Installment 6 of a series on case analysis
© Will Taylor, MD 2001 (bio)
Specificity of Seat -
James Compton Burnett
and the Generalization of Locality
Sections: 1 | 2
The previous 4 installments in this series have addressed the characterizing dimensions of symptoms. Last month's article investigated Boenninghausen's generalization of modalities and sensations, and the use of modalities and sensations by analogy in reconstructing complex symptoms. I'd like to turn attention now to investigating the dimension of Locality.
The characterizing value of Locality is often underrated by contemporary homeopathic practitioners. This may stem from a confusion between how we look at Local disease (as described in aphorisms 185-203 in Hahnemann's Organon), versus how we can look at Locality as a characterizing dimension of complex symptomatology. The observation that we can generalize modalities and sensations and apply them by analogy across localities, along with the central importance of the mental/emotional state suggested by Hahnemann's aphorisms 210-213, the writings of Kent, and the teachings of many contemporary lecturers, has sadly placed Locality somewhere in the background of our attention.
Yet Boenninghausen, in his grand essay A Contribution to the Judgement Concerning the Characteristic Value of Symptoms, reminds us:
" The seat of the disease ... deserves to be more particularly emphasized, as it frequently furnishes a characteristic symptom, since almost every medicine acts more and also more decidedly on certain particular parts of the living organism."
Perhaps no other name is as closely related to the topic of Locality, as that of James Compton Burnett (1840-1901). Burnett was born in Redlynch, England in 1840. He attended medical school in Vienna in 1865, where he remained 2 additional years studying anatomy, receiving a gold metal for his accomplishments in that field. He graduated from Glasgow in 1872, and completed an internship for his MD degree at Barnhill Parochial Hospital and Asylum in Glasgow in 1876.
Burnett was converted to homeopathy during his internship, by his friend and colleague Alfred Hawkes. He was contemporary with Richard Hughes (A Manual of Therapeutics, A Cyclopaedia of Drug Pathogenesy, A Manual of Pharmacodynamics), RE Dudgeon (Lectures on the Theory and Practice of Homoeopathy, and translator of many of Hahnemann's works into English), and JH Clarke (Dictionary of Practical Materia Medica and many other writings).
In addition to the influence of homeopathy in his work, Burnett was highly inspired by a contemporary of Hahnemann's, Johann Gottfried Rademacher (1772-1850, in Goch, northwestern Germany). Rademacher published his 1600-page Erfahrungsheillehre (empiric medical practice) in 1841, giving birth to the practice of Organopathy. (The full title of his work was Rechtfertigung der von den Gelehrten misskannten, verstandes rechten Erfahringsheillehre der alten scheidenkunstigen Geheimarzte, und treue Mittheilung des Ergebnisses einer 25-jahrigen Erprobung dieser Lehre am Krankenbette - "Justification of the empiric medical practice of the old alchemistic physician, misjudged by the learned, yet perfectly rational, ..."). Rademacher based his work on his own empirical observations, which he supported on the writings of Theophrastus Bombast von Hohenheim (Paracelesus), the 16th-century Swiss alchemist/physician. Many of Rademacher's remedies were introduced to homeopathic practice, or saw homeopathic applications inspired by their organopathic uses, via Burnett.
Theophrastus is often credited with a pre-Hahnemannian understanding of the phenomenon of cure by similars, but there are important differences between Hahnemann's homeopathy and Theophrastus' appreciation and use of the principle of similars. Theophrastus emphasized a relationship between microcosm and macrocosm, a bringing of "the external lung" to "the internal lung" - the organ of the remedial substance to the organ of the person. Theophrastus' similitude was based not on the detailed investigation of the totality of symptoms that characterized Hahnemann's work, but rather on a gestalt that included empirical observations along with information from arcane sources such as astrology and the discernment of remedy signatures.
Rademacher's Organopathy - drawing on Paracelsus to rationally support his empirical observations - posited the physical organs as the seat of disease, often creating symptoms seen & felt elsewhere in the body "through sympathetic affections of the strangest nature". As with Hahnemann, Rademacher did not seek the nature of these diseases in the "invisible interior of the organism," but rather identified them by similitude to their remedial substance - a Celandine liver disease, a Carduus Mariae liver disease, etc.
Remedies were selected on the basis of their affinity for the organ in which the disease was felt to reside, and differentiated further on the basis of the "genus" of the disease - a concept less well defined than Hahnemann's totality of symptoms, and based on empiricism and considerations arcane to the practice.
It is immediately apparent how such a system would entice the anatomist in Burnett - author of Diseases of the Spleen, Diseases of the Liver, Enlarged Tonsils, Cataract, Consumptom, On Fistula, Gout, Diseases of the Skin, On Neuralgia, Tumours, Tumours of the Breast, Diseases of the Veins, et.al. (n.b. - Organopathy survives today principally through its vestiges in the "drainage" school of homeopathy in France, based on the teachings of Nebel and Vannier in the early 1900's).
It would be superficially easy to disregard Burnett as a fringe-homeopath, mixing homeopathy inelegantly with an eclectic medical tradition, or to identify him more closely with the contemporary "drainage" practitioners, were it not for his close association with JH Clarke. Clarke references Burnett 140 times in his Dictionary of Practical Materia Medica. Clarke and Burnett met over dinner weekly for many years, as part of the "Cooper Club;" Clarke described Burnett as one of "the three most potent influences on the evolution of British Homeopathy ... during the last twenty years Burnett has been the most powerful, the most fruitful, the most original force in homeopathy."
Following Burnett's death, Clarke devoted himself to writing Burnett's biography, The Life and Work of James Compton Burnett. Margaret Tyler, a later member of the London-based "Cooper Club," described Burnett as having "a genius for grasping [remedy] idiosyncrasies and possibilities and employing them with success for the patients that besieged him".
Although Burnett initially cut his teeth on the writings of Richard Hughes, he came to regard Hughes' work as "homoeopathic milk for allopathic babes" and fell in with the less allopathically-oriented group of Clarke, Cooper, and Thomas Skinner. Early on in his homeopathic career, he attended the clinic of Dr. John Drysdale at Liverpoole, along with Alfred Hawkes and JH Clarke. Drysdale came at the matter of Locality from a direction that must have touched closely on Burnett's fascination with Organopathy. Of this, Richard Hughes wrote, in A Manual of Pharmacodynamics:
"Dr. Drysdale also has laid much stress on what he calls "specificity of seat," connecting it with the special irritability displayed by the various parts for their natural stimuli and for causes of disease, and extending it to the minutest localities or nerve-branches which have anything independent and special about them."
Burnett adopted Drysdale's concept of "specificity of seat," and used this term and concept liberally in his writings.
This concept of "specificity of seat" of a remedy, and Burnett's borrowed Organopathic concept of organ-specific remedies for diseases "of the organs," seem to stand in conflict with the homoeopathic understanding of disease originating in the dynamic plane, and of remedies acting on the dynamis, rather than on specific tissues of the body. Burnett fuels this seeming contradiction with his assertion (in Diseases of the Liver):
"That the organ in the organism does indeed possess not only autonomy but hegemony, i.e. the organ is an independent state in itself and in and on the organism exercises an important influence."
How can we look at these two apparently conflicting concepts to discern the truth that runs deeply through both?
Sections: 1 | 2