0 0 0 7.1
Lycopodium 0.05 0 0 1.5
Nitric acid 1.8 1 5.5 5.9
Nux vomica 9.4 7.3 3.5 11.6
Petroleum 0.3 0.05 0.04 1.8
Phos. acid 0.6 0.6 4.2 2.4
Pulsatilla 5 5.5 0.3 5
Rhus tox. 5.9 0.7 0.2 1.2
Sepia 0 0 0 5.3
Sol Phos 0 0 0 3.3
Stannum 0.2 3.7 11.3 1.19
Staph 3.2 1 2 0
Sulphur 8.2 44.9 52.3 15.7
Thuja 6.1 5.2 2.1 0.3
Sum 71.45 86.35 88.38 77.56
No presc 2192 1908 2711 337
No Rx 91 69 53 56
This table shows that in Leipzig roughly 80% of his prescribing
was covered by the 23 remedies listed. His prescribing had moved
substantially away from the acute remedies of the early period. He
got his best work at this point from remedies like Aurum, Stannum,
Nitric acid and Sulphur, which are much more deep-acting as
compared to those of the early period, even though he is still
using some of the latter as well. Here once again we see continuity
combined with change. Notice also the gradual reduction in the
numberofremedieshewasusingfrom91to53:presumably,some
had fallen by the wayside as they were no longer any use to him
and had been replaced by more effective ones. We may note also
in this period the rise to prominence of Stannum and Sulphur and
the decline of Belladonna, Pulsatilla and Rhus tox. I have included
in this table the data for Antonie Volkmann (nee Hübel, 1796-
1863) (21). She was the second wife of the Leipzig judge Johann
Volkmann, and was treated by Hahnemann for many years (1819-
31) primarily it seems for skin complaints, a suspected scabies
history, acid indigestion, menstrual problems and varicosities
of her legs. Although her data stand on their own and re lect
her own medical problems, yet the percentages also it neatly in
between the late Leipzig period (D22) and the data shown below
for Coethen. Her longitudinal case therefore demonstrates a ine
example of the evolution of Hahnemann’s prescribing work over a
considerable period of time.
Figure 1 Hahnemann’s consultations per month in Leipzig, 1811-21 (22)
Coethen
Records show that Hahnemann moved from Leipzig to Coethen
in June 1821. (23) For him, the greatest advantage in this move,
as compared to his time in Leipzig, was that the ruler, Duke
Ferdinand, quite speci ically allowed him to make and dispense his
own medicines to patients. This meant that for once he was able
to live and work in peace, undisturbed by the kinds of attacks that
had dogged him intermittently for over twenty years and which
had therefore necessitated him changing location many times. But
of course the chief aim of the move to Coethen was simply for him
to continue his homœopathic practice, research and writings.
The years in Coethen (1821-35) saw Hahnemann develop his
miasm theory with the publication of The Chronic Diseases in 1828
and the incorporation of the vital force and miasms concepts into
the 5th Organon in 1833. Other than that his practice seems to
have carried on more or less unchanged as before in the Leipzig
years. One imagines he was still seeing around 2-14 patients per
day as in the previous period. The Coethen Casebooks are numbers
D22 to D38.
The French physician, Dr Pierre Rapou (1780-1857), who visited
Hahnemann in Coethen 1829-32, reported on his impressions
of the great man and his work, saying “his practice is very large...
strangers attend him from all parts on account of (his) great
reputation and successful practice...(coming) from distances to
consult the oracle of Homoeopathy...for example, I noticed among
others a Dane, a Courlander, a Hungarian, a Russian and a Silesian.”
(24)
For some useful insights into his prescribing habits in the Coethen
period, I refer to Heinz which covers the period 1829-35. In that
period, Hahnemann treated Princess Luise von Preuschen (1799-
1882).
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
14
The remedies he used at that time are shown (pp.106-113) and
the potencies he used are explored in pp.137-138, pp.146-7 and
pp.271-2. Heinz also includes a study of his use of placebo in
pp.150-155.
Remedies prescribed:
 1829-30 = Am-c, Carb-v, Calc-carb, Conium, Graph, Lyc, Nat-m
and Zinc
 1831 = Alum, Am-c, Bell, Mag-m, Phos, Plat, Sep
 1832 = Am-m, Carb-an, Cham, Cocc, Coff, Coloc, Hyos, Nit-ac,
Sulph
 1833 = Am-c, Ars, Aur, Coff, Con, Hep, Nat-m, Sulph
 1834 = Ant-c, Ipec, Lyc, Mur-ac, Nit-ac
 1835 = Ambr, Croc, Tarax
Potencies used:
1x, 2x, 3x, 6x, 7x, 9x, 10x mostly 2x (25)
Also:
 D33 = 30c
 D34 = 30c
 D35 = 30c (26)
Carbo an and Carbo veg irst used in D34 (1830) (27)
Olfaction becomes very prevalent from D38 (1833-5)
Summary of Coethen period Prescribing (%)
Remedies D34 (1830) D38 (1834)
Arsenicum 4.5 1.6
Calcarea carb. 7.2 6.3
Carbo veg. 4.8 1
Conium 4 1.1
Hepar sulph. 0.1 12.3
Kali carb. 5.4 1.1
Lycopodium 4.9 2.6
Natrum mur. 4.4 3
Nitric acid. 4.2 3.6
Nux vomica 2 3.9
Sepia 4.8 2.2
Silica 4.9 1.2
Sulphur 14.4 30.3
Sum 65.6 70.2
No presc 2809 2201
No Rx 80 91
The table shows that while in Coethen roughly two thirds (66%)
of his prescribing is covered just by the 13 remedies shown. Once
again, we see that he was (presumably) getting his best work from
the deep-acting remedies like Calcarea carb, Hepar sulph. and
Sulphur. This list continues the previous trend away from acute
and super icial remedies typical of the early period (e.g. Aconite,
Belladonna and Rhus tox.) with a notable shift towards the kind of
remedies that have become the standard tools of all homœopaths
even today. Furthermore, two remedies, Sulphur and Hepar sulph.,
have increased substantially to become central to his work.
Paris
It looks highly likely that Hahnemann changed his methods quite
radically in Paris. Many have questioned why he did this. The
underlying reason for this could well be the difference in culture
and behaviour of the French people as compared to those patients
he had been used to in rural Saxony. The contrast between them
could not have been much sharper. The pleasure-loving French
locked to the city of the beau monde leading famously hedonistic
lives in which drink, drugs and sexual promiscuity seem to have
been the norm. He would inevitably have encountered more
complex medical cases: patients with richer and far more diverse
medical backgrounds than those he had ever met before. This
will have had three most obvious effects on his practice. First, the
need to pay much closer attention to the detail of patient histories
and use that information to work out a long-term programme of
treatment. Second, the development of new and experimental
methods such as changes in potency and dosage so as to lessen
the effects of aggravations (e.g. LM scale), and making greater use
of the deeper-acting (miasmic) remedies to address the level of
disorder he encountered.
Thirdly, such complex cases would have required much more
frequent consultations in order for him to keep a close track of
the changes, progress and setbacks, that such cases would have
inevitably involved. One imagines this would also include much
more frequent use of Sulphur to drive out suppressions from
allopathic drugging, and increased use of Thuja and Mercury for
the after-effects of Gonorrhoea and Syphilis. These key changes can
actually be seen, for example, in the Paris cases as compared to his
Casebooks from the 1820s. His Paris Casebooks contain the longest
patient notes he ever recorded, amounting to 136 lines per case on
average. Casebooks of this period are: DF1 to DF17 (1835-43).
Summary of late period prescribing (circa 1830-41)
summary
D34
(1830)
D38
(1834)
DF2
(1839)
DF5
(1841)
Arsenicum alb. 4.5 1.6 1.1 2
Belladonna 0.2 1 1.4 2.5
Bryonia 1.5 0.3 1.7 1
Calcarea carb. 7.2 6.3 2.9 2.8
Carbo veg. 4.8 1 0.6 1
Causticum 1.3 1.5 2.5 2.1
Cinnabar 0 0 2.7 2.3
Graphites 2.4 1.2 2.1 2.7
Hepar sulph. 0.1 12.3 10.3 9.7
Kali carb. 5.4 1.1 0.9 0.2
Lycopodium 4.9 2.6 3.3 0.7
Mercurius sol. 0.8 1.2 7.6 1
Natrum mur. 4.4 3 1.2 2.4
Nitric acid 4.2 3.6 1.2 0.8
Nux vomica 2 3.9 3.1 5
Pulsatilla 0.4 1.2 1.3 2.2
Rhus tox. 0.2 1 1.2 0.6
Sepia 4.8 2.2 0.9 1.5
Silicea 4.9 1.2 1.5 0.2
Sulphur 14.4 30.3 30.7 32.4
Veratrum 0 0.3 3.2 0.7
sum 68.4 76.8 81.4 73.8
No presc 2809 2201 977 1232
No Rx 80 91 73 89
The table above shows that in his later years of practice roughly
75% of his prescribing is covered by these 21 remedies, most
of which are deep-acting ones we recognise today as standard
polycrests, with a few acute remedies (e.g. Belladonna, Bryonia,
Rhus toxicendron, Nux vomica) which he has reintroduced having
presumably found the need to use them frequently once again. We
can also see the rise to dominance in his late practice of Calcarea
15
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
carbonica, Sulphur and Hepar sulph., and to a lesser extent of
Mercurius solubilis and Lycopodium.
Potency in the later Casebooks
By counting the number of times a potency is used in each of the
casebooks we can build a picture of his use of potency throughout
thelaterperiod(D16toDF2).The irsttablegivesashortsummary
and the second expanded table provides more details.
summary Percent
Year KJ 7c or less 9c to 18c 24c to 30c >30c
1817-18 D16 98 2 0 0
1819-20 D19 96 4 0 0
1830 D34 84 15 1 0
1833-5 D38 5 11.8 82.5 0.7
1836-42 DF2 2 11.8 85 1.2
1838-41 DF5 1.7 10.8 80.6 6.3
potency summary (%) by casebook and year
Journal D16 D19 D22 D34 D38 DF2 DF5
Years
1817-
18
1819-
20
1820-
21 1830
1833-
5
1836-
42
1836-
42
potency Leipzig Coethen Paris
1x 2.3 0.9 1.1
1c 4 1.1 0.35
2c 7.1 0.47 0.09
3c 1.7 1.3 2.5 48.1 0.13 0.28
6c 4 5.2 4.6 32.6 9.22 1.92 1.30
13x 7.1 3.3 4.6
7c 61.3 79.4 75.4 5.6
9c 9.9 0.13 0.38
12c 2.2 10.1 3.33 4.11
15c 0.16 0.38 1.96
18c 0.05 15.1 7.56 4.67
21c 1.02 0.65
24c 0.05 1.25 23.08 21.51
27c 0.26 0
30c 1.12 64.1 60.77 59.12
32c 0.13
80-100c 1.30
100-
189c 0.46
190-
200c 1.03 4.49
These data show a clear trend in which Hahnemann shifts from a
heavy reliance on the lower potencies (1c to7c) in 1816-17 and
1819-20, towards greater use of potencies 3c, 6c, 9c and 12c in
1830, and inally to a pattern of prescribing based mainly around
30c, 18c and 24c in his Paris period. The shift seems to have
occurred in the mid-1820s. In the Paris period, he also uses some
unusual higher potencies like 65c, 85c, 167c, 195c, etc; there are
no LM potencies in DF2 and DF5, but they do appear in some of
the later Paris Casebooks. Not shown here but also visible in the
Paris Casebooks, is his tendency to use descending potencies like
30c followed by 24c, then followed by 18c. This pattern occurs
quite often in the Paris Casebooks but is not found in the earlier
patient journals.
Trends
Some patterns emerge from the data. For example, by comparing
the number of patients seen per year and the number of
consultations we can see how many consultations per patient
changed over time. This is shown in the graph below. In the middle
and later periods, the number of consultations per patient has
increased compared to the early period.
We might interpret this in relation to his growing con idence
in prescribing and perhaps also to the growing con idence
patients had in him as a doctor. It may also re lect the af luence
of some of his clients who presumably were inancially able to
undertake repeat consultations. One imagines, for example, that
such repeat consultations would not have occurred if con idence
in Hahnemann as a doctor had been low or if patients were
inancially unable to make them. One also imagines that patients
who returned for several consultations must have been drawing
some bene it from each appointment. Otherwise, it seems hardly
likely that they would keep going back repeatedly. Some patients,
even in the early days, saw him 40 or 50 times in the same year.
Clearly these patients must have done so for valid medical reasons
while also drawing some bene it from seeing him. It is hardly
likely that such patients would keep going back to see him if they
had no con idence in his medical skills or if they derived no bene it
from seeing him.
His Consultation Style
When reading through several of the casebooks one cannot fail to
be struck by the layout that he uses for almost every case. They
each follow a certain predictable pattern. He lists the date, name,
age and town of origin followed by notes about the problem the
patient is consulting him about. Almost anywhere in the text
remedy names appear, perhaps singly, sometimes several in a
chain, either directly at the end of the text, in a line of their own, or
in brackets after a few words. Towards the end of the text a speci ic
remedy appears often with the potency given. That is the general
layout but there are many variations of it.
In some cases, the remedy name will appear at the top or halfway
downandatothertimesnoremedynamesappearatall,therebeing
instead references to north or south magnet and ‘mesmerismus’
or ‘elektricitas’. His practice of mesmerism seems to have been
especially common during the Leipzig period (1811-21). One
wonders on what criteria he based a decision to use mesmerism
or magnets on a patient rather than homœopathic remedies. In
some cases several remedies will appear, often with dates in the
recent past when they were given. In some cases two or three
remedies are listed with no indication if they were all given or in
what potency or dosage. There is usually an indication of several
packets of placebo (sac lac) also given to the patient. Sometimes
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
16
only placebo is given, usually indicated by the word Quentchen or
the section symbol §.
Certain words appear frequently and so stand out. These include
menstruation, coition, erections, pollution, amount of sleep, sleep
position, dreams, urine, thirst, stool, appetite, alcohol and coffee
consumption, body temperature, headaches, nosebleeds, taste in
the mouth, food preferences. This includes personality descriptor
words such as anxious, sad, angry, impatient, passive, iery
temperament, etc. Another key feature is the length of the notes.
Most of them tend to be only seven or eight lines in length while
others may only be two or three lines. At the other extreme, and
more rarely, some notes go on and on, illing up several pages. One
assumes he gave a remedy when he was certain of it and left few
notes to indicate why. Alternatively, when he was unsure of the
remedy the notes seemed to go on at greater length. However, he
became much more diligent and detailed about writing his case-
notes as time went on.
The table below shows how frequently selected German words
occur in Krankenjournal D22 (1821). It clearly reveals many
aspectsabouthisstyleofquestioninginconsultationwithpatients,
and shows the very broad range of topics he wanted information
about. This list is broadly typical of what is found in all the later
Casebooks; the brevity of notes in the early ones do not reveal so
much.
English German Frequency
Unsettled unruhig 312
Anxious or fearful ängstlich 62
Angry böse 129
Hesitant zögerlich 0
Indecisive unentschlossen 1
Hasty hastig 4
Impulsive treibend 1
Sensitive emp indlich 34
Unhappy unzufrieden 5
Impatience Ungeduld 1
Serious ernst 19
Indifferent gleichgültig 7
Sad traurig 19
Wretched miserabel 4
Tired ermüdet or müde 112
Foul smelling stinkend 17
Right side rechte Seite 1
Left side linke Seite 1
Worse schlimmer 228
Better besser 815
Neat ordentlich 7
Tidy aufgeräumt 2
Bathing baden 15
Stool Stuhlgang 1534
Taste Geschmack 203
Nosebleed Nasenbluten 26
Diarrhoea Durchfall 216
Dreams Träume 222
Erection Erektion 103
Sweat Schweiß 607
Constipated verstopft 42
Tongue Zunge 434
Night sweats Nachtschweiß 79
Phlegm/mucus Schleim 397
Expectoration Auswurf 208
Nocturnal emissions Pollution 128
Complexion Gesichtsfarbe 16
Swollen geschwollen 103
Thirst Durst 3
Beer Bier 81
Wine Wein 128
Coffee Kaffee 228
Appetite Appetit 900
Coitus Coitus 40
Urine Urin 253
Menstruation Menstruum 395
Galvanism Galvanismus 4
The words that appear most often in the Casebooks suggest that
Hahnemann was in the habit of following a regular format for
his consultations. One imagines he started by asking the patient
to talk freely about their main problem while he made a few
brief notes. Once they had inished speaking he undoubtedly
then started quizzing them further to obtain more detail from
them about speci ic points they had raised, such as what made
them feel worse or better, sides of the body, times of day, types
of pain, etc. He must also have then asked them about the more
intimate topics listed above, such as sweat, urine, stool, periods
and sexual function. His focus on what we might term the
‘unconscious bodily functions’ like sleep, dreams, menstruation
and sexual function, were clearly designed to obtain insights that
would point to speci ic remedies which he could then exclude or
include in his anamnesis according to the answers the patient
gave. Fragments of these exchanges appear in his notes.
One gets the feeling that his focus on these unconscious
aspects of the patient symptomatology enabled him to bypass
any unconscious bias on the part of the patient, Likewise his
questions about urine, appetite, sweat, stool and his notes on
the tongue, taste in the mouth and facial complexion: they are
all things a person cannot really fake or exaggerate—and some
of them can be directly observed by the physician—meaning
they can be regarded as genuine aspects of the symptom totality
of the patient. They are also symptoms that appear in many of
the provings. This must surely re lect an important correlation
that he was making between the provings and the symptoms of
patients in the clinical situation. This allows me to repeat and
emphasise a point made earlier: Hahnemann was clearly viewing
his patients through the ‘lens’ of the proving symptoms of his
single drugs and making symptom correlations in order to ind
the best it match between the two. And so, ‘in essence’ (put
bluntly), what we are looking at throughout all the casebooks is
the very birth and evolution of the ‘homœopathic gaze.’
“These clinical notes (D4) give the reader an excellent
picture of the day-to-day practice of an observant physician
of the early nineteenth century. Anyone who wishes to
understand Hahnemann’s doctrine of homoeopathy must
study these records and notes. They are reproduced as
Hahnemann jotted them down, including his idiosyncratic
abbreviations and the colloquialisms and dialect of his
patients. A very interesting and signiϔicant publication.”
(28)
Looking through the entire opus it is also very clear that over
time he changed the remedies and the potencies that he used,
much like an artist changing the colours on his palette. In other
words, certain remedies were in common use for a time; before
long they would go into decline and disappear altogether only
to be replaced by new ones which then ‘take the stage’ and have
their day. At any point in time he was using some remedies less
while he was proving new ones which he found to be very useful.
There are therefore de inite phases in his use of remedies. In
general, there is a shift from using mostly acute remedies in the
early years (such as Aconite, Belladonna, Drosera) to using more
deep-acting remedies (like Sulphur, Stannum, Aurum) in the
later years. No indication is given for the reasons he made these
changes to his therapeutic armamentarium. We might assume
that they were linked to his ongoing provings and changes in his
medical theories as well as changes in the presenting conditions
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SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
of the patients who consulted him. In the case of potency, we
have seen that this also changed many times before he adopted
the centesimal scale we are familiar with today.
Strange, Rare and Peculiar Remedies
Throughout his Casebooks Hahnemann was in the habit of
occasionally using some odd and unusual remedies. Some of
these were in common allopathic use at the time while many of
the others are unfamiliar to us today. It is of interest to include
here a brief outline of them. One might be tempted to imagine
that he used these unconventional remedies more in the early
phase of his career, but in fact they are spread almost evenly
across the whole range of his Casebooks. For example, in D2-
D6 there are 26 of them, while in D16-DF2 there are also 26. He
seems to have used them more in the Leipzig years, between D6
and D16, which contain 9 and 10 of them respectively.
In the early period (D2-D6), notable examples include the old
herbal drugs Hedyotis, Melampyrum, Dryopteris ϔilix-mas, Mentha,
Millefolium, Sambucus, Santalum album, Thebaica (Opium
tincture), Tilia and Ulmus along with unusual mineral remedies
such as Acid sal (hydrochloric acid), Oleum ferrum, Oleum mart,
Spirit vitri (sulphuric acid), Spirit salis (hydrochloric acid),
Spirit vini (ethanol), and Vitri zincum (Zinc sulphate). Another
is Thiertod which he used in D5. It is not very clear at this stage
where he came across some of these remedies, but his use of them
probably re lects the depth of his pharmaceutical knowledge,
and his ability to adapt them in some way for homœopathic use
because of their speci ic action.
In the middle and later phase of his work (D16-DF2) some of
the key herbal drugs he employed include Aegopodium (Ground
Elder), Bovista, Cascara, Crocus, Lamium album, Lichen islandica
and Tincture radix ϔilicis (tincture of a fern root?). More exotic
examples include Anthraxin, Antipsorica, Antiepileptica,
Athamanta, Auripigmentum (Orpiment or Arsenic sulphide),
Autonosode, Hepar sulph. natrum, Oxymura (possibly chlorine
water (29)), Plumbago, Psorin, Sal culin, Sol phos and Zinc vitriol
(Zinc sulphate).
Again, it is hard to know where he got these remedies from or
more speci ically why he used them, often only once. It seems
safe to assume that he knew of their healing properties and
was able to adapt them for homœopathic use for a speci ic
health problem which he had found dif icult to cure with his
mainstream remedies. It is open to question how many of them
had been properly proved. Since he used these remedies, mostly
on a one-off basis, most of them have fallen out of fashion and
been lost in the backwaters of homœopathy never to be heard of
since. However, it is worth noting that the English homœopaths,
Drs Burnett and Cooper also felt the need at times to fall back on
some unusual and old fashioned herbal drugs in the 1890s. For
example, Burnett used Ceanothus (30); Fraxinus (31); tincture of
Acorn (32); Carduus marianum (33); and also Urtica (34). Cooper
used Star of Bethlehem (Ornithogalum) as a tumour remedy (35).
Burnett “resorted to old herbal Drugs like Acorns, Bruisewort,
Walnuts, Nettles, Couchgrass and Daisy.” (36) And so this habit
did not entirely die out with Hahnemann himself.
I give the last word to the author of an old book review of
Casebooks 2 and 3:
“What Heinz Henne has shown very clearly and objectively
is Samuel Hahnemann’s thinking and work as a doctor;
the clinical histories superbly illustrate his practical
achievements as a physician. The medical records are not
always easy to read. They originate from Hahnemann’s
Eilenburg period and cover the years 1801 to 1803.
Journal No. 2 gives reports on more than 400 patients.
The interesting thing is that Hahnemann presents his
patients’ complaints in a form identical to the one patients
use in this day and age. It is astonishing how meticulously
Hahnemann records the complaints of his patients and how
he elaborates on his thinking process about the remedy
selection on the basis of the symptoms.
But Hahnemann is also a very attentive and precise
observer. There are, for example, drawings in the medical
journal, in which he has marked the exact position and
extent of a pannus on the right and the left cornea. It also
shows time and time again that he is not only interested
in the subjective symptoms, but also in observing the
objective phenomena. Hahnemann’s medical journals are
truly an enjoyable work, not only for the historian and
the homoeopathic doctor, but for anyone who wants to
understand how Hahnemann was able to empathise with
his patients. We can learn from that in every way. Some
pages of the medical records are given as facsimiles at the
beginning of the book. Although the present work has no
practical value for the busy doctor, but anyone who has
a sense of the originals should draw some beneϔit from
ϔlicking through the book in the quiet hours.” (37)
This article has attempted to convey some aspects of the
contents of the Casebooks to people who have never seen any
of them. I have tried to illustrate many aspects of the evolution
of Hahnemann’s practice, his experimentation, his style of
consultation with patients, his obviously warm and empathetic
nature, the struggles he had with diluting drugs to render them
more gentle (less aggravating) while retaining their therapeutic
effects, the numerous changes he made to his system of notation
and the complex system of shorthand and symbols he employed
forpotencyanddosage.Ihavealsoattemptedtodelineatede inite
trends in his prescribing habits both in terms of his choice of
remedies and potency. Overall the reader will hopefully have
gained new insights about him from the glimpses I have given
into his daily work spanning his entire career. Readers should try
to put aside what has been written about Hahnemann’s practice,
and remember that the Casebooks contain the actual raw
material from which homœopathy as we know it irst evolved.
In future articles I plan to examine potency across his career in
more depth, the Paris Casebooks and a selection of cases from
every phase of his life.
Acknowledgements
I wish to express my sincere thanks to fellow homœopaths Kalin
Blaskoff, David Levy and Alexandre Winkler for encouraging
my research and for general homœopathic feedback on early
drafts of this article. I am also grateful to Kalin Blaskoff and
Gregory Vlamis for inding (and supplying) some useful resource
material, and to Martina Esonajo and Alexandre Winkler for
their help with German translation. I am also grateful to Beate
SIMILIA - The Australian Journal of Homœopathic Medicine
June 2018 - Volume 30 Number 1
18
Schleh, Librarian at the Robert Bosch Institute for the History
of Medicine in Stuttgart, for her kind and patient help and for
supplying a Xerox copy of part of Krankenjournal D5. Thanks
are also due to Susanne Rehm of Deutsche Homoöpathie Union,
Karlsruhe, and Carolyn McLaughlin of the Bulletin for the History
of Medicine in Baltimore, for supplying very useful book reviews.
References
1. Hahnemann’s Will, The American Homoeopathic Review, vol.V, 1865,
pp.478-9
2. Anton Jayasuriya, Clinical Homoeopathy, India: B Jain & Co, 2002, p.44
3. Martin Gumpert, Hahnemann, the Adventurous Career of a Medical Rebel,
New York: Norton, 1945, p.92
4. Silvia Waisse, The Science of High Dilutions in Historical Context,
Homoeopathy 101, 2012, (pp.129-137), p.132
5. Marianne Winder, Hahnemann’s Krankenjournal Nr 4 by Heinz Henne,
Stuttgart: Hippokrates-Verlag, 1968 (book review), Medical History
13.3, July 1969, p.309
6. G B Risse, Hahnemann’s Krankenjournal No. 4., 1968, (book review) In
Bull. Hist. Med. 44 (1970): pp.285–86.
7. Risse, p.285
8. Ursula Sharma, The Homoeopathic Body: Reiϔication and the
Homoeopathic Gaze, in H Johannessen, S G Olesen J O Andersen (Eds),
Studies in Alternative Therapy 2: Body and Nature, Odense: Odense
University Press, 1995, pp.33-49
9. Charles C Savage, Illustrated Biography or Memoirs of the Great and the
Good of all Nations, etc, Buffalo: Phinney & Co, 1856, p.408
10. K Schreiber, Samuel Hahnemann in Leipzig, Stuttgart: Haug, 2002,
pp.202-266
11. T L Bradford, The Life and Letters of Hahnemann, Philadelphia: Boericke
& Tafel, 1895, pp.537-8; Materia Medica Pura, Dresden: Arnold. 6 vols.
Vol. 1 1811 ; vol. 2, 1816 ; vol. 3, 1817 ; vol. 4, 1818 ; vol. 5, 1819 ; vol.
6, 1821.
12. These include the following: Dissertation on the Helleborism of the
Ancients. Leipsic. Tauchnitz. Thesis to the Faculty at Leipsic. 1812, also
in Lesser Writings.; Spirit of the homoeopathic doctrine of medicine. In
Allgemeine Anzeiger, March, 1813. Vol. 2 of Materia Medica Pura. Lesser
Writings. As a pamphlet in New York by Hans Birch Gram in 1825. Trans.
by Ad. Lippe in 1878, and published in The Organon, a journal. Hom.
Exam.,Oct.,1840.Alsotrans.byG.M.Scott,London,Glasgow.1838.Trans.
by Lund into Danish.; Treatment of typhus & fever at present prevailing.
Allgemeine Anzeiger, No. 6. 1814, Lesser Writings.; Venereal disease
and its improper treatment. Allgemeine Anzeiger, No. 211. 1814, Lesser
Writings.; Treatment of burns. 1816; Answer to Dr. Dzondi. In Allgemeine
Anzeiger, Nos.. -156, 204. 1816, Lesser Writings.; On uncharitableness
to suicides. Allgemeine Anzeiger, No. 144, 1819. Lesser Writings.; On the
preparation and dispensing of medicines by homoeopathic physicians.
1820, irst published in Stapf’s Lesser Writings of Hahnemann. Also
in Dudgeon’s Lesser Writings.; 1821. Treatment of purpura miliaris.
Allgemeine Anzeiger, No. 26. 1821, and in Lesser Writings.
13. Kathrin Schreiber, Samuel Hahnemann in Leipzig, Stuttgart: Haug, 2002,
p.159
14. See note 8
15. Schreiber, p.156
16. Bradford, op cit, pp.66-69
17. Bradford, pp.56-7
18. Bradford, p.124
19. Richard Haehl, Samuel Hahnemann his Life and Works, 2 volumes,
London: Homoeopathic Publishing Company, 1922, pp.111-114
20. Haehl, op cit, p.114
21. Samuel Hahnemann, ‎Reinhard Hickmann, Das psorische Leiden der
Antonie Volkmann: Edition und Kommentar einer Krankengeschichte aus
Hahnemanns Krankenjournalen von 1819-1831 (Quellen und Studien
zur Homoopathiegeschichte), Stuttgart: Haug, 1996
22. Schreiber, op cit, p.140
23. Schreiber, p.149; Bradford, p.124
24. Rosa W Hobhouse, Life of Christian Samuel Hahnemann, Founder of
Homoeopathy, London: The C. W. Daniel Company, 1933, pp.238-9
25. Inge C Heinz, Schicken Sie Mittel, senden Sie Rath!, Stuttgart: KVC Verlag,
2011, pp.146-7
26. Schreiber, pp.271-2
27. Ute Fischbach Sabel, Analisis de Los Diarios Clinicos de Samuel
Hahnemann, Tarragona: ACN Edicion, 2014, p.242
28. George Rosen, Hahnemann’s Krankenjournal Nr 4 by Heinz Henne, Book
Review, J Hist Med & Allied Sciences, XXV.3, July 1970, p.371)
29. JohnMurray,ASystemofMateriaMedicaandPharmacy,volII,Edinburgh:
Adam Black & Co, 1816, pp.184-8
30. M Wood, The Earthwise Herbal: A Complete Guide to New World Medicinal
Plants, North Atlantic Books, 2009, p.104
31. Wood, 2009, p.161
32. M Wood, The Book of Herbal Wisdom: Using Plants as Medicines, N
Atlantic Books, 2017, p.409
33. Wood, 2017, p.446
34. Wood, 2017, p.479
35. T Bartram, Bartram’s Encyclopedia of Herbal Medicine, Hachette UK,
2013
36. John H Clarke, The Life & Work of Dr. Burnett, London: Homoeopathic
Publishing Co., 1904
37. Dr Schwa, Hahnemann’s Krankenjournale Nr. 2 u. 3 by H Henne,
Buchbesprechungen (Book review), Allgemeine Homöopathische
Zeitung (1963), 208 (11): p.655
Other Works Consulted
R E Dudgeon, The Lesser Writings of Samuel Hahnemann, New York:
William Radde, 1852
Samuel Hahnemann, The Organon of Medicine, combined 5th/6th
Edition, translated by R.E. Dudgeon, and edited by William Boericke,
Philadelphia: Boericke & Tafel, 1893
Peter Morrell, A Guide to Hahnemann’s Translations, published online,
1998
http://www.homeoint.org/morrell/articles/pm_trans.htm
Peter Morrell graduated in Zoology at Leeds
University (UK), has taught Biology for many
years and was a part-time homœopath
throughout the 1980s. He completed an MPhil
thesis on the history of British homœopathy in
1998 and has written many articles on the history
of homœopathy and the life of Hahnemann since
the mid-1990s, which have been published in the USA, the UK, Sweden, Brazil,
Italy, Romania, and Australia. Apart from writing, he teaches Biology on a
part-time basis at three colleges in Central England. Peter was Guest Editor of
issue 1 of Homœopathic Links published in March 2016.

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October 2019 - The Hahnemanns Casebooks of Continuity and Change.pdf

  • 1. 9 SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 The Hahnemann Casebooks Part 2 - Continuity and Change “he bequeathed...to his youngest daughter Louise, the books which contained the cases of all his patients, carefully and elaborately written with his own hand, forming perhaps the most interesting work for Homœopathy that could possibly be.”(1) “the lost treasures of his works were discovered long after his death. They were with Hahnemann’s second wife in Paris. They consisted of 54 case books containing the records of all patients treated by Hahnemann from 1799 to 1843 (four large volumes of about 1500 pages each) with alphabetically arranged repertories, none of which had been published before.” (2) Peter Morrell Abstract Having recently bought a range of Hahnemann’s transcribed Casebooks (2), I realise what a treasure they have turned out to be! This article gives the reader an introduction to what the Casebooks contain and what their contents reveal about Hahnemann’s methods, his consultation style, prescribing habits and thus some insights into his ideas and his reasoning. In addition, of course, one can also see how these methods and ideas change and evolve across the entire span of his medical career. This article serves merely as a brief introduction to the Casebooks, and in a future article, I intend to explore in more detail further aspects of Hahnemann’s cases and methods. • • • • • • • This article continues my exploration of Hahnemann’s Casebooks (Krankenjournal) and attempts to bring their interesting contents to a wider homœopathic audience. It hopefully begins to place the casebooks into the life history of Hahnemann, and also to reveal in greater detail the evolution of his medical practice. By way of introduction, some general data about the numbers of Casebooks and their dates can be organised into a table and converted into a bar chart (see Chart 1 below). In brief, this shows that Hahnemann was gradually using more casebooks per year as time went on. This supplements and reinforces the data supplied in the previous article (Similia volume 29, number 2) which showed that Hahnemann was gradually devoting more written lines to each patient as time went on. Taken together, the data indicate that as time went on Hahnemann was writing longer notes for each patient and his Casebooks were getting longer and so he needed to write more of them. Period Years Ds No Years No Ds ratio Early 1799-1805 D1 - D5 6 5 0.83333 Torgau 1805-1811 D5 - D10 6 5 0.83333 Leipzig 1811-1821 D10 - D21 10 11 1.1 Coethen 1821-1835 D20 - D38 14 18 1.28571 Paris 1835-1843 D38 - DF17 8 16 2 Chart 1: Casebooks per year/city produced by Hahnemann Early Practice “Now a period of happy creative work began for Hahnemann. He had the key: the door stood open. It was his task to bring order, to assemble proofs, and to weld his healing instrument out of unholy chaos.” (3) The irstcasebookscovertheperiod1799-1805,duringwhichtime Hahnemann resided in Königslutter (1796-99), Altona (1799), Hamburg (1800), Mölln (1800), Machern (1801), Eilenburg (1801) and Schildau (1804) before he moved to Torgau in January 1805. These years include the casebooks D1 to D4. However, D1 from 1799 has never been found. In this early period Hahnemann was still very much in his wandering intellectual phase working on his ideas and practice, which was evolving in its early stages. Four of the main features of these early casebooks can be stated from looking through them. First, they contain extremely brief patient notes. Second, he is still using some conventional drugs. Third, he changes the remedy and the potency quite often. Four, he uses some very strange dilutions. Here are some examples (4):
  • 2. SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 10 The D4 Casebook contains “all the idiosyncrasies of Hahnemann’s way of setting down day-to-day observations, down to the dialect and exact colloquial speech used by his patients ... Most of the ailments complained of by the people of Eilenburg near Leipzig from autumn 1802 to summer 1803 were minor ones and provided an excellent opportunity for trying out the effect of drugs on a practically healthy body before experimenting with the sick one. Hahnemann records not only the objectively observed symptoms but also the patients’ utterances allowing us an insight into their view of the situation, as for example p. 207 ‘butter tastes bitter’, or on p. 85, ‘when she gets out into the open air it drives her nuts’ (will sie aus der Haut fahren).” (5) “Krankenjournal No.4 is ...a diary with clinical histories extending from October 1802 until July 1803. These records were personally written by Hahnemann during his three-year residence at the small town of Eilenburg, near Leipzig. The journal deals with the illnesses of about 300 patients seen over the ten-month period ...often age and sex are not recorded ... the complaints elicited from the sick inhabitants of Eilenburg were set down in telegraphic fashion. Written partly in German and partly in Latin, these miscellaneous symptoms form a conglomerate whose relevancy was difϔicult to discern. Next to the patient’s intestinal spasms, we read that he snores at night, cannot yawn nor belch, etc... the patients consulting Hahnemann complained mainly of digestive symptoms, such as anorexia, constipation, and intestinal cramps. Others came with insomnia, headaches, dizziness, weakness, and peripheral paraesthesia. During the winter months there were abundant respiratory ailments, and the women had backaches, menstrual irregularities, leucorrhoea and menopausal hot ϔlashes ... thus the reasons for composing the “Krankenjournal” become clear: he wanted to preserve for his own future reference the successful correlations he was obtaining between the presenting symptoms and his therapy.” (6) Part of the above quote by Risse is very revealing: “these miscellaneous symptoms form a conglomerate whose relevancy was difϔicult to discern. Next to the patient’s intestinal spasms, we read that he snores at night, cannot yawn nor belch, etc.” (7) The relevance may be hard for an allopath to comprehend but let us just remind ourselves what was really happening here. The ‘miscellaneous symptoms’ Risse refers to, along with the snoring, belching and yawning are of course not just what patients experience but they are also the material of the provings; they are aspects of the patient totality, a concept entirely absent from allopathy. What Hahnemann was doing was viewing his patients through the ‘lens’ of the proving symptoms of his single drugs and then making correlations in order to ind the best match between the two. And so, put bluntly, what we are looking at in these early casebooks is the very birth of the ‘homœopathic gaze.’ (8) Far from being irrelevant, this was in fact a remarkably ground-breaking set of circumstances. Summary of early prescribing 1801-7 (%) Remedies D2 (1801) D3 (1802) D4 (1802-3) D5 (1803-6) D6 (1806-7) Belladonna 3.6 4.2 4.7 4.4 3.3 Chamomilla 18.9 19.7 22 14 10 China 4.6 2.5 1.9 4.2 3.9 Cocculus 5.8 6.8 3.7 3.7 5.7 Ignatia 5.4 3.2 3.5 3.9 1.8 Ipecac 4.9 1.3 0.6 2.9 4 Ledum 1.5 5.8 5.1 1.8 0.9 Nux vomica 14.4 11.7 9.9 13.3 19.7 Pulsatilla 10.1 18 23 21.3 23.7 Veratrum 4.1 4.4 4.4 3.2 1.9 sum 73.3 77.6 78.8 72.7 74.9 No presc. 1102 1104 1071 1733 1597 No Rx 59 40 41 73 47 This table shows that in his early practice roughly three quarters of his prescribing work was covered by just the ten remedies listed. We can see from this summary of the remedies he was using that they consist mostly of what we today might regard as quite super icial acute remedies. Presumably this re lects not only the relative paucity of well-proven remedies at his disposal at this time, but also the types of acute conditions he was mostly called upon to treat. However, it is clear that he got much of his work from Chamomilla, Nux vomica, and Pulsatilla, all of which have stood the test of time and are still in widespread use today. Hahnemann’s Use of Potency Hahnemann’s use of potency varies through time. In general, and as might be expected, he used higher potencies as he matured in age and experience. However, in the early casebooks (D2 to D6) his use of potency is highly variable and is clearly still at a very experimental stage. We know this because he tends to use all sorts of different dilutions for the drugs in use; there seems to be no really consistent pattern. This variability in itself suggests uncertainty and continued experimentation. In the early casebooks he uses a system of fractions that signify how much he has diluted the remedy. These tend to be quite speci ic for each drug and this fraction only rarely changes. For some drugs it never changes, while for others it changes a little. Examples include 1/384 for Chamomilla, 1/40 for Cocculus, 1/16 for Aconite and 1/20 for Ledum. He then varies these fractions by increasing them. Examples include 1/384  1/3840 or 1/384000 for Chamomilla; 1/16  1/160 and 1/1600 for Aconite. In the early casebooks he was clearly using greater and greater dilutions of the drugs. He increases these dilutions many times such that some of the fractions become huge such as 1/384000000000 for Chamomilla. He therefore starts to use m for million, b for billion and tr for trillion to make writing them out easier. In the table we can also see he starts to simplify these fractions by writing 1/384m meaning 1/384000000; the ‘m’ signi ies a million times smaller, or a millionth. One assumes he did this as a shorthand to make writing down the remedies easier. In D2, D3, D4, and D5 he uses a small m = millionth, b = billionth and tr = trillionth to signify the further dilutions as some of his fractions have gotten so big. In Hahnemann’s time a billion was a million million and a trillion was a million million million. Only in the last 100 years or so have these been supplanted by the modern versions. He also uses a sign towards the end of D5: § (= Section Sign), which apparently signi ies placebo or sugar of milk. I have counted all the m’s, b’s and tr’s in D2 to D5. The results are shown in the table below, and show how much diluting he was doing 1801-1806
  • 3. 11 SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 and he was already using big dilutions even in 1801 (D2). The approximate centesimal potency is indicated. Number of times listed D2 D3 D4 D5 potency millionth 230 546 480 229 3c billionth 2 62 274 347 6c trillionth 4 1 0 10 9c One of the main dif iculties in assessing his use of potency in the early casebooks is that it is hard to translate some of them into modern centesimal scale potencies that we today understand. The table below shows some examples of this. Remedy Typical fractions Chamomilla 1/3840m, 1/85, 1/8500, 1/3840000 Nux vomica 2/220000, 1/12m, 2/2400, 1/20, 1/120m Pulsatilla 1/800m, 1/16, 2/16000m, 2/80m, 1/400 Veratrum 1/12m, 1/4800m, 2/24m, 1/20 Ledum 1/2000, 1/200m, 3/2000, 1/200000 Belladonna 1/12m, 5/12, 1/126, 1/72m, 1/600000, 1/12tr Cocculus 1/1500m, 1/7680000, 1/300000m, 1/768 Aconite 1/1800000m, 1/18000, 1/180m Arsenicum 1/48, 1/46b, 1/4000, 1/500 Hyoscyamus 3/16, 1/200, 2/10000, 1/20000 Regarding the fraction denominators, it seems likely that he began by using the standard doses in common allopathic use as his starting point and some would naturally be much higher doses than others. And then he could dilute them down from there. This would explain why the denominators vary so much between remedies, like 1/384 for Chamomilla, 1/1500 for Cocculus or multiples of 1/20 for Ledum. What is also clear, and which remains unexplained, is why Cocculus seems to be his remedy of choice when it comes to permutations of potency; he seems to dilute that one remedy much more than all therest,followedcloselybyNuxvomica,PulsatillaandChamomilla. Is it such a deadly poison? Well, so too are Aconite and Belladonna, but he doesn’t seem to potentise them as much as Cocculus. This mightsuggestthathisdilutionofdrugswasdrivennotsolelybythe natural toxicity of a drug—as one would expect—but also by how aggravated a patient became from taking it: the more aggravated their condition became, the more he diluted the drug in question. Hahnemann noted very early on that the sensitivity of a patient to the similimum is far greater than for a person for whom it is not the similimum. Therefore, it is perfectly possible that he reduced his doses due to the patient’s sensitivity to the similimum more than because of the raw toxicity of a drug, to which all people are broadly subject. From around page 260 in D5 he changes his potency notation system yet again. He now starts to use a number system, e.g. Pulsatilla No.1, Nux vomica No.3, Chamomilla No.4, etc. In spite of prolonged study of them, it is still not very clear what these numbers actually refer to. Logically, and based on the changes he made in the fractions, one might imagine, that No.1 means millionth, No.2 means billionth and No.3 means trillionth. But at no point is this ever stated and also the situation is made more complicated when he uses No.7, No. 13, etc. And so we are left more or less completely in the dark about his use of potency from D5 through to D16 when he starts to use the Roman numerals I, II, III, IV, V, to signify the centesimal potencies, in which, for example, III = 9c, V = 15c, VIII = 24c and X = 30c We can thus identify a sequence of changes in his system of potency notation forming a series like this: the fractions -> fractions + m’s, b’s and tr’s -> numbers -> Roman numerals -> centesimals We search in vain for his hidden reasoning and the smooth methodical low of his logic; we want to see that and we expect he himself must have followed it, for that is the truly methodical man we know him to have been. But in the early years he seems to have indulged a phase of unbridled experimentation, which also seems to be quite loose, ad hoc and lacking rigour. Although we like to think of Hahnemann as rigorous and systematic yet in this early phase he seems to have been literally experimenting continuously. He experimented with potency again when in Paris. In studying his use of potency in the early Casebooks what is very interesting is what might have derived from his use of million, billion and trillion dilutions. These igures all increase in powers of 6 and thus a millionth dilution is equivalent to the centesimal 3c; likewise, a billionth is equivalent to 6c and a trillionth to 9c. Once you adopt and use this series, which forms a sequence rising in 3 centesimal gaps like this, it is not a very big step to then reach the dilution sequence he adopted later, namely: 3c, 6c, 9c, 12c, 15c, 18c, 21c, 24c, 27c and 30c. One therefore wonders if his use of the sequence millionth, billionth and trillionth eventually led him much later to use the centesimal dilution system that eventually became a trademark feature of homœopathy worldwide. It is also of interest that the metre of 100 centimetres was invented in France in 1793. With the centesimal scale could he perhaps have been following that trend, of which he might have been aware? Beyond the above points it is not possible at this point to compile and present any accurate data of his use of potency for the early casebooks as they are not presented in an easily intelligible form. The middle period of his prescribing i.e. 1806-21 includes his residence irst in Torgau (1805-11) and then in Leipzig (1811- 21). The Casebooks reveal this period as involving both continuity and change. Continuity, in the sense that he continues in much the same way as before; change, because he introduces many new remedies and continues experimenting with potency. In many ways, it is a phase of consolidation of previous work combined with the introduction of new developments. Leipzig “In the year 1811 he returned to Leipsic, where he was appointed ‘magister legens’...at Leipsic he had an extensive practice, and was assisted by a great number of friends and pupils in the proving of medicines. The apothecaries of that city, however, rose against him...” (9) Records show the steady progress Hahnemann made when residing in Leipzig 1811-21 and teaching at the university. This phase includes Casebooks D11 to D22. Here he was seeing 2-14 patients per day (averaging at 7.4) according to the data displayed in Schreiber. He was also making more extensive patient notes, roughly 2-3 patients listed per page of the Casebooks. This is equivalent to 12-18 lines per case.
  • 4. SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 12 Year Cons/m Cons/day 1811 59.2 1.973333 1812 85.6 2.853333 1813 149.8 4.993333 1814 263.3 8.776667 1815 263.3 8.776667 1816 228.9 7.63 1817 172.1 5.736667 1818 190 6.333333 1819 426.4 14.21333 1820 432.5 14.41667 1821 173.4 5.78 Avg 222.2273 7.407576 Hahnemann’s time in Leipzig (1811-21) is characterised by the steady expansion of his medical practice and his work at the university. He was also engaged in conducting new provings and publishing works. It is very clear from the data given in Schreiber (10) that the number of his consultations increased substantially towards the end of his stay in the city. He had approximately 200- 300 consultations per year for the irst 6 years and then in 1819 there is a sudden increase to 420 and in 1820 to 583. This means he saw roughly 20 patients per month up to 1819, then 35 and then 49 in 1820. This sudden increase in his patient workload might have been stimulated by the publication in 1818 of the second edition of his Organon. And some of the volumes of his Materia Medica Pura: volume 2 (1816), volume 3 (1817), volume 4 (1818) and volume 5 (1819). (11) He also published a series of articles while residing in Leipzig. (12) Throughout his time in Leipzig he tended to see more male than female patients, averaging 56% male to 44% female, but in some years it was almost a 50:50 split (e.g. 1811 and 1818). However, in 1821 the ratio had risen to 65% male and 35% female. No explanation for this pattern seems to be very clear. The average age of his patients varies very little. It is generally around 30 years of age. It was 29 yrs in 1813-16 and between 33 and 34 yrs 1819- 1821. The age range of his patients is also fairly constant averaging between 1 year and 73 years of age. The oldest patients he saw were aged 83 and 84 years (in 1820 and 1821) and the youngest recorded overall was a 3 month old baby. The data above have been extracted from Schreiber (pp.202-266) and processed to give the table showing key changes in gender, number of consultations and age range during his Leipzig practice. The occupations of many of his patients are given throughout the casebook notes and basically they fall into two main categories: irstly, ordinary craftspeople and secondly clerics, lawyers, administrators and clerks. In Graphik 25 (13) these are groups 2 and 5. These seem to have formed the vast bulk of his patients throughout the Leipzig period. The commonest patients listed were theologians, lawyers, merchants, cobblers, pastors, printers andaverywiderangeoftradespeopleofeverydescription.Further examples include: carpenters, saw sharpeners, schoolteachers, printers, soap makers, tailors, bookmakers, hairdressers, a telegraphist, a tinsmith, publicans, fruit sellers, basket makers, soldiers, actors, clerks, locksmiths and butchers. (14) Graphiks 22 and 23 (15) show that in 1801-3 44.9% of his patients were group 2 labourers and 24.9% were group 6 admin/clerks. In 1811-21 labourers accounted for 32.6%, church, educators and academics 21.6% and group 6 lawyers, court workers and administrators 15.4%. This change strongly re lects the greater religious and legal nature of Leipzig as compared to his residence in the more rural parts of Altona, Gotha, Mölln, Machern, Eilenburg then Dessau in the years 1801-3. (16) Schreiber’s Graphs 22 and 23 (p.156) show the occupations of the majority of his patients:  1801-3 labourers 44.9%; and 24.9% were admin, clerks, law/ managerial total > 60%  1811-21 labourers 32.6%; church 21.6% and admin clerks, law 15.4% total = 68% Schreiber has also collated some information about the distances his patients travelled to consult him. Graphik 21 on p.155 shows that 27% of his patients were local to Leipzig and were travelling less than 25km to see him. 19.5% were coming from up to 50km distant, while 31.7% were travelling over 100km to visit him. Only 21% travelled between 50 and 100km to consult him. Compared to modern doctors today one imagines these distances are much further than usual. It would be useful to have some comparisons for other physicians of the same period. The sudden increase in the success of his medical practice in the years 1819 and 1820 might also have laid the foundations for the prosecution brought against him by lawyers acting for the physicians and apothecaries of the city, who wanted him put out of business for making and dispensing his own medicines and for thusinfringingthesolerightofapothecariestodispensemedicines on behalf of physicians. For example, his increasing popularity and success as a physician had perhaps attracted the wrong sort of attention from the city medical authorities. This could have been a signi icant factor lying behind the drafting of the lawsuit against him and his eventual downfall at trial early in 1821. Bradford described very well what had happened twenty years earlier: “The physicians of Königslutter became jealous of his rising fame, and they incited the apothecaries against him, and these brought an action at law against Hahnemann for dispensing his own medicines, and thus encroaching upon their rights. It was decided against him; he was forbidden to give his own medicines, and this, of course, rendered his further stay impossible. He could not remain in Königslutter, and in the autumn of 1799, with his family, he departed from the ungrateful city.” (17)
  • 5. 13 SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 What happened in Leipzig was but a repeat of the same old process. “Dr Schwenke says that the reason why Hahnemann ϔixed upon Coethen as his residence, after the persecutions of the jealous physicians and apothecaries had driven him from Leipsic ... (was) to practice according to the dictates of his own conscience.” (18) But Haehl adds that attacks upon homœopathy increased dramatically after the death of Prince Schwarzenberg in October 1820 and the privileges previously enjoyed by doctors dispensing their own drugs came under the scrutiny of the state government. (19) However, in any case, Hahnemann did not wait to hear his fate, for he left Leipzig at the end of May 1821, several months before a decision was announced by the Saxon government about the self- dispensing of homœopathic pills. (20) By collecting data from the Casebooks we can see the trends in his prescribing for the Leipzig period, shown below. Summary of Leipzig Period Prescribing (%) summary D16 (1817) D19 (1819) D22 (1821) Volkmann (1819-31) Aconite 0.3 0.2 1.2 3 Acid vitriol 0.7 0 0 3 Ant. crud. 0 0.1 3.5 1.5 Arsenicum 2.8 1.6 2.5 1.5 Aurum 4.9 1.7 1.3 2.07 Belladonna 1.5 4 0.1 1.8 Bryonia 5.8 2 0.1 0.3 Calomel 6.9 1.3 0.8 1.5 Chamomilla 0.9 0.4 0.1 2.4 China 3.2 2.3 0.1 2.1 Cocculus 2.2 1.2 1.9 1.2 Digitalis 2 1.5 0 0.3 Ferrum 0.5 0.4 0.04 2.1 Graphites 0 0 0 7.1 Lycopodium 0.05 0 0 1.5 Nitric acid 1.8 1 5.5 5.9 Nux vomica 9.4 7.3 3.5 11.6 Petroleum 0.3 0.05 0.04 1.8 Phos. acid 0.6 0.6 4.2 2.4 Pulsatilla 5 5.5 0.3 5 Rhus tox. 5.9 0.7 0.2 1.2 Sepia 0 0 0 5.3 Sol Phos 0 0 0 3.3 Stannum 0.2 3.7 11.3 1.19 Staph 3.2 1 2 0 Sulphur 8.2 44.9 52.3 15.7 Thuja 6.1 5.2 2.1 0.3 Sum 71.45 86.35 88.38 77.56 No presc 2192 1908 2711 337 No Rx 91 69 53 56 This table shows that in Leipzig roughly 80% of his prescribing was covered by the 23 remedies listed. His prescribing had moved substantially away from the acute remedies of the early period. He got his best work at this point from remedies like Aurum, Stannum, Nitric acid and Sulphur, which are much more deep-acting as compared to those of the early period, even though he is still using some of the latter as well. Here once again we see continuity combined with change. Notice also the gradual reduction in the numberofremedieshewasusingfrom91to53:presumably,some had fallen by the wayside as they were no longer any use to him and had been replaced by more effective ones. We may note also in this period the rise to prominence of Stannum and Sulphur and the decline of Belladonna, Pulsatilla and Rhus tox. I have included in this table the data for Antonie Volkmann (nee Hübel, 1796- 1863) (21). She was the second wife of the Leipzig judge Johann Volkmann, and was treated by Hahnemann for many years (1819- 31) primarily it seems for skin complaints, a suspected scabies history, acid indigestion, menstrual problems and varicosities of her legs. Although her data stand on their own and re lect her own medical problems, yet the percentages also it neatly in between the late Leipzig period (D22) and the data shown below for Coethen. Her longitudinal case therefore demonstrates a ine example of the evolution of Hahnemann’s prescribing work over a considerable period of time. Figure 1 Hahnemann’s consultations per month in Leipzig, 1811-21 (22) Coethen Records show that Hahnemann moved from Leipzig to Coethen in June 1821. (23) For him, the greatest advantage in this move, as compared to his time in Leipzig, was that the ruler, Duke Ferdinand, quite speci ically allowed him to make and dispense his own medicines to patients. This meant that for once he was able to live and work in peace, undisturbed by the kinds of attacks that had dogged him intermittently for over twenty years and which had therefore necessitated him changing location many times. But of course the chief aim of the move to Coethen was simply for him to continue his homœopathic practice, research and writings. The years in Coethen (1821-35) saw Hahnemann develop his miasm theory with the publication of The Chronic Diseases in 1828 and the incorporation of the vital force and miasms concepts into the 5th Organon in 1833. Other than that his practice seems to have carried on more or less unchanged as before in the Leipzig years. One imagines he was still seeing around 2-14 patients per day as in the previous period. The Coethen Casebooks are numbers D22 to D38. The French physician, Dr Pierre Rapou (1780-1857), who visited Hahnemann in Coethen 1829-32, reported on his impressions of the great man and his work, saying “his practice is very large... strangers attend him from all parts on account of (his) great reputation and successful practice...(coming) from distances to consult the oracle of Homoeopathy...for example, I noticed among others a Dane, a Courlander, a Hungarian, a Russian and a Silesian.” (24) For some useful insights into his prescribing habits in the Coethen period, I refer to Heinz which covers the period 1829-35. In that period, Hahnemann treated Princess Luise von Preuschen (1799- 1882).
  • 6. SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 14 The remedies he used at that time are shown (pp.106-113) and the potencies he used are explored in pp.137-138, pp.146-7 and pp.271-2. Heinz also includes a study of his use of placebo in pp.150-155. Remedies prescribed:  1829-30 = Am-c, Carb-v, Calc-carb, Conium, Graph, Lyc, Nat-m and Zinc  1831 = Alum, Am-c, Bell, Mag-m, Phos, Plat, Sep  1832 = Am-m, Carb-an, Cham, Cocc, Coff, Coloc, Hyos, Nit-ac, Sulph  1833 = Am-c, Ars, Aur, Coff, Con, Hep, Nat-m, Sulph  1834 = Ant-c, Ipec, Lyc, Mur-ac, Nit-ac  1835 = Ambr, Croc, Tarax Potencies used: 1x, 2x, 3x, 6x, 7x, 9x, 10x mostly 2x (25) Also:  D33 = 30c  D34 = 30c  D35 = 30c (26) Carbo an and Carbo veg irst used in D34 (1830) (27) Olfaction becomes very prevalent from D38 (1833-5) Summary of Coethen period Prescribing (%) Remedies D34 (1830) D38 (1834) Arsenicum 4.5 1.6 Calcarea carb. 7.2 6.3 Carbo veg. 4.8 1 Conium 4 1.1 Hepar sulph. 0.1 12.3 Kali carb. 5.4 1.1 Lycopodium 4.9 2.6 Natrum mur. 4.4 3 Nitric acid. 4.2 3.6 Nux vomica 2 3.9 Sepia 4.8 2.2 Silica 4.9 1.2 Sulphur 14.4 30.3 Sum 65.6 70.2 No presc 2809 2201 No Rx 80 91 The table shows that while in Coethen roughly two thirds (66%) of his prescribing is covered just by the 13 remedies shown. Once again, we see that he was (presumably) getting his best work from the deep-acting remedies like Calcarea carb, Hepar sulph. and Sulphur. This list continues the previous trend away from acute and super icial remedies typical of the early period (e.g. Aconite, Belladonna and Rhus tox.) with a notable shift towards the kind of remedies that have become the standard tools of all homœopaths even today. Furthermore, two remedies, Sulphur and Hepar sulph., have increased substantially to become central to his work. Paris It looks highly likely that Hahnemann changed his methods quite radically in Paris. Many have questioned why he did this. The underlying reason for this could well be the difference in culture and behaviour of the French people as compared to those patients he had been used to in rural Saxony. The contrast between them could not have been much sharper. The pleasure-loving French locked to the city of the beau monde leading famously hedonistic lives in which drink, drugs and sexual promiscuity seem to have been the norm. He would inevitably have encountered more complex medical cases: patients with richer and far more diverse medical backgrounds than those he had ever met before. This will have had three most obvious effects on his practice. First, the need to pay much closer attention to the detail of patient histories and use that information to work out a long-term programme of treatment. Second, the development of new and experimental methods such as changes in potency and dosage so as to lessen the effects of aggravations (e.g. LM scale), and making greater use of the deeper-acting (miasmic) remedies to address the level of disorder he encountered. Thirdly, such complex cases would have required much more frequent consultations in order for him to keep a close track of the changes, progress and setbacks, that such cases would have inevitably involved. One imagines this would also include much more frequent use of Sulphur to drive out suppressions from allopathic drugging, and increased use of Thuja and Mercury for the after-effects of Gonorrhoea and Syphilis. These key changes can actually be seen, for example, in the Paris cases as compared to his Casebooks from the 1820s. His Paris Casebooks contain the longest patient notes he ever recorded, amounting to 136 lines per case on average. Casebooks of this period are: DF1 to DF17 (1835-43). Summary of late period prescribing (circa 1830-41) summary D34 (1830) D38 (1834) DF2 (1839) DF5 (1841) Arsenicum alb. 4.5 1.6 1.1 2 Belladonna 0.2 1 1.4 2.5 Bryonia 1.5 0.3 1.7 1 Calcarea carb. 7.2 6.3 2.9 2.8 Carbo veg. 4.8 1 0.6 1 Causticum 1.3 1.5 2.5 2.1 Cinnabar 0 0 2.7 2.3 Graphites 2.4 1.2 2.1 2.7 Hepar sulph. 0.1 12.3 10.3 9.7 Kali carb. 5.4 1.1 0.9 0.2 Lycopodium 4.9 2.6 3.3 0.7 Mercurius sol. 0.8 1.2 7.6 1 Natrum mur. 4.4 3 1.2 2.4 Nitric acid 4.2 3.6 1.2 0.8 Nux vomica 2 3.9 3.1 5 Pulsatilla 0.4 1.2 1.3 2.2 Rhus tox. 0.2 1 1.2 0.6 Sepia 4.8 2.2 0.9 1.5 Silicea 4.9 1.2 1.5 0.2 Sulphur 14.4 30.3 30.7 32.4 Veratrum 0 0.3 3.2 0.7 sum 68.4 76.8 81.4 73.8 No presc 2809 2201 977 1232 No Rx 80 91 73 89 The table above shows that in his later years of practice roughly 75% of his prescribing is covered by these 21 remedies, most of which are deep-acting ones we recognise today as standard polycrests, with a few acute remedies (e.g. Belladonna, Bryonia, Rhus toxicendron, Nux vomica) which he has reintroduced having presumably found the need to use them frequently once again. We can also see the rise to dominance in his late practice of Calcarea
  • 7. 15 SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 carbonica, Sulphur and Hepar sulph., and to a lesser extent of Mercurius solubilis and Lycopodium. Potency in the later Casebooks By counting the number of times a potency is used in each of the casebooks we can build a picture of his use of potency throughout thelaterperiod(D16toDF2).The irsttablegivesashortsummary and the second expanded table provides more details. summary Percent Year KJ 7c or less 9c to 18c 24c to 30c >30c 1817-18 D16 98 2 0 0 1819-20 D19 96 4 0 0 1830 D34 84 15 1 0 1833-5 D38 5 11.8 82.5 0.7 1836-42 DF2 2 11.8 85 1.2 1838-41 DF5 1.7 10.8 80.6 6.3 potency summary (%) by casebook and year Journal D16 D19 D22 D34 D38 DF2 DF5 Years 1817- 18 1819- 20 1820- 21 1830 1833- 5 1836- 42 1836- 42 potency Leipzig Coethen Paris 1x 2.3 0.9 1.1 1c 4 1.1 0.35 2c 7.1 0.47 0.09 3c 1.7 1.3 2.5 48.1 0.13 0.28 6c 4 5.2 4.6 32.6 9.22 1.92 1.30 13x 7.1 3.3 4.6 7c 61.3 79.4 75.4 5.6 9c 9.9 0.13 0.38 12c 2.2 10.1 3.33 4.11 15c 0.16 0.38 1.96 18c 0.05 15.1 7.56 4.67 21c 1.02 0.65 24c 0.05 1.25 23.08 21.51 27c 0.26 0 30c 1.12 64.1 60.77 59.12 32c 0.13 80-100c 1.30 100- 189c 0.46 190- 200c 1.03 4.49 These data show a clear trend in which Hahnemann shifts from a heavy reliance on the lower potencies (1c to7c) in 1816-17 and 1819-20, towards greater use of potencies 3c, 6c, 9c and 12c in 1830, and inally to a pattern of prescribing based mainly around 30c, 18c and 24c in his Paris period. The shift seems to have occurred in the mid-1820s. In the Paris period, he also uses some unusual higher potencies like 65c, 85c, 167c, 195c, etc; there are no LM potencies in DF2 and DF5, but they do appear in some of the later Paris Casebooks. Not shown here but also visible in the Paris Casebooks, is his tendency to use descending potencies like 30c followed by 24c, then followed by 18c. This pattern occurs quite often in the Paris Casebooks but is not found in the earlier patient journals. Trends Some patterns emerge from the data. For example, by comparing the number of patients seen per year and the number of consultations we can see how many consultations per patient changed over time. This is shown in the graph below. In the middle and later periods, the number of consultations per patient has increased compared to the early period. We might interpret this in relation to his growing con idence in prescribing and perhaps also to the growing con idence patients had in him as a doctor. It may also re lect the af luence of some of his clients who presumably were inancially able to undertake repeat consultations. One imagines, for example, that such repeat consultations would not have occurred if con idence in Hahnemann as a doctor had been low or if patients were inancially unable to make them. One also imagines that patients who returned for several consultations must have been drawing some bene it from each appointment. Otherwise, it seems hardly likely that they would keep going back repeatedly. Some patients, even in the early days, saw him 40 or 50 times in the same year. Clearly these patients must have done so for valid medical reasons while also drawing some bene it from seeing him. It is hardly likely that such patients would keep going back to see him if they had no con idence in his medical skills or if they derived no bene it from seeing him. His Consultation Style When reading through several of the casebooks one cannot fail to be struck by the layout that he uses for almost every case. They each follow a certain predictable pattern. He lists the date, name, age and town of origin followed by notes about the problem the patient is consulting him about. Almost anywhere in the text remedy names appear, perhaps singly, sometimes several in a chain, either directly at the end of the text, in a line of their own, or in brackets after a few words. Towards the end of the text a speci ic remedy appears often with the potency given. That is the general layout but there are many variations of it. In some cases, the remedy name will appear at the top or halfway downandatothertimesnoremedynamesappearatall,therebeing instead references to north or south magnet and ‘mesmerismus’ or ‘elektricitas’. His practice of mesmerism seems to have been especially common during the Leipzig period (1811-21). One wonders on what criteria he based a decision to use mesmerism or magnets on a patient rather than homœopathic remedies. In some cases several remedies will appear, often with dates in the recent past when they were given. In some cases two or three remedies are listed with no indication if they were all given or in what potency or dosage. There is usually an indication of several packets of placebo (sac lac) also given to the patient. Sometimes
  • 8. SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 16 only placebo is given, usually indicated by the word Quentchen or the section symbol §. Certain words appear frequently and so stand out. These include menstruation, coition, erections, pollution, amount of sleep, sleep position, dreams, urine, thirst, stool, appetite, alcohol and coffee consumption, body temperature, headaches, nosebleeds, taste in the mouth, food preferences. This includes personality descriptor words such as anxious, sad, angry, impatient, passive, iery temperament, etc. Another key feature is the length of the notes. Most of them tend to be only seven or eight lines in length while others may only be two or three lines. At the other extreme, and more rarely, some notes go on and on, illing up several pages. One assumes he gave a remedy when he was certain of it and left few notes to indicate why. Alternatively, when he was unsure of the remedy the notes seemed to go on at greater length. However, he became much more diligent and detailed about writing his case- notes as time went on. The table below shows how frequently selected German words occur in Krankenjournal D22 (1821). It clearly reveals many aspectsabouthisstyleofquestioninginconsultationwithpatients, and shows the very broad range of topics he wanted information about. This list is broadly typical of what is found in all the later Casebooks; the brevity of notes in the early ones do not reveal so much. English German Frequency Unsettled unruhig 312 Anxious or fearful ängstlich 62 Angry böse 129 Hesitant zögerlich 0 Indecisive unentschlossen 1 Hasty hastig 4 Impulsive treibend 1 Sensitive emp indlich 34 Unhappy unzufrieden 5 Impatience Ungeduld 1 Serious ernst 19 Indifferent gleichgültig 7 Sad traurig 19 Wretched miserabel 4 Tired ermüdet or müde 112 Foul smelling stinkend 17 Right side rechte Seite 1 Left side linke Seite 1 Worse schlimmer 228 Better besser 815 Neat ordentlich 7 Tidy aufgeräumt 2 Bathing baden 15 Stool Stuhlgang 1534 Taste Geschmack 203 Nosebleed Nasenbluten 26 Diarrhoea Durchfall 216 Dreams Träume 222 Erection Erektion 103 Sweat Schweiß 607 Constipated verstopft 42 Tongue Zunge 434 Night sweats Nachtschweiß 79 Phlegm/mucus Schleim 397 Expectoration Auswurf 208 Nocturnal emissions Pollution 128 Complexion Gesichtsfarbe 16 Swollen geschwollen 103 Thirst Durst 3 Beer Bier 81 Wine Wein 128 Coffee Kaffee 228 Appetite Appetit 900 Coitus Coitus 40 Urine Urin 253 Menstruation Menstruum 395 Galvanism Galvanismus 4 The words that appear most often in the Casebooks suggest that Hahnemann was in the habit of following a regular format for his consultations. One imagines he started by asking the patient to talk freely about their main problem while he made a few brief notes. Once they had inished speaking he undoubtedly then started quizzing them further to obtain more detail from them about speci ic points they had raised, such as what made them feel worse or better, sides of the body, times of day, types of pain, etc. He must also have then asked them about the more intimate topics listed above, such as sweat, urine, stool, periods and sexual function. His focus on what we might term the ‘unconscious bodily functions’ like sleep, dreams, menstruation and sexual function, were clearly designed to obtain insights that would point to speci ic remedies which he could then exclude or include in his anamnesis according to the answers the patient gave. Fragments of these exchanges appear in his notes. One gets the feeling that his focus on these unconscious aspects of the patient symptomatology enabled him to bypass any unconscious bias on the part of the patient, Likewise his questions about urine, appetite, sweat, stool and his notes on the tongue, taste in the mouth and facial complexion: they are all things a person cannot really fake or exaggerate—and some of them can be directly observed by the physician—meaning they can be regarded as genuine aspects of the symptom totality of the patient. They are also symptoms that appear in many of the provings. This must surely re lect an important correlation that he was making between the provings and the symptoms of patients in the clinical situation. This allows me to repeat and emphasise a point made earlier: Hahnemann was clearly viewing his patients through the ‘lens’ of the proving symptoms of his single drugs and making symptom correlations in order to ind the best it match between the two. And so, ‘in essence’ (put bluntly), what we are looking at throughout all the casebooks is the very birth and evolution of the ‘homœopathic gaze.’ “These clinical notes (D4) give the reader an excellent picture of the day-to-day practice of an observant physician of the early nineteenth century. Anyone who wishes to understand Hahnemann’s doctrine of homoeopathy must study these records and notes. They are reproduced as Hahnemann jotted them down, including his idiosyncratic abbreviations and the colloquialisms and dialect of his patients. A very interesting and signiϔicant publication.” (28) Looking through the entire opus it is also very clear that over time he changed the remedies and the potencies that he used, much like an artist changing the colours on his palette. In other words, certain remedies were in common use for a time; before long they would go into decline and disappear altogether only to be replaced by new ones which then ‘take the stage’ and have their day. At any point in time he was using some remedies less while he was proving new ones which he found to be very useful. There are therefore de inite phases in his use of remedies. In general, there is a shift from using mostly acute remedies in the early years (such as Aconite, Belladonna, Drosera) to using more deep-acting remedies (like Sulphur, Stannum, Aurum) in the later years. No indication is given for the reasons he made these changes to his therapeutic armamentarium. We might assume that they were linked to his ongoing provings and changes in his medical theories as well as changes in the presenting conditions
  • 9. 17 SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 of the patients who consulted him. In the case of potency, we have seen that this also changed many times before he adopted the centesimal scale we are familiar with today. Strange, Rare and Peculiar Remedies Throughout his Casebooks Hahnemann was in the habit of occasionally using some odd and unusual remedies. Some of these were in common allopathic use at the time while many of the others are unfamiliar to us today. It is of interest to include here a brief outline of them. One might be tempted to imagine that he used these unconventional remedies more in the early phase of his career, but in fact they are spread almost evenly across the whole range of his Casebooks. For example, in D2- D6 there are 26 of them, while in D16-DF2 there are also 26. He seems to have used them more in the Leipzig years, between D6 and D16, which contain 9 and 10 of them respectively. In the early period (D2-D6), notable examples include the old herbal drugs Hedyotis, Melampyrum, Dryopteris ϔilix-mas, Mentha, Millefolium, Sambucus, Santalum album, Thebaica (Opium tincture), Tilia and Ulmus along with unusual mineral remedies such as Acid sal (hydrochloric acid), Oleum ferrum, Oleum mart, Spirit vitri (sulphuric acid), Spirit salis (hydrochloric acid), Spirit vini (ethanol), and Vitri zincum (Zinc sulphate). Another is Thiertod which he used in D5. It is not very clear at this stage where he came across some of these remedies, but his use of them probably re lects the depth of his pharmaceutical knowledge, and his ability to adapt them in some way for homœopathic use because of their speci ic action. In the middle and later phase of his work (D16-DF2) some of the key herbal drugs he employed include Aegopodium (Ground Elder), Bovista, Cascara, Crocus, Lamium album, Lichen islandica and Tincture radix ϔilicis (tincture of a fern root?). More exotic examples include Anthraxin, Antipsorica, Antiepileptica, Athamanta, Auripigmentum (Orpiment or Arsenic sulphide), Autonosode, Hepar sulph. natrum, Oxymura (possibly chlorine water (29)), Plumbago, Psorin, Sal culin, Sol phos and Zinc vitriol (Zinc sulphate). Again, it is hard to know where he got these remedies from or more speci ically why he used them, often only once. It seems safe to assume that he knew of their healing properties and was able to adapt them for homœopathic use for a speci ic health problem which he had found dif icult to cure with his mainstream remedies. It is open to question how many of them had been properly proved. Since he used these remedies, mostly on a one-off basis, most of them have fallen out of fashion and been lost in the backwaters of homœopathy never to be heard of since. However, it is worth noting that the English homœopaths, Drs Burnett and Cooper also felt the need at times to fall back on some unusual and old fashioned herbal drugs in the 1890s. For example, Burnett used Ceanothus (30); Fraxinus (31); tincture of Acorn (32); Carduus marianum (33); and also Urtica (34). Cooper used Star of Bethlehem (Ornithogalum) as a tumour remedy (35). Burnett “resorted to old herbal Drugs like Acorns, Bruisewort, Walnuts, Nettles, Couchgrass and Daisy.” (36) And so this habit did not entirely die out with Hahnemann himself. I give the last word to the author of an old book review of Casebooks 2 and 3: “What Heinz Henne has shown very clearly and objectively is Samuel Hahnemann’s thinking and work as a doctor; the clinical histories superbly illustrate his practical achievements as a physician. The medical records are not always easy to read. They originate from Hahnemann’s Eilenburg period and cover the years 1801 to 1803. Journal No. 2 gives reports on more than 400 patients. The interesting thing is that Hahnemann presents his patients’ complaints in a form identical to the one patients use in this day and age. It is astonishing how meticulously Hahnemann records the complaints of his patients and how he elaborates on his thinking process about the remedy selection on the basis of the symptoms. But Hahnemann is also a very attentive and precise observer. There are, for example, drawings in the medical journal, in which he has marked the exact position and extent of a pannus on the right and the left cornea. It also shows time and time again that he is not only interested in the subjective symptoms, but also in observing the objective phenomena. Hahnemann’s medical journals are truly an enjoyable work, not only for the historian and the homoeopathic doctor, but for anyone who wants to understand how Hahnemann was able to empathise with his patients. We can learn from that in every way. Some pages of the medical records are given as facsimiles at the beginning of the book. Although the present work has no practical value for the busy doctor, but anyone who has a sense of the originals should draw some beneϔit from ϔlicking through the book in the quiet hours.” (37) This article has attempted to convey some aspects of the contents of the Casebooks to people who have never seen any of them. I have tried to illustrate many aspects of the evolution of Hahnemann’s practice, his experimentation, his style of consultation with patients, his obviously warm and empathetic nature, the struggles he had with diluting drugs to render them more gentle (less aggravating) while retaining their therapeutic effects, the numerous changes he made to his system of notation and the complex system of shorthand and symbols he employed forpotencyanddosage.Ihavealsoattemptedtodelineatede inite trends in his prescribing habits both in terms of his choice of remedies and potency. Overall the reader will hopefully have gained new insights about him from the glimpses I have given into his daily work spanning his entire career. Readers should try to put aside what has been written about Hahnemann’s practice, and remember that the Casebooks contain the actual raw material from which homœopathy as we know it irst evolved. In future articles I plan to examine potency across his career in more depth, the Paris Casebooks and a selection of cases from every phase of his life. Acknowledgements I wish to express my sincere thanks to fellow homœopaths Kalin Blaskoff, David Levy and Alexandre Winkler for encouraging my research and for general homœopathic feedback on early drafts of this article. I am also grateful to Kalin Blaskoff and Gregory Vlamis for inding (and supplying) some useful resource material, and to Martina Esonajo and Alexandre Winkler for their help with German translation. I am also grateful to Beate
  • 10. SIMILIA - The Australian Journal of Homœopathic Medicine June 2018 - Volume 30 Number 1 18 Schleh, Librarian at the Robert Bosch Institute for the History of Medicine in Stuttgart, for her kind and patient help and for supplying a Xerox copy of part of Krankenjournal D5. Thanks are also due to Susanne Rehm of Deutsche Homoöpathie Union, Karlsruhe, and Carolyn McLaughlin of the Bulletin for the History of Medicine in Baltimore, for supplying very useful book reviews. References 1. Hahnemann’s Will, The American Homoeopathic Review, vol.V, 1865, pp.478-9 2. Anton Jayasuriya, Clinical Homoeopathy, India: B Jain & Co, 2002, p.44 3. Martin Gumpert, Hahnemann, the Adventurous Career of a Medical Rebel, New York: Norton, 1945, p.92 4. Silvia Waisse, The Science of High Dilutions in Historical Context, Homoeopathy 101, 2012, (pp.129-137), p.132 5. Marianne Winder, Hahnemann’s Krankenjournal Nr 4 by Heinz Henne, Stuttgart: Hippokrates-Verlag, 1968 (book review), Medical History 13.3, July 1969, p.309 6. G B Risse, Hahnemann’s Krankenjournal No. 4., 1968, (book review) In Bull. Hist. Med. 44 (1970): pp.285–86. 7. Risse, p.285 8. Ursula Sharma, The Homoeopathic Body: Reiϔication and the Homoeopathic Gaze, in H Johannessen, S G Olesen J O Andersen (Eds), Studies in Alternative Therapy 2: Body and Nature, Odense: Odense University Press, 1995, pp.33-49 9. Charles C Savage, Illustrated Biography or Memoirs of the Great and the Good of all Nations, etc, Buffalo: Phinney & Co, 1856, p.408 10. K Schreiber, Samuel Hahnemann in Leipzig, Stuttgart: Haug, 2002, pp.202-266 11. T L Bradford, The Life and Letters of Hahnemann, Philadelphia: Boericke & Tafel, 1895, pp.537-8; Materia Medica Pura, Dresden: Arnold. 6 vols. Vol. 1 1811 ; vol. 2, 1816 ; vol. 3, 1817 ; vol. 4, 1818 ; vol. 5, 1819 ; vol. 6, 1821. 12. These include the following: Dissertation on the Helleborism of the Ancients. Leipsic. Tauchnitz. Thesis to the Faculty at Leipsic. 1812, also in Lesser Writings.; Spirit of the homoeopathic doctrine of medicine. In Allgemeine Anzeiger, March, 1813. Vol. 2 of Materia Medica Pura. Lesser Writings. As a pamphlet in New York by Hans Birch Gram in 1825. Trans. by Ad. Lippe in 1878, and published in The Organon, a journal. Hom. Exam.,Oct.,1840.Alsotrans.byG.M.Scott,London,Glasgow.1838.Trans. by Lund into Danish.; Treatment of typhus & fever at present prevailing. Allgemeine Anzeiger, No. 6. 1814, Lesser Writings.; Venereal disease and its improper treatment. Allgemeine Anzeiger, No. 211. 1814, Lesser Writings.; Treatment of burns. 1816; Answer to Dr. Dzondi. In Allgemeine Anzeiger, Nos.. -156, 204. 1816, Lesser Writings.; On uncharitableness to suicides. Allgemeine Anzeiger, No. 144, 1819. Lesser Writings.; On the preparation and dispensing of medicines by homoeopathic physicians. 1820, irst published in Stapf’s Lesser Writings of Hahnemann. Also in Dudgeon’s Lesser Writings.; 1821. Treatment of purpura miliaris. Allgemeine Anzeiger, No. 26. 1821, and in Lesser Writings. 13. Kathrin Schreiber, Samuel Hahnemann in Leipzig, Stuttgart: Haug, 2002, p.159 14. See note 8 15. Schreiber, p.156 16. Bradford, op cit, pp.66-69 17. Bradford, pp.56-7 18. Bradford, p.124 19. Richard Haehl, Samuel Hahnemann his Life and Works, 2 volumes, London: Homoeopathic Publishing Company, 1922, pp.111-114 20. Haehl, op cit, p.114 21. Samuel Hahnemann, ‎Reinhard Hickmann, Das psorische Leiden der Antonie Volkmann: Edition und Kommentar einer Krankengeschichte aus Hahnemanns Krankenjournalen von 1819-1831 (Quellen und Studien zur Homoopathiegeschichte), Stuttgart: Haug, 1996 22. Schreiber, op cit, p.140 23. Schreiber, p.149; Bradford, p.124 24. Rosa W Hobhouse, Life of Christian Samuel Hahnemann, Founder of Homoeopathy, London: The C. W. Daniel Company, 1933, pp.238-9 25. Inge C Heinz, Schicken Sie Mittel, senden Sie Rath!, Stuttgart: KVC Verlag, 2011, pp.146-7 26. Schreiber, pp.271-2 27. Ute Fischbach Sabel, Analisis de Los Diarios Clinicos de Samuel Hahnemann, Tarragona: ACN Edicion, 2014, p.242 28. George Rosen, Hahnemann’s Krankenjournal Nr 4 by Heinz Henne, Book Review, J Hist Med & Allied Sciences, XXV.3, July 1970, p.371) 29. JohnMurray,ASystemofMateriaMedicaandPharmacy,volII,Edinburgh: Adam Black & Co, 1816, pp.184-8 30. M Wood, The Earthwise Herbal: A Complete Guide to New World Medicinal Plants, North Atlantic Books, 2009, p.104 31. Wood, 2009, p.161 32. M Wood, The Book of Herbal Wisdom: Using Plants as Medicines, N Atlantic Books, 2017, p.409 33. Wood, 2017, p.446 34. Wood, 2017, p.479 35. T Bartram, Bartram’s Encyclopedia of Herbal Medicine, Hachette UK, 2013 36. John H Clarke, The Life & Work of Dr. Burnett, London: Homoeopathic Publishing Co., 1904 37. Dr Schwa, Hahnemann’s Krankenjournale Nr. 2 u. 3 by H Henne, Buchbesprechungen (Book review), Allgemeine Homöopathische Zeitung (1963), 208 (11): p.655 Other Works Consulted R E Dudgeon, The Lesser Writings of Samuel Hahnemann, New York: William Radde, 1852 Samuel Hahnemann, The Organon of Medicine, combined 5th/6th Edition, translated by R.E. Dudgeon, and edited by William Boericke, Philadelphia: Boericke & Tafel, 1893 Peter Morrell, A Guide to Hahnemann’s Translations, published online, 1998 http://www.homeoint.org/morrell/articles/pm_trans.htm Peter Morrell graduated in Zoology at Leeds University (UK), has taught Biology for many years and was a part-time homœopath throughout the 1980s. He completed an MPhil thesis on the history of British homœopathy in 1998 and has written many articles on the history of homœopathy and the life of Hahnemann since the mid-1990s, which have been published in the USA, the UK, Sweden, Brazil, Italy, Romania, and Australia. Apart from writing, he teaches Biology on a part-time basis at three colleges in Central England. Peter was Guest Editor of issue 1 of Homœopathic Links published in March 2016.