patients over a period of time while they are appropriately treated and managed by the (hom~eopathic) physician. The length of time necessary for follow-up would depend upon the type of illness and the remedies involved, as some are said to take longer than others to begin to work. Who can say that a patient's good response to a second remedy given was not because the first remedy, although possibly showing 'little' physical evidence of a response, actually prepared the patient for the improvement (one must obviously take into account the length of time a remedy is said to work for, once it is no longer given). Such problems as 'proper clinical trials' are not new to hom~eopathy; those who do not study the past are doomed to repeat its failures, as this quotation from 1852 points out:

"Why will not Allopathists remember, that when the line of direction (by way of potentization) of a drug is changed, all the circumstances of the case are so altered, that reasoning by analogy becomes palpably illogical? Their comparison o f the drugs in question, reminds me of the silly formulae made by little school boys, just commencing the Rule of T h r e e . . . such as, if a pound of soap costs a dime, what will a bushel of corn come to? In which there is no natural relation between the elements of the problem. When we begin to apply a remedy hom0eopathically, we enter on a new field of observation, in which all previous experience with drugs is comparatively valueless. It becomes our obvious duty to record the facts and to practice upon them. ''7

It is a highly questionable scientific practice to dismiss a body of significant imperical evidence (such as hom~eopathy) simply because the underlying philo- sophy, which rationally interprets such results, assumes premises foreign to those currently accepted.

REFERENCES

la Polanyi M. PersonalKnowledge. University of Chicago Press, 1962. Chap. 5. lb Kane J. Doctoral thesis, New York University, 6/82. 2 Wolff O. Conferenc~ on the Seven Metals. Wilton, N. H., 6/80. 3 Polanyi M. Study of Man. University of Chicago Press, 1968, p. 54. 4 Those interested in a detailed discussion of the eanses of these imbalances should begin with Lectures to

Young Doctors, by R. Steiner, Jan. 1924, obtainable from Dr M. Evans, Park Attwood Therapeutic Centre, Trimpley, Bewdley, Worcs. DY12 1RE.

5 Culpeper N. Culpeper's Complete Herbal. 1640, p. 12. 6 Mathur KN. Principles of Prescribing. Bombay: Jain Pub. Co., 1981. 7 Holcombe W. The Scient~cBasis of Honu~opathy. Cincinnati: H. W. Derby, 1852, p. 183.

International Homoeopathie Congress Vienna 1983

When we flew into Vienna I was surprised to see that the city covered such a large area. It lay on either side of the Danube, which unfortunately at that time was grey, not the expected blue. Although the winter had been mild, there was no

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evidence of the spring, and the gardens therefore were very bleak in appearance. The sun shone most of the time, hut there was a bitterly cold and often strong force wind blowing. This retarded the expected flowers, but in no way dampened the enthusiasm for the social programme.

The opening reception was marred by the Hilton's failure to assess our appetites, and the buffet ran out after ten minutes. The opening tour of Vienna was disappointing as the published eight-hour drive was shortened to two hours in the morning. It did however include the famous Schoenbrunn Palace, and this was greatly enjoyed. In the evening we visited a typical wine cellar in Grinzing, and thoroughly enjoyed the typical Viennese evening with wine and music under the shadow of the famous Vienna Woods. This did much to break down the formal atmosphere of the Congress. The other features of the social programme included a trip to Neusiedl with an excursion on an Old-Time steam train to the famous lake, returning via Esterhazy Palace. There was a further tour of the Vienna Woods, visiting the Liechtenstein Fortress and the Cistercian monastery with the famous Verdun Altar and returning via Mayerling where the former Prince Rudolf had his hunting lodge. The Vienna Boys' Choir put on a marvellous per- formance at the Palais Augarten, the former hunting lodge of Maria Theresa, a building characterized by strict naval precision. In addition visits had been arranged to the Vienna State Opera and to several of the museums with their fine collections of pictures. The whole programme was brought to a conclusion by a dinner and dance held in the Town Hall decorated with the flags of all participa- ting nations, by kind permission of the Mayor.

The scientific sessions of the Congress itself were opened by Dr M. Dorcsi, Pre- sident of the Congress, supported by Dr K. H. Gebhardt and Dr K. H. Illing, Pre- sident of the League. Visiting Professor A. Stacher stressed the importance of the patient in medicine and made a plea for tolerance. Dr H. Pietschmann, Professor of Physics at the university, then gave an address entitled "Medicine--A dis- cipline between art and science". These philosophical papers were interspersed with Viennese music played by the Wiener Instrumentalsolisten which I think everyone thoroughly enjoyed.

Education had been chosen by the Council as one of the main themes for the Congress. The aim is to formulate the essential fundamental and basic principles of homoeopathy which would be acceptable worldwide. With this basis, pro- gressive improvement in education could be achieved. This has never been achieved until now. In Asia and South America excluding Brazil, the aim has been to train homaeopathic doctors from the outset of their medical training. This, they maintain, is essential to ensure the doctors' correct orientation to Hahnemannian principles. In the West, however, the emphasis has been on postgraduate study, enlarging on existing knowledge of pharmacology and clinical medicine. This is particularly important nowadays when patients attending for homceopathic treat- ment often have homceopathy combined with their existing basic medication. If the doctors were not instructed in orthodox pharmacology they would have to rely entirely on allopathic colleagues for maintenance of this part of their therapy. This would result in two doctors attempting to collaborate in the management of one patient, and we feel this is unsatisfactory. This trend has been increasing in

15 2 The British Homaeopathic Journal

recent years, and we feel it will soon extend to Asia and South America. It is note- worthy that Hahnemann himself admitted that some patients were "incurable", and it is in this field that combined therapy may well be required. To gain the respect of our orthodox colleagues it is essential for us to be able to speak to them in a language which they can understand, and without training in ordinary medicine, this would be difficult. However, it is now recognized that drug therapy plays only a minor part in the management of the patient, and with this I think we would agree, provided they accept the homcropathic approach as an essential adjunct to this management.

These proceedings were opened by Dr Dorcsi speaking on the Viennese School, and their personotropic medicine. He advises his students to ask four questions:

Where - that is, the location and extent of the condition How - the nature of the patient's response and symptomatology When - the aetiology and modalities of the symptoms Who - the patient's general and individual characteristics

All doctors seek to cure their patients, and he therefore called for a synthesis of the orthodox and homceopathic schools.

Continuing this theme, I drew the attention of Congress to Hahnemann's three basic points of cure:

1 The clinical medical aspect, and we consider thut excellence in this art is essential for a good homQeopath

2 The pharmacology, pointing out that homoeopathic drug action was a mirror image of orthodox pharmacology

3 The appropriate employment I suggested that these points were sufficiently simple to be accepted by homceopathic physicians throughout the world and yet explicit enough to be understood by our orthodox colleagues and so gaining their respect.

The South American School, under Dr Ortega and others, presented their series on the chronic miasms. The points they made have largely been covered at the congress in Brighton and provide no further information. In the end they again would appear to use the similia principle for their choice of drug.

It would be quite impossible to mention all the papers, but I feel I should draw your attention to a very neat paper submitted by Dr Charles Elliott. In a succinct, well illustrated paper, he discussed 17 patients who had responded to Calc. phos., and the conclusion which could be drawn.

Another paper worthy of mention was presented by Dr H. Pfeiffer of Germany, discussing the relations between Calc. carb., Calc. phos., Acid fluor, and Acid nit., placing them respectively in the psoric, hypotensive, phlegmatic group, the tuber- culinic, athetotic group, the syphilitic, spastic group, and the sycotic, ataxic group.

Mr John Ainsworth gave an interesting paper on the spread of homoeopathy throughout the world in the last 50 years.

As usual, there were several papers on the use of potentized hormones-- Folliculinum in aiopecia, and DNA and RNA particularly in malignant disease or advanced collagen disease. The scientific approach took an important place in the discussions, and it is only possible to mention a few, particularly one by Dr Belon from Boiron Laboratories presenting a series of photographic evidence of the use

Volume 72, Number 3, July 1983 15 3

of Arnica in plastic surgery on the face. The problem was on how to ensure adequate standardization and it proved impossible to assess the extent of the bruising from the photographs. This strikes me as most unusual, for surely with modern technology this ought to be easy. Arnica 7ell was used.

Boiron Laboratories provided an interesting series of papers in demonstrating the protective effect of hom0eopathic remedies in induced cancer cases. Further studies were also given, demonstrating the effect of potentized Arsenic on the excretion rate in arsenic poisoning. Mme Binsard's team presented an interesting series of cases using accepted models for assessing the effects on the gastric actions of histamine. She compared the effects of Histamine and Apis in several potencies and noted that Histamine did produce a certain protection. In addition the team presented a very neat experiment demonstrating that the circadian rhythms affected the toxic manifestations of mercury and that this was reflected in the efficacy of Mercury in potency. Such a factor further complicates the problem of experimental proof. In other experiments she showed the protective effect of Mercury C5 and C9, but not in C 15. Unfortunately, as on previous occasions, the papers presented were not those published in the Proceedings, nor were the inter- preters familiar with them, which made them very difficult to understand, and of course the diagrams, too, were different. The recurring incidence of this to my way of thinking mined the good of these papers.

Mile David from Boiron Laboratories demonstrated the high performance liquid chromatography which is presently used. This technique was found to be more sensitive, the results were reproducible, answers achieved in a shorter length of time. By this method, concentrations of less than 10 -9 (one nanogram) were easily identified.

Professor V. Gutman and Dr G. Resch, both of Austria, presented a very high- powered paper demonstrating that potency energy does exist; that it does not con- form to the normally accepted physical principles which have been based on ideal models--as these do not in fact occur in nature. In trituration and succussion, a dynamic energy pattern is liberated and the solvent "memorizes" the characteristics of the solute. The process of dilution has the effect that the energy contained in the molecules has a very much greater freedom of movement. The memory can be transferred to glass, as many hom~eopathic pharmacists have stated. These effects are present using water as a diluent, but are enhanced in the use of alcohol mixtures and by succussion. Preliminary experiments suggest that the centesimal scale of potentization gives results superior to the decimal.

It must not be taken for granted that the other papers do not merit mentioning, but it is impossible to describe them all in a short report.

There are several points I feel should be rrsolved before the next International Congress. It is important that the copyright be settled, but at this congress both video and tape recorders were in evidence and their showing to non-professional audiences may compromise the contributors, especially if they are misrepre- sented and taken out of context. The papers presented for publication in the Pro- ceedings should be the same as those presented at the Congress; only in this way is the audience able to assimilate the material and the interpreters enabled to do their work efficiently.

15 4 The British Homaeopathic Journal

The Council were very concerned to learn of the inconsistencies in the recent Rhus tox. trials carried out in Britain. They feel that every effort must be made to ensure complete accuracy of the preamble and protocol of such trials. They remarked on the almost instantaneous worldwide distribution of reports on this trial, under the banner headlines "The Trial of Hom0eopathy". It was implied that Rhus tox. was considered to be the treatment for osteoarthritis and its action similar to that of analgesics. The Council emphatically denied that such views were ever held by hom~eopathic physicians. One doctor suggested that this trial was similar to one comparing the results of the surgical reduction of a fracture with morphia. Such a trial is patently ridiculous. They further commented on the conclusion of the trial that stated that there was no difference between Rhus tox. 6x and placebo, yet in the text reference was made to aggravations which occurred after Rhus tox. 6x but apparently not after placebo. It was noted that neither of the homceopathic physicians undertaking the trial had commented on this inconsistency.

Only bona fide medical students should be allowed to attend at the reduced student rate, and it has been suggested that anyone who is not a member of the International League should be required to pay a higher attendance fee.

In conclusion I should like to thank both the Faculty and the Trust for their interest and help in defraying my expenses to attend this International Congress. There is no doubt that the presence of Britain at these congresses is always regarded as extremely valuable, and I fancy it is because the British have a reputation for being first-class clinicians.

C. OLIVER KENNEDY

Medicine A discipline between art and science

DR HERBERT PIETSCHMANN*

1 Introduction

Today, there is again considerable discussion as to how far medicine should make use of scientific methods, and indeed as to what should be regarded as "scientific method". I hope to show, in this address, that the simple either/or type of log ic - - an approach apparently so dear to our hearts that we tend to apply it to every- thing--always misses the mark when it is used in the complex fields where specifically human aspects also have to be taken into account. I think we are all agreed that medicine is one of these fields. To begin with, we need to consider in

An address given at the International Homceopathic Congress held in Vienna in March 1983. *Professor of Physics at Vienna University.

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