(b) Because some provers are susceptible to the action of dilutions or small doses, and not to that of massive doses of the crude substance. For instance, Dr. Wurmb got decided and persistent symptoms from dilutions (thirtieth to sixth) of Natrum muriaticum. From lower dilutions and from the crude substance, even in half ounce doses and repeated frequently, he got no symptoms. Was this because his system was saturated? We think not; for on recurring to the dilutions, he again got symptoms as at first. Now, had the provings been confined to the crude substance, we should not have Dr. Wurmb’s proving of Natrum muriaticum, the most complete and reliable single experiment that we possess, and which we could hardly consent to give up, notwithstanding Dr. Hempel’s opinion that “potency-provings should rather be rejected than encouraged.” The same thing is observed in the provings of Aconite, Thuja and colocynth.
2. “Potencies do not produce reliable symptoms unless the system has been previously saturated with massive doses of the crude substance; and Corollary, massive doses render the system susceptible to the action of smaller quantities.”
We have shown that in repeated instances, symptoms which Hahnemann and the Austrian provers regarded as “reliable” have resulted from potencies not preceded by massive doses-symptoms confirmed by other provings and by clinical experience. On what grounds does Dr. Hempel question their reliability?
Again, we have no conclusive evidence that massive doses, as a rule, render the system more sensitive to small doses. In some cases they appear to do so. In others they have the opposite effect. In the records, we find the utmost variety as regards the susceptibility of provers to various doses. Some, like Dr. Wurmb, are susceptible to dilutions alone of a given drug, others to massive doses alone. Many obtain symptoms at first from comparatively small doses of the crude substance, but find it necessary to steadily increase the dose, until finally, after taking in some cases several hundred drops or grains, they get no symptoms at all from any preparation. This looks like a blunting of the susceptibility rather than an exaltation. We are not always justified in assuming that, where dilutions were taken after massive doses, the symptoms were due to the massive doses and not to the dilutions. In the majority of these cases a sufficient period elapsed between the experiments to prevent all possibility of the one complication the other. In a few cases no such period elapsed, and in these it may be that the symptoms ascribed to the dilutions were really due to the previous massive doses, yet even in these really due to the previous massive doses, yet even in these cases we cannot be certain of this; for in one of them, that of Prof. Zlatarovich, who, after taking in the aggregate several thousand drops of the Thuja-tincture, changed without delay to the twelfth dilution, a symptom was observed which had not occurred to him or to any one else while provings the tincture, but only to Huber while taking the sixtieth.
In conclusion, we see in the Austrian records more reason to suppose that massive doses, as a rule, blunt than that they exalt the susceptibility, although in some cases they unquestionably have the latter effect. As these cases cannot be recognized in advance, it is clear that in the case of an individual drug or prover, nothing positive on this head can be assumed as a basis on which to plan a proving.
3. It is said that “idiosyncrasy” determines the action of potencies, and that provings having this origin are not reliable.
The word “idiosyncrasy” is used in two senses. Properly, it signifies an abnormal sensibility to drug-action; or such a relation to a special drug as that the drug produces in the prover symptoms that occur to no other prover, and which bear no analogy at all to the symptoms which others experience. Such symptoms as these must always be regarded as suspicious until verified by clinical experience. Such an idiosyncrasy is exemplified by persons who have “hay asthma,” “rose catarrh,” etc.
But, as most frequently employed, the word “idiosyncrasy” is synonymous with “susceptibility,” implying an unusually acute, but not abnormal,, sensibility to the action of the drug, and a prover who shows a marked susceptibility to the action of a drug is said to have a marked susceptibility to the action of a drug is said to have an idiosyncrasy which favors its action. This susceptibility is similar to that what individuals exhibit for natural diseases- some being prone to one kind of disease, others to another, just as one prover is especially susceptible is similar to that which individuals exhibit for natural diseases-some being prone to one kind of disease, others to another, just as one prover is especially susceptible to Thuja, another to Aconite. now, what pathologist would think of objecting to a case of pneumonia that it was not a reliable picture of the disease, because it could be shown that the patient had a great susceptibility to the disease, and took it on the slightest provocation? A certain susceptibility to the action of a drug is absolutely necessary to a good proving. Hahnemann speak of it in his Organon as a necessary condition. What the Austrian provers think on the subject may be gathered from the following remarks of Watzke (Dr. Wurmb proved Thuja five times, four time in massive doses and once in dilutions; result very meager): “We may observe that the proving of a drug is not so easy an affair as it seems to be. The individuality of the prover as well as of the drug plays here so important a part, that a successful proving is often an entirely accidental piece of good fortune of the susceptible prover, while the boldest, but unsusceptible prover, with the best good-will and the greatest devotion may obtain only a scanty and one-sided result.”
This susceptibility may be to the drug in general or to particular preparations of it. Wurmb was acted on only by dilutions of Natrum muriaticum. Watzke only by immense doses of the crude substance. Watzke was sensitive to very small doses of Thuja, while Wurmb and Reisinger were almost insensible to every preparation of it. Obviously, then, a prover’s susceptibility varies with the drug and and with the preparations, and can be learned only by experiment with all preparations.
From the general tenor of Dr. Hempel’s report, one might infer that while the middle and higher potencies produce symptoms only in very exceptional cases, massive-doses of the strongest preparations act always. The records of the Austrian provings hardly warrant such an assumption. Of the thirty-one experiments made with tincture of Aconite, six were not followed by any trustworthy symptoms. Of the thirty-six made with large doses of tincture of Thuja, seven were without result. Of fourteen made with large doses of crude Colocynth, one was without result. Of the fifteen provers of Bryonia, one at least took very large doses of the tincture without observing any symptoms, Several who took large doses of crude Natrum muriaticum were insensible to its action. It is obvious, then, that the development of symptoms is not of necessity copious and satisfactory in ration of the dose. The Austrian records abound in editorial remarks, intimating that provers have defeated their object by taking too large does, and by repeating the dose too frequently.
We have seen, then, that potency-provings may be trust-worthy and that they are indispensable to a complete and exhaustive proving. It is to be observed that even the few Austrian potency-provings which we have, were not, generally, conducted in such a way as to demonstrate the full value of such experiments. In very many cases, only a few days were allowed for the development of symptoms before a larger dose was taken. In the few cases in which a different course was pursued, as in Wurmb’s proving of Natrum muriaticum, clear and persistent and most valuable series of symptoms were obtained.
In order to obtain a perfect proving, the prover should ever bear in mind certain fallacies to which he is liable. These fallacies differ according to the dose which he is employing; they are equal for either extreme of dose. If he use the higher dilutions, he is in great danger of confounding “imaginary” symptoms with real subjective drug symptoms. If he employ massive doses, he is in equal danger of including in his record chemical and mechanical symptoms. Either error is a source of confusion and uncertainly, but he is greatly mistaken who think to avoid introducing confusion and uncertainly into the Materia Medica by simply rejecting potency provings. They can be avoided only by the constant analysis of the symptoms (whether produced with potencies or with large doses), by frequent repetitions of the provings of the symptoms. The Austrian records give an example of the latter fallacy. The symptoms are so intermingled with chemical; and revolutionary effects, that one cannot use too great caution in basing a prescription upon them.
Dr. Dunham graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. His works include 'Lectures on Materia Medica' and 'Homoeopathy - Science of Therapeutics'.