Lesser Writing of Hahnemann

1. AESCULAPIUS IN THE BALANCE
Dr. VIGNESH V. NAIK
PG I
DEPT. OF ORGANON OF MEDICINE

2. CONTENT
• In this Chapter master Hahnemann is displaying his
indignation at the pathetic state of contemporary therapy
and how apothecaries monopolized the medical system.
2

3. AESCULAPIUS
Ancient Greco- Roman God of medicine
Represents healing aspect of the medical arts.
Son of Apollo
His daughters are,
• HYGIEA-goddess of cleanliness
• IASO -goddess of recuperation from illness
• ACESO-goddess of healing process
• AGLAEA-goddess of good health
• PANACEA –goddess of universal health
•
Rod of Aesculapius – Snack-entwined staff remains a symbol of medicine .
3

4. ABOUT THE TITLE
• Published by Dr. Hahnemann in 1805 in Leipzig.
• In the time of Aesculapius lived the art of medicine made little
or no progress other than searching in undiscoverable source of
disease.
• In the time of Hahnemann, prevalent medical system lack in
progress and very torturous and irrational practice based on
speculations, was going on.
• So he termed as it 'Aesculapius in the Balance'.
4

5. FAULT IN THE ART
• After I had discovered the weakness and errors of my teachers and
books, I sank into a sorrowful indignation, which had nearly altogether
disgusted me with the study of the medicine.
• I was on the point of concluding that the whole art was in vain and
incapable of improvement.
• I gave myself solitary reflection, and resolved not to terminate my train
of thought until I had arrived at a definite conclusion on the subject.
5

6. INHABITANTS OF EARTH:
• Short life span
• Difficulties to contend at every step.
• In order to maintain bare existence
• What is avail for you if you don’t process HEALTH?
6

7. MULTITUDE OF DISEASE
• How often is this disturbed ?
• How numerous are the lesser and greater degrees of
ill health ?
• How innumerably great the multitude of disease ,
weakness and pain, which bow man down as he
climbs with pain and toil towards his aim.
• Which also terrify and endanger his existence.
• Even when he is supported by
7
Fame
luxury

8. DIVINE SPIRIT
• Did he design these trivial bodily ailments which
we call diseases to helplessly and irremediably
oppressed you ?
• If he has allowed disease to injure his offspring,
then he must have laid down a means by which
those torments might be lessened or removed.
8

9. • Let us trace impressions of this
• The noblest of all arts
• Which has been devoted to use of perishing Mortals
• This art which can make so many happy
• IT MUST NOT ONLY BE POSSIBLE, BUT ALREADY EXIST
9

10. • Man is rescued every now and then as by miracle from some fatal diseases
• We find recorded in writings of physicians of all ages
• Yet such cases have been rapidly and effectually cured and perfect health is restored
• BUT HOW SELDOM HAVE THESE BRILLIANT CURES BEEN EFFECTED
WHEN THEY WERE NOT RATHER CONSIDERED AS A CAUSE
Either to force of youth over mastering disease or to the
Unreckoned influence of various fortunate circumstances, than to medicine employed.
10

11. CAN WE IMITATE THEM TO GET
SIMILAR RESULTS ?
• All that we see is great cures are possible
• BUT HOW THEY ARE TO BE EFFECTED
The power and particular circumstances by which they accomplished
How these are to be controlled
So that we may transfer them to other cases is quiet beyond our knowledge
Perhaps the art of healing does not consist in such transferences.
• This much is certain that:
ART OF MEDICINE EXISTS but not in our hands nor in our symptoms.
11

12. ACUTE DISEASES
• Majority of cases for treatment of which a physician is
called in are Acute diseases.
• Short course
• Terminate either in recovery or death
• If patient die- death
• If recovered- the natural strength of patient is sufficient to
overcome both force of disease and obstructing action of
drugs he took.
• The power of nature often suffice to overcome both.
12

13. EPIDEMIC DYSENTERY
13
•Those who followed indications
of nature without taking medicine
at all.
DEATH
RECOVERY
Those who were treated
according to method of Brown,
Stoll , Hoffman etc.
DEATH
RECOVERY
Physicians
and quacks
boasted
their skill.

14. WHAT IS THE INFERENCE ?
• All were equally wrong .
• Milder cases uniformly recovered by itself, if gross errors in diet
were not committed.
• Cases were treated with opposite principles.
• This could not be called cure.
• But spontaneous recovery.
14

15. • Until you say you can cure , cure rapidly and without any bad
consequences
• Your cures are nothing but spontaneous recovery
• This Thought is saddening !!
• Patient recovers by miracle.
• E.g.) Prostate patient- not only refused physicians medicine but also by
prohibiting certain diet such as pork, sour-crout, potato, coffee, brandy etc.
• Such a kind are the apparent cures of acute disease.
15

16. BENEFICIAL AND USEFUL REGULATION FOR THE
ARREST OF PESTILENTIAL EPIDEMICS
16
MEASURES
TO BE
Cutting of communication with affected
district.
Separation and removal of sick from the
healthy.
Fumigation of the affected abodes and
furniture with nitric and muriatic acid.

17. THIS ARE WISE POLICE REGULATIONS AND NOT
MEDICAL CURE
17

18. NULLITY OF MEDICINE:
• In the infected spots where a further separation of infected from the
healthy is not to be thought of
• There die all
• Nurses, physicians, apothecaries, surgeons are all alike borne to their
grave.
• At the same time it is undeniable that occasional, but rare cures occur,
effected obviously by medicines
• These are the hints by author of life, “ THAT THERE IS A HEALING ART”
18

19. QUESTIONS
 How did it act here?
 What medicine did the real good?
 How can anyone imitates such an
experiment in an apparently similar
cases?
19

20. OBSERVATIONS
• Particulars were unknown
• A single medicine was not given
• It was all mixture of learned recipes
• Patient also drank an infusion of variety of herbs
• All we see is cure is possible but how it is to be effected, and how
an indefinite case can tend to perfect art of MEDICINE, that we do
not see.
20

21. CHRONIC DISEASES
• There is time to show the art of prescribing
• Physicians feel themselves weak in chronic diseases- avoid
treatment
21

22. ELDERLY PARALYZED PERSON
• Example:-
• Physician observes that the strength of the Patient
is not sufficient.
• Speaks about unfavourable season, healing herbs,
mineral water.
• In mean while he orders something : - to amuse
patient
- to make some money
But certain relief he cannot give.
22

23. TREATMENT ON ASTHENIA
Internal or external stimulants
• To fortify the tone of muscle - Bitter extracts
• To strengthen digestive system- cinchona bark
• To cool the blood – equal decoction of unknown plants/saline
• Purgatives – to hasten the sluggish evacuation.
• This art is too weak . Hence reposes gout, consumption(tb),
old ulcers, contractions, so called dropsies, spasmodic asthma, angina pectoris
pains, spasms.
23
Medical school whisper that :
“ yes, they are incurable evils and our books tell us they are
incurable”

24. RARE DISEASES
• Because of :- Defects in civic constitution. (Modern era)
• Artificial, complicated mode of life, nature, luxury deranging our natural
constitution.
• To accustom himself with change there will be great disturbance in his health.
• E.g. - The fat of seal and the train oil eaten with bread made of dried fish
bones prevents Greenlander from enjoying health in general.
• luxurious refinements and absence of exercise in fresh air - rare
diseases
24

25. • The simple uniformity that obtains in airy hut of humble villager.
(old era)
• E.g. Water colic of peasants etc
• There must be one kind of art for former and later
• Or if it were only one would it not be applicable to both??
• There is such a thing for all that, it is a possibility.
25

26. BROTHER PRACTICIONERS
REGULAR PRACTITIONER QUACK(NECK/ NOTHING
PRACTITIONER)
Stumbles by a lucky hit
upon cure
Without any degree makes
great and wonderful cure
26

27. HELPFUL SYSTEM OF MEDICINE IS POSSIBLE
Both doesn’t know how to eliminate the evident and fruitful truth which the
cure contains.
Neither can separate and record the medicine which certainly was of use out of
the mass of useless ones they employed.
Neither Indicate the case in which it did good and in which it will certainly
benefit again.
All that we learn is , that a helpfully system of medicine is possible.
Yet it has not attained the rank of science.
That Even the way has yet to be discovered how such a science is to be learned
and taught.
27

28. BRILLIANT BUT RARE CURES(HORSE
CURE)
• However great the noise they make, are not a character to be
imitated.
• Salti mortali, But desperate attempts by means of most powerful
drugs in enormous doses.
• Which brought the patient into imminent danger Where life and
death wrestled for their mastery –lethal outcome
• And then kind nature gave the fortunate turn to the case
• Patient was recovered himself.
28

29. NOT A DIVINE ART
• 1) A treatment with couple of jalap- resin to the dose is by
no means inferior in severity to helleborism.
• Such modes of treatment are not very unlike murders.
• The results alone renders them not a criminal, And imparts
them lustre of good action - the saving of life.
• This can’t be a divine art
• Mighty working of nature should effect the greatest deeds
simply, mildly and by means of smallest agencies.
• Physicians partially attain their object, but in a hurtful way.
29

30. • 2) Unknown disease accompanied by general swelling
• They called it as dropsy .
• Treatment- frequent repetition of hydragogue and
purgatives.
• Conquered dropsy the most serious disease
• Only a small disadvantage, new disease, which nobody
anticipated is come in its place due to excessive purgation.
30
HORRIBLE REVOLUTIONARY CURES:

31. • Thus yet it is impossible that such a procedure
can be called a cure, where the disease, by
means of violent unsuitable medicines, only
loses a portion of its outward form and
a new one.
The change of one disease for another is not
a cure .
31
THIS IS NOT CURE

32. THESE ARE THE CURES
• DISEASE
• They are not direct transformation of the disease
treated into health ,
• But revolutionizing , disturbance of the order of the
things by medicine .
32
HEALTH

33. OTHER WAYS TO CURE
• Here he talks about lucky circumstances
• The leaving off of medicines
• Youthful vigor
• commencement of menstrual flow or its cessation
proper periods of life
• Mistakes of chemist respecting medicines and signs in
prescription
• But such circumstances are so uncertain of all arts
33

34. UNDERSTANDING OF ORDINARY
PHYSICIANS
• Treatment with Powerful, violent attack upon the body with
things that are to be found in chemists shop , with an
alteration of the diet .
• Prescribe every case with an exactly opposite diet.
• E.g. - Such as ham, strong meat soups, brandy etc often in
case where very smell of meat makes patient sick
• With use of violent remedies in enormous doses.
34

35. HAHNEMANN’S QUESTIONS
• 1. How does it happen that in 35 centuries since
Aesculapius lived, this is indispensable art of medicine
has made little or no progress ?
• 2. What was the obstacle?
• Physicians started filling gaps and inconsistencies of
their knowledge by heaping system upon
• . Systems
• . Opinions
• . Definitions
• . Postulates
35

36. ANCIENT TIME WHERE THERE WAS AN
EXCEPTION TO THIS RULE- HIPPOCRATES
• Discovery of science of medicine by HIPPOCRATES
• He saw and described diseases before him accurately
• without addition ,without Coloring, without speculation .
• No physician is greater than him regarding to his pure observations.
• Acknowledged his deficiency in that he gave almost no medicines- trusted to
diet
• All succeeding ages degenerated or wandered more or less from indicated path,
empirics
• Origin of disease some poison universal antidote
(Theriaca and
Mithridatium) 36

37. GALEN’S SYSTEM OF MEDICINE
• In this great period of 2000 years pure observation of disease was
neglected, The wish was to be more scientific, and to discover hidden
causes of disease .
• Galen devised a system for this purpose, his 4 qualities with their diff
degrees.
• It remained for 100-150 years and worshipped as NON PLUS ULTRA of
medical truth
• This neither advances, it rather retrograde practical art of healing.
37

38. DISCOVERY OF PRINTING
• It had become easy to communicate and obtain name by writing
hypothesis
• The systems rapidly increased
• Influence of stars, evil spirits, witchcraft
• Alchemist with salt, sulphur and mercury
• Silvius- acids, Biles, and mucus
• Reil, browns postulates etc
38

39. • Iatromathematicians and mechanical sect – explained everything by
the shape of the smallest parts .
• Humoral pathologists – acridities of the fluids .
• Solidist – Tone of the fibres and abnormal state of the nerves.
• Physicians no longer tried to see diseases as they were
• What they saw didn’t satisfy them
39

40. • But they started explaining undiscoverable cause of disease in
regions of speculation
• Superstitions
• Metaphysical theories
• super human powers
• Started building CASTLES IN AIR
• These concealed their poverty in art of healing
40

41. PRELIMINARY SCIENCE ADVANCED
• Explained functions and localization of human body in
detail
• Position of internal parts etc.
• After the absorbents were discovered anatomy started
explaining, in what way medicines must permeate them in
order to get to that spot of the body where the remedial
power was wanted
• But these useful sciences which have increased the
knowledge of the physician have contributed so little to
the improvement of art
41
ANATOMY

42. PHYSIOLOGY
• Physiology until HALLER’S time looked only spectacles
hypothetical concepts, Gross mechanical explanation, and
pretension to systems.
42
PHILOSOPHY
Natural philosophy somewhat explain the
phenomenon of healthy and diseased body.
Manifest laws which, in inorganic world , regulate
the extrication, confinement, and diffusion of
caloric, and the phenomena of electricity and
galvanism applied without change and without any
exception.

43. CHEMISTRY
Chemistry plays an important role in explaining certain
appearances of healthy as well as diseased body
And is a guide to the preparation of various medicines
Explains physiological and pathological phenomenon
These accessory sciences of medicine have advanced to
a height and maturity which seems not to be capable of
further advancement .
Yet they have had no beneficial influence on treatment
of disease.
43

44. HOW THIS HAS HAPPENED ?
• Anatomy can see only external organs
• Physiology explains only the state of health and functioning at that state
• In diseased state it’s explanation is deceptive which is untrue.
• Even chemistry could not explain if anything occurs other than its laws.
44

45. Case of intermittent fever
Goes through books on treatment of fever
Tries to learn about medicine which were discovered in experience of bygone ages.
Then gives a mixture of all medicines which were indicated for fever
Mixed together in one prescription .
. A basis( fundamental medicine)
. A corrective
. An adjuvant
. An excipient
45

46. PERICULOSAEPLENUM OPUS
ALEAE
• What we think of a science, the operations of which are founded upon perhaps
and blind chance
• Most physicians at that time not convinced by own experiences
• Again refer to works of mm or some authorities or results of domestic practice
• Then started combinations of medicines with simples and found advantage from
that.
• There may be 2 reasons
Either from confused use of it in combination with other drugs
Or from domestic practice 46

47. EXPERIMENTS WITH SIMPLE MEDICINES
• Conrad gender
• Cullen
• Alexander
• Stoerk
• Coste
• Willemet
• Administered simple medicines alone and uncombine in certain
diseases or to persons in health
47

48. • Martin Herz thought water hemlock cured pthisis, although
he gave it combined with other drugs
• But there were still chaos in administration of medicines
whether simple or mixture yet no advancement of knowledge
• To overcome this the order of apothecaries were instituted .
48

49. UNLUCKY PERIOD OF MEDIEVAL AGE- APOTHECARY
SYSTEM
INTRODUCTION OF COMPOUND MEDICINES:
The time when then the authorities introduced dispensatories
(Book) .
It became necessary to form the apothecaries into the close
corporation.
 Monopoly was done- condition that they should have always a
stock of ready prepared medicinal mixtures
 Their number was fixed and limited Called each compound by
name after the disease which it was to remove
 Mode of administration was described Numerous commendations
of its virtues
 Young physicians started employing these in preference with simple 49

50.  Rule of receipt books of compound medicines .
 Rule of apothecaries Regulation of converting simple drugs into compound mixture
 Forbidding physicians to give any medicines directly to the patients
 idea of expression was to dispense
• Such regulations may have adopted for 3 reasons:
 Owing to physicians rendered them unable to prepare a tolerable
combination of drugs or even to measure out the simple medicine .
 Made in order to enrich apothecaries
 Benefit of patients.
50

51. By not dispensing himself physician loses all practice Gradually
becomes less experienced in his art
Has to depend completely on assistant
Manipulations of chemists
Errors committed by apothecary
Physician should be able to make out
Business of treatment for welfare of sick
51

52. The medicinal regulations do not provide only for the
apothecary
They are for interest of physician also
Gets four pence for every prescription
The physician becomes mechanical workman, his occupation
becomes labor
He writes prescription for whose effect he is not answerable and
he pockets his money.
52

53. INSTRUCTION TO THE PHYSICIAN
Physician should prepare his own medicine . I repeat, the physician should
be prohibited , under the severest penalties , from allowing any other
person to prepare the medicine required for his patient .
He should be required , under the severest penalties, to prepare them
himself , so that he may be able to vouch for the result .
E.g.: If Titian, Guido Reni , Michael Angelo , Raphael , Correggio or Mengs
have ordered their expressive and beautiful colors from shop . By the
purchased colors , not prepared by themselves , their painting,
Daubs and mere market goods
rather than inimitable masterpiece
53
If so , the medicines prepared from strangers will become an UNTRUSTWORTHY HEALTHY INSTRUMENTS

54. AVOID INJUDICIOUS MODE OF PREPARING
MULTIFARIOUS MIXTURES OF DRUGS
If he does this he will
be abused in every
apothecary’s shop and
will have 2 options
Being harassed to death
Abandoning it and again write compound
prescription
54
Physician should wish to avoid that Injudicious mode of prescribing
multifarious mixtures of medicine for
The weal of his
patient
Furtherance for his art by
prescribing simple medicine
He says adieu to all progress in our art ! Adieu to the successful
treatment of the sick!

55. 55