Romantic medicine
Romantic medicine is part of the broader movement known as Romanticism, most predominant in the period 1800–1840, and involved both the cultural and natural sciences, not to mention efforts to better understand man within a spiritual context. Romanticism in medicine was an integral part of Romanticism in science.
The impetus for Romantic ideas in medicine came from the Great Britain, and more specifically Scotland - John Hunter - and the idea of life as a principle not reducible to material constructs, and John Brown, founder of the Brunonian system of medicine. The nexus for Romantic Medicine was Germany, largely nurtured and guided by German natural scientific inquiries regarding the vital aspects of nature, such as that of Johann Friedrich Blumenbach and his influential ideas regarding a life principle, a formative drive as well as a philosophical tradition that emphasized the dynamic aspects of man and nature, and their essential relationship as part of a unity - German idealism and Naturphilosophie - all guided by Immanuel Kant's challenge calling for critical inquiry as the basis for science.
The essence of romantic medicine was to overcome the deep crisis that Western medicine found itself in during the latter half of the 1700s by means of a science of life that went beyond the simple application of the method of the inertial sciences that had worked so well for inert nature, but was found wanting when applied to vital nature, but also a science of life that went beyond the idea of medicine as a subjective art largely to be left to individual practice. The Zeitgeist of Romantic medicine sought to unite the uneasy partnership of material natural science and subjective clinical practice to create a true scientific foundation for Western medicine
The question of life
The issue of life – what is life? – or the scientific inquiry and quest regarding vital nature was one that increasingly drew the attention of philosophers and scientists in the 1700s, following the great advances concerning the laws and principles of inert nature - the Copernican, Galilean and Newtonian revolutions in celestial and earthly mechanics - astronomy and physics. With great confidence and optimism, philosophy and science turned to the mystery of life, or rather, that of health - how to restore and maintain it. Those most immediately drawn to this field were those who had some concern with health issues, physicians in particular. Thus, a natural alliance formed between natural philosophy and science on the one hand and medicine on the other. What they had in common was to advance the discipline of the study of living functions or physiology.Irritability
Because of the influence of the inertial sciences and the success of the method used to gain knowledge of the laws and principles applying to inert nature, the initial approach was to apply the same method to vital nature. What emerged from this was the extensive study in the first part of the 1700s of ‘irritability’, this being based on the central nervous system and involving physical forces such as electricity and magnetism. However, the mechanico-material explanation was not fruitful when it came to actually dealing with life in the case of healthcare practitioners. Albrecht Von Haller's '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, led to a split between those who clung to the ancient tradition, but in name only, and those, largely in the universities, who sought a scientific basis regarding life and medicine. This split led to a widely acknowledged crisis in Western ‘medicine’ in the latter half of the 1700s.Romantic medicine and dynamics
The attempt on the part of philosophers and scientists to come to grips with the question of life led to an emphasis away from mechanics or statics, to dynamics. Life was action, living movement, a manifestation of an underlying polarity in nature and the universe. Instead of seeing nature from a ‘one-eyed, color blind’ spectator perspective, what was needed was a perspective that was binocular and participative. Inertial science had advanced in man's understanding of inert nature, her outer form or shell, what Francis Bacon termed natura naturata. However, it was not capable of going beyond this to a more dynamic discernment or apperception of the living inner content of nature, the domain of life – life in general, not just life biological as Samuel Taylor Coleridge, at the philosophic core of the scientific effort to penetrate to natura naturans, put it, asking further “what is not life?” based on the understanding of life as a dynamic polarity between powers, forces and energies. As one observer wrote "Die eigentliche Lebenslehre der Romantik aber war: Polarität." But as he promptly adds: "Sie klingt uns überall entgegen, nicht nur in der Naturphilosophie."The foundations
Bacon's ''Novum Organum''
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 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. 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’, 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", or epistemology. The Baconian approach was further developed by C.S. Peirce who made a distinction between induction and abduction: the latter being the method of discovering hypotheses, the former that of testing them.Coleridge and the role of philosophy
Bacon's work provided what Coleridge termed ‘method’ – the derivation of laws or ideas to guide the mind in its observation of nature, out of which emerges understanding and principles. It is also the task of philosophy, as Coleridge emphasized, to "settle the nomenclature," as the key to science is terminology where one term is not synonymous with something else, as is the case in demotic language, but instead the term discloses its meaning and increases understanding and knowledge. This was further developed by Heidegger and phenomenology.Greek philosophy later emerged as philology to interpret philosophical works. It is this penetration of nature using both the eductive arts and sciences to achieve a rational, conscious understanding of nature, both outer form and inner essence that those who became part of the Romantic movement in England and Germany in particular, were seeking. It is not surprising that Romanticism, a scientific endeavor and quest, involved the cultural sciences or humanities, as well as the natural sciences.
Search for method for vital nature
Romanticism rejected the application of the method that had worked so well for inert nature to the realm of living nature, or life biological. While living organisms contained a degree of a mineral, material nature amenable to being approached via the laws of material physics and chemistry, life itself could not thereby be satisfactorily explained. On the one side, the material scientists sought a solution in reducing the non-material or metaphysical to ‘just’ a manifestation of the material, essentially thereby ignoring that this did not at all account for life. On the other side, a part of the ‘Old School’, drawing from the Hippocratic humoral theory, sought to emphasize the non-physical or vital aspect of nature, which somehow existed above and outside of nature and directed its activities. The Romantic scientists and philosophers rejected both reductionist mechano-materialism and conflationist mystical-idealism.Locke, Fichte and German Idealism
Romanticism also involved a fundamental understanding of functional polarities as the basis for and essence of life as Idea, Law and Principle. One of these polarities in cultural history involved the seminal influence of the English genius and the germinal or gestational genius of German-language culture. Coleridge mentions this in his Essays on Method, and the theme is explored in D.E. Faulkner-Jones' The English Spirit.The seminal ideas came from Francis Bacon regarding scientific method and from John Locke regarding the ideas of self-consciousness and mind. Locke set up a relationship between mind and outer world wherein the mind is set in motion by objects producing sensations but also has an internal activity of its own that acts on the sensations to create perception and conceptions. For Locke, the activity of mind is paramount, as for Bacon, and it is only through the activity of mind that the outer world can be ‘realized’ as causative and as actual. Identity for Locke lay in the capacity for the ‘I’ to unite disparate ‘deeds’ or actions of nature, into a meaningful unity. For Locke, identity of self exists in nothing other than participation in life by means of fluctuating particles of matter rendered meaningful and real by acts of the mind and consciousness. The Romantics, as Locke, refused to accept the view that life is a product of “the chance whirlings of unproductive particles”.
Locke's ideas were taken up by Johann Fichte in Germany and developed into a philosophy of nature and natural science based on mind and consciousness, which he termed Wissenschaftslehre. Fichte, as so many of that time, was also inspired to challenge Kant's views on human freedom 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. For Fichte, selfhood is an act not a thing or a substance, and being or identity consists in the acts of mind and self-consciousness, such that being and identity are co-operant. Fichte's work heavily influenced German philosophy and science, leading to a general system of thought known as German Idealism, though this idealism would either end paradoxically in accepting the methods of material science for natural science, or in academic and lifeless dialectics that negate life rather than support it and used for political ends.
The Idea of the living principle
Prior to Fichte's writings, the idea of life as a power and principle independent of and not reducible to matter or substance had been put forward in England and Scotland in the mid-1700s, by the philosopher, Thomas Reid and John Hunter, a highly influential anatomist and surgeon as well as an observational scientist in the true Baconian tradition. Hunter rested the idea of the life principle on solid observation of nature. For him, anatomy and structure, matter and form were simply outer expressions of a vital dynamics.This idea found a receptive soil in German philosophy and eclectic medicine, as represented by Christoph Hufeland, which had developed the concept of a life force or energy 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 between a sustaining power and a generative power, not just for procreation in all its myriad forms, but also creative acts of the mind, which Coleridge said involved the imagination, both primary involving perception, and secondary, the latter leading to apperceptive concepts as a result of conscious acts of the mind.
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 as well as reactions to sensations involving objects. Equally, the climate was conducive to considering a dynamic between subject and object, one in which the mind is both receptive and pro-active, and also one in which the mind is critical to determining the meaning and reality of any given stimulation from the world outside.
Crisis in medicine
By the end of the 1700s, medicine, not only in Germany, but throughout Europe, was in a deep crisis. This widely acknowledged crisis was brought into stark relief in 1795 in a famous critical essay by a German physician and philosopher, , in the ‘shot’ that was heard around the medical world. "Erhard's attack focused on what he called the "uncertainty" of medical knowledge and its failure to measure up to the criteria of a philosophical Wissenschaft. He located the central problem in doctors' lack of a clear idea either of illness in general or of particular diseases."The ‘elements’ of a new system
Johann B. Erhard’s essay, coupled with the earlier introduction of the Brunonian system into German medical circles, almost immediately triggered a remarkable surge of writings by a graduating medical student, Andreas Röschlaub. Röschlaub wrote his doctoral dissertation on the work of a rather obscure and then little known Scottish physician, John Brown, Elementa Medicinae. Almost at the same time, in 1796, a German physician., Samuel Friedrich Hahnemann, who had been highly critical of the medical practices of his day, published a remarkable essay on the treatment of disease that became the foundation for the homeopathic approach to medicine, as part of a more comprehensive scientific approach for therapeutics he termed Heilkunde, and then later Heilkunst.While Brown’s work had been available in Germany for almost 15 years, since its publication in 1780, it had been mostly ignored or rejected, as in England itself, because the method outlined by Brown was seen as a mechanical approach, which hardly endeared it to the German philosophical tradition and mindset seeking a more dynamic, vital approach. However, Röschlaub grasped, where no one else had been able, even Schelling with his Naturphilosophie, that Brown had provided the very elements of an approach to health and sickness that were dynamic in nature and by means of a synthetic concept – ‘excitation’ – that was the practical application of a Lockean and Fichtean approach to the problem of cognition due to subject/object or observer/observed, to the problem of the relationship between qualitative and quantitative, and also to the very problem of life itself. "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.... where Erhard had offered only criticism, Brunonianism offered an alternative. Brunonianism now stood ready to complete what Erhard had begun, and to inaugurate a revolution in German medicine."
Röschlaub and the general theory of disturbance and disorder
Through Röschlaub’s writings, mainly between 1795 and 1806, Brown’s conception of life was brought out: as a potential in us that is brought into action and reality as a result of the workings of the actual on us, and of the living principle as a receptive potentiality and pro-active, that is, as a dynamic power.Brown's use in the original Latin of ‘incitability’ contained the germ of a distinction between the sustentive and generative powers, as Coleridge astutely noted: “Brown has not proved that the Incitability itself cannot be altered – not merely thro’ incitement – but unmittlebar – Says the Jena recensent, Feb. 1799, No. 48. He might have been thinking of Brown's discussion of contagious diseases wherein we see this interplay between the general action of the sustentive power and the more specific and different action of ‘contagions’, or his reference to a pro-creative as well as sustaining power as in CCCXXVI.
When added to his distinction between beneficial and harmful ‘excitants’, Brown provided the basis for understanding how the level of excitability/incitability can be shifted upwards. Finally, Brown introduced the powerful idea that pathology was simply physiology extended beyond a certain range of sustainable variability or pulsation.
Röschlaub worked initially with Fichtean insights and then Schelling and his Naturphilosophie, establishing a dynamic philosophical basis in natural science for medicine. However, he realized that medicine could not be restricted to natural science, even a dynamic science grounded in physiology, but had an artistic/aesthetic side. In this regard, he made a distinction first between Wissenschaftslehre and Heilkunde, in which latter work he established the first teaching clinic, in concert with Dr. Markus, in Bamberg, Germany.
Röschlaub made a further distinction between biophysical and biomedical. The second took him into the very dimension of life itself, the etheric, that is, beyond the physical, a dimension that required an entirely different organ of knowledge from the intellect or Sinn that was the foundation of both WissenschaftsHeillehre and Heilkunde, as the construction of a protocol entails arte. Unbeknownst to him, one of his countrymen had been working on the development and understanding of this new cognitive capacity, called the Gemüt. As a result, Goethe was able to ‘see’ into the dynamic realm of nature and comprehend the very movement behind the forms, and the very functions that determined a given form, including the dynamic archetype out of which all forms of a given Idea emanated. It was Goethe who founded the science of morphology. Although Goethe termed this study Metamorphosenlehre, it was, more accurately stated, a pleomorphic process.
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. It was the task of the physician to draw out, and allow ‘to come forth’, the natural state of health of the individual so as to enable him to undertake his individualized higher purpose in life.
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, seeks to bring forth out of the tangle of illness and disease at all levels, the true physiological selfhood, the fully liberated and conscious man or mensch.
Röschlaub also realized that Brown had only provided the basic ‘elements’ of a method for the science of life, and that what was still needed was the overarching or archetypal function from which all other functions were derivable and given meaning and direction, and which would also then provide the very goal and purpose of medicine and health, the ‘positive’ as well as the ‘negative’ sides of healthcare. However, this overarching, archetypal function would have to wait until the 20th century for its discovery and elucidation by Dr. Wilhelm Reich and Rudolf Steiner's Metamorphosis, the exponents of the underlying Kraftwesen.
Hahnemann and the special theory of disease
At the same time that Röschlaub embarked on his quest for a true science of life and health, a compatriot, Dr. Samuel Hahnemann, who had quit his medical practice earlier in protest against the lack of science and efficacy of the Old School and the empty ‘metaschematisms’ of the academic ‘doctors’, had also begun a similar quest for a true system of medicine. 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 and generative sides of the living principle, between physic, operating under the natural healing law of opposites, and medicine proper, operating under the natural curative law of similars, and between disease, a dynamica impingement on the generative power, a derangement of the sustentive power, or disturbance of homeostasis.Hahnemann further established various principles for the application of the law of similars, including a crucial distinction between diseases of a fixed nature, and those of a variable nature, the basis for the later discovery by some of his followers of a dual remedy prescribing, each remedy addressing one ‘side’ of disease, the tonic and pathic sides. Hahnemann set out a comprehensive approach to the diagnosis and treatment of disease, including a nosology.
Details of Heilkunst
Hahnemann argued, logically, that the material effects of disease could not be their own cause. Disease was instead a dynamic affection of the generative power occasioned by a spirit-like morbid entity that had the power to impinge upon the generative power of a human , acting as malignant ‘excitants’ in the Brunonian sense. However, this power depended on a susceptibility or receptivity caused by weakening of the life force from various malignities.The disease process consists of a dual action: the initial action of the disease agent, which impinges upon the generative power, which is generally imperceptible, and the counter or after-action of the sustentive power, which produces the various sufferings the patient complains about.
While the fixed nature of tonic diseases could be identified by discerning the underlying causal state of mind, along with a curative medicine based on fixed principles, the variable or pathic diseases could only be identified, along with their curative medicine, through the symptoms produced by the disease in the patient. However, such an approach was problematic as a person could have more than one disease at a time. This then required a principle to organize the symptoms into an identifiable complex correspondent to a given disease state. Just as each tonic disease has a unique state of mind disturbance, so does each pathic disease contain a unique disturbance of the thermal organization in man. This approach to pathic diseases Hahnemann termed homeopathy. This approach expanded empiricism from its limitation within the bounds of Erfahrung to Erlebnis provings.
The tonic diseases were to be found in various jurisdictions: homotoxic, homogenic, pathogenic, iatrogenic and ideogenic. The pathic diseases are found in reversible layers.
Because the pathic diseases generally arise out of the more primary constant diseases, such as the chronic diseases that arise out of the chronic miasms, Hahnemann also laid down the principle that the tonic diseases should be treated first, and second any remaining pathic diseases.
While the curative medicines for the tonic diseases could be largely determined by the principle linking disease and medicinal agent for the relevant jurisdiction, pathic disease treatment required a corresponding image of derangement of the Lebenskraft or Leib so that this could be matched to the image presented by the patient. The problem lay in that a patient could present with more than one disease, each with a particular grouping of symptoms, but how could the practitioner link which symptoms manifest disorder and of those ascribable to disease, and to which disease of the several possible at a given time in the patient, and finally, how could one trace any symptoms so identified to their origins? Here Hahnemann's genius adduced a living experience of the essence of a natural substance by way of a human prover, and in doing so, also provided the very practical scientific basis for removing the barrier set up by Kantian intellect between observer and observed, by invoking the cognitive capacity of Goethe's Gemüt. Goethe himself, later in his life, recognized that Hahnemann had found a way to apply to and through human nature what he was doing with Mother Nature.
In the light of difficulties treating more complex cases, Hahnemann undertook further research and developed a theory of chronic miasms, which are fixed nature diseases of the pathogenic type which give rise to all the chronic diseases, which are pathic in nature. 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. Constantine Hering, often called the Father of Homeopathy in the US, further developed these guidelines, which are often referred to as "Hering's Law or Principles" :
- from less vital to more vital organs
- in the case of pain, from above down
- in the same direction as the natural disease process.
While medicine had historically recognized, even into Hahnemann's time, the law of similars, it was also wary of its use because of risk of harm with the improper dose, and had largely abandoned it in favor of the other approach set out by Hippocrates involving the law of opposites, that is, acting to support the physis or sustentive power. Dr. Hahnemann discovered a way to attenuate the dose so that it could be rendered harmless but remain therapeutically active, what is often referred to as ‘dynamization’. Later he also discovered a way in which to sublimate, or the increase in dynamic power, of medicines.
Because of the use of these two laws, we have two great realms of therapeutics: medicine proper, which is the application of the law of similars, and physic-al, which is the application of the law of opposites. This gives us the mutually interactive and supportive jusrisdictions of the true Heilkundiger and Heilkünstler – physician and medician, involving respectively a "physic" approach based on the law of opposites and a "medic" approach based on the law of similars.
Compeers, not rivals
Dr. Brown provided the essential elements for a new, functional approach to understanding life and health, which insights were elaborated by Drs. Röschlaub and Hahnemann. Through their work, a fundamental set of dynamic polarities emerged with which to understand the essential polaric nature of life itself:- sustentive and generative sides of the living power
- disturbances that lead first to disorders which can render one susceptible to contracting disease
- physical and medical interventions – physician and medician
- regimen and remedial agents for physic
- tonic and pathic diseases/chronic miasms and chronic diseases
- Erfahrung/Erlebnis
- Healing and curing
- Disease process: direct action of disease wesen and counteraction of human wesen
- Remedial process: curative action and healing reaction
Goethe and Hahnemann
Goethe's approach to Mother Nature provided the theoretical foundation for and found a practical application in human nature in the works of Samuel Hahnemann. Goethe was aware of Hahnemann and his new approach to disease, and was treated using Hahnemann's system of medicine, Heilkunst. On one occasion Goethe wrote:In his famous play, Faust, Goethe has the lead character, Mephistopheles, assert the homeopathic principle of similars: “To like things like, whatever one may ail; there’s certain help.”
Goethe wrote several letters in 1820 mentioning and supporting ‘Hahnemann’s method’, ‘Hahnemann’s terminology’, and declaring his ‘confession of faith of a Hahnemannian disciple’, and indicating that he had read his works and looked forward to reflecting on ‘the wonder physician’.
Goethe was also aware of and followed Hahnemann's dietary rules. In 1826, he wrote to the Grand Duke Karl August that his diet was ‘almost Hahnemannian in its strictness’.
Hahnemann grasped and worked directly with Goethe's key contribution to Romantic epistemology, the Gemüt, or emotional mind and resonance organ, as well as its polarity to the Geist or spiritual mind, the directive organ: Geistes oder Gemüths Zustandes des Kranken; Geistes- oder Gemüths-Krankheiten; gemüthlicher und geistiger Charakter; Gemüthsart; Gemüths- und Denkungs- Art; Geistes- und Gemüths-Organe, Gemüths-Verstimmung.
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 the impact of a natural Wesen on a human Wesen, producing a systematic image of the disturbance it produced in terms of pathology and semiology, both over time in the one person, and then over time in a number of people giving an image 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’ and fault of material science, namely the separation of experimenter from nature, producing abstract hypotheses and artificial 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."
Hahemann also sought to understand disease in its historical progression, as in the case of his Wesensgeschichte of Psora, the archetype of inherited chronic disease, as well as its pleomorphic unfolding via numerous levels of secondary diseases, which then required a sequential approach to treatment. Goethe's morphological insights provide the theoretical basis for Hahnemann's empirical discoveries and living experiments. In these provings, Hahnemann sought to contemplate the movement, the flow and transformation of a disease state, not just an abstract image. Hahnemann also had a Goethean understanding of the sequential nature or unfolding of a disease phenomenon.
In Hahnemann's distinction between the two sides of the Lebenskraft – the sustentive or Erhaltungskraft and the generative or Erzeugungskraft, we find the polar logic identified in Goethe's Chromatology – ‘the sufferings and deeds of light’ via a turbid medium, in the struggle between light energy and the now identified 'dark' energy. 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 and secondary or pathic disease. For Goethe the turbid medium is the atmosphere, for Hahnemann it is the living organism. Goethe's interplay of Licht and Finsternis can also be seen in Hahnemann's polarity between Geist and Wesen.
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. Hahnemann's criticism also was based on an historical study of the morphology of this medical state of mind or Kurwesen, much as Goethe considered the study of history of a phenomenon as a form of knowledge.
Equally, Hahnemann was critical of a static approach to disease nosology, which was constantly shape-shifting as the interaction between Krankheitwesen and Menschenwesen expressed different aspects of the same underlying disease. Hahnemann also understood that there was an element of fixity and variability to disease between primary and secondary diseases, just as Goethe accepted a degree of form and structure at the physical level whilst pointing to the underlying dynamics leading to new forms over time.
Lutze and Schönlein
The works of Hahnemann and Röschlaub were continued and furthered by Drs. Arthur Lutze and Johan Schönlein respectively. Lutze took the foundations of Hahnemann's approach to disease and placed it on a solid romantic footing in consciously and consistently applying dual remedy prescribing.Where Hahnemann had hesitated and eventually withdrew his public support in the 5th edition of his Organon der Heilkunst for dual remedy prescribing, having been unable yet to establish a principle upon which to ground it rationally, Lutze later re-issued the 5th edition with the withdrawn dual remedy section and clinically practiced based on such an approach. His contribution is recognized in the monument to both Hahnemann and Lutze in Köthen, Germany.
Röschlaub's innovative work in establishing a teaching clinic based on the Brunonian system, in conjunction with Dr. Albert Marcus, was developed further by J. L. Schönlein, who is recognized explicitly even in allopathic historiography for having established the scientific foundation for the modern teaching and practice clinic. This foundation is one based on natural science, but also on the arte of the practitioner, which is something objective and reproducible though based on a different logic and involving more fugitive causes
The schism
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 and a true physiology involving living functions rather than simply mechanics and chemistry. However, it seemed that the Zeitgeist could not yet accept such an approach, most minds being still fully ensconced in the intellectual phase 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, came to dominate Western science. 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. The achievements of Romantic Science and Medicine could not be denied, but neither could they be accepted; instead, the followers of the Romantic tradition were either denigrated as considered misguided, occult, and ultimately dreamers rather than serious scientists. The following historiographic assessment is the one that has generally prevailed until recently.
Virchow's cellular theory provided the supposed basis for life, without explaining it, and superseded the ancient, and by now denigrated humoral theory. 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.
The problem of life was to be ‘solved’ by Virchow's cellular hypothesis as the basis of life, which conveniently posited life within medicine without having to explain it.
Thus, as N. Tsouyopoulos points out, Western ‘medicine’ was effectively reduced to surgery and emergency drug treatments, possessing no basis to deal with chronic, complex disorders or diseases having rejected the dynamic approaches developed by the Brunonian orientation, as developed in general terms by Röschlaub/Schönlein and Saumarez, and in particular regarding disease by Hahnemann/Lutze. As one reviewer of Tsouyopoulos' major work on romantic medicine summarized: "Romantic medicine was to fall into disfavour as the positivist approach from France gained ground, to the point where Karl August Wunderlich in 1859 dismissed it as mere hollow theory divorced from all empiricism, a myth that survived for nearly a century."
To the extent that human physiology contains a physical/chemical aspect, a mechanic-material approach will produce effective results, witness the ‘miracles’ of Western emergency medicine, but in the realm of internal ‘medicine’, there are no cures, only the suppression of symptoms or long-term disease and disorder management using chemical means, mostly synthetic, the intellect seeing no difference between a natural ‘chemical’ and a synthesized one. As one writer summarizes: "Alongside of English and French medicine of that time, whose significance was never under-appreciated, German Romantic Medicine comes off in no way as inferior or reactionary. Its contribution to overcoming the foundational crisis in medical history and for founding a scientific clinic is substantial and decisive for the whole of later developments...today, in our searching for new models and alternatives in medicine, Romantic Medicine lies closer to home than the so-called natural
scientific medicine of the later 1800s and early 1900s."