Provings: Volumes I and II

From the Book

In all the years of homeopathy, we had never developed a clear understanding of what provings are. What was missing was a model that could explain provings and at the same time place them within the greater body of homeopathic theory.

In this book, we will discuss the technical fundamentals of provings and develop a model that translates them into successful results in your practice.

Comprehending the applications of provings should not be relegated to first year homeopathic curriculum and then shelved for occasional reference. Keeping this cornerstone of our profession central in the homeopath's mind will help practice outcomes from the initial prescription through long term follow-up care.

The reason for this is that day-to-day practice follows exactly the same rules, protocols and outcomes that provings do.

These skills are described in this book. We first apply them to the proving, and then indicate how the same skills are useful to find the correct remedy for a patient. It is important for you, the practitioner, because understanding provings can dramatically sharpen your clinical skills, and help more of your patients get better.

In addition, this volume contains the first modern proving of Alcoholus, a remedy which has been used often and with good effect in the treatment of children with autism, attention difficulties, and behaviour issues.

Paul Herscu, ND is the author of several other books and articles on homeopathy including, Stramonium, & The homeopathic Treatment of Children.

Praise for Provings, Volume I

Paul's teaching, while often genuinely innovative, has always been framed in the historical context of homeopathy's master prescribers. The apt quotations from both famous and obscure homeopaths in Provings provide further evidence of his depth as a scholar.

His previous books, of course-one on children's remedy types, and a second that outlines his theory of Cycles and Segments through a study of Stramonium- have been important contributions toi homeopathic literature.

While I look forward to reading the additional books he promises here, his position as a teacher and theorist is quite unassailable with the publication of this one.
Peter Wright ND
American Homeopath

I am impressed by Paul's ability to go deep into original sources of homeopathy and extract important features of our profession making them available to a large community of students and active practitioners of homeopathy.

His work has always made us think and frequently reset our approaches to various things that we thought we knew and understood so well.

I highly recommend this book to all my colleagues. It also should be read by any student of homeopathy. Provings is a very important and reliable reference for scientific endeavors in the realm of homeopathy.

Dr. Herscu offers a clear description of the theory and practice of provings based on numerous important classical texts provided unabridged in the main body of the book.

In my opinion his new book advances our community. This book is refreshing. It brings back the feeling of having a solid, powerful foundation. The intent of the author is clearly to unite, to strengthen our community by clarifying very important points of the theory and practice of the trade.
Edwards Shalts MD

Provings, Volume II further classifies the work of Provings, Volume I. Using original source materials, Dr. Herscu reviews each article and shows how a clear model finally answers many of the dilemmas that have plagued the testing of our medicines.

The volume ends with two original works: a description of an experiment that shows clear effects of homeopathy and a piece which lays out a distinct method of deciding which symptoms to accept during the course of a proving.

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Author

Paul Herscu
ND, DHANP

(1959 -     )

Paul Herscu was born on May 5th 1959 in Bucharest, Romania. His family moved to Israel in 1961 where he spent his childhood. He immigrated to the USA in 1969 and became a naturalized US citizen in 1975.

He graduated from the National College of Naturopathic Medicine in 1986, where he first began to teach homeopathy. He is a Diplomate of the Homeopathic Academy of Naturopathic Physicians. He maintains an active practice in Enfield, Connecticut.

Dr. Herscu had been exposed to homeopathy for his own medical needs as a teenager and decided soon after remarkable results to pursue a career in this field. A voracious reader of the old literature, Dr. Herscu read through the great libraries of the naturopathic schools as well as others throughout the USA.

His teachers were those sources: Hahnemann, Kent, Boenninghausen, Hering, and Lippe. From these readings, he came to understand the importance of writing and teaching from one's own clinical experiences.

Dr. Herscu is credited with revitalizing the homeopathic approach to the treatment of children, making the treatment much more effective. He is also credited with the new approach of writing materia medica from the writer's own experience. He is the author of

The Homeopathic Treatment of Children: Pediatric Constitutional Types
and
Stramonium with an Introduction to Analysis Using Cycles and Segments.

Paul has had numerous articles published in all of the major homeopathic journals. He helped to revitalize and recreate the Homeopathic Academy of Naturopathic Physicians in the late 80's.

He began the concept of Case Conferences that became popular through the 80's and 90's. He was the founder in 1989 with his wife, Amy Rothenberg, of the New England School of Homeopathy. In 1991, he began publishing the New England Journal of Homeopathy.

Through the New England School of Homeopathy (www.nesh.com) Dr. Herscu has taught on-going homeopathic courses to practitioners and physicians in England, Germany, Sweden, Norway, Austria, South Africa, Belgium, Italy, and throughout the USA..

Paul's recent work on the development and teaching of Cycles and Segments has made both the study and practice of homeopathy that much more enjoyable for those who have learned this method.

Paul's system is so valuable that it's been incorporated into a special module for RADAR software, giving the software user a systematic way of questioning their patient in order to gain deeper insight into their symptoms.

Dr. Herscu began publishing, via email the Herscu Letter (letter@nesh.com) in 1999. This distance learning opportunity gives those who are unable to travel a chance to learn this logical and cohesive approach to doing homeopathy.

Herscu's upcoming books include: The Basis of Provings, The Theory Behind the Practice, Including the Provings of Alcohol and the book, The Treatment of Autism with Homeopathy.

CONFERENCE: WORKING WITH TROUBLED CHILDREN
On March 8-9, 2003 Dr. Herscu taught his Cycles and Segments model in Toronto, with emphasis on its use with troubled children. He presented examples from the thousands of clinical cases he has treated.

Conference details:
ADD, Autism and Behavior Problems Conference

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Reviews

From:
SOCIETY OF HOMEOPATHS
Reviewed by Julian Winston

Paul Herscu, NO, OHANP is a well-known international educator. He has taught regular courses for a number of years in Sweden, Norway, South Africa, among other places, as well as in the USA.

He currently runs the New England School of Homeopathy in Amherst, Massachusetts and, until recently, edited the New England Journal of Homeopathy, which is now, sadly, no longer in publication. His demeanor has always been one of quiet certainty. I have found that when Herscu says, "Well, you might want to think about..." it is always worth listening.

His two previous books The Homeopathic Treatment of Children (1991) and Stramonium (1996) are based upon his acute perceptions in his clinical practice. The second book offers an insight into his methodology of 'Cycles and Segments', which he has traced back to the conceptual work of Hahnemann and Boenninghausen.

Herscu's latest book, Provings, has two parts. Part one discusses the conceptual reason for provings. Part two, is a complete proving of Alcoholus, which Herscu conducted with 114 provers over five years.

Herscu has promised Volume II, which will contain the historical articles about provings that have been written by homeopaths, showing how they contended with the same issues we are facing today. Each piece will be annotated.

It is Herscu's hope that this will become a valuable resource/compendium for anyone interested in seeking the legacy, and more importantly building their own understanding of provings, an approach which is signaled by the the sub-title of the book: "How understanding provings offers an essential foundation to successful patient care."
In Chapter One - "Basic concepts"
Herscu introduces the idea of 'stress and strain', and how they manifest both in a proving and in health. In the ideal proving, he points out, the remedy is given and it is such a perfect simillimum to the prover that all the prover's symptoms disappear.

So, in the ideal world, the practice is the same as the proving. The problem is that for most people the remedy is NOT what they need and the 'stress' of the remedy will find the prover 'straining' against it, and thus producing symptoms. Says Herscu: "The process of proving and the process of practice is at the same time a mirror image of itself and a continuation of one to the other."

Another question posed in the chapter is how to tell the difference between a placebo and the verum in a trial? If you cannot tell the difference, then all of homeopathy is up for question.

In Chapter Two
Herscu suggests that the debate about provings has always been one of methodology how to do them - rather than on developing a clear understanding of what a proving actualIy is.

And the process of developing this understanding is what Herscu's book is about. I found that when I posted a brief review of the book on the Lyghtforce e-mail list, that most of the comments offered against the book were concerned with arguments about methodology.

And it is this very thing that Herscu wishes to avoid. Before you discuss the methodology, you should understand what the subject is about.

When a homeopath takes a case, he or she is often presented with a long list of symptoms. The successful outcome depends upon the homeopath's ability to pick from the list those symptoms that are characteristic of the patient's disease (Organon, Para. 153). On the other side of the coin, when a proving is done, it results in a listing of symptoms from the provers. Are they all important? The skill in doing a proving is to be able to select from the myriad of symptoms those that are characteristic of the remedy.

Says Herscu,

"Learning which symptoms to include in a proving enhances your ability to do the same thing in case taking...by not understanding provings, we have created mistakes that Hahnemann was trying to rid us of by creating a more perfect or pure materia medica of the drugs via the proving...We fear that the rubrics of the repertory are expanding so rapidly that soon every remedy will be in every rubric. This will, literally, ruin the usefulness of the repertory as a tool"

Chapter Three
...is a detailed discussion of the models of stress and strain, as well as of the models of cycles and segments. These explain why certain people react to a remedy and others do not. The proving is simply a basic scientific experiment of recording changes that happen to people. The model at which Herscu is aiming will be able to explain all possible reactions to the proving substance.

Chapter Four - "What provings add to the medical community"
- includes the entire text of an article on provings that was presented to the AIH in 1885. This places the proving in its historical context, and shows that homeopaths were there first with a Phase I Drug Trial, first with masked studies, and first with placebo controlled trial.

Chapter Five
- is titled, "What provings are not". (Before continuing, readers are reminded that, although what I have written here is true to the book, it is not the book. Before you become offended about your favorite person or method being attacked, I suggest that what I offer is a summary, and all criticisms should be made of the book after reading it, and not from the out-of-context snippets I have place in this review.)

Herscu strongly believes that it is from the lack of a common language, a lack of a model, that we have come to the place where there is so much fighting. Without a common language we cannot describe what troubles us; and if we try, what comes out may look like an attack on this or that person. What Herscu is attempting to do in the book is to layout a language that will further discussions about ideas, and not about personalities.

When studying provings we can find that one group of provers exhibits many symptoms in their provings, while another group exhibit very few, if any, symptoms. Can these two polarities be reconciled?

The chapter begins with a discussion of some examples of current provings: - meditation provings, song provings, seminar provings, dream provings, and provings where N = infinity, i.e. everyone even near the proving, whether they have taken the remedy or not, is believed to have symptoms elicited by the proving.

Herscu admits that many of the people who began these methods he counts as friends. But he is talking about ideas and not homeopaths. He finds the methodology and thinking behind some of these provings is questionable. This is because the great virtue of a pure Hahnemannian proving is the ability to isolate the symptoms of the remedy, and to do it in a way which eliminates 'background noise', so that what you are measuring is the remedy.

Many years ago I bought a Citizen Band (CB) radio for my car. The CB radio came with a few controls. One was a channel selector (there were about 20 operational channels), one was off/on/volume and the third was called 'squelch'.

If the squelch knob was all the way to the left, you heard everything- a constant drone of static, distant conversations, beeps and clicks. As you turned the squelch to the right you started to filter all that other stuff out. At some point, the radio went quiet-coming to life only when there was a strong transmission from nearby.

For most provings the squelch knob is set too low. Any and all symptoms are admitted, and by doing so we develop huge lists of symptoms that are added to repertories, making the repertories almost unusable.

Given time, this will sort itself out. We will find which symptoms are of value and which are not, and the rubrics will be culled, and the repertories will be useful again.

But, says Herscu, "Once the 'noise' is included in the repertory, there is no easy way to extricate it...we have included so many symptoms that all the remedies begin to look alike."

But need this be the case? If the provings set a higher 'noise threshold', and were seen as the mirror image of our patients, we might be able to abstract that which is characteristic and unique to the remedy being proven and then these lists of 2,000 possible symptoms could perhaps be culled to 100 or so meaningful ones.

Chapter five also includes a discussion of several homeopathic "misconceptions", one of which examines the so-called 'Hawthorne Effect', first observed in experiments by Western Electric in Hawthorne, Illinois in the 1920s. "By showing your interest, you are intruding in the experiment. Behaviour is changed if the person knows they are the subject of a study."

Other areas Herscu discusses or questions concern the limits or edges of the proving experience, dreams as a source of symptoms, the doctrine of signatures, and the question of whether objects have attributes that are outside their constituent parts, i.e., would a proving of a brick from a house be any different than a proving of an identical brick from a monastery.

Herscu asks:

"What are we testing? Are we testing the substance? Are we testing the air? Are we testing the fact that we are away from home? Are we testing new foods?..The threshold has dropped so low that a great deal of background noise is no longer being filtered out...The true symptoms of the substance are buried within the multitude of symptoms from the lowered threshold...

"Having numerous people who did not take a substance or who took placebo develop the same symptoms as the ones who took the remedy is not a demonstration of our interconnectedness; rather it shows that the filters are so porous, and the threshold is so low that the experiment is faulty.

"If you take the proving substance and then your wife is in a car accident, maybe the accident is part of the proving... this sort of thinking may seem humorous to some, but it is not; especially when these symptoms then make it into our materia medica and repertories, making the tools of our trade full of misleading information, ultimately making the practice of homeopathy, already challenging, that much more difficult."

Of the 13 misconceptions that Herscu discusses, the one I found most interesting was the last, number 13: "That it will not impact your practice". If the threshold is so low, he asks, what is the implication in practice? Where does a case history end?

"If the patient's husband fell should the patient take Arnica? If you look out the window and see a certain bird fly by, should you give that remedy?

"One mirrors the other. If your borders are not tighter, if your threshold is not high enough, then your analysis of patients will eventually follow suit. One will mirror the other. I have seen my colleagues go through this for many years. It winds up as a painful process to all involved, at the end. The problems are so numerous that it will take a long time to correct"

Chapter Six
...describes a model of a proving. One of the things Herscu suggests factoring-in is the 'constitution' of the prover. This has not been done before because there was no adequate model to explain it. All people were thought to be equal. But they are obviously not, and if we know their 'constitution' we have a better chance of getting a diverse group of provers. "Having 30 people of only three 'constitutions' is not as beneficial to us as having 30 people of 10 constitutional types."

Chapter Seven
...outlines the actual methodology that Herscu used when he did his proving (of Alcoholus).

Chapter Eight
In Chapter Eight, Herscu reiterates that the proving must always reflect the clinical practice.

If you meditate in the proving you must meditate in the case-taking. If you include experiences of those who did not take the remedy in the proving, then you must include experiences of people who are not your patient in your clinical practice. In reality the proving always reflects the practice. When they do not, when one diverges from the other, then you are running into a problem. The information included in the proving will be incorrect and many people will wind up receiving the wrong remedy as a result. Your practice will suffer.

Strong words.

In Part Two, he 'puts his money where his mouth is' with a full proving of the remedy Alcoholus.

The provings were done five times over a period of five years. 114 people took part. Of that group, 89 fell under the 'threshold' (and so were not mentioned in the proving). Not one of the placebo provers made it above the threshold. Of the 25 whose symptoms were considered, 18 of their daybooks are reproduced at the end of the section.

The remedy is not a new one. It does appear in Allen's Encyclopedia, but the symptoms are sparse and many were "incorporated with hesitation". Herscu selected it because of mankind's long relationship with alcohol, its addictive properties, its essentially poisonous nature, and the genetic/social trail it leaves through foetal alcohol syndrome.

The materia medica of the remedy is fully fleshed out, and the proving symptoms clearly brought out the specific segments and the cycle of Alcoholus. Herscu includes 477 rubrics of Alcoholus although, as he points out, many are simply sub-rubrics, or contain modalities, of a single symptom.

He also includes a history of alcohol, and a short case where he found the remedy curative. He believes that the remedy is "like a nosode" and will be as useful as Cannabis and Opium are in the treatment of drug-related conditions.

How does a proving supervisor establish the 'threshold'? Herscu outlines this in a separate 10 page chapter, "Instructions to provers". This section can also be used as a binding document between the prover and the supervisor.

There is a discussion of how to eliminate 'noise' through establishing a baseline, not changing the daily routine, and having a full case taken by the supervisor before the start of the proving. But the 'threshold' itself is still not well defined, and is open to much interpretation.

A great deal of the burden is on the supervisor. As Herscu points out, unless a case is well taken your chance of finding a good remedy is nil. The same applies to a proving - unless the supervisor carefully conducts it, the symptoms will be meaningless. He points out that some provers, who were not part of the placebo control, had few (if any) usable symptoms. Their susceptibility obviously fell outside the range of the remedy.

Obviously, meditation provings, seminar provings, or dream provings all fall outside the scope of a properly conducted proving, as Herscu sees it.

Herscu acknowledges the help of Frank Gruber, Christopher Ryan (both sadly now deceased), Amy Rothenberg and Todd Hoover. These colleagues provided a forum for his ideas, and many of his concepts grew from conversations with these four.

Although the ideas presented in the book are, I believe, of great importance, the book suffers from much repetition and a certain difficulty of style. Some of this might have been mitigated had Herscu not written in the first person so much.

The book often seems more like a transcript of a seminar lecture than a cohesive book. The first part could have been cut down considerably with the assistance of a good editor. Although I did not mind the style, it might be difficult for some people to read - which is a problem, since the material within is valuable.

I am also bothered by Herscu's lack of definitions. It is one thing to say that the 'noise level' should be set higher - but what exactly does that mean? We all have our own internal definitions.

When Herscu says that he set the bar and only 25 of the 114 provers were over it, I would have liked more definition. Because if we can not understand how to set the bar, then we are left with Herscu being the only one who can.

This book could well be one of the most important books written by the current crop of authors. The proving is exact, and the results immediately useful in practice. The concepts proposed are carefully enunciated and, if followed, can lead to a more accurate way of understanding and conducting provings.

It remains to be seen if anyone is bold enough to attempt doing what is suggested. If not, the world of provings will continue down the uncontrolled track they are often on and, with the filters being so porous, homeopathy itself will be the major loser.

Society of Homeopaths
Reprinted with permission from the Society of Homeopaths

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Contents

-- VOLUME I --
Acknowledgements -- vi-ix
Author's Comments -- x-x

Part One: A Model of Homeopathic Provings --1-139

Introduction -- 3-4
1: Basic Concepts -- 5-12
2. Why Provings Are Important to You -- 13-22
3. Provings From the Models of Cycles and Segments as Well as Stress and Strain -- 23-38
4. What Provings Add to the Medical Community -- 39-64
5. What Provings Are Not -- 65-84
6. What Provings Are or Great Exaptations -- 85-106
7. Conducting a Proving - One Method, With Tools -- 107-136
8. Conclusion -- 137-139

Part Two: The Proving of Alcoholus -- 143-320

Introduction -- 143-146
9. Why Me? Why Prove the Substance Alcohol? How do You Prepare it? -- 147-154
10. Alcohol and Humans: Why the Connection? -- 155-158
11. Pathophysiology of Alcohol -- 159-166
12. Materia Medica of Alcoholus -- 167-182
13. A Short Case -- 183-186
14. The Rubrics of Alcoholus -- 187-202
15. The Proving Journals -- 203-320

New England School of Homeopathy -- 321-322
Index -- 323-349

-- VOLUME II --
Acknowledgements -- vi
Author's Comments -- vii
Organon of Medicine -- 5-20
Cases Illustrative of Homeopathic Practice -- 21-28
On the Proving of Medicines -- 29-62
The Dose in Drug Proving -- 63-78
Directions for Drug Provers Given to the Women who Proved Lilium tigrinum -- 79-82
Lilium tigrinum - A Summary of a Few Provings Upon Women -- 83-92
Idiosyncrasy -- 93-96
Revision of our Materia Medica -- 97-100
The Study of our Materia Medica -- 101-118
Idiosyncrasies -- 119-124
Drug Proving -- 125-132
Provings and Laboratory Tests -- 133-134
Provings -- 135-150
A Review of Recent Provings -- 151-170
Susceptibility and Drugs -- 171-174
Provings -- 175-186
A Protocol for Proving -- 187-194
The Birth of a Remedy -- 195-216
A Model for Homeopathic Drug Tests: Including Statistical Analysis -- 217-228
The Development of Proving Methods Since Hahnemann -- 229-238
Provings - Planning and Protocol -- 239-248
Testing Drugs - Personal Experiences -- 249-254
Provers -- 255-268
Provings: The Method and its Future -- 269-274
Correspondence - Proving Potencies -- 275-276
Proving Report - Veronica Officinalis -- 277-288
For Debate: Provings Concept and Methodology -- 289-298
Proving and Poisoning -- 299-308
Correspondence - Proving Methodology -- 309-316
When Does Unbiased Become Biased -- 317-336
Improving the Success of Homeopathy: Setting a New Research Agenda for Homeopathy -- 337-344
The Pillar of Homeopathy: Homeopathic DrugProvings in a Scientific Framework -- 345-356
Extracting Symptoms form Homeopathic Drug Provings -- 357-364
Good Homeopathic Provings -- 365-376
Proving of Parthenium Hysterophorus, L. -- 377-386
Comments on Jeremy Sherr's The Dynamics & Methodologies of Homeopathic Provingsv387-394
Provings and the Organon Revisited -- 395-400
A Double-Blind Placebo-Controlling Pilot Study of The Validity of Proving as a Method of Finding -- thogenic Characteristics of Homeopathic Remedies -- 401-418

A Quick Summary of the Two Volumes, Which Symptoms to Use -- 419-428
End Note -- 429-431
New England School of Homeopathy -- 432-433
About the Author -- 434

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