Hahnemann's Allergy to Quinine

The first idea of the fundamental doctrine of homeopathy - Similia Similibus Curentur - seems to have entered Hahnemann's mind in the year 1790, the forty-fifth year of his life, while he was engaged in translating Cullen's 'Materia Medica' into German^[1].

In the question of the medicinal effect of Peruvian bark, Cullen defended the old opinion of the efficacy of this remedy through its 'tonic effect on the stomach'. Dissatisfied with the author's explanation of the action of Cinchona bark in curing intermittent fevers, Hahnemann resolved to make trials with it on his own person:

"I took by way of experiment, twice a day, four drams of good China (Cinchona). My feet, finger ends, etc., at first became cold; I grew languid and drowsy, then my heart began to palpitate, and my pulse grew hard and small; intolerable anxiety, trembling, prostration, throughout all my limbs; then pulsation in the head, redness of my cheeks, thirst, and in short, all these symptoms which are ordinarily characteristic of intermittent fever, made their appearance, one after the other, yet without the peculiar chilly, shivering rigor, briefly, even those symptoms which are of regular occurrence and especially characteristic - as the dullness of mind, the kind of rigidity in all the limbs, but above all the numb, disagreeable sensation, which seems to have its seed in the periosteum, over every bone in the body - all these made their appearance. This paroxysm lasted two or three hours each time, and recurred if I repeated this dose, not otherwise; I discontinued it, and was in good health."^[1]

Jesuits brought Peruvian bark to Europe in 1632. It was known that the bark of various Cinchona trees, native to South America, had curative effects in fever^[2]. The first actual mention of Cinchona bark, named after the Countess Anna Chincon, whose husband was Viceroy of Peru, is in a book from 1643. The first record of its use in England is in the casebook of a Northampton doctor in 1656.

Cinchona bark was accepted into the London Pharmacopoeia in 1677 under the name Cortex peruvianis. Linnaeus established the genus Cinchona and in 1753 named the tree Cinchona officinalis^[3].

The Cinchona was imported in the form of dried stems and root bark. This was supplied in fine large quills called 'druggists' or 'pharmaceutical' bark. The active alkaloids appear to be present in the parenchymatous tissues of the bark to the extent of five to eight per cent. The amount of alkaloids present and their rations to one another vary considerably in the different species of the tree and the age and method of collection of the bark. For use in galenicals, the drug should contain not less than six percent of total alkaloids, of which not less than one-half consists of quinine and cinchonidine.

The genus Cinchona numbers some twenty to thirty species besides numerous varieties and sub-varieties. The following species were imported and used in Europe for medicinal purposes around the year 1790:

Species	Total alkaloids	Quinine
Cinchona officinalis	6%	3%
Cinchona calisaya	5-7%	3-4%
Cinchona succirubra	6-9%	1.3-3.5%

Hahnemann could therefore have used the Cinchona bark in a rather crude form, taking a teaspoonful of the bark, often in a glass of claret, or in the form of galenicals. There have been at least three noted galenicals^[4] which appeared in the middle of the 17th and 18th centuries, used an infusion of Cinchona bark as a remedy for agues and fevers. In whatever forms Hahnemann used the Cinchona bark, the quinine content is important for our purpose. Whether in the form of a galenical, or powder, the quinine content could have been only about three per cent.

That Hahnemann could not have taken pure quinine, as it is quite often reported in homeopathic literature, is clear from the following:

The single dose of Chinidin sulphuricum is 0.2 gram; the dose per day is 1.5 gram. Maximum single dose is 0.5 gram, and maximum dose per day is 2 grams.

PONDUS MEDICUM NORICUM (Nuremberg weights in Hahnemann's time)
ONE DRAM	*equals*	sixty grains
1 grain		0.0621 GRAM
60 grains		0.0621 x 60 = 3.726 GRAMS
3.726 x 4 drams		14.904 GRAMS
FOUR DRAMS		FIFTEEN GRAMS

There are, however, conditions known as hypersensitivity^[5] to quinine, when small doses of Cinchona alkaloids cause toxic manifestations; the individual is usually hypersensitive to the drug. Cinchonism is the term given to a group or symptoms, which usually occur when quinine is given repeatedly in full doses.

The most common adverse reaction to Cinchona alkaloids (quinine and quinidine) in Australia^[6] from November 1972 to March 1988 were thrombocytopenia, anorexia, nausea, vomiting, diarrhoea, skin rash, fever, rigors, disturbed liver function, arrhythmia, hypotension, arthralgia, and deaths.

The toxic effects of quinine are tinnitus, vertigo, visual impairment, rashes, nausea, vomiting, diarrhoea, abdominal pain, fever, hypotension, convulsions, respiratory depression, cardiac irregularities, weakness, drop in blood pressure, and kidney failure with anuria.

The vivid description of symptoms which Hahnemann experienced and described in 1790 after 'four drams of good China', is an excellent report of a hypersensivity state to quinine. Hahnemann's four drams of good China is fifteen grams of Cinchona bark powder, which contains between 400 to 500 milligrams of quinine. This represents the therapeutic or suppressive dose of quinine, a dose, which has been taken by millions of people in the past one hundred and fifty years with minimal, or no side effects.

What did Hahnemann experience in 1790 after ingesting four drams of Cinchona bark approximately 0.447 grams of quinine? He felt languid and drowsy, which corresponds to hypotension. He noticed palpitations, signifying cardiac irregularity, most probably ventricular tachycardia. Pulsation in the head is a good description of headache, as is redness in cheeks of a rash. Prostration through limbs signifies weakness. We all feel thirst when we are feverish, so did Hahnemann. Cold fingers and feet with trembling are typical of any allergic reaction. Hahnemann's 'disagreeable sensation' means that he felt generally unwell.

It can be concluded that Hahnemann suffered from hypersensitivity to quinine. This means that the fundamental doctrine of homeopathy - Similia Similibus Curentur - is based on a pathological condition of its founder, Dr.Samuel Hahnemann, an allergy to quinine.

In view of what has been said, the following homeopathic statement: 'Cinchona bark was to Hahnemann what the falling apple was to Newton and the swinging lamp to Galileo'^[7], brings a new light to the whole teaching of homeopathy^[8].

[1] Cullen, W.: 'Abhandlung uber die Materia Medica. Ubersetzt und mit Anmerkungen versehen von Samuel Hahnemann.' 2 Bande. Im Schwickertschen Verlag. Leipzig 1790.

[5] Bayr, G.: 'Hahnemann's Selbstversuch mit der Chinarinde im Jahre 1790.' Haug Verlag, Heidelberg 1989. [Bayr mentions the possibility of Hahnemann being hypersensitive to Quinine (pp.9-10; 62) ].

[6] Australian Adverse Drug Reactions Bulletin. December 1988, Canberra City, ACT 2600, Australia.

[7] The sentence "Cinchona Bark was to Hahnemann what the falling apple was to Newton, and the swinging lamp to Gallilleo" comes from: Clarke, J.H.: 'A Dictionary of Practical Materia Medica'. In two volumes. The Homoeopathic Publishing Company, London 1900 (Vol.1. p.478). An Indian post-stamp carried the sentence to commemorate the XXXII. Congress of the Liga Medicorum Homoeopathica Internationalis at Delhi in 1977. It also appears on the cover of Richard Haehl's book 'Samuel Hahnemann' (New Delhi 1989 edition).

[8] Thomas, W.E.: 'Homeopathy - Historical Origins and the Present'. Melbourne (private) 1995