II. THE CRITERIA TO MAKE AN ADDITION
1. Confidence in Additions
Not all homeopaths agree with each other's additions or criteria to make additions. In the book, the only way to solve this is to clearly indicate the source, permitting each one to make his decision. For those who use the RADAR program an ingenious technology is being designed allowing you to select or deselect the authors you want to work with. Any combination of authors, more precisely of sources, can be selected or unselected! But there are some perspectives. To the presence of any remedy a confidence rating will be given based on homeopathic criteria allowing one to select only the most confident additions at any stage.
The lowest level of confidence means that it is a one-time addition from just anyone. If other homeopaths start making the same observation and reporting the same addition, the confidence in this information will increase. A confidence rating of 2 may appear if the remedy belongs to the original Repertory of Kent, or if the information is supported by at least three different authors, etc. The confidence rating is NOT reflected in the degrees of the remedies. It is entirely possible that different authorities confirm that a symptom is sometimes, but not often, found for a remedy: in this case the confidence rating will increase, but not its degree.
At first this tool will only be usable by those working with the computer, as we have yet to imagine how this information can be translated to the printed form. Our only reasonable solution now seems to be to accept everybody's additions with consideration, provided they have been added with caution and precision. There is no selection that would please everybody. Can we refuse to take additions from the Latin-American schools? Or include only their additions? Not everybody would be pleased. We are toolmakers and Synthesis is like a violin. We can make it sound very charming, but we cannot define which music will be played on it: Mozart, a Bohemian rhapsody or a cacophony.
2. Literature versus Words
"Verba volant, scripta manent": it is common sense that what is written has more scientific value than what is told. Our first attention goes to the integration of written information. Another point of attention has unfortunately proved to be the following. When homeopath X quotes an addition from colleague Y, he should be sure that Y has been quoting from his own experience. The most relevant question when additions are proposed is: "From whom?". If there is no reassuring answer to this question, we are better off with no addition at all.
3. Provings versus Clinical Experience
A proving has always been the primary source of homeopathic information. As most provings are supervised by more experienced homeopaths and are, in fact, a scientific study, the results tend to be more reliable. The rules to extract useful symptoms from a proving have sufficiently been laid down, but nevertheless, quoting Jeremy Sherr, "good supervision is the key to a good proving".
It is different with clinical information since homeopaths are so different. One homeopath mentions with some reluctance one new addition after ten years of practice, while another one shouts with joy at his ten additions within his first year of practice. I do not want to dictate rules, but I believe that the general concern is that one should have at least ten years of full time homeopathic practice before "offering" additions to the community. Even more experienced homeopaths agree that the additions purely on clinical experience should be integrated with caution. That is why we added the additions from living "authors" in the first degree in Synthesis, unless they get confirmation, which may affect a higher degree.
Then finally: when do symptoms of a cured case become possible additions? There is a difference in the attitude to be taken towards acute or chronic cases.
A chronic case can yield additions if:
- the reaction to the remedy is clear cut, which means - no interference from positive circumstances — no mix up with other remedies or therapies
- the reaction to the remedy is spectacular and repeated. A strong reaction to one dose is not sufficient proof of the remedy's action: we must have placebo-awareness. If the same symptoms disappear a second and a third time, we feel already more confident about the causative agent.
- the duration of action should clearly exceed the possible placebo effect, e.g. from a "nice conversation". It might take several years before you can decide whether a chronic case is "good enough" to use for additions.
An acute case can yield additions if:
- the reaction is clear cut (see above)
- the reaction to the remedy is spectacular and carries the patient to a prompt cure (no further remedies nor therapy needed)
- the speed of onset of improvement should be considered. In a full hit acute case, useful for additions, this should be within 24, preferentially 12 hours after the dose. Be aware that some acute cases get better on their own, if you wait long enough. We should prefer to consider only the very spectacular cases. In both acute and chronic cases, placebo-awareness is a key. For this reason homeopaths were advised by Dr. Jacques Imberechts (Brussels, Belgium) to first prescribe a placebo.