As much as homeopathy is a therapeutic system centered on experience, it is also a philosophy and ideology (Pinet 1998). Philosophy and medicine are not such strange bedfellows as one might suppose. Indeed, my homeopath interlocutors would argue that conventional biomedicine is philosophically impoverished. The great philosopher of medicine Georges Canguilhem (Canguilhem 2008a) reminds us that health is not a neat object of scientific judgment. Invoking Kant, he tells us
“He can feel well (to judge by his comfortable feelings of vitality), but he can never know that he is healthy… Hence if he does not feel ill, he is entitled to express his well-being only by saying that he is apparently in good health” (Kant 1979:181). These remarks by Kant are important, in spite of their apparent simplicity, because they make health an object outside the field of knowledge. Let us bolster the Kantian statement: there is no science of health. Let us accept this for the moment. Health is not a scientific concept; it is a crude concept. Which is not to say that it is trivial or out of reach, but simply rough and inexact” (2008a:469).
Health is indeed a crude concept, and medicine, that sphere of knowledge brought to bear on its amelioration, must be able to take this crudeness into account if it is to do its job properly. This is why Martin, a homeopath, believes that the physician is not a scientist: medicine is not a rigorous science like physics or chemistry; one works with human beings, which are more complex and require intelligences and sensitivities that lie outside the realm of science. Martin alluded to the idea that science proper can tell the physician only so much about the patient, and that a certain art and intuition must accompany scientific knowledge. Martin’s point here, and the larger philosophical basis of homeopathy, is that finding ways to talk about health and illness that lie beyond science in its strict sense might make for better medicine. These new ways of talking should attend to the experience of illness, including its psychological and social dimensions.
In the sense that traditional homeopathic practice echoes Canguilhem and Martin, homeopaths are all philosophers. They build upon the scientific foundations of their training, incorporating the vagaries of human experience into their therapeutic gaze. Hahnemann’s original concept for
homeopathy was not so encompassing, but over the centuries the method has surpassed the boundaries of therapeutics to articulate a larger philosophy of life. Critics charge that
homeopathy undoes itself by reaching too far, laying claim to too much territory outside of medicine (Stalker and Glymour 1989), but for homeopaths, one cannot disentangle illness from life itself; they must be approached as a whole.
I believe that the thickness at stake in the industrial transformation of homeopathy is precisely this philosophical orientation, and this chapter is dedicated to “thickening” our understanding of the thickness. For industry, a “crude” concept of health cannot be translated into catchy marketing messages and concise product claims. For these priorities, a “tidy” conception of health is required, one which has been de-constellated from its thick surround of illness experience, and homeopathic ideology, and history and re-constellated within a thin market matrix of discrete, branded definitions of health. For the consumer, the pursuit of health is recast as shopping.
I was fortunate enough to speak with two individuals who have formal training in philosophy in addition to their medical training. They helped me to gain a deeper understanding of
homeopathy’s philosophical-therapeutic thickness. In the first section of what follows, I let the voices of the philosopher-doctors describe what philosophy means to homeopathy. Later, I explore other kinds of thicknesses: Thick Experience, Thicker than Rationalism, Rejected Thickness, Philosophical Vitalism, and Care and the Caregiver.
Philosopher-Doctors
While not all homeopaths are able to quote philosophers at will, a general awareness of France’s colossal contributions to Western philosophy runs deep in all of French culture, including medical culture. Physicians of any political or ideological stripe will invariably be able to tell you which philosophers are influential in their thinking and work. Two physicians I spoke with, Georges and
received formal academic training in philosophy. I found this combination of training fascinating and looked to them to see what they might have to say beyond the hagiographies of
homeopathy’s mythic founders and champions, the recitation of homeopathy’s endless virtues, and the equally endless complaints and recriminations against biomedicine. It turns out that they had a lot to say, and while many others had warned me of the impending doom of their traditional way of practicing homeopathy, few outside of Georges and Guillaume were able to move beyond the common refrains, and none were able to do it as powerfully.
I arrived in Georges’s clinic in Strasbourg on a hot afternoon. The neighborhood was sleepy. I mounted the stairs to his office above a travel agency and as I opened the door, I scanned the room and noticed his enormous desk facing me against the window looking out onto the street. It was flanked on either side by children’s toy sets and colorful books. It was my first time in a homeopathic clinic for children and I was surprised by how awkward I felt. I realized I had never given much thought to homeopathy for children as all of my time had been spent talking with adults about other adults (patients, allies, adversaries, etc.). In almost every respect it was just another private pediatric practice. The one exception was that the clinic’s physician was a homeopathic pediatrician who studied philosophy. Georges greeted me warmly and quickly put me at ease. My immediate thought was that he had gained this skill while working with anxious children and (projecting a bit) I was grateful that he had.
My undergraduate degree is in philosophy, and I was eager to hear his thoughts on the relationship between homeopathy and philosophy. For Georges, philosophical awareness is central to homeopathic practice. And, as he spoke, I gathered that with this increased intellectual sensitivity came equally increased moral and affective sensitivities. Both dispirited and resolute, he told me of his belief that the loss of traditional, clinical homeopathy is a condition of our
increasingly secular and materialistic world. It is a world where we have lost certain wisdoms and values, where we have forgotten that “that which has value has no price.”
…In our material world…which is to say a world without God, a world without spirit where everything is for sale, everything was thought, but there is nothing left that has value, that is to say dignity.
Georges’s indictment of the modern world echoes that of homeopathy: modern medicine has become a pernicious form of materialism that alienates the patient from the meaning of her own bodily experience. I did not find this statement surprising, but I did find it extraordinarily eloquent compared to other formulations I had heard from homeopaths. Neither was I surprised to hear Georges mention God. Indeed, a number of those I spoke to, especially Julien and his coterie of friends and colleagues, explicitly wove their Christian beliefs and their commitments to
homeopathy together. For Julien, homeopathy’s notions of purity, authenticity, and naturalness aligned with his conception of God’s wishes for an orderly and just world. This included
conceptions of the body, which are inscribed in a hybrid rationale of modern medicine and Christian faith.
Homeopathy for Georges is not just something he does in his clinic; it is a social-political- philosophical project of trying to restore a sense of appreciation for the value of certain things, particularly the inherent dignity of life and the body. He told me that homeopathy is uniquely qualified to achieve this because it is
…A form of wisdom that exists outside of time…it has a dignity.
Homeopathy, then, seems to be a form of conjuration, a type of medicinal incantation that removes the contamination of modernity (technological enchantment, commodity fetishism), and aims to restore essence to things that are out of balance internally and with one another: the body, the psyche, and social relationships. For Georges, Nature bestows us with inherent balance, which is our authentic, default state of being. Through negative influences (e.g.
biological contagion, poor self-esteem, social discord, misplaced desires, anxieties, disagreement between one’s internal “systems,” disagreement with one’s internal systems and external forces), authenticity and balance are compromised. Homeopathy restores authenticity by putting the self
back in tune with itself. Homeopathic practitioners are the bearers of this message of restoration, as well as the agents of its performance. As we will see below, the notion of balance and re- tuning the self are critical components of homeopathy’s thickness.
Moments into our spirited discussion of philosophy and homeopathy, Georges invoked the founding prophet of homeopathy, Samuel Hahnemann:
Hahnemann gave us something. We received it and now we seek to give it back. “The Three Graces”: the given, the received, the returned. That is, now the old guard like me, we teach, we transmit the knowledge and knowing that does not belong to us…[we are] the messengers of the gods, but not just of the gods, of men too…[we are] “psycho- ponts” [“psychological bridges”], that of messages, mediators.
In Georges’ estimation, homeopathy is the capacity for rendering visible, the inherent dignity of the world bestowed by Nature or God via the body, a dignity which modernity, materialism, and science had diminished. I had heard this word “dignity” before. Why was it so important to him and to homeopathy? What was its starting point? Where did it come from? Some had
mentioned it in the same breath as religion, but that was the exception not the rule. More commonly there seemed to be a secular-spiritual a priori assumption that some value adhered in human existence that transcended not only the ways of scientific seeing but also the modern world’s ways of reckoning value and meaning. For Georges, and for homeopathy more generally, the dignity of human existence was a self-evident first principle as incontestable as the laws of gravity and motion. As he spoke about dignity, my momentary exasperation gave way to a realization—I had already heard the answers to my questions about dignity many times without realizing it. I had overlooked it because I was being “too rational”, looking for a reason for dignity’s existence; it does not have one; it simply is. If I had followed the admonitions of the homeopathic “gospel” to let go of my “hyper-rationalism,” I would have discovered sooner that such things as dignity, meaning, and value (a fortiori wellness and illness) cannot be always encountered through reason and must be accepted as universal truths.
… Today there is a global inversion of all values. We walk on our heads, actually! And the word technê has become “technique,” so we only see the appearance of clinical research called Evidence Based Medicine, but Evidence Based Medicine is not the
original technique. For example, EBM is based on 4 pillars, not only clinical, but also the life of the patient, medical ethics and circumstances. So there is clinical research, circumstances, physician ethics, patient's opinion, therefore [with] EBM, since the American term "Evidence Based Medicine" has become the norm, everyone thinks that Evidence is [the same as] “l’évidence” [“an obvious fact”], but these ideas are “faux amis!” [“false friends”]. […] So, I want [a] science very much in the sense of technê, ancient Greek, that does not describe technique, but rather talks about “the medical arts,” but “art” in the generic sense, which is to say with the ensemble of its components, including technical components, that is with clinical research, double-blind studies, randomized control trials with placebo, etc. […] For medicine not to be determined by technique. Georges’s point here is well taken. Medicine’s enchantment with technological achievement has occasioned the emergence of a sometimes-harmful moral logic of treatment where possibility is reconfigured as imperative (Good 2001). In the study of Greek philosophy, technê is often contrasted with êpistemê (not to be confused with Foucault’s formulation). The latter refers to knowledge, while the former refers to art or craft. Over time, technê has mistakenly come to be seen as “practice,” the province of facts, when it is actually more accurately the province of “how things should be” (Parry 2014). In an ideal world, this should be a domain off limits to science proper (e.g. Beauvais 2007b; Benveniste 2005; Fottorino 1997a; Fottorino 1997b; Fottorino 1997c; Picart 1994). What we think of as orthodox scientific knowledge is closer to êpistemê. Georges wants a medicine that is both technê and êpistemê, that is art, craft, and knowledge, but which also is able to articulate a moral position that calls out the neglect of what is essentially the secular divinity of human life.
So a human being by its nature… I say… I don't take care of Airbuses or Boeings, I don't take care of animals; I care for humans. Yet a human has dignity, the dignity of humanity, the dignitas of the Latins and the dignity of the Greeks, and voilà. This is simply evidence, but this time not 'evidence' as in proof, but something that is in front of our eyes, you know? One cannot deny that!
The notion of an inherent human dignity in homeopathy is an explicit argument against biological reductionism and physicalism. For homeopathy, there is always a soul that underlies the self, though it may be called by other names (e.g. essence, nature, spirit). It is a lived-soul in communication with the lived-body. This is the “whole person” that is the object of homeopathic thickness.
Guillaume is the other philosopher-doctor I met. He and his wife graciously welcomed me for the weekend into their beautiful home which was nestled on a hill overlooking a picturesque village at in the Jura Mountains. I was weary from my long trip from Paris, which had involved both air and car travel, and I was grateful for the serenity of the setting. I barely had time to sit down when Guillaume started enthusiastically asking me questions about my work and how he could help me. A late-middle-aged man, he had the energy and enthusiasm of someone half his age. He beamed with an optimism that was unusual among the usually forlorn community of homeopaths. I was touched by his curiosity and deeply flattered by his questions and comments about the larger implications for anthropology of my research on homeopathy. Our interactions that weekend ended up being the high point of my entire sojourn in France. It was a supremely stimulating weekend after which I felt like I had learned more about homeopathy than I had in the previous six months. Guillaume was remarkably generous with his thoughts and opinions and made sure to hold my hand as he gave me a guided tour of his perspective on homeopathy, particularly its philosophical dimensions. He was not just an interview subject; he was also a teacher and friend. Below, I quote Guillaume at length because he represents himself much better than I could try to distill him.
Guillaume wanted to make sure I understood that despite our ascendance into the exalted realms of philosophical reverie, our discussion was nonetheless absolutely grounded in the concrete. I had the sense that having to justify and ground his philosophical musings in “the real” was a reflex acquired from earlier encounters with skeptics and would-be converts. Homeopaths are accomplished rhetors. It comes with the territory. And while just decades ago such rhetoric might have been targeted toward potential new patients and clinical settings, it is more often today directed internally, at homeopathy itself, as activists like Guillaume struggle to corral opinion among his colleagues, a necessary precondition for hope.
…All this is not a theoretical, abstract discussion of the real. All this is a theoretical discussion starting from the real... No, that's what is important, finally it seems important to me... It is not the theoretical plated on the concrete; it's the theoretical extracted from
the concrete. […] What Husserl says, or I think a lot in Merleau-Ponty, but it's that... returning to things in-themselves means returning to a world before knowledge in which knowledge always comes from, let's say, geography, to define what a river and
landscapes were... This means that scientific abstraction starts from the concrete and from the world of life... and that the world of life is not a kind of little superfluous thing; it's the basis of everything. When we practice homeopathy, we stick to the disease as the sick person experiences it and this can't be devalued because the disease as the patient feels is the basis of everything. It's even the basis of what the scan, the MRI, and the rest show... And if today we can do without the experience of the disease by the patient it's because yesterday the patient’s experience of the disease allowed the development of techniques that today allow us to do without it. That is, if today we can detect a coronary problem due to the ultrasound without you having cardiac symptoms, this is a type of progress and it's so much better, but this does not devalue the symptomatology that has long since been at the origin of all these discoveries. So what the patient experiences, the fidelity to the experience of the patient can never be ignored...except by positivism in the bad sense of the word. Really extreme I mean, ideological, dogmatic. It cannot be devalued; the vital field is the field of all fields... And homeopathy sticks to the vital field. Guillaume’s comments here are a call to allow the illness experience to serve as a diagnostic tool that is as epistemically “hefty” as an MRI scan. For him, patient experience is no less informative an instrument of diagnosis than any other tool. Indeed, in this sense patient experience can be seen as a homeopathic diagnostic technology. And, importantly, there is nothing “less real” about this experience. For homeopathy, it is no less concrete than one’s flesh and blood. As such, experience is thus established as an infallible basis for subsequent reasoning, i.e. diagnosis and