PROVING GUIDELINES AS PER ORGANON OF MEDICINE – SIXTH
EDITION
DR. SUMIT GOEL M.D. (Hom)
For
the selection of a suitable homoeopathic remedy for the natural diseases, the
whole pathogenetic powers of medicines must be known. All the morbid symptoms
and alterations in the health that each medicine is capable of producing in a
healthy individual must first be observed before administering the similimum.
[aphorism 106]
As
Hahnemann's observations on the action of drugs were confirmed by earlier
writers who noted the toxicological effects of many drugs used in large doses
(though they had no idea of their therapeutic indications), he concludes that
the pathogenetic effects or pharmacological actions are produced according to
fixed, eternal laws of nature and by virtue of these they produce certain
reliable disease symptoms each according to its own peculiar character.
[aphorism 111]
OBJECT
OF PROVING
Every
plant species differs in its external form, mode of life and growth, in its
taste and smell from every other species and genus of plant; so also every
mineral and salt differs from all others in its external and internal physical
and chemical properties.
Each
of the medicinal substances, that are derived from these sources, also differ
and diverge among themselves in their pathogenetic and therapeutic effects.
They
produce alterations in the health of human beings in a peculiar and different,
unique and determinate manner. Hence is essential for determining their
peculiar therapeutics so as not to confound one with another.
As
the selection of the similimum is based on the homoeopathic philosophy of
Totality and Individualization, it is the peculiar technique of drug proving
that provides the true, complete 'portrait of the drug' that can be compared
with the portrait of the disease. Anyone understanding this basic principle
will never resort to 'surrogates' or substitutes in prescription. [aphorism
119]
Hence
medicines, on which depend man's life and death, disease and health, must be
thoroughly and most carefully distinguished from one another and tested by
careful, pure experiments on the healthy body for the purpose of ascertaining
their powers and real effects, in order to obtain an accurate knowledge of
them. It is only then, can a correct selection of them can be made for the
permanent restoration of the health of the body and of the mind. [aphorism 120]
PROVING
ON SICK AND HEALTHY INDIVIDUALS
·
Medicines,
even though singly and alone, must not be administered to sick persons because
little or nothing precise is seen of their true effects, as those peculiar
alterations of the health to be expected from the medicine are mixed up with
the symptoms of the disease and can seldom be distinctly observed. [aphorism
107]
·
There
is no other sure, possible and natural way in which the peculiar effects of
medicines on the health of individuals can be accurately ascertained than to
administer the medicines in moderate doses to healthy individuals. [aphorism
108]
ACTION
OF DRUGS IN RELATION TO THEIR DOSES
Hahnemann
observed the following facts regarding the action of drugs in relation to their
specificity and the varying doses in which they are to be administered to
healthy human beings.
1.
Administration
of drugs in excessively large doses leads to production of certain symptoms
during the initial stage that are followed later by symptoms that were of an
exactly opposite nature to those that first appeared. The first set of symptoms
constitutes the primary action of remedies and the following set of symptoms
are the reaction of the vital force of the organism and constitute its
secondary action. [aphorism 112]
2.
Administration
of drugs in moderate doses seldom or hardly ever produces the least trace of
secondary actions. Only their primary action is observed. [aphorism 112]
3.
Administration
of drugs in small doses does never produce secondary action. [aphorism 112]
4.
In
the homoeopathic curative operation, the living organism reacts from these only
so much as is requisite to raise the health again to the normal healthy state.
[aphorism 112]
5.
An
exception is in case of narcotic medicines. Even with moderate doses the
narcotic medicines have been observed to produce secondary action in the form
of increased sensibility and greater irritability. In their primary action
these narcotic medicines take away sometimes the sensibility and sensation,
sometimes the irritability of the healthy organism. [aphorism 113]
6.
With
the exception of narcotic substances, the primary actions of the medicines are
to be noted. [aphorism 114]
7.
Among
the symptoms of the primary action of drugs administered in moderate doses,
there occur in the case of some medicines not a few which are partially or
under certain conditions, directly opposite to other symptoms that have
previously or subsequently appeared – which represent the alternating state of
the various paroxysms of the primary action and are termed alternating action.
[aphorism 115]
8.
Referring
to the symptoms produced by a medicine, it has been noted that (a) some
symptoms are produced more frequently, i.e. in many individuals; (b) others
more rarely or in few persons; (c) some only in very few healthy bodies.
[aphorism 116]
Symptoms are the manifestations of the actions of the
drug on the vital force and the reaction of the vital force to the same drug.
So they are, in all cases, the product of their actions and reactions. The
variability in the manifestation of symptoms depend on the inherent power of
the influencing substance and the capability of the vital force that animates
the organism to be influenced by it.
In case of some symptoms appearing only in very
healthy bodies, the condition is called idiosyncrasy. Though the state of
idiosyncrasy implies a peculiar constitution, but this must also be ascribed to
the influencing drug in which must lie the power of making the same impression
on all human bodies, yet in such manner that but a small number or healthy
constitution have a tendency to allow themselves to be brought into such an obvious
morbid condition by them. [aphorism 117]
9.
As
each man differs from another man in their individual aspects, so each drug
differs from another in their pharmacological properties, and each of these
substances produces alterations in the health of human beings in a peculiar,
different, yet determinate manner, so as to preclude the possibility of
confounding one with another. [aphorism 118]
ASCERTAINMENT
OF DOSES OF MEDICINES FOR PROVING
1.
Strong
medicines are liable even in small doses to produce changes in the health even
in robust persons. [aphorism 121]
2.
Those
of milder power must be given in more considerable quantities. [aphorism 121]
3.
In
order to observe the action of the very weakest medicines, the subjects of
experiment should be healthy persons who are delicate, irritable and sensitive.
[aphorism 121]
METHOD
OF PREPARATION OF DRUGS FOR PROVING
The
purity, genuineness and energy of the medicines must be thoroughly assured, and
for this purpose [aphorism 122] -
1.
Each
of the medicine must be taken in a perfectly simple, unadulterated form.
[aphorism 123]
2.
The
indigenous plants in the form of freshly expressed juice must be mixed with a
little alcohol to prevent its spoiling. [aphorism 123]
3.
Exotic
vegetable substances must be prepared in the form of powder or tincture
prepared with alcohol when they are in the fresh state and afterwards mixed
with a certain proportion of water. [aphorism 123]
4.
Salts
and gums should be dissolved in water just before being taken. [aphorism 123]
5.
If
the plant can only be procured in its dry state, an infusion of it may be made
by cutting the herb into small pieces and pouring boiling water on it, so as to
extract its medicinal parts.
Immediately after its preparation, it must be
swallowed while still warm as all expressed vegetable juices and all aqueous
infusions of herbs without the addition of the spirit, pass rapidly into
fermentation and decomposition whereby all their medicinal properties are lost.
[aphorism 123]
PRECAUTIONARY
MEASURES TO BE TAKEN DURING PROVING
Regarding the
medicine to be proved
·
Every
medicinal substance must be employed quite alone and perfectly pure without the
admixture of any foreign substance and without taking anything else of a
medicinal nature the same day, nor yet on the subsequent days, nor during all
the time, the effects of the medicine are to be observed. [aphorism 124]
Regarding the
prover
(a)
During
the whole period of the experiment the diet of the prover must be strictly
regulated – it should be as much possible destitute of spices, of roots and all
salads and herb soups. The diet should be of a purely nutritious and simple
character, consisting of green vegetables. Young green peas, green French
beans, boiled potatoes and in all cases carrots are allowable, as the least
medicinal vegetables. [aphorism 125]
(b)
The
drinks are to be those usually partaken of, as little stimulating as possible.
The prover must either be not in the habit of taking pure wine, brandy, coffee
or tea or he must have totally abstained for a considerable time previously
from the use of these beverages, some of which are stimulating, others
medicinal. [aphorism 125]
(c)
The
prover must be pre-eminently trustworthy and conscientious. [aphorism 126]
(d)
During
the whole period of proving he must avoid all overexertion of mind and body, all
sorts of dissipation and disturbing passions. [aphorism 126]
(e)
He
should have no urgent business to distract his attention. [aphorism 126]
(f)
He
must be self-observing and not be disturbed whilst so engaged. [aphorism 126]
(g)
He
must possess a sufficient amount of intelligence to be able to express and
describe his sensation in accurate terms. [aphorism 126]
(h)
The
medicines must be tested on both males and females in order to ascertain
especially the changes in the sexual sphere. [aphorism 127]
DETERMINATION
OF DOSAGE AND ITS DIFFICULTIES – MODE OF ADMINISTRATION
Drug
proving is not so simple and easy a matter for the following reasons –
·
Medicinal
substances, in their crude state, do not exhibit nearly the full amount of the
powers that lie hidden in them, which they do when they are taken in high
dilutions. In this manner, one can investigate the medicinal powers even of
substances that are deemed weak. [aphorism 128]
·
Medicine
should be given to the prover, on an empty stomach, daily from four to six very
small globules of the thirtieth potency, moistened with a little water or
dissolved in more or less water and thoroughly mixed and this is continued for
several days. [aphorism 128]
·
If
the effects of this dose are but slight, a few more globules may be taken
daily, until they become more distinct and stronger and the alterations of the
health more conspicuous. [aphorism 129]
·
All
persons are not effected by a medicine in an equally great degree. On the
contrary, there is a vast variety in this respect. An apparently weak
individual may be scarcely affected by moderate doses of a medicine known to be
of a powerful character, whilst he is strongly enough acted on by others of a
much weaker kind. [aphorism 129]
·
On
the other hand, there are very robust persons who experience very considerable
morbid symptoms from an apparently mild medicine and only slighter symptoms
from stronger drugs. [aphorism 129]
·
As
this cannot be known beforehand, it is advisable to commence in every instance
with a small dose of the drug and, where suitable and requisite, to increase
the dose more and more from day to day. [aphorism 129]
·
If
at the very commencement, the first dose administered is sufficiently strong,
it is advantageous in a way that the experimenter learns the order of
succession of the symptoms and can note down accurately the period at which
each occurs, which is very useful in leading to a knowledge of the genius of
the medicine, for then the order of the primary actions and alternating actions
is observed in the most unambiguous manner. [aphorism 130]
·
A
very moderate dose even, often suffices for the experiment, provided only the
prover is sufficiently delicate and sensitive and is very attentive to his
sensations. [aphorism 130]
·
The
duration of a drug can only be ascertained by a comparision of several
experiments. [aphorism 130]
RULES
FOR AN EXHAUSTIVE PROVING OF DRUG
1.
The
drug must be proved, both in dilutions and in massive doses.
2.
If
the same medicine is given to the same person to test for several successive
days in ever-increasing doses, the various morbid states that the medicine is
capable of producing in a general manner is learnt, but not their order of
succession; and the second dose often removes curatively, some of the symptoms
caused by the previous dose, or develops in its stead an opposite state. Such
symptoms should be enclosed in brackets, to mark their ambiguity, until
subsequent purer experiments show whether they are the reaction of the organism
and secondary action or an alternating action of the medicine. [aphorism 131]
3.
But
when the object is only to ascertain the symptoms, especially of a weak
medicinal substance and not the sequential order of symptoms, nor the duration
of action of the drug, then it is to be administered for several successive
days, increasing the dose every day. In this manner, the action of an unknown
medicine, even of the mildest nature, will be revealed, especially if tested on
sensitive persons. [aphorism 132]
4.
On
experiencing any particular sensation, the exact nature of symptoms needs to be
determined, as for example – to observe whether, by moving the affected part,
by walking in the room or open air, by standing, sitting or lying the symptom
is increased, diminished or removed and whether it returns on again assuming
the position in which it was first observed – whether it is altered by eating
or drinking, or by another condition, or by speaking, coughing, sneezing or any
other action of the body and at the same time to note at what time of the day
or night it usually occurs in the most marked manner. In short, what is
peculiar to and characteristic of each symptom will become apparent. [aphorism
133]
5.
All
the symptoms peculiar to a medicine do not appear in one person, nor all at
once, nor in the same experiment, but some occur in one person chiefly at one
time, others again during a subsequent trial. In another person, some other
symptoms may appear, moreover they may not recur at the same hour. [aphorism
134]
The
greatest care should be exercised in verifying symptoms by repeated experiments,
in order that "imaginary" symptoms as well as chemical and mechanical
symptoms may be excluded.
WHEN
A MEDICINE CAN BE CONSIDERED TO HAVE BEEN THOROUGHLY PROVED
A
medicine is regarded to have been completely proved when
1.
Numerous
observations are made on suitable persons of both sexes and of various
constitutions. [aphorism 135]
2.
Subsequent
experiments can notice little of novel character from its action. [aphorism
135]
3.
During
reproving only the same symptoms are noticed as had been already observed by
others. [aphorism 135]
4.
The
symptoms are recorded complete with regard to their sensations, localities,
modalities and concomitant factors so that a complete individual picture of the
drug disease has been ascertained.
Although
a medicine on being proved on healthy subjects cannot develop in one person all
the alterations of health it is capable of causing, but can only do this when
given to many different individuals, varying in their corporeal and mental
constitution, yet the tendency to excite all these symptoms in every human
being exists in it. [aphorism 136]
RELATIVE
MERITS OF EMPLOYING LARGE AND MODERATE DOSES OF MEDICINE IN PROVING
(A)
DISADVANTAGE OF EMPLOYING LARGE DOSES OF MEDICINE IN PROVING
If excessively large doses are used, there occur at
the same time not only a number of secondary effects among the symptoms, but
the primary effects also come on in such hurried confusion and with such
impetuosity that nothing can be accurately observed. [aphorism 137]
(B)
ADVANTAGES OF EMPLOYING MODERATE DOSES OF MEDICINE IN PROVING
The more moderate the doses of the medicines – so much
the more distinctly are the primary effects developed, and only these occur
without any admixture of secondary effects. [aphorism 137]
RECORDING
OF THE PROVING
All
the sufferings, accidents and changes of the health of the prover during the
action of a medicine are solely derived from the medicine that is being proved
and must be regarded and registered as belonging peculiarly to this medicine,
as symptoms of this medicine, even though the experimenter had observed, a
considerable time previously, the spontaneous occurrence of similar phenomena
in himself.
The
reappearance of these during the trial of the medicine only show that this
individual is by virtue of his peculiar constitution, particularly disposed to
have such symptoms excited in him. In this case they are the effect of the
medicine; the symptoms do not arise spontaneously while the medicine that has
been taken is exercising an influence over the health of the whole system, but
are produced by the medicine. [aphorism 138]
1.
The
physician may take other persons on whom the drug is administered.
(a)
The
prover must note down distinctly the sensations, sufferings, accidents and
changes of health, he experiences at the time of their occurrence, mentioning
the time after the ingestion of the drug when each symptom arose and if it
lasts long, the period of its duration, and to keep a day book for the purpose.
[aphorism 139]
(b)
The
physician looks over the report in the presence of the prover immediately after
the experiment is concluded; or
(c)
If
the experiment is continued for a long period of time he inspects the day book
of the prover daily while everything is still fresh in his memory and
questioning him about the exact nature of every one of those circumstances,
write down the more precise details and makes each symptom precisely complete
with regard to its sensation, localities, modalities and other concomitant
factors. [aphorism 139]
(d)
If
the prover is illiterate and cannot note down his alterations in health, he
must inform the physician every day of what has occurred to him, and how it
took place. What is noted down as authentic information, must be chiefly the
voluntary narration of the person who makes the experiment, nothing conjectural
and not derived from answers to leading questions, to ensure authenticity.
[aphorism 140]
2.
The
physician may prove the medicine on himself. The best provings are those that
the healthy, unprejudiced and sensitive physician institutes on himself
[aphorism 141]
Advantages –
(a)
He
knows with the greatest certainty the things he has experienced in his own
person.
(b)
The
great truth that the medicinal virtue of all drugs lies in the changes of
health he has himself undergone from the medicines he has proved becomes for
him an incontrovertible fact.
(c)
By
such self-observation the physician will be brought to understand his own
sensations, his mode of thinking and his disposition and he will also get
trained to be a good observer.
(d)
The
uncertainty about the exact changes in the health of others produced by a drug
ceases entirely when a physician proves the drug on himself. The experiments on
himself give him a reliable knowledge of the true value and significance of the
medicinal agents.
(e)
He
who makes the trials on himself knows for certain what he has felt and each
trial is a new inducement for him to investigate the powers of other medicines.
(f)
He
thus becomes more and more practised in the art of observing, by continuing to
observe himself.
(g)
Experience
shows that the organism of the prover becomes, by the frequent attacks on his
health, all the more expert in repelling all external influences inimical to
his system and all artificial and natural morbific noxious agents and becomes
more hardened to resist everything of an injurious character by means of these
moderate experiments on his own person with medicines. His body resistance
against all sorts of infections is increased, health becomes more unalterable
and he becomes more robust.
Symptoms
that, during the whole course of the disease, might have been observed only a
long time previously or never before, consequently new ones, belong to the
medicine. [footnote to aphorism 142]
Proving
of medicines to unknown persons at a distance, who are paid for their work is
uncertain in its results and loses all its value, as the proving demands the
greatest moral certainty and trustworthiness that is doubtful in such a case.
[footnote to aphorism 143]
BUILDING
UP OF THE MATERIA MEDICA
If
tests with a considerable number of simple medicines have thus been carried out
on healthy individuals, and a careful and faithful recording of all the disease
elements and symptoms that they are capable of developing is done, then only a
true Materia Medica can be built up.
This
will be then a collection of real, pure, reliable modes of action of simple
medicinal substances, a volume, wherein is recorded a considerable array of the
peculiar changes of the health and symptoms ascertained to belong to each of
the powerful medicines, as they were revealed to the attention of the observer,
in which the likeliness of the (homoeopathic) disease elements of many natural
diseases to be hereafter cured by them are present, which, in a word, contain
artificial morbid states, that furnish for the similar natural morbid states
the only true, homoeopathic, that is to say, specific, therapeutic instruments
for effecting their certain and permanent cure. [aphorism 143]
From
such a Materia Medica, EVERYTHING THAT IS CONJECTURAL, ALL THAT IS MERE
ASSERTION OR IMAGINARY SHOULD BE STRICTLY EXCLUDED. Everything should be the
pure language of nature carefully and honestly interrogated. [aphorism 144]
Of a
truth it is only by a very considerable store of medicines accurately known in
respect of these their pure modes of action in altering the health of man that
we can be placed in a position of discover a homoeopathic remedy, a suitable
artificial (curative) morbific analogue for each of the infinitely numerous
morbid sates in nature, for every malady in the world.
Few
disease remain for, which a tolerably suitable homoeopathic remedy may not be
met with among those now proved as to their pure action, which without much
disturbance, restores health in a gentle, sure and permanent manner infinitely
more surely and safely than can be effected by all the general and special
therapeutics of the old allopathic medical art with its unknown composite
remedies, which do but alter and aggravate but cannot cure chronic diseases,
and rather retard than promote
recovery from acute diseases and frequently endanger life. [aphorism 145]
We
thus build a complete Materia Medica.
Hahnemann
called it Materia Medica Pura, because it consisted of the collective
statements of the positive and perceptible reactions of the healthy human body
recorded in the words of persons acted upon by drugs and admits no
misinterpretations with changing medical terminology, altered biological
concepts and newer scientific developments.
It
is to borne in mind that the daybooks are not the Materia Medica. Not until the
masses of symptoms have been analyzed, sifted, classified.