Dr. Michael Wayne

A Look at Homeopathy, Part 4

homeopathic-remedies1The four-part article on homeopathy concludes today with a continuation from last time on the topic of homeopathic remedies.

In case you missed the other three articles in this series on homeopathy, here are the links to the other articles:
A Look at Homeopathy, Part 1
A Look at Homeopathy, Part 2
A Look at Homeopathy, Part 3

Dilution debate

Not all homeopaths advocate extremely high dilutions. Many of the early homeopaths were originally doctors and generally used lower dilutions such as “3X” or “6X”, rarely going beyond “12X”. The split between lower and higher dilutions followed ideological lines. Those favoring low dilutions stressed pathology and a strong link to conventional medicine, while those favoring high dilutions emphasised vital force, miasms and a spiritual interpretation of disease.

Some products with such relatively lower dilutions continue to be sold, but like their counterparts, they have not been conclusively demonstrated to have any effect beyond the placebo effect.

Provings

Samuel Hahnemann experimented on himself and others for several years before using remedies on patients. His experiments did not initially consist of giving remedies to the sick, because he thought that the most similar remedy, by virtue of its ability to induce symptoms similar to the disease itself, would make it impossible to determine which symptoms came from the remedy and which from the disease itself.

Therefore, sick people were excluded from these experiments. The method used for determining which remedies were suitable for specific diseases was called proving, after the original German word Prüfung, meaning “test”. A homeopathic proving is the method by which the profile of a homeopathic remedy is determined.

At first Hahnemann used material doses for provings, but he later advocated proving with remedies at a 30C dilution, and most modern provings are carried out using ultradilute remedies in which it is highly unlikely that any of the original molecules remain.

During the proving process, Hahnemann administered remedies to healthy volunteers, and the resulting symptoms were compiled by observers into a drug picture. The volunteers were observed for months at a time and made to keep extensive journals detailing all of their symptoms at specific times throughout the day.

They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be “too exciting”, though they were allowed to drink beer and encouraged to exercise in moderation. After the experiments were over, Hahnemann made the volunteers take an oath swearing that what they reported in their journals was the truth, at which time he would interrogate them extensively concerning their symptoms.

Provings have been described as important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine. The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.

The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle.

His Fragmenta de Viribus (1805) contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65.

For James Tyler Kent’s 1905 Lectures on Homoeopathic Materia Medica, 217 remedies underwent provings and newer substances are continually added to contemporary versions.

Repertory

Homeopathic repertory by James Tyler Kent.

Homeopaths generally begin with detailed examinations of their patients’ histories, including questions regarding their physical, mental and emotional states, their life circumstances and any physical or emotional illnesses. The homeopath then attempts to translate this information into a complex formula of mental and physical symptoms, including likes, dislikes, innate predispositions and even body type.

From these symptoms, the homeopath chooses how to treat the patient. A compilation of reports of many homeopathic provings, supplemented with clinical data, is known as a homeopathic materia medica.

But because a practitioner first needs to explore the remedies for a particular symptom rather than looking up the symptoms for a particular remedy, the homeopathic repertory, which is an index of symptoms, lists after each symptom those remedies that are associated with it. Repertories are often very extensive and may include data extracted from multiple sources of materia medica. There is often lively debate among compilers of repertories and practitioners over the veracity of a particular inclusion.

The first symptomatic index of the homeopathic materia medica was arranged by Hahnemann. Soon after, one of his students Clemens von Bönninghausen, created the Therapeutic Pocket Book, another homeopathic repertory.

The first such homeopathic repertory was Georg Jahr’s Symptomenkodex, published in German (1835), which was then first translated to English (1838) by Constantine Hering as the Repertory to the more Characteristic Symptoms of Materia Medica. This version was less focused on disease categories and would be the forerunner to Kent’s later works.  It consisted of three large volumes. Such repertories increased in size and detail as time progressed.

Some diversity in approaches to treatments exists among homeopaths. Classical homeopathy generally involves detailed examinations of a patient’s history and infrequent doses of a single remedy as the patient is monitored for improvements in symptoms, while clinical homeopathy involves combinations of remedies to address the various symptoms of an illness.

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