DR. SUMIT GOEL M.D. (Hom)
The recording of the proving is the most important
aspect of the entire proving exercise; for it is on the experiences of the
provers that the pure Homoeopathic Materia Medica is derived. Hence it is
important that the observations of the prover have to be recorded in meticulous
detail and in a systematic way, so as to ease the post-proving analysis of the
records.
PROFORMA
LAYOUT
·
INITIAL MEDICAL REPORT
PROFORMA
As it is practically
impossible to find perfectly healthy human beings, the recording of the Initial
Medical Report Proforma serves as the reference point for the inclusion or
exclusion of the prover from the proving project. A detailed history taking,
physical examination and necessary investigations can fairly judge the health
status of the prover. The provers selected for proving are then subjected to a
thorough preliminary medical examination. Laboratory investigations such as
pathological, biochemical and radiological evaluation were carried out, if
required. Detailed medical and personal history of the prover is recorded in
this proforma by the proving supervisors. The ascertainable physical
constitution, moral and intellectual character, occupation, mode of living and
habits, social and domestic relations, sexual function, etc are to be taken
into consideration. If necessary, services of specialist consultants are made
use of. This proforma is also later analyzed with the proving records in the
post-proving stage.
·
PROVER’S DAYBOOK / LOGBOOK
The prover’s daybook or the
logbook is a properly designed format wherein the prover makes data entries in
chronological order as per instructions. Provers should begin to take notes 7
days prior to taking the remedy. This helps them to get into the habit of
observing themselves and recording symptoms, as well as bringing them in
contact with their normal state. The prover, in a daybook, then enters the drug response data originating in the
proving trials after the administration of the test drug.
·
RESPONSE MONITORING PROFORMA
Each prover is to be
interrogated meticulously at each visit. The investigators monitor the
responses of the prover in the Response
Monitoring Proforma. Location,
sensation, modalities, concomitants, extension, duration, etc. with regard to
each sign and symptom; their intensity, sequence of their occurrence and
recurrence is noted on the sheet. Time keeping is an important element of the
proving. Weather, temperature and humidity are to be noted down daily during
interrogation by the investigators. Laboratory investigations and services of
specialist consultants may be made use of, if deemed necessary. The nature of
monitoring of the prover’s response is analogous to the careful investigation
of a case of disease to form the portrait of the disease.
RECORDING
OF SYMPTOMS
Each prover is provided with a daybook to
make a record of all the signs and symptoms, subjective and objective, they
experience during the proving. Any
alteration from the normal health should be recorded.
HOW TO NOTE
·
Adherence to
the protocol, honesty and sincerity are the prerequisites both on the part of
investigators and the prover.
·
Recording
should be done without pre-biased ideas about the outcome of the proving.
·
It is
important for the quality and credibility of the proving that one should not
discuss the nature of symptoms with other provers. Provers and supervisors
should refrain from discussing symptoms or experiences they are going through
with other provers or supervisors during the entire duration of the proving.
·
The
recording should be done as vigilantly and frequently as possible so that the
details will be fresh in memory. Also a note is to be made even if nothing
happens.
·
The prover
should preferably keep the daybook at all times. It is a good idea to keep
paper pad and a pencil in order to note down the symptoms as and when they
arise and later transfer and elaborate in the daybook.
·
Each day is
started on a new page with the date and which day of the proving it is, noted
at the top of each page. The day of the first dose is day one. Records are made
on alternate lines, as this allows space to comment.
·
The prover
should note in an accurate, precise and detailed manner the symptoms in one’s
own language and not in the repertory language of rubrics. Accounts should be
written in the first person.
·
In order to
produce a proving of enduring value, the prover has to keep a daily diary of
symptoms during the period that new symptoms are arising and for a minimum
period of six weeks.
·
For provings
of longer duration, the prover needs to be in daily communication or on
alternate days, with assigned proving supervisor.
·
The Proving
Supervisor must note down his observations chiefly from voluntary narration
without asking any leading questions.
·
Symptoms
have to be reviewed by prover and supervisor, investigated, clarified and
recorded in detail. Supervisor should always seek to elicit any feelings and
modalities that have been overlooked.
·
One should
always discuss any queries with the supervisor.
WHAT TO NOTE
·
When
beginning the proving, the prover needs to note down carefully any symptoms
that arise, whether they are old or new and at what time of the day or night
they occurred. The prover must note down distinctly the sensation, sufferings,
accidents and changes of health he experiences at the time of their occurrence,
mentioning the time after the ingestion of the drug.
·
Information
about the time the symptoms appeared, the location, sensation, intensity,
concomitant symptoms, extensions and modalities (such as weather, food and
thirst) are especially important. This information should be recorded on the
right hand page of the daybook.
·
The left
hand page is devoted to recording the details and circumstances of the proving
experiences in one’s own words. It is advisable for the prover , on a daily
basis, to run a check through the different body zones to ensure that one has
observed and recorded all symptoms.
·
Use of
general terms such as, “daughter”, “son”, “place” is recommended, rather than
proper names.
·
A record of
occurrences is also to be maintained.
·
The
attendants or the people about and around the prover are also a good source to
remark on the changes in the prover and should be regularly considered.
·
Avoid mixing
up symptoms that can be separated unless they link together, for instance, as
concomitants do. If one can break symptom into discrete parts, this is helpful.
·
Dreams,
fantasies, delusions and fears are the expressions of the response to the
proving. These symptoms and dreams should be set within the context of the
story, the dream events before and after, and the context of what may be best
expressed as, the primary core of the dream.
·
The exact
time of onset of symptoms, their chronological sequence, pattern of
development, duration and whether symptoms are continuous or intermittent;
onset slow or rapid.
·
The exact
site of occurrence of the symptom, whether constant in location, or the
radiation, of the symptom.
·
Careful
noting of modalities that include factors of aggravation and amelioration as
rest, movement, pressure, thermal, etc as well as the exact time of the day or
night and its relationship to normal physiological functions.
·
Emotions,
thought processes, impulses and cravings must be noted in detail, including
those for certain foods.
·
Any
modification of normal physiological functions as taste, touch, sight,
appetite, thirst, sleep, digestion, sweating, discharges, sexuality, etc.
·
The
possibility of any external causative factors, other than the proving remedy
that could excite symptoms must be carefully recorded.
·
It is a good
exercise to have a special note of the place characteristics and of the daily
whether of the location of the prover.
·
On a daily
basis, the prover should run through the entire check list to ensure that one
has observed and recorded all symptoms.
Criteria for
including symptoms:
·
New
symptoms, unfamiliar to the prover, i.e., ones that have never experienced
before,
·
Usual
or current symptoms that are intensified to a marked degree.
·
Current
symptoms that had been modified or altered (with clear description of current
and modified components).
·
Old
symptoms that have not occurred for at least one year (note time of last
appearance).
·
Present
symptoms that have disappeared during the proving (cure).
·
If a
symptom is in doubt, it is included in brackets. If another prover experienced
the same symptom it could be valid. If not, it is excluded.
·
A
symptom that may have been produced by a change in life or exciting cause
should be excluded.
The Supervisor,
in the presence of the prover should categorize each symptom by making a
notation according to the following key in brackets next to each entry:
NS : New symptom;
RS : Return of a recent
symptom;
OS : Return of an old symptom;
AS : An altered symptom i.e. a symptom that
has changed its character, modality or concomitant;
CS : A cured symptom i.e. one
which has disappeared;
US : An unusual symptom.
SUPERVISION
PROCEDURES
1.
The prover
is expected to remain in regular contact with the proving supervisor at all
stages of the proving. The role of the supervisor serves two purposes. The
first is to provide support for the prover, while the second is to ensure that
the information gathered is as complete, detailed and accurate as possible. The
role of the supervisor during this time is to clarify, verify and enlarge.
2.
The
supervisor should record all information in a diary similar to that used by the
prover – Response Monitoring Proforma – noting down location, sensation,
modality, etc., and starting a new page each day with the current date, and
writing legibly on alternate lines - this record will therefore follow the same
format as the prover's diary. When recording symptoms, he should write down the
prover's own words as fully as possible. Detailed information and concise
legible recording is crucial to extracting the proving texts. Events may be
triggered by the proving experience and should therefore be noted down.
3.
When the
proving has finished, the prover and supervisor should meet and compare notes
in order to eliminate any ambiguities or uncertainties. However, the Supervisor
should not change the information in either diary, merely make a commentary
about the nature of the discrepancies in a different coloured ink. The prover
and the supervisor are also invited to write up a resume of their appraisal of
the proven remedy's action.
INSTRUCTIONS TO
PROVERS
Throughout the proving the prover needs to maintain
contact with a supervisor.
Pre-Proving Stage
·
Protect the
remedy until you have finished taking it. Keep the sealed bottle away from
light, heat and strong smelling substances.
·
Ask the
queries and clear the doubts completely before the onset of the proving. The
supervisor will contact you before you begin the proving to take your case,
answer any questions and to schedule a start and arrange contact times.
Onset of the Proving
·
Record your
symptoms daily in the diary for one week prior to taking the remedy to get into
the habit of observing and recording your symptoms, as well as bringing you in
contact with your normal state.
Taking the Test Dose
·
Begin taking
the remedy on the scheduled day. Record the time that you take each dose.
Maintaining a Time Log is the most important aspect of the proving.
·
The remedy
should be taken on a clean and fresh mouth.
·
Take the
“coded test dose” for up to 3 doses daily for two days.
·
Symptoms
appearing at the early stage are sometimes most useful, and anything you
experience, no matter how subtle or unusual is to be recorded.
·
In the event
that you experience symptoms or those around you observe any proving symptoms
do not take any further doses of the remedy.
·
If in doubt
contact the supervisor. Be on the safe side and do not take any further doses.
PRECAUTIONS TO BE TAKEN BY PROVER DURING DRUG PROVING
·
The prover
should avoid all substances that have any medicinal property, which should not
be taken on the same day, nor yet neither on the subsequent days, nor during
all the time we wish to observe the effects of the medicine, so that it may not
interfere with the symptomatology.
·
Provers must
be at least 3 months clear of any previous treatment or of a homeopathic
remedy.
·
There should
be a strict regulation of diet when the drug is being proved.
·
Any usage of
restricted substances should be stopped 2 weeks prior to the beginning of the
proving.
·
Diet during
proving should be purely nutritious and of simple character.
·
Avoid all
potential antidoting factors like tea, coffee, wine, brandy, camphor or mint
during proving.
·
Overexertion
of mind and body should be avoided. Provers should stick to their normal habits
and way of life
·
All sorts of
dissipation and disturbing passions should be avoided.
·
No drugs
(medical or "pleasure", birth control pills, HRT etc.), no mental
pathology (including long past pathological mental conditions, no chronic
physical pathology (check for suppressions)
·
Provers
should stick to their normal habits and way of life.
·
Remedy
taking - dose repetition - up to 6 doses (3 a day).
·
Duration of
supervision - the duration of supervision, particularly for those who clearly
respond, should last a minimum of three months. They should also have a six
month follow-up
·
There should
be no urgent business to distract his attention.
·
Avoid any
extraneous influences that may distort the results.
·
Should
devote himself to careful self-observation and not be so disturbed whilst so
engaged.
·
Hahnemann
did not encourage even games or work activity that might disturb the
concentration or judgement of the prover. Moderate exercises may be undertaken.
·
Should not
be suffering from such chronic diseases as are liable to severe acute episodes
(i.e. asthmatic attacks, psychotic episodes) or from degenerative chronic
states; nor should be currently under either homoeopathic or allopathic
treatment.
·
Refrain from
inadvertently negating the remedy’s action by the use of drugs, remedies or
other possibly antidoting substances.
Confidentiality
·
It is
important for the quality and credibility of the proving that the prover
discuss the symptoms only with the supervisor, and not with anyone else who is
doing the proving or who has contact with someone who is.
·
Women should
note when they have a period and any differences in any symptoms before, during
or after.
·
Reports from
friends and relatives can be very enlightening. Please include these if
possible. At the end of the proving make a general summary of the proving. Note
how the proving affected you in general. How has this experience affected your
health?
Finishing the Proving
The supervision of proving is considered over, when
there has been no change in the symptom picture for a month.
Reviewing the Information
On meeting the prover, supervisor shall
compare and clarify the notes. The prover may add any further comments,
thoughts or insights about the proving to the daybook. These daybooks,
alongwith the Medical Report Proforma and the Response Monitoring Proforma are
the sent to the compilation and analysis team, under the guidance of the
Project Director. All the records are then decoded. This is followed by various
stages of compiling and sorting the huge data. The provers may again be
contacted in future for a “Follow up Evaluation”, to check for any residual
symptoms of the proving, evaluating the state of health and to clear any doubts
that may still be present.
A meeting of provers and supervisors may
be arranged, where they are informed of the substance they had proved and for
any other feedback.
DR. SUMIT GOEL M.D. (Hom)