When you can’t find a proving (or can’t find it in English)…

Why view remedies through the P&W repertory?

I have written on the importance of source material, especially of provings, in working to principle. As Hahnemann specified in Aphorism 3, in order to do homoeopathy we need to know what’s wrong with the patient, what the remedies can do and how to match a remedy to a complaint – with the proviso regarding appropriate potency and dosing.

How do we know what remedies can do? Through provings, first and foremost – the symptoms can a substance cause in a healthy person.

Hahnemann’s lesser writings include an essential article published in 1796, among his writings leading up to the Organon published in 1810. It is entitled “Essay on a New Principle for Ascertaining the Curative Powers of Drugs.” In this article, Hahnemann tackles existing methods one by one, and demonstrates their problematic nature. One after the other, with reasoned arguments and logical discussion, he knocks over chemistry as partial, nixes mixing unknown drugs with newly drawn blood, and more. He counsels against the doctrine of signatures, botanical affinity and families, stating categorically that the hints of the natural system “can only help to confirm and serve as a commentary to facts already known… or in the case of untried plants they may give rise to hypothetical conjectures which are, however, far from approaching even to probability.” He discusses experiments on the sick and how many discoveries were made by chance – and then laments “how humiliating for proud humanity did his very preservation depend on chance alone…”

Through step-by-step argument, Hahnemann comes to the conclusion that “nothing then remains but to test the medicines we wish to investigate on the human body itself,” which he states has so far been done “empirically and capriciously in diseases.” A standard human response to medicines, “some natural normal standard,” he states “can only be derived from the effects that a given medicinal substance has, by itself in this and that dose developed in the healthy human body.”

The body of provings which is easiest for us to access nowadays is in the Materia Medica Pura and Chronic Diseases. All the symptoms were carefully sifted through by Hahnemann, so if we see Hahnemann as a reliable source of information, that reliability extends to the provings he collated – and to his decisions to include some symptoms not taken from provings, rather from clinical work. We have less knowledge regarding the provings of other remedies noted in Boenninghausen’s Therapeutic Pocket Book, although here again, if we see Boenninghausen as a reliable source, information about these remedies will be important in our work. There is information in Hughes Cyclopaedia, and many other materia medica refer to provings, but all too often provings information is intermixed with symptoms derived from therapeutic clinical work and poisonings, or separate as in Hughes, but not organized.

But we have another source of information for those remedies whose provings were not collated or overseen by Hahnemann – the Therapeutic Pocketbook itself. Boenninghausen examined and brought together all the remedies in use in his time. Some were proven by Hahnemann but not published by him. Some were proven by Hartlaub and Trinks and others. Furthermore, Boenninghausen was kind enough to give us a grading system, indicating where a symptom derives from a proving of a remedy with grades 1 and 2, and strengthening the relevance of that symptom for that remedy from his clinical work with grades 3 and 4.

This means that if we take a remedy through the Reversed Materia Medica in the P&W software, we can actually gain a picture of the proving through grades 1 and 2, together with reliable clinical expansion on that remedy through grades 3 and 4. This in itself is information from early and primary sources, with Boenninghausen and Hahnemann’s stamp of approval. Furthermore, thanks to P&W, this information is available in English, Spanish, and Hebrew in addition to the original German. And there are other languages on the way. This means that those who have difficulty accessing the Materia Medica Pura in their own languages and use the P&W reversed to shed more light on these primary sources.

How can we begin to analyze this mass of information? The TPB was developed to help repertorize, guide the practitioner towards remedies to read up on more intensively. But the computerized version has given us the ability to access the material in different ways, including using the Reversed Materia Medica as a “back door” into gaining reliable knowledge of remedies where the provings are not accessible.

For example, on a very basic level, we can see a remedy’s position in any rubric. We can see if it’s there because it’s in the proving, graded 1 or 2, or because Boenninghausen emphasized its clinical use with grades 3 and 4. A remedy may appear in a symptom with very few other remedies, giving it additional importance in that symptom regardless of its grade. A remedy may appear in a large rubric, with over a hundred remedies, and there we may want to see if it’s in a higher grade than other remedies, if that symptom is very strongly connected to the remedy we’re examining. The relationship between remedy grade and rubric size may have relevance in the case we’re working on. All this while keeping in mind that the appearance of a remedy in proving is the basis for prescribing, and Boenninghausen’s clinical use of that remedy is an added bonus.

For those interested in working to principle, which means using provings-based materia medica, the reversed MM offers a treasure trove of information about provings which are harder to access, which is definitely worth while exploring.

LMs – what are the odds (or the evens)…

hardworking horses…

I have recently been asked about changing potencies in LMs, with people mentioning using odd numbers, even numbers, going up in steps of 2 potencies (LM1 – LM3 – LM5) etc.

I came across this issue before I started studying with David Little, from a post he wrote on the Minutus list, sometime around 2005.  He mentioned that while most people do just
fine on a series of ascending potencies (LM1 – LM2 – LM3 etc.)  he had noticed that some seem to do better on odd or even numbers of dilutions or succussions.  He also noted that Hahnemann didn’t always start with LM 1.

There are two issues in play here, in my view.

The first is the risk of putting theory before experience.  The beauty of homoeopathy is that Hahnemann first observed, then developed a way of harnessing the power of the similar stronger artificial disease without harming the patient, and  what he thought was the most probable explanation for what he was observing.  In Aphorism 28 (and elsewhere), Hahnemann sets out the basis for his thinking on experience versus explanations of how something happens:

“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 second issue is the sensitivity of the patient, something that is difficult to assess ahead of time.  In Aphorism 278 Hahnemann explains that individual sensitivity can’t be deduced through “fine-spun reasoning” or “specious sophistry.”  In order to learn the appropriate dose, “pure experiment, careful observation of the sensitiveness of each patient and accurate experience can alone determine this in each individual case…”

To my mind it comes down to “specious sophistry” if we adopt a theory of odds and evens, where there is no solid backing for the theory, or to apply it and then say it worked – especially when there is a body of material showing that many patients do well just going up through the potency scale.  On the other hand, some patients do especially well on a particular potency, but we cannot know if it was the potency itself or if the improvement was built up by the work of the previous potencies and only manifested itself with the current one.

And furthermore – although it is natural to look for protocols, for theories which provide rules for action which can be employed in every case, we will then have moved away from the individualization of the patient, and of the patient’s sensitivity.

In my own experience, many patients do very well going up the scale, some seem to advance more with specific potencies in the scale, and if the remedy is going to help it is usually already visible in the patient’s response to LM1.

However, looking for a pattern in the sensitivity of individual patients and developing theories to govern posology rather than drawing on pure experiment, careful observation and accurate experience on an individual case-by-case basis seems to be a case of putting the dazzling cart of theory in front of the plodding hardworking horse of experience.  Specious to say the least.

 

 

Video presentation: Case-Taking in Emotional Trauma

Case-taking in emotional trauma can be much more effective if we have more clarity about what we want to learn from the patient.  I’ve set out a more focused way of working with cases involving emotional trauma in the video below.  I’ve disabled comments as I don’t always have time to keep track and reply, but if you’d like to comment please drop me a line on the contact form.

I hope you find this presentation helpful.

Viewed through repertory: Senega

VIEWED THROUGH REPERTORY: SENEGA

There are often remedies which show up in repertorization which we overlook – remedies which we aren’t familiar with, have never used and are just not part of our prescribing “vocabulary”.

Senega is such a remedy.  I have never prescribed it, but I do see it showing up on occasion in repertorization.

Polygala Senega, or snake root is of North American origin. From Wikipedia:
This plant had many uses among Native Americans. The Cherokee used it as an expectorant and a diuretic, and for inflammation, croup, and common cold. The Chippewa used preparations of the root to treat convulsions and bleeding wounds. The Cree chewed the root for sore throat and toothache.[5] According to Canadian botanist Frère Marie-Victorin, the Seneca may have been inspired to use the tortuous root to treat snakebite by its resemblance to the tail of a rattlesnake. It’s still in use for treatment of pneumonia.

Senega was proved by Massie in 1803. More detailed results of the proving can be found, among other sources, in Hughes’ Cyclopaedia of Drug Pathogenesy. The following are some examples from the proving:

1. Dr. MASSIE took 10 dr. of gum dissolved in water.
In 5 minutes sensation in esophagus as if membrane had been abraded, lasted 1 hour.
Pulse, 84 before experiment, at 15 minutes was 78, 20 minutes 73, 30 minutes 70, 35 minutes 68, thence gradually rising to 76.
He then took 20 gr.
Irritation in esophagus was again felt, with some nausea; the drug also operated slightly as a purgative. (Inaug. Thesis, Penns. Univ., 1803; from ALLEN.)

2. Mr. L. took 20 gr. of powdered root. In 10 minutes burning sensation in esophagus with considerable discharge of mucus from trachea (still continuing in slight degree 1 1/2 hour later).
Pulse, 65 before experiment, in 10 minutes was 70 and fuller; later 72, whence it fell again. (Ibid.)

3. Mr. L – took same.Had similar feeling in esophagus, with much hawking of mucus.
In 30 minutes nausea, which increased up to 40 minutes.
Pulse, 65 before experiment, gradually rose in 5 – 40 minutes up to 90, and was still 80 – 86 after 1 – 2 hours.
In 1 1/2 hour skin became very hot; in 1 3/4 hour profuse perspiration set in, and disagreeable symptoms were quite removed. (Ibid.)

4. Mr. W. took same. Same irritation in esophagus; pulse, 68, was 80 at 30 – 40 minutes, and only returned to its starting-point in 2 1/2 hours (Ibid.)

So what does Seneca look like in the repertory?

Seneca appears in four points in the following rubrics. However, it takes its place among many other remedies, and does not appear in four points in any rubric with less than 50 remedies.

What about rubrics with less remedies?  Seneca is prominent in the following, and appears in three points:

So far this gives us a picture of a remedy state where the patient has a tendency to dryness, lack of perspiration and to an increased production of mucus in the larynx and trachea. There is very clear aggravation from mortification in this remedy state, and also relaxation of the body (pathological) and very deep sleep. In its appearance in three points in “Mortification” Senega is accompanied by Chamomile and Phosphoric Acid, with Colocynthis, Ignatia, Natrum-Muriaticum and Staphysagria in four points.

Where does Senega stand in terms of relationships with other remedies? For this I’ve done a search of its position in the Concordances section.

From this search we see Senega is noted as an antidote to Arnica and Bryonia, as having some connection in terms of modalities with Angustura, Crocus Sativus, Kali Carbonicum, Kali Nitricum and Rhododendron Chrysanthum. In Generalities we find it in concordance with Aurum, Caladium, Carbo Vegetabilis, Causticum and Digitalis. The only remedy where we see Senega appearing twice is in Kali Nitricum, in modalities and in body parts.

This is just the tip of the iceberg in terms of what can be learned about a remedy through searching through the repertory. I did one last search, to see where Senega appeared in any grade, in rubrics with 10 remedies or less, and got the following result:

Senega’s only partner in the symptom Amelioration from Chewing is Bryonia. Its only partner in the symptom of Imaginary Odors resembling Pus is Sulphur.

In the concordance symptoms and in this last search, for the most part Senega appears in one point, indicating that Boenninghausen did not have much clinical experience with the remedy for these symptoms. However, its appearance in the TPB means it has definite significance in such cases, where it matches the totality of the disease state.

Aphorism 224 – mental disease

These days so many situations are classified as mental disorders, from defiance in children to reasonable depression (where it is normal to be unhappy, due to  temporary or changeable situations of loss, firing etc.) in adults.  So many people are on anti-depressants these days, and the age of those taking the drugs is constantly dropping.

But where will these mental states fit into our prescribing?  Are we looking at early stages of a mental disease, which is part of a systemic problem, or at a reasonable mood change resulting from events and lifestyle where what is really needed is encouragement and advice from friends or professionals?  I am of necessity simplifying a complex differential for this article, as when a reasonable mood change becomes prolonged and entrenched, encouragement and advice may no longer be of use.

Are homoeopaths killing homoeopathy?

The article below was written by Gary Weaver and posted on the IHM main site.  You can see the original here.  I have deliberately “amped up” the headline. 

Homoeopathy has been under attack almost since its inception.  The principle  of cure by similars was too foreign, the idea that very small amounts can stimulate the body to heal itself was too bizarre, and cures were dismissed as a “fluke”, as placebo, even when the cures involved babies or animals.  In addition, our society is still used to the idea that the body must be nagged at like a recalcitrant child – if it doesn’t respond to a medicine, give more.  This has resulted in an addicted society – most people I see today are addicted to some form of medicine, whether anti-depressants, analgesics, anti-biotics, nasal sprays, prescription and non-prescription medications for indigestion and heartburn – the list goes on and on.  People have learned to bless modern medicine for providing these means for palliation.  They have learned to fear any threat to the supply of their fixes.

Questions that have been asked regarding homoeopathy

The following article, posted by Gary Weaver on the main IHM site, sheds light and clarity on issues which are constantly confused, sometimes among homeopaths and frequently among the general public:

What is Psora?

Psora is Hahnemanns model for a disease process stemming from a singular root. Hahnemann considered it as the most common ailment to affect mankind. He also made the point that it was acquired by INFECTION and therefore was not transferred by hereditary.  A full and thorough examination of the medical models of Psora Sycosis and Syphilis is conducted in the IHM Advanced training course. It is not a disease per se, it is a process via infection and the resultant sequela.

Viewed through proving: IGNATIA’s alternating symptoms

Alternating Ignatia

OK, you prescribed Ignatia.  You’re absolutely sure of the remedy.  You’ve looked at it, repped it, slept on it, thought about it, checked materia medica, checked your patient notes, and you know.  You just do.

You gave the remedy and it did nothing.  Or it aggravated but didn’t seem to do anything interesting, worthwhile or exciting for homoeopathy.  But you were absolutely certain!

Viewed through repertory: Intellect vs Emotion

I’ve mentioned previously in this blog that I enjoy reading books  in hard copy. When looking at a page, elements and patterns jump out in a way that does not happen when searching for rubrics in software. (The software does provide better screenshots though.)

This article was prompted by casual leafing through Mind symptoms in the P&W hardcopy edition of the Therapeutic Pocketbook.  I was looking at the pages on disposition and intellect, flipping back and forth between the two sections, and noticed that while Belladonna appears frequently in four points in Intellect, it only appears in that grade in the main Mind Disposition rubric, and not in other more emotion-related rubrics.

Homoeopathy studies in extremis

Hahnemann monument in Leipzig

How long to study homoeopathy?  There are four-year courses which are considered very prestigious.  There are courses of several hours in some countries offered to medical doctors who wish to add some homoeopathic letters to their names – and it might be added here that the extent of instruction is often homoeopathic in terms of the size of the dose, but not necessarily the aptness of the prescription…