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Sources and Studies on the History of Homeopathic Medicine (Volume 15)

Inge Christine Heinz, "Send medication, send advice!" Princess Luise of Prussia as a patient of Samuel Hahnemann in the years 1829 to 1835
KVC Verlag, Essen 2011.
ISBN 978-3-86864-007-6

To achieve the most comprehensive documentation possible of the treatment of Princess Luise by Samuel Hahnemann in the years 1829 to 1835, the following sources were investigated:
- The appropriate patients' journal entries by Hahnemann in D33-D38
- The letters and reports of the Princess to Hahnemann of the years 1831 – 1835
- The exchange of letters between Hahnemann and Aegidi in the appropriate years, insofar as they relate to the treatment of the Princess and her family

The search for letters from Hahnemann to the Princess was unsuccessful. One must assume that she destroyed the letters herself.

The named sources were transcribed for this examination, insofar as they were not available in typed or published form, and were edited with brief comments. The totality of the letters and reports of the Princess to Hahnemann have thus been published for the first time here. It was necessary to depict the life of Princess Luise Friedrich of Prussia in great detail, whilst, for Hahnemann, it was sufficient to limit the depiction to key events in his life in the period between 1829 and 1835. His therapy concept was described using keywords and the most important changes in his documentation during the named period were investigated.

This meant that it was possible to use the sources to reconstruct the most comprehensive patient history yet published from Hahnemann's documents. The Princess indicated, alongside a large number of physical ailments, "her" cramps when laughing and crying as her main motive for consulting Hahnemann. An attempt was made to investigate her case for its historical significance and to subject it to a retrospective diagnosis, in which it could be seen that historical "homoeopathic diagnoses" barely changed when compared to the "illness name diagnoses" of academic medicine.

In Luise's case, therapeutic measures were applied, ranging from the prescription of countless homoeopathic medicines – always in the C30 potency – through placebos, spiritus nitri dulcis, diet and lifestyle, mesmerism and magnetism, right up to psychotherapy. At the beginning, the Princess received the homoeopathic medication for individual oral consumption, which Hahnemann gave up to seven weeks to work. From 1831, he prescribed all the medication to be inhaled. For example, in 1832, he had her inhale sulphur several times every two weeks. Other measures and home remedies of the Princess were mentioned in the sources, along with Hahnemann's rejection of vaccinations against smallpox. He employed everything his healing abilities comprised. In practice, he primarily stuck to the theory of his publications, also with regard to the so-called antipsoric therapy.

Thanks to an overlap between a patient diary entry by Hahnemann and a letter of the Princess, it can be proved that Hahnemann completed his journal in minute detail. A further feature of this patient history is the simultaneous treatment by Hahnemann and the doctor arranged by him, Dr Karl Julius Aegidi, from the spring of 1831 onwards. The correspondence of the two doctors on the therapy of the Princess offers important additional information. In spite of all the resistance from the court in Düsseldorf, the Princess supported homeopathy and managed to "convert" both her husband and her two sons to homoeopathy. Her estimation of Hahnemann was such that he became her closest confidant, whom she consulted regarding all pertinent matters. Another feature of the reports is the numerous depictions of dreams, which played no role in academic medicine at that time. By contrast, Hahnemann recorded the occurring dreams for the medication tests, but did not assign an overall significance to them. The "irritability" of the Princess frequently produced medication symptoms during the course of treatment, which Hahnemann recorded in the 2nd edition of his Chronische Krankheiten, a procedure he only permitted "masters of observation" to undertake.

The letters of Luise also contain information on the situation in the courts. Her husband is frequently mentioned, as, on occasion, are her children and her father, her brother and King Friedrich Wilhelm III of Prussia.

Hahnemann regarded the early allopathic treatment and the spa visits as an obstacle to the treatment of the Princess. Added to this were the problems with courtly life, which, thanks to Hahnemann's psychological support, she became better at dealing with, but from which she could not "get away". An additional obstacle to treatment, which neither Hahnemann nor the Princess mentioned, was the family pathography, the serious mental illness of her mother, other ancestors and her brother. She herself lived longer than any of her ancestors, her brother and her husband, but, at the age of about 50 – roughly 15 years after the end of her treatment by Hahnemann – she suffered from serious emotional illness. In general, Hahnemann kept to the regulations he espoused in any given period, in the form which appeared in his publications.

A comparison of the letters and reports of the Princess with other published patient histories shows that Luise had problems in describing her feelings, although Hahnemann enjoyed her full confidence and their doctor-patient relationship was closer than that with other correspondence patients. Therefore it is surprising that there no further letters exist for the period after Hahnemann moved to Paris. A comparison of Hahnemann's initial anamneses shows that they vary widely in their scope and the prescription of the individual medicaments cannot always be clearly understood, as it frequently looks like he "only" included the physical symptoms in his choice of medication. It is apparent that Hahnemann had increasingly been using antipsorics from about 1829 onwards, in accordance with his discoveries in the treatment of chronic illnesses, a subject he continued to study until his death. Apart from his principle of "Similia similibus curentur", which he formulated in 1790, he kept changing the potentisation, the form of dispensation and the dosage of his medication.

It is conceivable that Luise – if she had lived a few decades later – could have consulted Sigmund Freud, as, throughout her life, she sought out the leading medical luminaries of the age. If, as a young woman, she had been subjected to psychoanalysis, then she may have experienced an improvement in her state of health. "It does me good and is of such comfort to my soul when I can talk freely."  This expression appears countless times in her letters to Hahnemann. His ability to empathise with her, to listen to her and to advise her seem to have helped her more than all the attempts made with medication. That, together with the dispensation of higher potencies, such as the LM potency used by Hahnemann in Paris, might have meant that she suffered less "per se". But she never sought out Hahnemann in Paris and, when he moved there, ceased writing letters to him.

The countless detailed letters of the Princess to Hahnemann, despite having Aegidi as her court doctor, are proof of the fact that she primarily sought out and cherished Hahnemann's psychotherapeutic aid. This gave him an advantage over Aegidi who, as we have seen, may have been a good "normal" homoeopath, but who, due to his age, did not possess the experience and knowledge that Hahnemann had. The latter was able to detect what the Princess primarily needed: A doctor for her soul.

The treatment of Princess Luise also shows that Hahnemann – in stark contrast to the radical vehemence seen in his publications – was a real healing artist. He applied a non-potentised inhalation agent, namely spiritus nitri dulcis, as it had frequently been helpful in treating certain complaints of the Princess. It can also be seen that excessively strict adherence to a theory, no matter how clever it might appear, may be improper in some cases, such as the frequent use of different kinds of antipsorics and Hahnemann's insistence on the 30th centesimal potency, as seen in this case.

With regard to medical ethics, the "case" of Princess Luise makes it clear that it is not important to treat patients according to a single doctrine, of which Hahnemann and homoeopathy have been and are accused, but to select the appropriate form of therapy for treatment from the wide range of available options. These days, it should not be important whether homoeopathy, allopathy or any other form of therapy is "a winner". What counts is that the study of medicine should include the presentation of as many methods as possible which can aid the convalescence of ill people, so that the doctor is able to select the appropriate method of treatment for his patients in each individual case, and they should be obliged to present alternatives to an allopathic-pharmaceutical therapy.
Hahnemann's principal work is called the Organon of Medicine and § 1 should have general validity:

"The physician's high and only mission is to restore the sick to health, to cure, as it is termed.