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.

   

3. 6 The Zemtsvo and
homeopathy

Leningrad
Hospital

Almost immediately after the zemstvo system had been
introduced, practising homeopaths and their supporters started issuing
books and brochures urging the zemstvos to turn to homeopathy as the
most reliable and safe system of medical treatment. Till the homeopathic
societies were established, those publications were due to the pens of
isolated propagandists for homeopathy. Since the 1880s, the issuing of
such literature (for which the societies were assigning resources),
became systematic. The societies, beginning with the St. Petersburg
Society of the Followers of Homeopathy, issued and distributed this
literature free of charge to the zemstvos. In fact, the main character
of the propaganda was left unchanged until the World War I. These
publications referred to events and statistics taken from current
allopathic medical documents of the zemstvos as instances to be analysed
and compared with the presumably “benefitable homeopathic method of
treatment” (cheaper, reliabler, safer etc.). Homeopaths and their
lay supporters pointed out that zemstvo medicine was: 1. expensive 2.
hardly available for the population, careless and indifferent, and 3.
unsafe because of use of dangerous substances, including poisons. It is
also important to mention that in homeopathic publications there were
rarely direct mentions of the Zemstvo. The societies used to have in the
headings or subheadings of their publications such sentences like
“First aid with homeopathic drugs”, “On the cheaper and
accessible medical help though homeopathy”, “On the safe first
help within the rural population”, and so on. General reports,
protocols of the opening of homeopathic societies and price-lists of the
large homeopathic pharmacies, were delivered to the zemstvo authorities.
Often these mailings were accompanied by covering letters of the
chairmen of the societies; these letters contained proposals for taking
advantage of homeopathy or just invitations to pay more attention to
homeopathy. Although extremely rare, there were a few examples of even
zemstvo physicians proposing the introduction of homeopathy into the
Zemstvo. The reaction of their allopathic colleagues was predictable:

There is a physician in the Novouzensk zemstvo
[…] [of the Saratov province] who said at the Meeting of physicians
that he had excellent results treating cholera with homeopathic drugs.
In order to save money, he proposed to the Meeting the idea of
replacing scientific treatment with homeopathic drugs, the zemstvo
would save thus more than 20,000 rubles yearly. While taking his age
into consideration, the Meeting had heard his report till the end, but
then suggested to him that he either deal with homeopathy privately or
leave the zemstvo service. ⁵⁴

It seems that the fate of those feldshers who tried
to use homeopathy, was not any easier:

Midwife and feldsher Ekaterina Zhelominskaia
serving at the Kromakha (the Orel province) zemstvo, after having
subscribed to homeopathy had started to treat patients with it during
the last year. She became soon convinced of its success and
superiority [to allopathy]. When the local physician Vil’chinsky had
knowledge of it, he forbade her in rage to use homeopathic drugs
[…]. Zhelominskaia remarked: ‘I was forbidden to treat with
homeopathy, as this method of treatment is not accepted in our
zemstvo. They know nothing about it and do not want to know. They
forbid it, not because they are convinced that this method is harmful
or does not bring any benefit; on the contrary, they see that
[homeopathy] treats with success many diseases, but they just forbid
it. I had no other choice but to leave […]. Even if I shall have to
suffer more for homeopathy, I shall continue to use it as I have been
convinced a hundred times over, that this is a much better method of
treatment'”. ⁵⁵

I have found one example belonging to the first years
(1877) of the zemstvo system, when a zemstvo physician and the zemstvo
authorities decided together to try homeopathy.

The Trubchev zemstvo [the Orel province] decided:
1. to order medicines for homeopathic experiments for 50 rubles,
whilst the physician Salov proposed his free service to make these
experiments […]. ⁵⁶

This report appears to be single of this kind. I have
not been able to find any other mention of this zemstvo in neither
homeopathic nor allopathic periodicals. Thus, one may conclude that,
most probably, Dr. Salov had not been satisfied with the results
obtained from his “homeopathic experiments” and the zemstvo
did not assign means for homeopathy any further.

I suppose that usually those zemstvos which wanted to
introduce homeopathy, turned to laymen for help, in the absence or in
spite of resistance of physicians. Doubtless, even from the most
enthusiastic laymen one cannot expect a sense of responsibility
comparable with that of physicians. “Vrach”, most probably in
the face of its editor Prof. Manassein, commented on that, referring to
the Kiev newspaper “Kievlianin” (The Kievan), N 265 of 1887:

In 1885, the Ostersk [of the Voronezh province]
zemstvo meeting decided: ‘to introduce treatment with homeopathy in
the district as an experiment’. Accordingly, in 1886, three
homeopathic kits and manuals were ordered and then delivered among ‘the
persons being popular in the district’ […]. About a year has
passed from then; probably, the zemstvo became ashamed of its
ignorance. At least, it did not publish any report on the activity of
‘popular persons’. This is to be regretted. We could have gotten a
very instructive document for the future historian of our mental
development [sic!]. ⁵⁷

No unbiased reader may understand what
“ignorance” should the zemstvo become ashamed of and why this,
probably unsuccessful, experience would be serve as “instructive
document for the future historian of our mental development”. I
guess, that in the opinion of the editorialist of “Vrach”,
i.e., Manassein himself, only mentally handicapped persons might decide
to examine homeopathy…

Nevertheless, homeopaths and their supporters were
absolutely right when they only expected from the zemstvo authorities
their permission for doing what needed in order to introduce in some way
homeopathy. The experience of the Belev zemstvo which supported
homeopathy during 25 years according to the decision of its authorities,
⁵⁸ may be seen as a proof of it. Yet homeopathic ideas could not
find a rich soil for their growth in the 1880s, when the homeopathic
propaganda, as I mentioned above, became more or less systematic. In my
opinion, there are explanations for the relative weakness of the efforts
made to spread homeopathy throughout the zemstvos. First of all, by the
1880s, allopathic zemstvo medicine was already rooted in the Zemstvo.
Zemstvo physicians, who were considered to be specialists in their
fields, bitterly resisted the penetration of homeopathy into the Zemstvo
(see examples above). Zemstvo officials could not ignore the opinion of
physicians and their threats to leave the zemstvo service if homeopathy
would be either financed together with regular practice or was even
allowed to be practiced by an invited homeopathic physician. Later we
shall also see some examples of this opposition. On the other hand, the
educational level of the zemstvo meetings had been constantly improving
since the introduction of the zemstvo system. It will be demonstrated in
the chapter “Homeopathy and the clergy” that the deputies of
the Belev zemstvo meeting approved the proposal made by its chairman who
was a nobleman, to introduce homeopathy, without any discussion. Yet
from the 1880s onwards, homeopathy could not have been introduced
without an exchange of views and without discussions.

‘Zemsky vrach’ [Zemstvo physician] of
April 30, reports that the chairman of the Kobeliaki district [Poltava
province] zemstvo board V. V. Gan agitates actively for introducing
homeopathy into zemstvo medicine. He sent recently to all the province
and district deputies an elegant folder containing a brochure by Dr.
Brazol against smallpox vaccination, 5-6 other brochures of
homeopaths, a January issue of “Vrach-gomeopat” and the
price-list of the Flemming [homeopathic] pharmacy in St. Petersburg.
To the folder was attached a circular letter of Mr. Gan in which he
requested that attention be given to ‘the problem of making zemstvo
medicine cheaper and putting it in good order’. As if ‘making
cheaper’ might be achieved by embracing homeopathy. To Mr. Gan’s
great disappointment, his effort came to grief. Some deputies sent the
folders back, whilst others, who had earlier been indifferent toward
the discussion initiated by homeopaths, now, on having read the
folders delivered, ‘understood that this polemic is ridiculous’.
But what about zemstvo physicians of the Kobeliaki district, forced to
be managed by such a person like Mr. Gan?! ⁵⁹

So, when zemstvo deputies refused some expensive
proposals of zemstvo physicians, those deputies were regarded as
“profane”, “dark” and “ignorant”.
Nevertheless, now zemstvo deputies seemed to the editor of
“Vrach” Manassein sufficiently educated to understand such a
primitive matter like homeopathic doctrine, and thus to conclude that
polemic between allopaths and homeopaths is “ridiculous”!

It goes without saying that the single efforts of
individuals not supported at the zemstvo meetings, could not influence
the situation.

At the Pereiaslavl’ [the Riazan’ province]
zemstvo meeting a deputy named Artem’ev (unfortunately, neither his
title nor his educational rate is mentioned) proposed to abolish
zemstvo schools and zemstvo medicine for creating a zemstvo fund.
[Zemstvo schools] may be replaced with church-parish schools, while
[zemstvo medicine] would be replaced by homeopathic treatment! Thus,
instead of 37,000 rubles only 5,000 [rubles] would be needed. To the
honor of the zemstvo meeting, the overwhelming majority [of the
deputies] approved the budget of zemstvo medicine and education
proposed by the Board, against Mr. Artem’ev’s attacks (‘Kievskoe
slovo’, October 26, 1893). It is characteristic that a defender of
homeopathy appealed also against zemstvo schools. ⁶⁰

What was “characteristic” in the fact that
a deputy proposed two absolutely different ideas? Nothing for any
unbiased observer. It could have been indeed “characteristic”
only for the readers of “Vrach” who considered the main
physician’s calling to be rather educator and enlightener within the
rural population than a treating doctor. Accordingly,
“unscientific” homeopathy and the denial of the benefit
brought by zemstvo schools, were in the opinion of zemstvo physicians
and their supporters from “Vrach”, the matters of the same
“reactionary”, or at least “conservative”, root.

It seems that often the general press, especially the
provincial periodicals, together with zemstvo physicians, condemned the
efforts of homeopaths and their supporters. The allopathic periodicals
readily cited these anti-homeopathic views:

‘Yuzhny Kur’er’ [South Courier] from
Simferopol’ was informed that some charitable society had proposed
to the provincial zemstvo to organize homeopathic treatment throughout
the villages. Reporting on that, the newspaper on its side mentions
that ‘more wild a proposal has hardly been received by the Tavria
zemstvo during its whole existence. That a councilor or a captain with
missing legs and with shooting pains in all his body, may be treated
by a homeopath, this may find some justification. But proposing to
leave hundreds of thousands of peasants for ridiculous homeopathic
experiments, this does not generate fun but indignation’. To what
extent can the blindness of the people reach, while deciding to
propose sweet grains instead of rational medical support! Do they
really believe indeed that instead of obstetric forceps or surgical
knife, those ill-fated grains might also have been proposed? Fiat
homeopathia pereat mundus. ⁶¹

I guess that what was indeed proposed by “some
charitable society”, is to examine homeopathy, nothing more.

Although the difficulties of introducing homeopathy
were more than evident, there were other factors which concurred in
making the starting positions of homeopathy in the early stages of the
zemstvo system promising enough. Due to landlords and their wives who
were responsible (at least before their own conscience) for the health
of their serfs, as well as owing to the enthusiasts from among rural
clergymen and teachers, homeopathy became known even in the most
provincial villages. I refer again to Prof. Engelhardt writing in 1873,
from some god-forsaken village in the Smolensk province where he had
been exiled:

There is a mistress here who treats with
homeopathic grains, with occasional success. Siddor [a peasant] and
other peasants are persuaded that this mistress ‘knows’ and
conjures on the grains. Many times I have tried to convince him that they
[the grains] are simply homeopathic medicines which can be bought and
given when somebody becomes ill and that everybody treats with
homeopathy because it is not difficult, and requires no specific
knowledge, but he has refused to change his mind. [In his
opinion]: what kind of medicine is that? There is no taste or smell,
[the medicine] being hardly felt in mouth – no, this is no medicine.
No doubt, she ‘conjures’ on the grains. A feldsher gives
medicines, either bitter or sour. This is a drug, and that one [giving
by the mistress] is the ‘conjuring’. ⁶²

Two things attract attention in this quotation. First
of all, at a relatively long time before regular homeopathic propaganda
started in the 1880s with the establishment of the St. Petersburg
Society of the Followers of Homeopathy, Engelhardt states that
“everybody treats with homeopathy”. Although we do not know
what that “everybody” means, we may guess that Engelhardt had
been a witness of many homeopathic experiences made in the locality
where he was living. Secondly, Engelhardt’s conviction that to treat
with homeopathy is “not difficult, and requires no specific
knowledge” testifies that his own knowledge on homeopathy was
obviously superficial. He seemingly based his statement mainly on his
experience of seeing laypeople, treating exclusively with homeopathy.

As to the opposition of zemstvo physicians to the
introduction of homeopathy, this may be considered as part of their
opposition to any initiative of the Zemstvo not approved by them.

Reflecting on an established view in the Soviet
historiography of “brave and progressive” zemstvo physicians
opposed to zemstvo deputies and officials who resisted the
“right” development of Russian society, Zhuk substantiates the
position of zemstvo physicians:

The attempts of some zemstvo boards that had been
made from the beginning of their activity, which aimed at replacing
physicians by feldshers, introducing homeopathy, ignoring the
problem of the organization of medical help for the peasantry, caused
the resistance of physicians not only because this contradicted their
professional interests but also because two different views crossed on
this [zemstvo] soil. One view is that a peasant [muzhik] has
simple diseases and the help of a physician is a blatant luxury for
him. Moreover, physicians thought it was inappropriate to lower the
scientific level of medical help for the mass of the peasants. ⁶³

Zemstvo physicians expressed and supported their own
views on the development of zemstvo medicine, science, etc., as they had
been taught in universities. As we shall see further, homeopaths never
succeeded to provide zemstvo medicine even with one single homeopathic
doctor. Generally, there was not the slightest reason for zemstvo
physicians to be afraid of any kind of rivalry with homeopaths in the
countryside during all the zemstvo period. Zemstvo physicians resisted
homeopathy in the same way and for the same reasons as they resisted
“feldsherism”, hydrotherapy or sorcery. Those were
“unscientific” methods, produced chiefly by non-physicians or
by single representatives of physicians’ community, and thus those
methods could not be accepted by the “specialists”.

It is interesting to add here that in Russia many
strange things were considered in the medical circles to be
“scientific” in the second half of the 19th century. For
example, the treatment with koumiss (horses’ milk) of different
diseases, including cholera and tuberculosis, was the subject of
numerous research projects and was considered doubtless
“scientific”. This was also true for the treatment of cholera
with juices made of wild beers, gymnastics, Russian baths, ⁶⁴
etc., and the reports on the investigations made, were
considered worthy to be published in the main Russian medical
periodicals.

Although in the large cities there was not less
hostility of allopathic physicians toward homeopathy than in the
countryside, the social urban environment was considerably preferable
for homeopaths. The representatives of the intelligentsia and the
nobility supported homeopathy in the urban zemstvos. Thus, in 1900 the
large Khar’kov district zemstvo meeting, answering the request of the
local homeopathic Society, decided to support the Society with a
contribution of 100 rubles. It is remarkable that a year earlier, in
1899, the Society had turned to the Khar’kov district zemstvo with the
same request attaching a brochure of Dr. Diukov “Homeopathy as a
problem of zemstvo-community medicine”; ⁶⁵ but the
zemstvo board passed the request to the district medical council. The
council decided that homeopathy cannot be viewed as an acceptable
method, thus the proposal was rejected. In 1900, the Society asked again
for zemstvo’s support and the zemstvo board passed again the inquiry
to the same medical council. The latter informed that there is no reason
to reconsider the decision accepted before. Then the zemstvo board
applied directly to the zemstvo meeting, leaving aside the opinion of
the local zemstvo physicians.

The members of the board decided:

‘The board has to recognize that the intent of
homeopaths striving to cheapen the cost of medicine, deserves
attention and thus, with the support on the side of the zemstvo, the
board is asking the meeting to support the Society with an adequate
donation’. The meeting discussed this intercession of the board,
whilst those deputies outspoken for homeopathy pointed out that
leaving apart the essence of the conflict between allopaths and
homeopaths, there is no doubt that some patients benefit from
homeopathy. Therefore, because of a possible financial profit for the
zemstvo, the latter has all the reasons not to close the door before
the homeopaths; on the contrary, they should be given the opportunity
to prove the practical value of their method of treatment. ⁶⁶

Most probably the similar positive decision made in
1898 and 1899, by the Khar’kov municipality (Duma) to support
the Society with a donation of 200 and 300 rubles respectively, was not
an accidental coincidence. Yet it is to be surmised that in the
following years neither the city Duma nor the district zemstvo supported
homeopathy any more. I may conclude this because the periodical
“Vestnik gomeopaticheskoi siny”, edited by Diukov and
issued till 1903 in Khar’kov, which was especially sensitive to the
situation of homeopathy within Russian society, never again mentioned
that Khar’kov homeopaths were helped in some way by the local
authorities. Thus, this “Khar’kov success” of 1898-1900
appears have been single and not leading to promising results.

Another important topic has to be elucidated here. I
discussed above the conflicts between physicians and feldshers within
zemstvos. Even if they recognized feldshers to be an “evil” of
zemstvo medicine, zemstvo physicians did not really imagine day-to-day
work without them. I cannot say that homeopaths had never considered
feldshers as a possible vehicle supporting the introduction of
homeopathy into the Zemstvo. Nevertheless, as it was usual for Russian
homeopaths, they were unable to establish even one single institution
which could provide minimal homeopathic education. In vain did the lay
readers of homeopathic periodicals in villages appeal for more widely
attracting feldshers to homeopathy. ⁶⁷ The editor of
“Vestnik gomeopaticheskoi siny” Dr. Ivan Lutsenko wrote,
while informing that the St. Petersburg Society of the Followers of
Homeopathy proposed training zemstvo feldshers to homeopathy: “But
it is clear enough that feldshers cannot play a chief role in zemstvo
medicine”. ⁶⁸ It is to be pointed out, that the editor
came to this thoughtful conclusion in the editorial in which he also
reported to the readers about the inability of Russian homeopaths to
provide the Zemstvo with even one single homeopathic physician! ⁶⁹

In 1912, in the same periodical, an article entitled
“Homeopathy and the feldshers’ problem” and signed
“Reader”, the issue of teaching homeopathy to feldshers was
again roused.

Physicians have tried to depreciate and discredit
the role of feldshers, whilst [physicians themselves] readily use
their services. [Physicians] treat the more intelligent patients,
while the common people has been left at the disposal of feldshers. I
think that if homeopathy has spread relatively slowly, this is due to
the fact that it has not had such an assisting staff as allopathy has
in the person of […] feldshers”. ⁷⁰

Moreover, the “Reader” offered a concrete
proposal: to establish a 4-years homeopathic course for feldshers at the
Emperor Alexander II Homeopathic hospital. No discussion whatever
followed this offer.

Summarizing this chapter, I would like to argue that
though the problem of a possible introducing of homeopathy had been
arisen indeed in many Russian zemstvos, nothing, in fact, resulted from
it. The reasons for that will be analyzed in more detail in the Summary.