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Sources and Studies on the History of Homeopathic Medicine (Volume 18)

Victoria Vieracker, Nosodes and sarcodes. Introduction and development of two homoeopathic material medica groups in the first half of the 19th century.
KVC Verlag, Essen 2013.
ISBN 978-3-86864-033-5

Nosodes and (to a lesser extent) sarcodes are two key groups of homoeopathic medicaments. In this investigation, nosodes are defined as homoeopathic remedies created from pathological human or animal bodily substances, physical human and animal bodily fluids and excretions and from parasitic animals. By contrast, sarcodes are homoeopathic remedies created from individual healthy organs or tissues, as well as from isolated bodily substances of human or animal origin. As with standard homoeopathic agents, preparations from the two groups of medicaments are primarily prescribed according to the homoeopathic principle of similars, meaning that no fixed indications can be specified for their therapeutic use.

In this text, it was possible, for the first time, to carry out a reconstruction of the history of these two groups of medicaments for the first half of the 19th century in the German-speaking area. The primary aims were to determine antecedents of the two remedy groups both inside and outside the field of homoeopathic therapy, to investigate the contemporary use of nosode and sarcode therapy, to explain the basic theoretical viewpoints of various homeopaths and to present the discussions surrounding the introduction of the two groups of remedies. To obtain as genuine an impression as possible of the therapeutic practice of that time and the convictions and opinions of the homeopathic community regarding nosodes and sarcodes, the latter were placed, in certain cases, in the context of the then level of medical and anthropological knowledge and were critically evaluated against this background. The results of this work are primarily based on an evaluation of original sources (in particular, articles of the homoeopathic periodicals AHZ, Stapfs Archiv, Hygea and Zooiasis) from the first half of the 19th century. The following section offers a brief summary of the key results. Emphasis has been placed on a presentation of those details which correct the current picture of nosode and sarcode history.

Nosodes were added to the homoeopathic pharmacopoeia by Constantin Hering. In his article "Nachträgliche Bemerkungen über das Schlangengift" (which appeared in Stapfs Archiv in 1831), he created the hypothesis that the potentised disease products of the pox, rabies and scabies could be effective in the treatment of the corresponding illness. Hering also introduced the idea of sarcodes in 1833. In contrast to sarcode therapy, which played an overall less important role in the first half of the 19th century, nosode therapy enjoyed a first Golden Age in Germany soon after the publication of Hering's "Nachträgliche Bemerkungen". However, the main reason for this was not so much the publication of Hering's journal article but rather a publication by the veterinarian J. J. Wilhelm Lux, who, in his book Die Isopathik der Contagionen (1833), recommended the use of potentised disease products for the treatment of the corresponding contagious ailments. In his sensational work, Lux also presented isopathy as a method of treatment superior to homoeopathy. It is not, like homoeopathy, based on the principle of similars, but on the principle "Things cure themselves." After the publication of Lux' work, nosode preparations were used with increasing regularity by homoeopaths (also as a result of the efforts by the homoeopath Gustav W. Gross). In addition, until 1834/1835, there was a considerable expansion (primarily due to the efforts of Lux and Hering) in the spectrum of substance classes used for the preparation of nosodes. For example, potentised concrements or pathologically modified tissue were employed for nosode preparation. The majority of the types of original materials for nosodes still in use today thus go back to developments during this brief period of time.

The original heyday of nosode therapy came to a rapid conclusion in the mid-1830s, although, again, a publication by Lux played no small role here. His "Geheimmittel", published in 1834, which was a list of some rather strange nosode preparations (e.g. foot sweat or vomit with black tinges), was the impetus that caused the collapse. The medical use of excretions and other animal products had been a therapy option frequently used up to the Baroque age. The Heilsame Dreck-Apotheke of Christian F. Paulini (published in 1696), based primarily on mixtures of urine and faeces, was published in large numbers and must be included in a widely known and highly successful collection of prescriptive remedies. However, in the 19th century – on account of changes to rationale brought about by the Enlightenment – the dispensation of animal products and excretions was disregarded as being old hat and no longer of relevance. As the nosode preparations listed in the "Geheimmittel" were strongly reminiscent of the ingredients listed in the Dreck-Apotheke, nosode therapy was completely compromised after the publication of Lux' list of medicaments. Positive reception by the public seemed no longer to be possible. An additional reason for the drastic fall in the dispensation of nosode preparations from 1835/1836 onwards seems to be that, just a few years after the start of nosode therapy, an increasing level of sobriety regarding their practical effectiveness was taking hold. This disappointment was compounded by the fact that nosode preparations had originally been regarded as a panacea, effective in cases previously regarded as untreatable or infaust. These amazingly high expectations could scarcely be fulfilled.

Set against this backdrop, it is scarcely surprising that the efforts of J.F. Hermann, a country doctor from Thalgau, in the mid-1840s to use the previously barely regarded sarcode preparations more frequently in homoeopathic therapy met with severe criticism. Hermann recommended the dispensation of extracts of the organs of foxes to treat illnesses of the corresponding organs, but (primarily due to his borrowings from traditional organ therapy) met with high levels of rejection within the homoeopathic world. Therapy with nosode and sarcode preparations only experienced a true upsurge again towards the end of the 19th century. This can partially be traced back to increased scientific significance being given to the medical use of disease products and organ extracts, based on new discoveries in the fields of bacteriology and hormone replacement therapy.

Even if Hering is today regarded by many homoeopaths as the "Father of the concept of nosodes and sarcodes" and is praised for their introduction and further development, his significance for the practice of nosode therapy in the first half of the 19th century is currently overrated. By contrast, the influences of Lux' works are barely known. As already mentioned, nosode therapy was only used to any great extent by homoeopaths after the publication of Lux' Isopathik.  An evaluation of case histories with nosode and sarcode treatments from the AHZ shows this to an impressive extent. A massive increase in the dispensation of nosode preparations can be seen after the publication of Lux' Isopathik in early 1833. Even by the mid-1830s, their frequency of prescription dropped considerably again, which was partially linked to the publication of the "Geheimmittel" in 1834.

Due to the wide reception of Isopathik, it was logical that the question of isopathy became a matter of debate amongst homoeopaths. There was the question of both the classification of nosode therapy as a form of homoeopathic or isopathic treatment and also the necessity of the foundation of a new method of healing, which was superior to homoeopathy. However, after nosode therapy was made subordinate to homoeopathy as a result of several controversies, the discussion continued unabated on whether the principle of homoeopathy should, rather than "Like cures like", be "Things cure themselves". Through his publication of Isopathik, Lux shook the homoeopathic world down to its foundations.

Here, it should be noted that multiple factors had to come together to make such a fundamental querying of the basic homoeopathic principles possible at all. Of key significance here was surely the circumstance – of which homoeopaths are not always aware – that the central similarity condition of the homoeopathic treatments was not clearly formulated. Hahnemann, the founder of homoeopathy, also contributed to the lack of clarity regarding the central basic principle of homoeopathy. Even in the first edition of his Organon (published in 1810), he explained the healing effect of a medicament based on the principles of similarity between the complaints of the patient and the symptoms occurring through the prescription of medication. He also failed to present the principle of similars clearly and unmistakeably – for example, through practical experience – which has led to the various versions of the principle of similars, stretching through to the present day.

On the one hand, there is the question of how far Hahnemann would have been able to present the basic principles of a therapy based on similarity in an exact and clear manner. The mutual distinction of the terms of similarity and equality has been the subject of discussion since the time of the ancient philosophers and has still not been decided upon once and for all. On the other hand, the question can be asked about whether the lack of clarity in the homoeopathic statement of similarity maybe had a positive impact on the practice of homoeopathic therapy, such as training using many different approaches to treatment and the variety of homoeopathic schools, which have lasted through to the present day. Nosode therapy was also able to profit from this. The classification of the nosode preparations as Simillimum instead of the more common homoeopathic Simile or isopathic Aequale in the context of the isopathic debate was, in the long term, the foundation for the exceptional significance of the group of medicaments. To a certain extent, this stylised nosode therapy as the ideal form of homoeopathic treatment. The fact that the nosodes have enjoyed a kind of special status, even up to the present day, was underlined by the study "Patienten in der homöopathischen Arztpraxis", which was published in the AHZ in 2006. No less than three of the ten most common medicaments used in the homoeopathic-paediatric treatment of chronic illnesses were nosodes. In classical homoeopathic therapy (compared with the substance groups of the homoeopathic remedies usually employed in practice), this group ought to represent a small group of medicaments in numerical terms.

The above-mentioned study is interesting for a number of other reasons. The three nosode preparations mentioned are a part of the inherited nosodes, made up of the preparations Psorinum, Medorhinnum, Syphilinum, Tuberculinum and Carcinsinum and are also frequently applied according to miasmic criteria. According to Hahnemann's miasmic concept, any ailments can be traced back to infection with the three basic illnesses: Psora (scabies), Syphilis and Sykosis (gonorrea). The latter can only be treated with specific medicaments with an antimiasmic action, amongst which many of today's homoeopaths would include the nosodes belonging to the basic illnesses. As the previously mentioned evaluation of AHZ case studies showed, even in the first half of the 29th century, nosodes were already being used by some homoeopathy as antimiasmics. However, in complete contrast to today, nosode preparations had only a minor role to play in the treatment of chronic miasma. Only approx. 10 % of all nosode prescriptions were made according to miasmic aspects or after suppression of skin diseases in the patients' case histories. Nosodes were far more frequently used in the treatment of epidemic acute illnesses, as well as other externally visible ailments. Accordingly, Vaccinin, Variolin, Anthracin and Morbillin could be found amongst the most commonly prescribed nosode preparations. The frequent use of nosode preparations in the treatment of infectious illnesses can easily be explained by the fact that, at that time, infectious diseases represented a not insignificant threat to the population, as there were no as yet effective therapeutic methods for their treatment. Thus, effective agents were sought for the fight against epidemic acute illnesses and it was hoped that nosodes were such agents. In addition, in their early works, which formed the basis of nosode therapy, both Hering and Lux expressly recommended the use of nosode preparations in the therapy of infectious acute illnesses.

In this context, it does though remain astonishing that the most commonly prescribed nosode was Psorin. A key reason for this can surely be seen in the fact that there were actually records of medical testing on healthy people for just this nosode, subsequently allowing the agent to be included in homoeopathic medical training, repertoires and lexicons of symptoms. This again shows the major significance of valid therapeutic experience and, in particular, the execution of medical testing on healthy people for the practice of nosode therapy in the first half of the 19th century. That little has occurred to change this up to the present day is shown by the fact that, in comparison to other preparations of this group of medicaments, there are also comprehensive medical pictures for the inherited nosodes – the nosode preparations most frequently prescribed these days (see above) – which are based on both testing and practical experience. An additional reason for the frequent contemporary dispensation of just these preparations can be found in the further development of miasmic therapy in the context of an increasing link with nosode therapy.

These days, nosodes, as previously mentioned, represent an integral component of the homoeopathic pharmacopoeia. This also applies to sarcodes, which may currently have a smaller role to play in current homoeopathic practice than nosodes, but which are also an essential part of the homoeopathic pharmacopoeia. Irrespective of the major significance of the two groups of medicaments for homoeopathy, the continued existence of nosode and sarcode therapy in large parts of Europe (including in Germany) is greatly at risk. For reasons of medical safety, many preparations have also been withdrawn from the market, as the original substances are potentially infectious. Set against this background, it is thus even more significant not to lose sight of the long tradition of nosode and sarcode therapy, which stretches back to the first half of the 19th century (or, through traditional organ therapy and practices of similarity, even back to the Ancient world). Without nosodes and sarcodes, the homoeopathic method of therapy would not only lose significant medicaments but also a part of its (historical) identity.