Studying from Provings: Characteristics of Remedies

monet“…So too with disease and medicines. A person familiar with the provings, will know of the characteristics of individual medicines.. He will know by its sphere of action, by its peculiar affinity to certain organs or types of action on the economy what medicines will produce certain symptoms ALWAYS in a peculiar manner to that drug, even if he has NEVER seen it in a location as is displayed before him in a case of disease. He will know the medicine by its feel, by its type of action and by its peculiar and characteristic expression, so much so that he will recognise it immediately  just like a snippet of a painting on canvas, when he sees it..”

This is from Gary Weaver’s article on Aphorism 153 and Characteristics.  For the full article click here.

Provings are difficult to study – unless you’re a genius who loves reading shopping lists of gory symptoms (and memorising every gory detail).  I’m afraid I’m not that person.  The following is a study method I developed a while back which may be useful.  I recommend writing or typing things out, following the steps, and most importantly, observe how you can start getting some true sense of a remedy through careful overview.

Provings are primary sources for our art, and therefore offer more potential certainty in prescribing than any other source.  Since so many materia medicas are copied from each other and are not primary sources, the value of working well with provings, learning to make them your “go-to” source where possible for information is immeasurable.

Studying Provings:

1.    Read Hahnemann’s preface.  Copy any points made in italics or bold print.  Note any points of interest in the introduction

2.    Go through symptoms, marking off different sections in the book/printout/wordfile – there are no absolutes and no right or wrong (except perhaps including “cramps in the calf” in your section on “inner head” – follow commonsense here…), follow your logic and be prepared to make changes as you understand better.

3.    List the section names  (inner head, outer head, vision, eyes, stomach, abdomen etc.)  There is no right or wrong (most of the time), just separate into sections that make sense to you. Start observing the order of symptoms in the provings (slightly different between MMP and CD)

4.    Count the number of symptoms in each section.   Note how many bold or italic symptoms are in each section and add in brackets after the number.

5.    Rank sections according to the number of symptoms in each – 1-10, 11-20, 21-30, 31-40 etc.  Note which sections are larger and which have much fewer symptoms.  Note where a small section may have a large number of symptoms in bold.

6.    From the work you’ve done so far, summarize in one sentence where you think the main affinities of this remedy are.

7.    Examine ratios of bold symptoms to total in each section.  Highlight where the ratio is more than 20%.

8.    Summarize in one sentence what conclusions you draw from the information you found in number 7

9.    Copy out bold and italic symptoms from each section.

10.  Read through each section and copy out or highlight:

  • any really weird symptoms that catch your eye
  • any word that seems to repeat over and over again (e.g. pressure, tension, cramp, blue, green etc.) – here if there are several do a count of occurrences to see if you can rank them.
  • any strong modality  (better for, worse for, etc.) especially if strange..

11.  Summarise the main points of the remedy that fix in your mind after doing this work.

12.  Read over your summary and glance through the symptoms every day for a week after completing the job.  If you work with a tasklist, you may want to set a reminder to re-visit this remedy once a month or so.  The summary isn’t set in stone – add other thoughts that come to you, notes regarding cases you’ve seen etc.

 

Homoeopathy: What we know and what we don’t know

booksWhat we know and what we don’t know.

I’m writing this post in response to comments made on Gary’s post here:

There are homoeopaths who describe the process with a certainty as if they know everything.  Then there are homoeopaths, as in the comments, who state that they don’t know – that those who say they know are merely speaking from a deluded zeal of quasi-religious conviction.

Well, lets take a look at what Hahnemann knew and didn’t know, and where he knew it from.

And just because I like definitions – here’s the Merriam-Webster definition of EMPIRICAL: “originating in or based on observation or experience”

Known:
There is a natural law of similars – meaning, just as what goes up usually must come down, what produces a disease-like symptom picture in healthy people usually must cure a similar disease symptom-picture in sick people.
Sources:  Hippocrates, Paracelsus, Hahnemann’s writings
Hahnemann’s experiments on himself and others
Nature of the knowledge: empirical

Known:
Substances can be active even when highly diluted
Source:  Hahnemann’s experiments on himself and others, provings and treatments over 200 years
Nature of the knowledge: empirical

Known:
Succussion acts to increase the potency of remedies
Source:  Theory – Hahnemann’s Lesser Writings (see my article on the subject of potentisation)
Practice:  Hahnemann’s experiments on himself and others, further experimentation, provings and treatments over 200 years
Nature of the knowledge: empirical

Known:
Different substances produce different disease-like symptom pictures in healthy people
Source:  Hahnemann’s provings and those of others over 200 years, reports of poisonings
Nature of the knowledge: empirical

There are many other definitely, conclusively known factors involved in homoeopathic treatment, and the homoeopath must base treatment on the known – otherwise homoeopathy falls into the “hit-or-miss”, “trial-and-error” format that has more in common with allopathy than homoeopathy as originally formulated.

So what don’t we know?

Not known:  how cure through similars takes place inside the organism

In Aphorism 28 of the Organon, Hahnemann states (bold text from original):

“As this natural law of cure manifests itself in every pure experiment and every true observation in the world, the fact is consequently established; it matters little what may be the scientific explanation of how it takes place; and I do not attach much importance to the attempts made to explain it.  But the following view seems to commend itself as the most probable one, as it is founded on premises derived from experience.”

The “following view” referred to is Hahnemann’s assessment of how homeopathically prescribed medicines effect cure in the organism – something he developed from his experience with the method and observations resulting from this process.  This is what is presented in the Organon from aphorism 29 onwards – Hahnemann’s self-stated theory which he saw actualized in practice.  Since the whole Organon is an invitation to try the method out, it is also an invitation to examine the validity of his theory.  But he himself defines it as “the most probable one”.  Please note – not exactly the same as a religious epiphany or commandment…

Hahnemann stated frequently that the actual internal mechanism is not known.  See also the note to Aphorism 12

“How the vital force causes the organism to display morbid phenomena, that is how it produces disease, it would be of no practical utility to the physician to know, and will forever remain concealed from him.. “

Some have assumed that Hahnemann, when referring to the unknown, intangible or immeasurable, is referring to the spiritual – but he states categorically that this is not the case.  In the footnote to aphorism 31, he states:

“when I call disease a derangement of man’s state of health, I am far from wishing thereby to give a hyperphysical explanation of the internal nature of diseases generally, or of any case of disease in particular.  It is only intended by this expression to intimate, what it can be proved diseases are not and cannot be, that they are not mechanical or chemical alterations of the material substance of the body, and not dependent on a material morbific substance, but that they are merely spirit-like (conceptual) dynamic derangements of the life.”

My personal favourite quote of Hahnemann’s acknowledgement that he does not know “how it works” appears in a footnote towards the end of the theoretical part of Chronic Diseases.  Here Hahnemann states categorically (bold is religiously mine…):

“this true theorem is not to be reckoned among those which should be comprehended, nor among those for which I ask a blind faith.  I demand no faith at all, and do not demand that anybody should comprehend it.  Neither do I comprehend it; it is enough that it is a fact and nothing else.  Experience alone declares it, and I believe more in experience than in my own intelligence.

For the full quote, click here.

Many prescriptions today are based on assumptions of “how it works”, rather than based on the known information, whether about the method, the remedies, and the patient’s case itself.  In addition, many remedies are prescribed based on assumptions of what symptoms they can cure, often based more on the Doctrine of Signatures rather than anything else.  That is not a known.  Homeopathy today is often misunderstood to be based on these and other assumptions – rather than on the empirically based method developed by Hahnemann.  Hahnemann presented the Organon as a method of how to work based on the known – with what he felt was a probable explanation of how the cure is effected.  His “most probable” explanation forms a small part of the Organon – the bulk of which deals with intensely practical instructions on how to work based on the known, rather than preoccupation with the speculative.  It is a sign of the times that in many courses offered today the Organon is referred to as the basis for homoeopathic philosophy and taught as such – whereas it really is the Users Manual for homoeopathic practice.

Personally, I find it difficult to agree that knowing the exact nature of how the organism effects the cure would not help.  The greatest difficulty homeopaths experience in treatment is often not the prescriptions themselves, but the case-management and understanding the significance of each response to remedies along the path in order to determine the next steps.  Having said that, many many times difficulties in case-management can be traced back to unreported obstacles to cure, to incomplete or ineffective case-taking, to lifestyle and allopathic interventions and medications.

This post is inevitably a short “out-take” of a much larger picture.  However some elements are clear:

  1.  The Law of Similars is empirically known, and is the basis of the homoeopathic method.
  2. Use of remedies based on the Law of Similars is empirically known.
  3. Hahnemann has presented a picture of how cure takes place in the organism based on his observations – although initially theoretical, eventually empirically demonstrated, especially when compounded with  200 years of experience.
  4. Prescription of remedies not based on the Law of Similars is not based on the homoeopathically known.  (this does not invalidate clinical experience, merely defines that it cannot be a certain starting point for the homoeopath working based on the known foundations of homoeopathy as a medical therapeutic)
  5. Assessment of how homeopathically prescribed remedies effect cure in the organism is essentially theoretical, possibly empirically demonstrated, but ultimately not known.

Restrictions during homoeopathic treatment: In search of the tone of the distant flute

distant flute“…in the dead of night, when all the sounds of day are hushed and perfect stillness prevails, the undisturbed ear distinctly perceives the softest tone of a distant flute…”

Reading Hahnemann is often a bracing experience.    When I read his thoughts, which he expresses so succinctly and sharply, I find myself looking at my practice and wondering…  Hahnemann’s introduction to China offers many expressions of the bracing sort… This particular subject, relating to medications and lifestyle of the patient while in treatment , appears in Hahnemann’s notes on his proving of China.

In the modern homoeopathy clinic, especially when working with older patients with chronic conditions, our patients are almost always taking chronic medications.   Rare is the patient who will challenge the doctor regarding the holy meds trinity of drugs for blood pressure / cholesterol / sugar levels.   It takes a very strong mix of courage, clarity and common sense to do so, and to do so in the best way.  In some cases those who refuse prescriptions may even risk problems with their insurance coverage.

In addition to the prescriptions, some for the perceived problem, and some which for elderly patients are often prescribed and then renewed without really assessing the continued need – there are the substances people take for themselves, believing “the more the merrier”.  Our pure, small dose must do its curative work in an environment of conventional drugs with their demanding, confusing and often debilitating side effects, supplements, herbs, oils, and, surprisingly often, some unidentified “pills that were hanging around the house” with the reasoning “they looked like they might help so I thought – why not ..”.  This cacophony of influences, each pulling in its own direction, cannot help but hinder the work of the remedy – and as a result we get patients who say “I tried homoeopathy but it didn’t work”.

How will Hahnemann’s words influence your practice? Or will they? And if not, why not?

In Hahnemann’s words (excerpted, and the bold is mine):

Here as elsewhere I insist on the sufficiency and efficiency of such small doses. And yet the vulgar herd can never understand me, for they know nothing of the pure treatment with one single simple medicinal substance to the exclusion of all other sorts of medicinal irritants, and their thoughts are enchained in the mazes of their old routine.

Even when the ordinary physicians now and then constrain themselves to give in some (acute) disease one single medicine, they never have the heart to refrain from using at the same time several other things possessing medicinal power, which, however, they regard as of no consequence, and to which they apply the trivial name of domestic remedies.

 They must always use simultaneously either a poultice of so-called aromatic or solvent herbs applied to the most painful part … or they must rub in some medicinal ointment… or they must administer simultaneously a tea of mint camomile, elder-flower, so-called pectoral herbs, etc. (Just as though a handful of such herbs or flowers infused in boiling water counted for nothing!).

 In such an onslaught with heterogeneous drugs, which, although ignorance looks upon them as innocuous domestic remedies, are to all intents and purposes medicines, and some of them very powerful medicines;…

 … it must be ascribed to his ignorance that he considers as nothing, as not at all medicinal, such things as herb-teas and clysters, poultices and baths of herbs and salts, and the other things just mentioned, and continues to use them thoughtlessly under the name of domestic remedies during the employment of medicine internally.

 Still more heedlessly in this respect is the treatment of chronic maladies conducted; for, in addition to what the patient takes from medicine chests and bottles, and the external applications and so-called domestic remedies that are usually administered to the patient, lots of superfluous hurtful things are allowed, and even prescribed, which are also regarded as indifferent matters in spite of the disturbing effects they may exercise on the patient’s health, and of the confusion they may cause in the treatment.

 … the patient is allowed, for example, to take (for breakfast) mulled beer, vanilla chocolate, also (even several times a day) strong coffee or black and green tea, not unfrequently – to strengthen the stomach (?)…strong spices… especially in sauces (made of soy, cayenne pepper, mustard, etc.) …- moreover, quantities of uncooked herbs cut small and sprinkled over the soup  – which are regarded as supremely wholesome, but are really medicinal…

 Besides all these there are tooth-powders, tooth-tinctures, and tooth-washes – also composed of medicinal ingredients, and yet considered innocuous because for-sooth they are not swallowed; just as though medicines only taken into the mouth or their exhalations drawn into the nose did not as surely act on the whole organism through its living sensitive fibres as when they are swallowed! And then the various kinds of perfumes and washes (musk, ambergris peppermint drops, oil of bergamot and cedar, neroli, eau-de-Cologne, eau-de-luce, lavender water, etc.), besides perfumed sachets, smelling bottles, scented soaps, powders and pomades, pot-pouri, and any other noxious articles de luxe the patient may desire. In such an ocean of medicinal influences the otherwise adequate homoeopathic dose of medicine would be drowned and extinguished.

 But is such a medley of medicinal luxury necessary and useful for the life and well-being or compatible with the recovery of the patient? It is injurious; and yet, perhaps, it has been invented by physicians themselves for the upper classes in order to please, to stimulate and to keep them ill.  … physicians …[do]  not know the medicinal noxiousness of all this luxury, and … they do not prohibit it to their chronic patients. This hotch-potch of noxious influences …is so much the rule, so universally prevalent, that the ordinary practitioner cannot think of treatment without such a simultaneous medical confusion, and hence, under these circumstances, he is unable to promise any decided effect from the internal administration of a single medicinal substance in a disease, even when it is given in a large dose, far less from a very small dose of medicine homeopathically employed!

 … A pure treatment with a single homoeopathic medicine, all counter-acting medicinal contaminations being removed (for it is only of such I speak and only such I teach), never is seen or dreamt of in routine practice. But the difference is enormous and incredible.

 So the glutton just risen from his luxurious meal of highly-spiced food is incapable of perceiving the taste of a grain of sugar placed upon his over-stimulated tongue; whereas a person contented with simple fare will, when fasting in the morning, experience an intense sweet taste from a much smaller quantity of the same sugar. Similarly amid the multifarious noises in the most crowded part of a large town we can often not comprehend the loudly spoken words of a friend at the distance of five or six paces, whereas in the dead of night, when all the sounds of day are hushed and perfect stillness prevails, the undisturbed ear distinctly perceives the softest tone of a distant flute, because this gentle sound is now the only one present, and therefore it exercises its full action on the undisturbed organ of hearing.

 So certain is it, that when all accessory medicinal influences are withheld from the patient (as should be done in all rational treatment), even the very minute doses of a simple medicinal substance, especially of one chosen according to similarity of symptoms , can and must exercise its adequate and complete action, as a thousand-fold experience will teach any one whom prejudice does not deter from repeating the experiment accurately…

Hahnemann on dilutions: Experience and observation

hahnemannWhen having to explain dilutions to those who think Hahnemann was just an off-the-wall eccentric, it’s important to remember that Hahnemann himself predicted and experienced such criticism, and prepared responses for just such questioning.  He presents his reasoned response in the proving of China, and his words are helpful in explaining the issue today.  Hahnemann’s homoeopathy was based on multiplied experience and faithful observation rather than on unfathomable theory or spiritual idea, something he repeats frequently in many of his writings.

In the case neither of this nor of any other medicine did a preconceived opinion or an eccentric fancy lead me to this minuteness of dose. No, multiplied experience and faithful observation led me to reduce the dose to such an extent. Led by experience and observations I clearly saw that larger doses, even where they did good, acted much more powerfully than was needed for the cure. Hence the smaller doses; and as I repeatedly observed from these the same effects though in a less degree, I gave still smaller, and the very smallest doses. These proved sufficient to effect a complete cure, and they did not display the violence of larger doses, which tends to delay the cure.

Hahnemann on China – then as now

Hahnemann 1Hahnemann’s words from the introduction to China in the Materia Medica Pura are truly timeless and need no further comment:

“As long ago as the year 1790 …I made the first pure trial with cinchona bark upon myself, in reference to its power of exciting intermittent fever.

“With this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy.

“This is a truth so incontrovertible, so absolutely without exception, that all the venom poured out on it by the members of the medical guild, blinded by their thousand-years old prejudices, is powerless to extinguish it; as powerless as were the vituperations launched against HARVEY’s immortal discovery of the greater circulation in the human body by RIOLAN and his crew to destroy the truth revealed by HARVEY. These opponents of an inextinguishable truth fought with the same despicable weapons as do to-day the adversaries of the homoeopathic medical doctrine.

“Like their modern congeners they also refrained from repeating his experiments in a true, careful manner, (for fear lest they might be confuted by facts), and confined themselves to abuse, appealing to the great antiquity of their error…This blindness, this obstinate appeal to the extreme antiquity of their delusion… was in those days not more stupid than the blindness of to-day, and the present aimless rancour against homoeopathy which exposes the pernicious rubbish talked about ancient and modern arbitrary maxims and unjustifiable practices, and teaches that it is only by the responses given by nature when questioned that we can with sure prescience change diseases into health rapidly, gently, and permanently.”

Viewed through proving: Veratrum Album – delusions of grandeur

Veratrum Album – delusions of grandeurNapoleon

How many of us have an indelible image of the would-be messianic Veratrum Album suffering from delusions of grandeur, carved into our memories, perhaps with a dash of forehead perspiration to give some physical back-up to a less common prescription?  And let’s face it, how many would-be messiahs are there to prescribe for?

This symptom from the proving is perhaps one of the main culprits:
672.  He pretends he is a prince and gives himself airs accordingly. [GREDING, l. c., p. 43.]

Greding did much work on Veratrum.   More about Greding’s work with Veratrum Album can be found in Woodville’s Medical Botany, quoted in Ralph Griffith’s The Monthly Review, 1794.  If you have a taste for Olde English and can handle “s” written as “∫”, you can read the article here.   In fact the book itself is fascinating but I cannot promise that you will escape with your “s”s unfcathed…

For those who don’t want to take that risk, here’s the quote:

“…But the fullest trial to have been lately made of the efficacy of Veratrum is by Greding, who employed it in a great number of cases, (twenty-eight) of the maniacal and melancholic kind; the majority of these, as might be expected, derived no permanent benefit; several however were relieved and five completely cured by this medicine…In almost every case which he relates, the medicine acted more or less upon all the excretions: vomiting and purging were very generally produced, and the matter thrown off the stomach was constantly mixed with bile…”

So Greding’s symptoms are clinical, and many, if not most of the “old school” symptoms reflect extreme mental disturbance.  Hahnemann found these symptoms valuable enough to include within the proving, but it’s instructive to note the symptoms that are not from the “old school”.   These symptoms present a picture of depression, anxiety and despair, from a bad conscience or from anticipation of misfortune.  This person lives under threat, does not talk about it, is critical, fault-finding and oversensitive.  And he’s always better when he’s busy or working, even if he is ill.

We won’t often come across the “would-be saviours and deluded Napoleons” – but the behaviours in these other symptoms also present a clear picture which we have all seen, both in patients and in our own social or familial circles.

I’ve presented the non-”old school” symptoms below:

684.   Restlessness of disposition, oppression, and anxiety (aft. 1 h.). [Bch.]
685.   Despondency, despair.
686.   Melancholy, with chilliness, as if he were sprinkled with cold water, and frequent inclination to vomit.
687.   Gloominess, dejection, sadness, with involuntary weeping and flow of tears from the eyes and inclination to vomit.
688.   She is inconsolable about an imaginary misfortune, runs about the room howling and crying out, with her looks directed to the ground, or sits absorbed in thought in a corner, lamenting and weeping inconsolably; worst in the evening; sleeps only till 2 o’clock.
689.   He groans, is besides himself, does not know how to calm himself (aft. 2, 3 h.).
690.   Anxiety as from a bad conscience, as if he had done something bad.
691.   Anxiety as though he anticipated misfortune, as if threatened with some calamity.
692.   A feeling in his whole being as if he must gradually come to an end, but with calmness.
693.   Soft, sad humour even to weeping (aft. 24 h.).
696.   Fear.
700.   Taciturnity.
701.   He does not talk unless excited to do so, then he scolds.
702.   Taciturnity: he is reluctant to say a word, talking is repugnant to him, he speaks low and with a weak voice. [Stf.]
704.   Crossness when cause is given (aft. 4 h.).
705.   He gets very cross, every trifle excites him (aft. 1 h.). [Stf.]
706.   He searches for faults in others (and taunts then with them.)
707.   Cross at the slightest cause and at the same time anxiety with rapid audible respiration. [Bch.]
708.   Over-sensitiveness; increased mental power.
709.   He is too lively, excentric, extravagant.
711.   When he is occupied is head is cheerful, but when he has nothing to do he is as if dazed, cannot think properly, is quiet and absorbed in himself (aft. 2, 15 h.). [Fz.]
712.   Busy restlessness.
713.   Busy restlessness; he undertakes many things, but becomes always tired of them, nothing succeeds with him. [Stf.]
714.   Activity and mobility, with diminution of the pains and passions.
715.   Inclination to and pleasure in work.
716.   All day a kind of indifference, so that he often rubbed his forehead in order to come to himself and to collect his thoughts. [Bch.]

Is it too late?

Posted in the Institute for Homeopathy’s main site by Dr. Gary Weaver.  To read the original click here.

“…………….Over excitement with the ideas of delusions and dreams might have caused some of our prescriptions to go prejudiced or in the totally wrong direction. Proving symptoms are the most reliable. with direct symptoms from the provers, we don’t need to look elsewhere. There are no preconceived notions of remedy pictures, just the symptoms of the patient.” Rajan Sankaran.

With these words, the single biggest influence on modern homoeopathic practice, “The Sensation Method” has been admitted to as being a false and misleading doctrine. For the vast majority of people in practice in the West, it has invalidated everything that they have been taught or believe.

I am sure that this quote, will be justified in the light of needing explanation so as to minimise the loss of followers for the income producing methodology (for Sankaran) that has replaced REAL homoeopathic treatment, and it will perhaps lead to yet another version of a watered down, if not antipathic version of Hahnemanns instructions for case taking and management.

For those of us in the West, who have pursued a life of research into the writings and methodology of Samuel Hahnemann, and have followed the development of the principles of practice as outlined by him, this ‘admission’ comes a little late. The entire homoeopathic community has been infected with his false teachings, and entry to professional organisations has only been allowed if a practitioner could answer questions based around the Sensation method.

Not one thing of value has been added to the physicians understanding of homoeopathic case taking by learning this methodology. It has prevented the students from learning the REAL medical practice, and unleashed a whole slew of untrained practitioners into the homoeopathic fraternity to dabble in quasi psychological models utilising the doctrine of signatures and many other things that are opposed to the curative abilities of symptom matching in the prescribed manner.

To those practitioners of the Sensation method. Please stop immediately. Go back and relearn the real homoeopathy. Send Mr Sankaran the bill for wasting your time.

The Sensation method could not and can not exist without the support of followers. What really gets to me is that each and every follower of Sankaran, could so easily have discerned the truth by reading the original works for themselves. Why did this not happen? What were you thinking? Why was it so easy to mislead you? Do you have the humility to go back and relearn and stop fiddling with peoples health and actually really cure them?

There are plenty of highly trained research homoeopaths in the West to help direct you onto the correct medical path for your training. George Dimitriadis and Ken D’aran in Australia. Doctor Guillermo Zamora in Mexico. Vera Resnick in Israel, Vladimir Polony in USA. Dr Gary Weaver in U.K. and Spain and Italy…… and many more in other countries. They will not teach you a philosophy. They will not teach you an opinion, they will direct you to the original works and guide you through so that YOU learn from the masters and practice accordingly with repeatable success in case management.

Its up to you. Time to reverse the damage.