The homeopathic pathogenic trial and conventional research
(first published in unamended form at: Clever Homeopathy)
Provings are a fundamental cornerstone of the homeopathic treatment approach [1]. The data derived from these appraisals serves to build the knowledge of the materia medicae, and specifically describes the remedy pictures therein contained [2].
Hahnemann introduced provings for the purpose of finding new substances adequate for the use as homeopathic medicinal prescriptions. With the conduction of provings Hahnemann was able to extrapolate the action radius of a potential new remedy, and was able to identify its possible impact on the ailment and disease symptoms expressed in patients [3, 4].
The first proving that Samuel Hahnemann undertook was of Peruvian bark, China/Cinchona officinalis. Hahnemann had trialed this on himself by ingesting it in crude form [2, 5]. Hahnemann in his life-time undertook some 140 provings, and with time his methodology underwent constant adaptation and modernization [4, 7]. By the time Hahnemann had completed his 6th edition of the Organon, he stressed that provings should be conducted in the 30th potency [6 – Aph. 128].
According to Hahnemann in the Organon, the true curative medicine acts at all times and under all circumstances on the living organism [6 – Aph.32]. As such, a homeopathic remedy aimed at being a curative treatment medicine, needs to have the potential to create, in the sick individual, an ailment of similar symptomatology to that of a presenting disease expression [6 – Aph. 35; 8]. The symptom picture derived from a proving enables the identification of such similarity, and consequently enables the prescription of the most similar remedy to the individual diseased state a patient is presenting with.
For homeopathy it has always been essential to become somewhat related to the medical standards current at a given time [4, 7]. Ledermann [7] specifies that only in such relation, can homeopathy survive as a healthcare discipline. Yet it is exactly this obligation, to satisfy conventional scientific standards, that until today remains one of the hurdles to the acceptance of Homeopathy as a viable treatment approach [7].
Today, for correctness of terminology, largely referred to as homeopathic pathogenic trial (HPT), the homeopathic proving stands in its conduction, quite close to conventional scientific research procedures [8]. As such the HPT is comparable to, what is in conventional medicine termed, the `Phase I trial´. These two investigative research methods are quite similar, but do have marked differences [8, 9].
The HPT trials a homeopathically prepared substance, that is in the event of the proving, given to healthy volunteers whose subsequent specific symptom expressions expose the idiosyncratic symptom potential of the particular substance tested [3, 8]. The participants need to describe the symptoms they experience following the ingestion of the homeopathic trial remedy. It is therefore impossible to undertake an HPT on sick subjects. Hahnemann specifies this in the Organon [6 – Aph. 107], and stresses clearly that all appraisals aimed at proving a substance must be undertaken on the healthy individual [6 – Aph. 108]. Only as such can a full remedy picture be extrapolated from the symptoms. The outcomes of a proving are therefore the subjective experiences of the trial participants, and are of a qualitative nature [5]. Thus, the purpose of the HPT is one much different to that of the Phase I trial.
The investigative purpose of the Phase I trial is to appraise efficacy, pharmacological effects and compliance [5, 8, 9]. This conventional trial methodology therefore, has to use actual patients that have a common pathology, as trial subjects [5, 8, 9]. The outcomes of such studies are usually measured in terms of statistical significance and are of a quantitative nature [5].
The efficacy of a homeopathic remedy cannot be appraised in a proving. For this purpose a second trial becomes necessary where the remedy may then be administered to sick individuals [5].
Furthermore, the expression of pharmacological effects of homeopathic remedies, is generally unlikely. The potency with which remedies are administered in an HPT, exceed the point where a measurable molecular substance is still present in the trial substance [5].
Both methodologies, the HPT and the Phase I trial, have in common that they give insight into the effects from the ingestion of a substance, and both methods commonly are undertaken with a control group that is usually placebo [8, 9].
There are today around 3000 homeopathic remedy pictures that fill our materia medicae. Most have been derived via homeopathic provings, and continually there are new provings being conducted. The quality of these have been diverse, and many are dating back to the origin of the homeopathic treatment approach itself, while only the more recent are in their quality comparable to scientific contemporary standards, as mentioned above. Experience in practice has provided evidence of the efficacy of these remedies and it is without doubt for the homeopathic practice necessary to continue to undertake homeopathic pathogenic trials. As controversial as they may be viewed by skeptics, the lack of provings would deprive the practising homeopath of the principal tool of practice. Provings grow the materia medicae and broaden the treatment radius that is available to aid patients in their recovery.
References:
[1] Bodman, F. (1987) Provers [online] The British Homeopathic Journal Vol. 76, pp.85-91, last accessed June 2013 at URL http://sciencedirect.com
[2] Rogers, J. (2010) Hahnemann and the methodology of pathogenic trials in healthy volunteers: a reappraisal [online] Int J High Dilution Res Vol. 9(32), pp.94-103, last accessed June 2013, available from: http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/view/373/444.
[3] Riley, D. (2007) Thoughts on homeopathic drug provings [online] Homeopathy Vol. 96, pp.231-232, last accessed June 2013 at URL http://sciencedirect.com
[4] Rowe, T. (n.d.) Provings: Then, now and future [online] last accessed November 2014 at URL http://www.amcofh.org/sites/default/files/Provings,%20Then,%20Now%20and%20Future.pdf.
[5] Wieland, F. (1997) Good homeopathic provings [online] British Homoeopathic Journal Vol. 86, pp. 229-234, last accessed June 2013 at URL http://sciencedirect.com
[6] Hahnemann, S. (1974) Organon der Heilkunst (2. Auflage) 6B Heidelberg: Karl F. Haug Verlag.
[7] Ledermann, E. (n.d.) The patient´s experience and the homeopathic drug picture [online] The British Homoeopathic Journal pp.75-80, last accessed June 2013 at URL http://sciencedirect.com
[8] ECH Position Paper (2005) Are homeopathic provings comparable to conventional clinical trials [online] Version 1, last accessed November 2014 at URL http://homeopathyeurope.org
[9] Duckworth, J. & Partington, H. (2009) Provings: the research and ethical context [online] The Homeopath Autumn, pp.43-45, last accessed November 2014 at URL http://academia.edu
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