The history of homeopathy in the Russian Empire – Alexander Kotok, M.D.

The
history of homeopathy in the Russian Empire

until World War I, as compared with other European countries and the
USA: similarities and discrepancies

by Alexander Kotok, M.D.

On-line version of the Ph.D. thesis improved and enlarged

due to a special grant of the Pierre Schmidt foundation.

   

1.5.5 The 9^th
Meeting of the Pirogov Society

Despite the deep contradictions, which were later
transformed into keen hostility, between the regular profession and the
homeopaths, no serious attempt at working out a negative policy toward
homeopathy was undertaken by regulars till 1904, except for the proposal
submitted by Dr. L. Ebermann at the 2^nd Meeting of Russian
physicians in 1887. While speaking of different kinds of wizardry, L.
Ebermann proposed that the Board of the Meeting turn to all medical
faculties at Russian universities in order to get their opinion on
homeopathy; would this opinion be negative, one should solicit from the
government to prohibit homeopathy entirely and to close all homeopathic
pharmacies and dispensaries. Nevertheless, those present did not support
this opinion. It was pointed out that all kinds of wizardry, including
homeopathy, will soon disappear in the light of the progress made by
scientific medicine, and that there was therefore no need for
prohibitory initiatives against them. Generally speaking, all the
speakers stressed that doctors have to be closer to the common people
and explain the danger of wizardry. ¹⁴¹ The 1890s clearly
demonstrated that the Russian regular profession was incapable of
fulfilling the role it had adjusted to itself. Homeopathy had
strengthened its positions during that period, whilst the cholera riots
of 1892 showed that physicians were too far from the common people, as
were the government officials.

The cholera riots challenged the physicians’
self-image of dedicated, appreciated public servants. This image,
though based on sincere aspirations, had an element of self-delusion –
the assumption that the common folk fully appreciated the medical
missionaries who wished to serve them. The faulty perception is
evident in an incident of 1885, when an eulogy to a community
physician used a few lines from Nekrasov as an epigraph: ‘Rest well,
wise kind and true – Rest well! And sincere thanks to you from the
Russian people’. The cholera violence exposed the fallacy. Distrusted,
slandered, and hated, physicians were regarded as the allies of the
upper classes and the state. ¹⁴²

Yet no fair self-account of its role in the society
and the efficiency of its treatment was made by the regular profession.
It continued to seek, find and marginalize enemies such as
“conservative” nobility, the “reactionary”
government, “unprofessional” zemstvo officials,
“betrayers”-homeopaths and their “light-minded”
high-ranking supporters, etc.

Homeopaths could not fool themselves by fancying that
they were expelled from allopathic societies, or were prohibited to be
consulted, or that they were marginalized and blackmailed in the
allopathic periodicals, etc., because of one individual’s influential
malicious will. Although several societies (like the St. Petersburg
Medico-Surgical Society at its meeting on January 14, 1899) ¹⁴³ condemned
homeopathy and forwarded their opinions to the Medical Council, it
nevertheless might have been considered as the opinion of members of one
local organization only. The Pirogov Society, however, could doubtless
be viewed as the mouthpiece of the Russian regular profession.

Nicholas
Pirogov

(1810-1881)

Before describing the events that occurred at the 9^th
Meeting of the Pirogov Society which was held in January 5-11, 1904, I
would like to offer several comments about this organization. I agree
with Nancy Frieden that the Society of Russian physicians in Memory of
N. I. Pirogov or merely the Pirogov Society, during the years 1883-1917,
was, together with the weekly “Vrach”, the most influential
medical institution, which completed the process of consolidation of
Russian medical profession. ¹⁴⁴ The decision to establish a
new medical society was accepted in 1881, when the jubilee of the
prominent Russian surgeon Nicholas Pirogov
(1810-1881) celebrating 50 years of scientific activity, was held in
Moscow, several months before he passed away. From the very beginning,
it was planned to be a scientific society, dealing with the solution of
scientific, medical and sanitary problems, and was open to every Russian
physician. This was the first all-Russian society of physicians. ¹⁴⁴
Among the founders of the Society were such famous Russian
physicians like Segey Botkin
(1832-1892) [See :

The Great Russian Brockhaus and Efron
Encyclopedia], Viachaslav
Manassein (see above), Alexey Dobroslavin
(1842-1889) [See : The Great Russian Brockhaus and Efron
Encyclopedia], M. Petrunkevich
[See : The Great Russian Brockhaus and Efron Encyclopedia], I. Molleson, S. Sychugov, E. Osipov and A.
Pogozhev. The First Congress of the Society (1885) elected Prof. Nicholas Sklifosovsky (1836-1904)
[See : The Great Russian Brockhaus and Efron Encyclopedia] as its President. No Russian medical society
could be compared with the Pirogov Society neither by the number of its
members, nor by notables present at meetings, nor by its influence. From
the very beginning the Society demonstrated its politically oriented
character, by presenting to the government social demands of different
kinds, which usually remained simply unanswered. In fact, this cold
attitude toward physicians’ proposals derived not from any special
maliciousness of the Tsar government, but from the tangled legislative
position of the medical profession in general.

In contrast to the medical police approach, most
proposals for health reform in tsarist Russia began from the
assumption that matters of health ought to be the exclusive
prerogative of physicians, to whose expert judgment lay persons –
including, of course, civil administration – ought to defer. For their
part, officials of the enormously powerful Ministry of Interior
refused to defer to ‘expert medical opinion’ even within the
ministry and blocked any attempt to establish a separate ministry of
health beyond their control. In this context, even the most
conservative reformers found their proposals blocked. ¹⁴⁶

One cannot understand the essence of the
anti-homeopathic decisions of the Meeting if one does not take into
consideration the very special social and political conditions in which
this meeting was held. At the 5^th Meeting of the Pirogov
Society in 1893, the Board of the Meeting accepted the lecture of Dr. A.
Lozinsky in which homeopathy and its spread within Russian society was
bitterly criticized and the regular profession was called “not to
be silent concerning homeopathy”. Nevertheless, at the common
conference of the Board and the heads of the sections which took part
before the Meeting, the lecture was rejected as “non suitable to
the aims of the Meeting”. ¹⁴⁷ Yet nine years later the
discussion on homeopathy was recognized to be suitable. The political
situation of the Russian Empire by 1904, was extremely tense and
difficult. The Tsarist government was openly accused of being incapable
to manage both the political and the economical affairs of the country.
Different public organizations expressed their lack of faith in the
contemporary political system and demanded its reorganization. We should
also note that the 9th Meeting of the Pirogov Society was preceded by
the Congress of Activists in the Field of Technological Education (2-5
January, 1904) which advanced a number of radical demands to the Tsarist
government, like freedom of speech, press and assembly, a constituent
assembly, an eight-hour working day and the abandonment of religious and
ethnic discrimination. The police closed the Congress and arrested some
of its leaders. The Congress and the Meeting of the Pirogov Society
coincided with the “Constituent Congress” of the Liberation
Movement.

Many of the 2,136 physicians who took part in the
Ninth Pirogov Congress may have had only partial knowledge of all that
was happening there and the content of the resolutions. At the
numerous controversial sessions, chaos reigned. Auditoriums with
seating space for 300 or 400 bulged with over 1,000 people and there
were milling crowds outside trying to gain entry. Many witnesses
remarked on the disorder and their inability to hear the speakers. A
large crowd of observers – mostly medical students, paramedical
personnel, and local citizens – added to the tumult with ‘hissing,
whistling, stamping and applause’ […]. Despite the disorderly
meetings, a consensus emerged that demanded basic constitutional
rights and echoed the goals of the Union of Liberation. The
resolutions of Pirogovtsy [i.e., members of the Pirogov Society], were
a combination of their traditional professional interests and of the
influence of the current political crisis, and became a platform for a
new kind of endeavor – political action. ¹⁴⁸

Another contemporary account taken from
“Izvestiia Imperatorskoi Voenno-sinskoi Akademii” (The
Imperial Medical-Surgical Academy Reports) describing the situation at
the Meeting, is recorded by Dr. Evgraph Diukov in his book:

The decisions of the Meeting were accepted by
majority vote, this is to say, by the representatives of the largest
section – public health, that part of the Meeting which represented
more than others pure medical science. The other scientific sections,
for example, anatomy, physiology, therapy, etc., because of the
limited number of their representatives, had little significance.
[…]. Moreover, it turned out that in the meetings of public health,
persons who had nothing to do with the meeting took an active part.
This crowd was so numerous that it took the places intended for the
participants of the Meeting. It was made up mainly of representatives
of one very passionate nationality [the Jews], ¹⁴⁹ which
influenced not only the speakers and the decisions accepted, it also
influenced the election of the chairman, […] by its signs of
approval or disapproval. Thus, it is no wonder […] that many
decisions of the section exceeded the professional parameters of the
Meeting, being distinguished by their political character […]. ¹⁵⁰

With this background I can present the protocol of
discussion concerning homeopathy which took place at the 9^th
Meeting of the Pirogov Society. The discussion on the topic of
“homeopathic doctors” was initiated by Dr. A. Tsenovsky of
Odessa, whose name had never appeared before the Meeting in any
connection with the subject of homeopathy. ¹⁵¹ After having
dedicated some critical words to wizards and wizardry, stressing that it
is senseless to struggle with this phenomenon, he began to discuss
homeopathy, remarking that he would not have spoken of this subject if
amongst those practicing it there were not some of “our
friends”, i.e., physicians.

When homeopathy was only a subject of interest to
retired generals and compassionate ladies, it might have been seen as
an innocent amusement. People who had nothing to do were playing
medicine like children play ‘horses‘. Yet since the doctors have
become involved [into this affair], it has become an evil which should
be resisted and against which one should fight. Let us see how the
problem is to be viewed: homeopaths are the same doctors like we are.
They also graduated from the universities, they also studied medicine.
Nevertheless, they are representatives of another medical schooling.
They are homeopaths, whilst we are allopaths. The vulgar cannot
understand that there is only one single medicine. A man who has
graduated from the medical faculty, may later become an engineer, a
shoemaker or a homeopath. The university does not teach any of these
occupations. Add to this the constant [meaningful] winking regarding
competition and we are perceived as victimizing homeopaths like the
Romans did to the first Christians – we get indeed a vicious circle.
Only a patient more cultured and well-informed in science can escape
it… ¹⁵²

A very strange conclusion, in light of the fact of
the wide involvement of well-educated people in the activity of
homeopathic societies and their patronage of homeopathy all over the
world!

Dr. Tsenovsky then began “to share his own
impressions about homeopathy”. The very first of his
“impressions” of how he viewed homeopathic drug preparation
(“300,000 years would be required to prepare the 5^th
hundredth dilution”) testified to his ignorance of the subject. Yet
some of his “impressions” were revealing and demonstrated that
Russian homeopaths were, sadly, too flexible in applying their doctrine
to the treatment of venereal diseases. Dr. Tsenovsky, a venerologist
himself, reported:

I consulted some patients, who were being treated
with ichthyolic liniment, resorcinum, corrosive sublimate solution,
etc., given to them by homeopaths with other homeopathic drugs with
the remark of a homeopathic pharmacy ‘sine copia’ […]. I had
consultations – medical ethics should forgive me for that! – with
homeopaths. […]. I was much interested, what homeopathy is able to
propose to such patients [suffering from syphilis]. So what? We spoke
of hypodermic injections, we prescribed mercurial liniments […], and
kalium iodide. None of the homeopaths even tried to propose the
possible use of [homeopathic] dilutions! ¹⁵³

Dr. Tsenovsky was right and his impression was
reasonable. Most Russian homeopaths had no inclination to follow the
pure Hahnemannian homeopathic orthodoxy, while combining homeopathy with
allopathy. Demonstratively, Tsenovsky adds a remark that “medical
ethics should forgive him” in order not to be charged by his
allopathic colleagues for consultations with the “friends”,
and with violation of “medical ethics”! The final conclusions
of Dr. Tsenovsky were the following:

1. Homeopathy has nothing to do with scientific
medicine and has no common points with it;

2. If the person dealing with homeopathy has a
physician’s certificate, he should be bound to all the rules to
which all doctors are subordinated. He should not prepare and deliver
homeopathic drugs, but only through pharmacies.

3. Medical [probably, he meant allopathic?] drugs should be delivered
   by medical pharmacies only. Homeopathic pharmacies will have only
   homeopathic medicines for sale.
4. It is desirable that the delivering of medicines ‘sine
   copia’ be excluded from the clinical practice of doctors.
5. It is desirable that the institutions responsible for
   the enlightenment of the people and promotion of health protection,
   would pay attention to the problem of popularization of scientific
   medicine and of natural science. ¹⁵⁴

As we see from these conclusions, Dr. Tsenovsky was
also unfamiliar with the legislative regulation of homeopathic practice
in Russia. It was sufficient just to refer to the law of 1833 when
proposing to forbid things that had been prohibited 70 years ago…

The next speaker, Dr. Tishkov stressed Dr. Tsenovsky’s
ignorance of homeopathic theory. He also appealed to the Society to give
homeopathy a chance to prove itself:

[…] Since the very first words of the speaker it
became evident to me that he is absolutely unfamiliar with the
problem. I have to mention that […] Prof. Euchwald [See : The Great Russian Brockhaus and Efron
Encyclopedia] viewed Hahnemann’s doctrines by far more
seriously than the speaker does. One can be convinced of that after
having read his lectures ‘About the specific method of treatment’.
From a general point of view, homeopathy represents a medical sect. As
we know from history, in every medical sect the conditions created are
unfavorable for the flourishing of ethics. Unfortunately, this
homeopathic sectarianism is supported by our legislation, preventing
scientific doctors from testing Hahnemann’s method on patients in
hospitals. It would be desirable to solicit support to abolish these
prohibitory laws. ¹⁵⁵

It was the only speech rather benevolent for
homeopathy, whilst other speakers actively supported the first speaker,
Dr. Tsenovsky.

Dr. Kirillov: Homeopathy is not wizardry, but a ‘fraud’.
[…]. It had some reason [to exist] one hundred years ago, when
medicine had been just formed and nihilism toward the old pharmacy was
dominating. Today, after the diagnosis of infectious diseases has been
established and measures of fighting with them have been worked out,
homeopathy has become an evil, an offense upon the people’s health.
[…]

Dr. Putilov: […] This is our duty: to enlighten
the intelligentsia. We should have done this long ago. Homeopaths have
been strengthened thanks to our silence; let us not forget that some
25 years ago homeopaths in St. Petersburg were almost invisible. One
of our colleagues made an unsuccessful attempt to defend homeopaths,
while referring to the mistake of a distinguished doctor. He proposed
to study homeopathy at the bedside. What should we study? The action
of a grain of quinine dissolved in a barrel of water, medicine of
witches with the drugs made of snake’s skin, lizard’s tail, animal’s
dung, etc.? […].

Dr. Kalantarov: Considering homeopaths like ‘criminals’,
I find it necessary to fight this ‘crime’, for the more
intelligent a criminal is, the more dangerous he is. […]. One of the
means of the struggle should be wide publicity. All we have achieved
should be circulated, for homeopaths do [their affairs] on the quiet,
whilst we later have to correct their errors…¹⁵⁶

Thus, the speakers considered homeopathy to be ‘fraud’
and ‘crime’. Nevertheless, they well understood that any attempt to
prohibit it would bring results opposite to those expected. It was
obvious for the speakers, that homeopathy had no value. Its successes
ought to be ascribed to “the silence of allopaths”. The
further speakers, Drs. Shingarev, Karrick, Rubel’ and Tsenovsky again,
also stressed that homeopathy is an absurdity, physicians have to
enlighten the people, explaining the true character of homeopathy and
stressing that treatment with medicines is not the most important thing
in medicine. When Dr. Tishkov asked for the right to respond again, the
chairman ordered the conclusion of the discussion.

[It was] resolved: […] While recognizing
homeopathy as a kind of wizardry, the Section [of Public Health]
considers any participation of physicians in this affair as being
incompatible both with scientific knowledge and with the ethical
principles of a physician. As to the struggle against this social
evil, the important thing is wide publicity and popularization of the
information on medicine and natural sciences. ¹⁵⁷

What can be learned from this meeting? First of all,
we meet among the speakers such well-known anti-homeopathic activists
like Karrick and Shingarev. ¹⁵⁸ Secondly, none of those who
spoke against homeopathy at the meeting, had apparently any intention to
seriously discuss the matter, whilst the main speaker “found it
irrelevant to test the strange theories of homeopaths”. Dr.
Tishkov, the only person who had a different view, was refused
permission to speak again.

Great
Duchess Elena Pavlovna

This decision could bring no real harm to homeopaths.
Nevertheless, after having decided on behalf of the main Russian medical
society that homeopathy is no more that a kind of wizardry, contradicting
scientific knowledge and the ethical principles of a doctor, the Russian
regular medical profession destroyed completely all the possible ways to
reconcile and collaborate with homeopaths. One should also note that
homeopathy was the only kind of medical practice which was officially
condemned by Russian doctors. Although contemporary Russian medical
periodicals publicized many cases of graduated physicians practicing
“secret” medicine, applying koumiss (horses’ milk) and
hypnosis as medicines “for all diseases” etc., only homeopathy
was found to be deserving open condemnation. As I said above, this fact
also reflected a growing fear of Russian physicians toward homeopathy and
its increasing influence, especially in the light of the Nizhnedevitsk
zemstvo’s decision to invite a homeopath and the several scandals, which
were connected with the expelling of homeopathic doctors from physicians’
societies in the 1890s. Additional pressure on allopaths was caused by the
conversion to homeopathy of the surgeon Dr. Alexander Zelenkov
(1850-1914), former Secretary of the Russian Pirogov Surgical Society, and
a consultant in the Great Duchess Elena Pavlovna
(Frederika-Charlotte-Maria, 1806-1873)[See :

The Great Russian Brockhaus and Efron
Encyclopedia] Imperial Clinical
Institute in 1888-89. Also the Sunday lectures entitled “About the
specific method of treatment” delivered by the distinguished Russian
clinician, Prof. Eduard Euchwald (1837-1889) in 1888-89 at the same
Institute, did attract many Russian physicians. In these lectures Prof.
Euchwald pointed out openly that

The future of therapy belongs to the treatment by
specific medicines. The specific medicines are the medicines that can
cause in the healthy phenomena similar to these we see in different
diseases; thus these specifics will treat these diseases. […]. The
specifics can be found according to the method invented by Hahnemann. ¹⁵⁹

The Russian medical profession had to protect itself at
least virtually from the threat of future conversions and homeopathic
propaganda within the profession. The 9^th Meeting of the
Pirogov Society and the interventions documented above aimed at providing
that protection.