Proving of Drugs – When a healthy person takes a medicine for experimental reasons, certain effects are produced – changes in body functions, secretions, and sensations – which collective phenomena are spoken of as a drug proving. When arranged schematically and written down, it is known as a drug’s Pathogenesis. These Pathogenic effects evaluated, interpreted, and abbreviated, form the Homoeopathic Materia Medica which we study, the sources of which appear at the end of their chapter. This study of pure, single, drug effects is a distinctive feature and the foundation on Homoeopathy and also an original contribution by Hahnemann to medical research – for which he deserves the greatest credit.
The fact stands that those drugs which are the greatest poisons become, if used according to Homoeopathic concepts, the greatest medicines. Indeed, Hahnemann pointed out the general rule that the possible good effect of any drug was directly proportional to its power to derange the healthy human mechanism.
This does not account for the effects of so-called inactive drugs like Silicea, Carbo veg., Sepia, Graphites, etc.These drugs have no power to affect the human body in material dosage, but if their powers are developed by the special processes of Homoeopathic pharmacy they are capable of profoundly affecting the organism. It is simply a case of some drugs being naturally active in their crude state, and others needing artificial development (dynamization).
Thus, Aconite, Arsenic, Gelsemium, have pronounced effects on the healthy body and, hence, are correspondingly useful on a sick body. Such drugs are known as Polychrests.
As drug proving is the very basis of our Materia Medica – it is not surprising that this activity has been the main contribution to medical research which the school of Homoeopathy has made.
All the important drugs have been most carefully proved, first by Hahnemann, and, subsequently, by numerous societies and individual experimenters. A tremendous volume of symptoms are the result of such observation. But, of course, it follows that the value of any one symptom depends on the faithfulness and integrity of the observer.
So it is, that not all symptoms recorded in the provings are true effects of the drug due to this element of human frailty. All this is well recognized by Homoeopathic students and often exaggerated. The whole point of the matter is this – for the great bulk of our Polychrests, the Pathogenesis has so often been put to test clinically that only reliable symptoms have remained.
The chaff has been discarded. This is especially true at this time when Homoeopathy has been in existence for one hundred and twenty-five years. The question is often asked as to the reason Hahnemann recorded his drug effects in non-medical language and also why his first book of drug effects was called, ” Materia Medica Pura.”
Hahnemann called this ” Pure” not because it was free from error but free from Speculation – it being a record of observed facts alone, independent of any theories of their action. Hahnemann appreciated the necessity for a scientific concept of the action of a drug on the body but, at the same time, was mindful of such a concept’s short-coming. Thus, in his essay on, “Power of Small Doses” in Hufeland’s Journal, he describes the knowledge of Materia Medica which a physician requires as follows:
“What organs a drug deranges functionally, what it modifies in other ways, what nerves it principally benumbs or excites, what alterations it effects in the circulation and digestive operations, what influence it exerts over secretions, what modifications the muscular fibre receive from it, how long its action lasts, and by what means it is rendered powerless, etc.”
Why then, did Hahnemann not construct his Materia Medica on this model? Unquestionably, because with a wonderful sagacity Hahnemann clearly perceived the following truths : That the positive facts with which a physician has to deal in constructing a Materia Medica are the observations of the prover recorded in plain, unfigurative, non-hypothetical language.
Their interpretation must be the result of the application of the sciences of Physiology and Pathology to these facts. That the facts of the proving being of the nature of positive observation are enduring and unchangeable. But, that the science of Physiology and Pathology, being incomplete and progressive, are continually undergoing change, and that their terms must, therefore, be ever varying in significance, as the theories on which the sciences are based, vary.
That, consequently, a Materia Medica constructed by him out of these two elements, one constant and the other variable, would of necessity be transient-could not be enduring-would soon grow obsolete and in its decline would carry out of sight the constant element also and thus the labor of the provers would soon be lost to the world. Such a structure would have involved an intermingling of the current physiological theories with the facts derived from observation. The precise point and extent of the intermingling would soon become undistinguishable and thus a vitiated record would be transmitted to posterity such as the advance of science would soon render useless.
” A comparison of the present state of Physiology with that of 1800 A.D., of which the very terms are almost obsolete, makes the great wisdom of this view apparent. On the other hand, the pure records of observed facts, untainted by theoretical speculations, come to us from the Master’s hand as pure, as intelligible, as available, as when first recorded.” (Dunham.)
Experience with drug-proving squads brings out other interesting considerations. Not everyone gives a complete proving. Susceptibility varies materially. Perhaps only twenty percent of the squad give comprehensive symptomatology. The same drug will not affect every man in the same manner or in the same parts, and lastly the intensity of sensation is subject to the widest variation. It takes, therefore, considerable experience to evaluate a proving, but there is no question that this is the best way to introduce a student into the study of the Homoeopathic Materia Medica.
The importance of studying the effects of drugs upon the living organism is appreciated by all medical men but only Homoeopaths emphasize the healthy human body. In Pharmacology, Digitalis, Ergot, Aconite, etc., are standardized by animal experimentation, and results must produce certain well-defined effects or the preparation is not acceptable to the U.S.P. For a full account of biologic assays and laboratory methods, see “Pittenger : Biologic Assays,” published by Blakiston, 1928, 2nd Ed.
This is a desirable procedure to insure active medicines but a fundamental point is that there are comparatively few medical substances with exert a marked physiologic effect and a further point of difference between the two schools is this : The Homoeopath believes that the last word has not been said about a drug until it has been ” proved.” And further, the corollary follows that this human prover must be sensitive. Now, there is no way of determining this sensitiveness beforehand and, unfortunately, records must be had to numerical probability. If twenty people take the drug, the chances are that perhaps six or eight are sensitive to it and will show a satisfactory protocol.
Now the questions arises. ” If it is a fact that comparatively few are susceptible to drug effects is that not a formidable point against the whole use of drugs in the Therapeutic field. Does that not explain the recent neglect of this study?”
This question must be answered affirmatively, if simply the mass or physiologic action of drugs is taken into account. Comparatively few people get a sore throat from Belladonna or tinnitus from Quinine or salivation with Mercury in the usual doses. If susceptibility were a constant, it must be confessed that all drug Therapy would be greatly handicapped. This, however, is not so. The threshold of susceptibility is a variable depending on a number of factors chief among which may be mentioned : inheritance, environment, morphology, and disease. For practical purposes, the last named is the most important.
It may be taken as an axiom that, ” Disease is a universal sensitizer.” It is because the disease process in some way breaks down the natural barriers of the body rendering it susceptible to action by drug stimulus – a condition which might not have been possible in health. A word must be interpolated here in regard to tolerance. Many will say that there are a number of instances where a disease seems to give a tolerance instead of increased susceptibility, thus syphilitics tolerate Mercury and and Kali iodide over well; those with malaria, Quinine. These substances at times (though by no means always) seem to provoke a body tolerance and it would seem as if the disease per se has little to do with this tolerance phase but that it is more a matter of chance tolerance, so to speak, instead of ” chance sensitiveness.”
In the desensitization practice of protein therapy, (asthma, skin test) when a disease is at its height we give a small dose (evidence of the sensitization of disease), gradually step it up as time goes on which is evidence of decreased sensitiveness due to declining diseased state (body approaching health and normal reaction). Thus, it is that Homoeopaths cannot accept the arbitrary rule of the U.S.P. Council regarding drug activity, because it takes no notice of the susceptibility of the disease process. Another reason of equal moment is the exaggerated importance given to animal experimentation. Such experiments can only be of gross physiologic type, which, of course, is quite sufficient to define the scope of their medicines but entirely inadequate for our Homoeopathic uses. This will be discussed further in the chapters to follow.
Brief rules for drug proving are here given :
1. Use a pure preparation and nothing else of a medical nature should be taken at the same time.
2. Keep a written record.
3. Dosage : usually appreciable doses of the tincture or low potencies are taken first followed by a reproving with the middle and higher dilutions. In this way the whole effect of the drug is exhibited – both functional and pathologic changes.
4. Repetition. The drug is taken at different intervals usually every two hours until definite symptoms develop. As soon as this takes place, these symptoms should be allowed to show themselves without further medication.
Original Provings and Sources of the Materia Medica – The first work embodying such record is that of Hahnemann, entitled, ” Fragmenta de Viribus Medicamentorum Positivis.’ It is a Latin work, and published in Leipsic in 1805. Twenty-seven drugs are treated of, containing symptoms Hahnemann himself had observed as effects of poisoning or from excessive dosing, and of provings on himself. ” I have instituted experiments,” he says in the preface, ” in chief part on my own person, but also on some others whom I knew to be perfectly healthy and free from all perceptible disease.
” In those experiments which have been made by myself and my pupils, every care has been taken to secure the true and full action of the medicines. Our provings have been made upon persons in perfect health, and living in contentment and comparative ease. When an extraordinary circumstance of any kind – fright, chagrin, external injuries, the excessive enjoyment of any one pleasure, or some event of great importance – supervened during the proving, then no other symptom has been recorded after such an event, in order to prevent spurious symptoms being noted as genuine.
When such circumstances were of slight importance, and could hardly be supposed to interfere with the action of the medicine, the symptoms have been placed in brackets, for the purpose of informing the reader that they could not be considered decisively genuine.” Five years now elapsed before Hahnemann published anything more in the line of drug pathogenesy.
Then appeared the first volume of that great classical work, the ” Materia Medica Pura,” containing the symptomatology of twelve medicines, six of which had already appeared in the Latin treatise published before. Five years later appeared the second volume, containing the symptomatology of eight medicines which was soon succeeded by the four other volumes, containing in all the pathogenic effects of sixty-one drugs. It is a monumental work, the result of Hahnemann’s matchless penetration, wonderful insight and accurate observation, of which he was a master. He was most ably assisted in this work by thirty-five fellow-provers, among whom the names of Franz, Gross, Hartmann, Herrmann, Hornburg, Ruckert, Stapf, and Friedrich Hahnemann are the conspicuous and deserve to be remembered by all students of Materia Medica.
In 1822, appeared a second edition of this work, with considerable additions to the symptomatology of all the remedies and some new medicines besides. A third and fourth edition were published after some years.
In 1828, Hahnemann published his ” Chronic Diseases,” containing the symptomatology of a completely new series of medicines, a series of deeply acting drugs, like Calcarea, Sulphur, etc., the so-called Antipsoric remedies. The symptomatology of these remedies was not wholly pathogenetic, but included observations at the bedside, so-called clinical symptoms.
A second edition, greatly enlarged and now containing the symptomatology of twenty-five remedies, besides the twenty-two of the first edition, appeared between 1834 and 1838. A peculiar feature of the provings in this work is that the bulk of them must have been obtained with the thirtieth potency, and often are observations when given to the sick, differing entirely, therefore, from the pathogenetic effects of the Materia Medica Pura.
Besides Hahnemann and his immediate workers, Constantine Hering, of Philadelphia, contributed the best provings to the Homoeopathic Materia Medica, some of his drugs ranking in importance with Hahnemann’s own. Of these, Lachesis, Glonoine, and Apis take first rank.
Another large contributor to the Materia Medica was Dr. E.M.Hale, not so much by proving as by introducing American remedies that had been in use by botanic physicians, and gathering all that was known as to the therapeutic properties in one volume, called, “New Remedies.” We have, then, as sources of Homoeopathic Materia Medica :
1. Hahnemann’s Materia Medica Pura, published in 1811, containing the pathogenesis of the great polychrests-i.e., remedies of many uses and wide and frequent application.
2. Hahnemann’s Chronic Diseases, published in 1828, containing the so-called Antipsoric remedies, those especially adapted to the cure of chronic diseases.
3. Dr. Jorg’s Provings – a professor at the University of Leipsic and contemporary of Hahnemann, but not one of his followers. He proved, among others, Camphor, Digitalis, Opium, Arnica, Hydrocy. acid, Ignatia. Some of his symptoms are quoted and included by Hahnemann in the second edition of his works.
4. Dr. Hering and the American Provers’ Union.
5. Dr. E.M. Hale’s contributions in his ” New Remedies.”
6. Various provings and reprovings under the auspices of the American Institute of Homoeopathy, various State societies and individual provings published in our journalistic literature. Also, Hartlaub and Trink’s pathogeneses, Stapf’s additions, provings by the Austrian Society, etc., etc.
There records are at present collected in four great works :
1. ” Allen’s Encyclopaedia,” in ten volumes.
2. ” Cyclopaedia of Drug Pathogenesy,” in four volumes. These two works contain the symptoms obtained by provings, and from records of poisoning, i.e., pathogenetic symptoms.
3. ” Hering’s Guiding Symptoms,” in ten volumes, which also contains clinical or curative symptoms-i.e., observed on the sick.
4. Clark’s ” Dictionary of Homoeopathic Materia Medica,” in four volumes.