...One remedy will not do for another, and we are always thrown back on the actual symptoms of the provings as our only sure guide ... (M.L.Tyler 1952)(A§118).
Our job is to match the symptom picture of the remedy to the patient. Our knowledge of the Materia Medica and the action of remedies can come from various sources. The main, and most rigorous source is from classical full provings. Another important source is from shared clinical experiences - cases. Recently data from dream or meditative provings have been published. In Dr. Sankaran's seminars each member of the group simply places the remedy under their pillow and then reports back to the group. Mediative provings can be as simple as just handling the substance and contemplating the thoughts and feelings that arise. Any sceptic could try handling a vial of Plutonium Nitricum. It is notorious for introducing chaos and destruction into our lives! On the face of it these methods may seem unreliable or even fanciful but many key symptoms have subsequently been confirmed by full provings, so they too have a "provisional" place in our literature.
A contemporary variation on Hahnemman's original method was the proving questionnaire developed by Brian and Lewith. It comprised a selection of predefined remedy specific symptoms. Its purpose was to validate original provings.
Another method of evaluation of remedy data, which is being developed in Homeopathy is the Randomised Controlled Trial which tries to measure the effectiveness of homeopathic treatment of diseases upon trial subjects. Problems using the traditional scientifically accepted type of trials arise from the idea that homeopathy operates according to a paradigm that is different from conventional “allopathic”medicine which usually treats disease (a pathogen) as if it is an entity which must be killed or destroyed.
Homeopathy treats the totality of symptoms - the person not the disease. In both paradigms the goals are similar and the assessment of the efficacy of a medicine in both cases is evaluated by measuring the outcome as a healing response and some degree of resolution of the chief complaint.
Objectives of a Proving
A proving is the traditional method for evaluating the medical properties of a substance. The proving trial initially focuses on the question of whether the homeopathic remedy has any effect of any sort; it is a question directed at the thesis that there may not be anything substantial, or “real,” in homeopathic remedies in the first place.
The first proving was conducted in 1790 by Hahnemann on Cinchona bark because some of the symptoms sounded similar to malaria. The only way to ascertain the validity of this was by direct experience, which means to ingest the substance and record the subsequent symptoms. Provings do not usually go as far as producing serious physical pathology - although many stalwart Homeopaths have done this E.g. Herings poisoning from the Bushmaster (Lachesis).
Suitable subjects (A§126)
During the proving process, Hahnemann administered remedies to healthy volunteers. His rationale was that a substance that produces symptoms in healthy subject can be used to help the sick(A§108). The healthy volunteers should include sensitive trained observers, because as Hahnemann says in the organon, they will provide the largest amount of symptoms. Sherr's MOPMEC scale can be used to measure both health and sensitivity. Should we include less healthy subjects? These can provide us with valuable curative results but are less useful in determining the pure action of the substance (A§107) . As long as the limitations and parameters are known, variety is acceptable in a proving (authors supposition!). The proving would yield some symptoms common to the group. These would be the "common ground" of the substance. Then there would be the idiosyncratic, odd and curious symptoms - perhaps some of these make up the modalities and S.R.P.s of the substance(A§117).
A Standardised Methodology
Preparation, Hahnemann says you have to be objective and become the unprejudiced observer: Aphorisms §105 and §145 (double-blind). Traditionally we do not give either supervisors or provers a preconceived idea about the remedy. We don't go into the proving looking for things - it is treated as a "tabla-rasa" (clear slate). That is also the approach in drug trials - anything else in considered to be unscientific. Some rigorous provings use a placebo control group.
The roles of the group and protocols are established. We always use a pure substance. If we mix two substances no one will know which substance produced which symptom. A highly reactive mixture of Potassium and Iodine (!) is not the same as the compound Kali Iodatum.
The remedy must be potentised and triturated (A§123). In the case of a liquid the substance is diluted by one drop to one hundred. Alcohol is sometimes used as it has preservative qualities. So to make a 3C potency add one drop to 100ml, one drop is taken from this 100ml solution and added to the next 100ml. You then succuss by banging the test tube on your Bible (x10). Repeat once more to get 3C. If the substance is a solid it is usually crushed up with sac-lac using mortar and pestle. The dilution can be done by weighing out one gram and adding it too 100g.
Proving - Provers take the remedy until symptoms are experienced (A§131). Usually one or two doses will suffice to challenge the Vital Force. Prover and supervisor then maintain daily contact and both take notes. Daily contact enables us to differentiate primary and secondary action. Many authors insist that the secondary action produces important symptoms toward the end of the proving (De Shepper), this may be because some substances have a longer cycle - compare Aconite and Causticum.
Extraction - Groups go through notes to extract valid mental, emotional and physical symptoms. The group meets to discuss their experiences. What needs to be noted (after Boger-Boeninghausen) is the location, direction, speed, time and intensity of each symptom. Next modalities, concomitants and periodicity. These are collated to determine the characteristics on the basis of symptom totality. Then we highlight the keynotes and ideally describe the whole as a sequential development in time.
Repertorisation - Symptoms are graded according to their spread through the group. I believe Grade 1 means everyone experienced it, although Vithoulkas says Grade 1 is for cured symptoms (which is indeed the case for qualification as Genus Epidemicus).
Repertory submissions are collated and organised by chapter. Large common rubrics need qualifying to give precision - but if they are over-qualified there is a danger that the repertory will be filled with too many highly specific symptoms with only one remedy indicated, as happened with the Falcon proving.
The modern repertories of Sholten, Mirilli and Zandervoort include information which groups symptoms with remedies conceptually (Periodically/Phylogenetically) or thematically. Conceptual grouping gives these repertories an underlying structure by associating symptoms to their roots or origin e.g. Kingdom, Family, Species or Periodic hierarchy. Mirilli's thematic grouping associates remedies linguistically, which gives us an additional level of overlying structure. Jose says, "symptoms are severed by being classified alphabetically". Theoretically crossing rubrics from different sections should bring the picture back together again as a whole, but ultimately interpretation still relies on the user.
Publication -The substance is described in detail to give Homeopaths some idea of its Doctrine of Signatures, e.g. physical properties and raw toxological virulence (taking 30c of Plutonium is not the same as taking 30c of gently acting remedies like Saffron (Colchicum) . There is also a chapter on Materia Medica which gives an account of the actual experiences - it is coded so that we can tell which prover developed the symptom and when.
Self-Reflection and Discussion - Problems of Affinity and Polarity.
Homeopathy already recognises that people and symptoms are unique. A wide range of experiences can be a good thing if our main object is to get a vision of the widest and deepest range of symptoms a substance can produce. Normally this is what we want from a proving.
Perhaps what we really need is a group of subjects who's suitability is defined by their probable affinity for the substance under consideration. How would we set that one up? Perhaps a preliminary test could be carried out on the substance by an experienced Homeopath who would be able to give some preliminary guidelines about the nature of the beast. Or, maybe we could predict some of its expected parameters using the doctrine of signatures combined with our understanding of the Families or Stages? Assume we have done some assessment of this nature and we are satisfied that we have at least some understanding of the substance. Next we match our subjects to these parameters. Easy-peasy.
Lets take an substance that isn't so well known, say Lutetium (Stg 17) as a hypothetical example. To determine its clinical benefit we need a subject who would be likely to respond to it favourably ... that's someone diagnosed with "Stg 17 Syndrome", for the arguments sake, say the profile fits a subject who's lost or abandoned their sense of inner power and feels resigned to taking an early retirement.
This subjects experiences would absolutely resonate with the substance and give us the depth of information that would be clinically useful. We would learn more about "Stg 17 Syndrome" and about the substance. We would be able to think about a Genus Epidemicus qualification for Lutetium - perhaps at level 4 - curative in at least one case. A good starting point for further investigation.
Polarity of Substance and Symptom
Now lets give Lutetium to another prover; someone at the peak of their career - perhaps our (Aurum) College Director! What are they likely to report? Perhaps dreams of giving up their job and flying away, or perhaps a feeling that their work is done on this Eartly plane?
The question then comes, is that a characteristic of Lutetium? It makes you want to escape into retirement? Well the fact that we know it was our Director gives us a frame of reference from which we can evaluate the response. Logically you could say that if your are at the peak of your career you could experience indifference to work on taking Lutetium. So you want to submit the rubric...
"Indifference, business to"
Wait a mo' ... consider the first subject with "Stg 17 Syndrome" who was about to take early retirement ... would they report a change of heart? So much so that their experience was summed up by the rubric...
"Enthusiasm, business for"
Which rubric would you submit?
What we are looking at are the so-called POLARITIES of Lutetium. It is the lower extreme of the polarity that was curative. The higher polarity was damaging (at least to our Director).
Perhaps, at the very least, we should annotate the rubric to signify the polarities as either high or low... but you have to know the prover to do that. If our Director joins in the proving anonymously the frame of reference is gone and the both rubrics get published.
Then we study the rubrics and then start wondering if, clinically it will produce indifference or enthusiasm!
(A§105-145) = Organon : Aphorisms from chapter IV, Acquiring a Knowledge of Medicine.
Vithoulkas - Science of H'pathy, Ch 10.
Sholten: Repertory of the Elements.
Mirilli: Thematic Repertory.
Nile: Plant Kingdom Database.
Jeremy Sherr: http://www.hpathy.com/interviews/jeremy-sherr-1.asp
Stages to a proving: