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 wizardry¹⁴¹. 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 state¹⁴².

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.

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 profession¹⁴⁴. 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 physicians¹⁴⁵. Among the founders of the Society were such famous Russian physicians like Segey Botkin (1832—1892), Viachaslav Manassein (see above), Alexey Dobroslavin (1842—1889), M. Petrunkevich, I. Molleson, S. Sychugov, E. Osipov and A. Pogozhev. The First Congress of the Society (1885) elected Prof. Nicholas Sklifosovsky (1836—1904) 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 blocked¹⁴⁶.

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 action¹⁴⁸.

Another contemporary account taken from "Izvestiia Imperatorskoi Voenno-Meditsinskoi 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 homeopathy¹⁵¹. 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 science¹⁵⁴.

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 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 laws¹⁵⁵.

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 sciences¹⁵⁷.

What can be learned from this meeting? First of all, we meet among the speakers such well-known anti-homeopathic activists like Karrick and Shingarev¹⁵⁸. 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.

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) 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 Hahnemann¹⁵⁹.

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.

Copyright © Alexander Kotok 2001
Mise en page, illustrations Copyright © Sylvain Cazalet 2001