A review on Hahnemann’s ‘Aesculapius in the balance’

Dr Aleena George

Aesculapius in the Balance was published by Dr. Samuel Hahnemann in 1805 in Leipzig just before his long sojourn in Torgau. In this article Hahnemann is displaying his indignation at the pathetic state of contemporary therapy and how apothecaries monopolized the medical system.

After discovering the weakness and errors of the existing system of medicine Hahnemann was on a point of concluding that the whole art of treatment was vain. But he resolved not to terminate his train of thought until a definite conclusion was made on the subject. Hahnemann believed that the author of all good must have laid down means by which the innumerably great multitude of sufferings human beings experience can be removed or lessened. 

The ‘cures’ taken place so far were either due to the rigor of youth of the patient over the disease or by some other fortunate circumstances than to the medicine employed. The majority of cases for the treatment in which a physician was called in were acute diseases, which had only two outcomes; either recovery or death of patient. These recoveries were not due to the treatment adopted, but rather due to the natural strength the patient possessed which was sufficient enough to overcome the disease force and the effect of the drug which was given to him (spontaneous recovery). There were even cases were the patient recovered from the illness like a miracle when he abstained from the drug which was prescribed to him. On the other hand in chronic diseases the physicians were often helpless. But they never failed to give an endless list of excuses!

A helpful system of medicine is possible; which would benefit both the aristocratic disorders of high life in towns as well as the multitude of illness prevalent among the simple peasantry of various countries. 

In the ordinary cures there is no direct transformation of the disease into health, but only disturbances of the order of things by medicines, where these medicines possess enough power to give matters another morbid shape. 

Example: – when hysterical ailments of a person were treated, the psychic symptoms were relieved but soon ended up in metrorrhagia. Later when uterine bleeding was remedied a new disease appeared. This continued. And thus the so-called cures went on like the shifting scenes of the same tragedy!

 How can the art of medicine progress so less even thirsty-five centuries since the Aesculapius (Greek demigod of medicine) lived? We were never nearer the discovery of science of medicine than in the time of Hippocrates. In the succeeding ages some sought the origin of the disease in a universal hostile principle, in some poison which produces all maladies. Hence the universal antidote called theriaca which was composed of innumerable ingredients was celebrated. From these ancient times came the idea that if sufficient number of drugs were mixed in receipt it would restore health in nearly all bodily ailments. The discovery of printing made preliminary sciences like anatomy, physiology, botany, natural history, natural philosophy etc. greatly advanced. But the healing artist stood alone abandoned by all his renowned preliminary sciences! When a physician stumbles upon an intermittent fever, when the disease wont yield to purgatives or China bark, his knowledge in preliminary sciences were of no use. He finally prescribes a number of most celebrated febrifuges mixed all together. A regular prescription must have an orthodox form, a basis (fundamental medicine), a corrective (something added in order to correct the faults of the basis), an adjuvant (an auxiliary substance to support the weakness of the basis), and an excipient (a substance that supplies the form and the vehicle).

“The primary origin of almost all authorities for the action of a simple medicine is derived, either from the confused use of it, in combination with other drugs, or from domestic practice, where this or that unprofessional person had tried it with success in this or that disease.” 

During the medieval age, the works of Nicolaus Myrepsus (the ointment maker) like Antidotaria and Codices Medicamentarii were compiled in Italy and Paris. In Germany, around the middle of sixteenth century the first Dispensatorium was written by Valerius Cordus. Before these events apothecaries were merely medicine venders. But from the time when authorities came across these books, which were filled with compound medicines, it was necessary to give apothecaries a monopoly. After the authorizing of complicated mixture in dispensatories, these apothecaries were granted a privilege of exclusive sale of these expensive medicines. As the dispensatories were authorized by the government, the physicians were compelled to employ these compositions over simple medicines of their own choice. Gradually the small dispensatories of Cordus grew explosively, where apothecaries did whatever they could do in order to increase their formulas for monetary and other benefits. These apothecaries claimed that they had ‘formulas’ for all the diseases known to humanity. The physicians were given receipt-books of apothecaries which was filled with receipts for diseases, sanctioned by the highest authorities.

The authorities prevented physicians from converting simple drugs into compound mixtures for themselves and forbid them from giving any medicines directly to the patient. The reasons for this regulation could be:-

  • The ignorance of the present day physicians, made it impossible for them to prepare the combination of drugs! If so, how could they write a prescription?
  • Are these regulations made in order to enrich the apothecaries? If a man has become a physician it is to serve the sick and not for the sake of assisting apothecaries to make their fortunes.
  • Was this regulation passed for the benefit of the patient? But so far they have not been benefited by these regulations, only apothecaries have.

Eventually physicians lost all their dexterity and less experienced in the field of compounding, which made him the laughing-stock of the apothecary. Even though the prices of drugs were fixed by the higher authorities, apothecaries often employed cheaper substitutes instead of the ones prescribed. “But the medical regulations do not provide only for the apothecary, they are for the interest of physicians also! The latter gets 4% for every prescription.” 

The physicians became mechanical workmen, and was compelled to prescribe combinations which were unknown to him. He writes prescription for which he is never answerable and pockets the money.

Hahnemann is telling that under any circumstances the physicians should be prohibited with severe penalties for allowing any other person to prepare drugs. If any physician decides to prescribe simple medicine in its genuineness, he would be abused in every apothecary’s shop until he abandons that method.

“Adieu to all progress in our art! Adieu to the successful treatment of the sick!”


  • Dudgeon R.E. The Lesser Writings of Samuel Hahnemann. Aesculapius in the balance, 1st edition. New Delhi, B.Jain publisher, 1984; 410-434.
  • Haehl R.Wheeler M.L, Grundy W.H.R, translators. Samuel Hahnemann: his life and work. London, UK: Homoeopathic Publishing; 1922

Dr Aleena George
PG scholar
Department of Organon of Medicine and Homoeopathic Philosophy
Government Homoeopathic Medical College, Bengaluru

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