Romantic medicine

Albrecht Von Haller's (1708–77) 'irritability' hypothesis and its failure adequately to explain the phenomenon of life, as well as the waning capacity of the Western mentality to participate living nature that lay at the root of the Hippocratic system of humours (or noetic capacities), led to a split between those who clung to the ancient tradition, but in name only (becoming routinists or empiricists), and those, largely in the universities, who sought a (material-mechanical) scientific basis regarding life and medicine.

"[4][5] The groundwork for this intensive search to understand life was laid down by Francis Bacon, who sought to sweep clean the Augean stables of late medieval Scholasticism, with its increasingly obtuse and confused attempts to approach natura naturans (nature becoming or 'naturing') using the old Greek noetic capacity, already long lost to the Western mind and having gone underground into the arts, but also the nominalist straying into abstractions and refractions in their study of natura naturata via secondary phenomena as in Newton's study of color (cf.

Neither the Realists nor the Nominalists of late medieval scholasticism could handle the task before them, and Bacon sought, at the start of the Age of Science, to provide a method to approach nature's outer form rationally, but by means of a conscious use of man's higher faculty in the form of the ‘forethoughtful inquiry’ (‘lux siccum’), that is, an inquiry that brought a particular idea, itself evinced through the mind and the domain of true philosophy, namely, the "mind’s self-experience in the act of thinking" (Coleridge's Biographia Literaria), or epistemology.

[6] Bacon's work provided what Coleridge termed ‘method’ – the derivation of laws or ideas to guide the mind (mens) in its observation of nature, out of which emerges understanding (concepts) and principles (reason).

For Locke, identity of self exists in nothing other than participation in life (the etheric) by means of fluctuating particles of matter rendered meaningful and real by acts of the mind and consciousness.

Fichte, as so many of that time, was also inspired to challenge Kant's views on human freedom (constraints by material forces) and the limits to cognition, and sought this in Locke's emphasis on the mind and consciousness as the pivotal actor and creator of reality.

[9] This idea found a receptive soil in German philosophy and eclectic medicine, as represented by Christoph Hufeland (1762–1836), which had developed the concept of a life force or energy (Lebenskraft)[3] as well, but one that had remained largely speculative or metaphorical.

In 1781, Johan Friedrich Blumenbach, a natural philosopher and researcher published his thoughts regarding the Bildungstrieb, a dynamic power that was evolutive, progressive, and creative.

Blumenbach's work provided for the later important distinction (by Samuel Hahnemann) between a sustaining power (homeostasis) and a generative power (Erzeugungskraft), not just for procreation in all its myriad forms, but also creative acts of the mind, which Coleridge said involved the imagination (as opposed to fancy), both primary (unconscious figuration) involving perception, and secondary, the latter leading to apperceptive concepts as a result of conscious acts of the mind (ideas applied to perceptions).

All of this set up a climate for ideas and concepts that went beyond the mechanistic method of inertial science, one that allowed a role for creative actions of the mind (works of art) as well as reactions to sensations involving objects.

This widely acknowledged crisis was brought into stark relief in 1795 in a famous critical essay by a German physician and philosopher, Johann Benjamin Erhard [de] (1766–1827),[10] in the ‘shot’ that was heard around the medical world.

"Brunonian doctrine therefore fulfilled Erhard's call for a medical practice based on the "real" causes of disease rather than on divination of the meaning of symptoms.

He might have been thinking of Brown's discussion of contagious diseases wherein we see this interplay between the general action (‘affection’) of the sustentive power (excitability/excitement) and the more specific and different action of ‘contagions’ (e.g., LXXVI: “Contagious diseases are] not an exception...because...no general affection follows the application of contagion, if no undue excess or defect of excitement is the consequence..."), or his reference to a pro-creative as well as sustaining power as in CCCXXVI (“every living system lives in that which it procreates…that the system of nature remains and maintains an eternal vigour”).

This new cognitive capacity is what was needed for the physician or Leibarts to go beyond the inner symptomatics and outer semiotics of a case as a basis for assessment and evaluation used by the Old School, and to avoid the pitfalls of the merely empirical approach.

Heilkunst was not simply another projective art form such as painting, music, sculpture or poetry, but an educative art, in which the artist, the Heilkünstler (Hahnemann), seeks to bring forth out of the tangle of illness and disease at all levels, the true physiological selfhood, the fully liberated (at liberty to follow his higher purpose or aspiration) and conscious (a super-conscious mind higher than ordinary or waking consciousness) man or mensch.

However, this overarching, archetypal function would have to wait until the 20th century for its discovery and elucidation by Dr. Wilhelm Reich (Super-imposition or Überlagerung) and Rudolf Steiner's Metamorphosis, the exponents of the underlying Kraftwesen.

Hahnemann's essay of 1796 and subsequent writings, all part of an extended Organon der Heilkunst, laid down the basic foundation for a distinction between the sustentive (Lebenserhaltungskraft) [Aphorism 63, 205 fn., 262] and generative (Erzeugungskraft) [Aphorism 21-22] sides of the living principle, between physic, operating under the natural healing law of opposites (contraria contrarius), and medicine proper, operating under the natural curative law of similars (similia similibus), and between disease, a dynamica impingement on the generative power (degeneration), a derangement of the sustentive power, or disturbance of homeostasis.

However, this power depended on a susceptibility or receptivity (negative resonance) caused by weakening of the life force from various malignities (Brown's underlying diathesis).

Hahnemann also gave indications as to when the practitioner could tell that the disease had been cured by the similar medicine and healing was underway (the complete process termed "heilen" or remediation).

Dr. Brown provided the essential elements for a new, functional (actions of powers, forces and energies) approach to understanding life and health, which insights were elaborated by Drs.

Underneath it all lay the elements of the Brunonian system, with its dynamic interplay of impression and response, positive or negative in terms of health (physiology) and divergences therefrom (pathology).

Hahnemann undertook in the human realm what Goethe had explored in the plant realm with his morphology, that 'adventure of reason' Kant had stated was not possible, and observed first hand, through a living experience (Erlebnis) the impact of a natural Wesen (dynamic, living essential power) on a human Wesen (initially himself, and later other volunteers), producing a systematic image of the disturbance it produced in terms of pathology (alterations in feelings, functions and sensations) and semiology (outwardly perceptible signs), both over time in the one person, and then over time in a number of people giving an image (Bild) of the disturbance through its various expressions and manifestations, a Goethean approach.

Indeed, the entire series and progression of provings or living experiences of medicinal substances by overtly healthy people constitutes an example of what Goethe was promoting as true scientific research: In his approach to disease diagnoses and treatment, Hahnemann avoided what Goethe considered the ‘greatest failure’ (Unheil) and fault of material science, namely the separation of experimenter from nature, producing abstract hypotheses (notions) and artificial (künstlich) approaches/treatments based on an accumulation of disparate facts, rather than seeing nature as a complex web of associations, and understanding, as did Hahnemann and Goethe that "scientific knowledge emerges out of relationships and historical contexts.

We also find this polarity, as well as Goethe's distinction between the spectrum of dark and of light, in the distinction Hahnemann made between primary or tonic disease (based on a super-sensible knowing of psychic states involving alterations in circumstances, occurrents and behaviors via the Goethean Gemüt or super-sensible cognitive organ) and secondary or pathic disease (based on the sensible manifestation of life energy at the somatic level in terms of feelings, functions and sensations, as well as signs).

The objections that Goethe leveled against the taxonomy of Linnaeus in botany can be found in the medical sphere in Hahnemann's criticism of the blindly empirical or abstractly intellectual nosology of his time that took a few outer elements, arbitrarily conflated them, then confounded similarity of appearance here with identity of cause and origin.

This foundation is one based on natural science, but also on the arte (Pascal's spirit of finesse) of the practitioner, which is something objective and reproducible though based on a different logic and involving more fugitive causes (allopathic ‘medicine’ accepting only the first and then only natural inertial science, not a true physiology of functions, both physical and etheric) Up until the middle of the 19th century, following the pioneering work of Brown, Hahnemann, Röschlaub, Lutze and Schönlein, to mention only the main figures, the scientific approach to the question of life, particularly as reflected in the development of Healthcare, seemed conducive to the development of a method that was based on a cognitive capacity going beyond mere mentation (Sinn or mens) and a true physiology involving living functions rather than simply mechanics and chemistry.

However, it seemed that the Zeitgeist (Spirit of the Times) could not yet accept such an approach, most minds being still fully ensconced in the intellectual phase (Coleridge's "epoch of the intellect and the senses") of human consciousness.

It was only the extraordinary mind of genius that was able at this stage to meet the challenge of a true science of life and mind, what Colerdige termed the “Dynamic System of Thought.” As a result, the analytical approach favored by the French, schooled in the Cartesian system of mind-body duality, and with their significant advances in surgery (albeit based on access to and development of original Greek medical writings and more modern Greek surgical practice), came to dominate Western science.

[3] In Germany, the work of Rudolf Virchow, while drawing from the advances made by Romantic science, effectively reduced and simplified them more in line with what the intellect was able to grasp.

As such, chemistry and physics could become the basis for medicine, all the more in that medicine effectively had been reduced to surgery and chemistry, the latter due to Pasteur's ‘germ theory’ of disease (really an unproven hypothesis and where proven according to strict requirements of Koch's postulates, still not fully explanatory in terms of the concepts and reality of ‘susceptibility’ and ‘immunity’, which contemporaries of Pasteur, such as Béchamp and Claude Bernard, sought to address).