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Installment 9 of a series on case analysis

© Will Taylor, MD 2001 (bio)

On our Knowledge of the Materia Medica:
Part 2: Qualitative knowledge of remedies proving vs. clinical symptoms

Section 2

Sections: 1 | 2 | 3

Category 1 -
Near-specifics

I find it useful to classify clinically obtained symptoms into several categories. This first category, described above, is of empirically determined near-specifics for a disease genus. We have only a handful of examples. It is the relative uniformity of presentation of these diseases that makes clinical empiricism useful, satisfying Hahnemann's concern regarding "a want of a constant character".

Several of the remedy/disease pairings in this group make sense when the pure proving symptoms are compared with the common/genus symptoms of the disease. Margaret Tyler wrote:

"I may say that I have been in the habit, from the first, of curing whooping-cough with single doses of Drosera 30 or 200; and I saw a good deal of whooping-cough during the war when in charge of the Children's Department of the Hospital … I can only remember one failure." 3

Accordingly, repertorization of the common or genus symptoms of Pertussis will bring Drosera up strongly in the lead.

Other pairings stand purely on clinical grounds. Croserio introduced Symphytum to our practice in the mid 1800's, based purely on empirical evidence in the herbal tradition.

Symphytum officinale

Category 2 -
The Experience of Weighty Authors

One category of clinically obtained symptoms consists of those that rest entirely on the word of one or more esteemed clinicians. Return for a moment to the example above, of Indignation for Staphysagria and Colocynthis.

The original clinical reference to the indignation of Colocynthis actually derives from Hahnemann himself:

"It has proved itself especially efficacious in the following ailments:

"… ill consequences and troubles springing from indignation and embitterment, or internal, gnawing mortification over the unworthy treatment of himself or of other persons who excited his pity." 4

And that to Staphysagria derives from Hahnemann's protégé, Jahr:

"As regards moral emotions, we have a good many remedies by means of which their unpleasant effects may be safely and gently prevented or removed. … Staphysagria or Colocynthis, when anger and indignation go together …" 5

Despite the absence of this symptom in the provings, we have come to accept Indignation as a valid symptom of these remedies on recommendation from the clinical experience of these highly respected clinicians and authors. We can easily place our trust in such classical authors as Hahnemann, Jahr, Hering, and Nash; and contemporary and near-contemporary authors including George Vithoulkas, Pierre Schmidt, Künzli and Phatak.

Other authors suggesting clinical additions, such as Gallavardin, are questionably credible. Concern has been raised regarding the credibility of many of Kent's clinical additions, most of which are not documented beyond their appearance in his Repertory. The issue of validity and author-credibility of clinical additions is very important today, with a proliferation of contemporary authors suggesting additions to our repertories.

Criteria for acceptance of additions to our repertories and materia medica that rest entirely on clinical experience have not been clearly defined or applied.

RADAR with Synthesis 8 offers an elegant solution, with both documentation of the source of additions, and the ability to select and even create repertory views that include and exclude authors of the user's choice.

Vithoulkas view
Vithoulkas view

Category 3 -
Confirmation of Similitude in the Context of a Disease Genus

These consist of observations of cure in a disease-as-named, for a remedy that could have been selected on the basis of the totality of symptoms. Hahnemann's protégé Jahr was a pioneer of such documentation of cured cases, as was Constantine Hering.

One of the numerous examples that could be taken from Jahr's Forty Years' Practice:

"If dropsy sets in after scarlatina, Ars. and Apis generally help most; sometimes also Hell., Bry., Colch., Lyc. or Sulph. and Calc. , [also Apoc. cannab. H. ]" 5

Here the weight of the additions in {GENERALS - DROPSY - external dropsy - scarlatina, after} do not rest entirely with the credibility of the clinicians/authors contributing to this rubric. We can find peripheral edema, as well as the generic symptoms of scarlet fever, as well-documented symptoms of these remedies. These clinical additions serve to confirm that these remedies may serve to meet the full character of the complete disease described.

As such, these are clinical confirmations rather than clinical indications. Jahr pioneered the recording of clinical confirmations in his Klinishen Anweisungen and Forty Years' Practice, following Hahnemann's fragmentary lead in his proving introductions in The Chronic Diseases. Hering built his text Guiding Symptoms of our Materia Medica around the clinically confirmed symptom. In his introduction to the Jain edition of Hering's Guiding Symptoms, Kishore wrote:

"For Hering, a symptom does not acquire the status of a guiding symptom unless, apart from its appearance in a prover or provers, it has been verified on the bedside a number of times."

This category of clinical symptomatology gains credibility by standing on two legs - the solid leg of the proving, supporting its individual elements; and the leg of clinical confirmation, supporting the appearance of these separate elements in combination in the context of a describable clinical condition.

Sections: 1 | 2 | 3

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FOOTNOTES

3. Margaret Tyler, Homeopathic Drug Pictures (chapter on Drosera)
4. Samuel Hahnemann, Chronic Diseases (introduction to the section on Colocynthis)
5. GHG Jahr, Forty Years' Practice