The Organon of Medicine

Francine,

No. Please explain. What controls? People have idiosyncracies.

If they are screened beforehand for any symptoms like that. If they identify them beforehand, making them valid to use if they appear during the proving. Or, people with idiosyncracies excluded.

I see the need for pilot runs anyway, just by the Homeopaths to test the quality of their procedures and medicines.

They would also identify the provers most useful to the "Real" run.

Once all that sorted out, modify expt for DBPC.

Returning to Aph 117, there is likely to be a problem trying to exclude people with idiosyncracies, as these may be the symptoms most important (peculiar) to the medicine.

 

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A pretty good methodology, however, I'd like clarification on items 2 and 3 in the following
"121: Medicines vary in strength:
1) Strong substances alter health even in small doses.
2) Milder one need larger doses.
3) Weak ones need sensitive people."

what is the difference between Mild and Weak?


One item which isn't directly dealt with is long-term effects of the medication. While it could be considered that the statement "When no new symptoms are reported, the medicine has been exhaustively tested." in item 135. However, that is not what this statement appears to be reffering too.


And what about chemical storage in fatty tissue? Item 134: "The symptoms of a medicine do not all come out in one subject, nor in each of his experiments. The proving is repeated many times by the group of provers."
But what about the effects of residual traces of the compound from the prior test? Taking the medication once and then taking it a second time are not allways going to result int he same thing- if the chemical is held onto by the body (in muscle or fat tissue), then the dosage levels will not reflect the actuall amount of compound actively in the body.

Lastly: in ref to Francine's comment - What if the tester takes the medicine, and at the same moment, a cold virus is activated in his body? He will have to attribute the symptoms he sees to the medicine, even though the medicine didn't create those symptoms. This uncertanty can be largely eliminated by re-testing at a different time frame, but then we get back into the chemical storage issue again.

edit: Oh, and this too:
"131: A more robust prover may need ever-increasing doses for several days before any symptoms appear (the symptoms WILL appear, though), they will appear in a mixed up sequence, and symptoms with "alternating type" of primary actions will be indistinguishable from the counteractions of the VP. "
By allowing the individual to increase the doses in this way, you have added another varible tot he equation. What symptoms are then caused by the increase in dosage? This method assumes that all symptoms will occur, but that the individual differences is what determines the doage needed for them to present. While this is close to accurate, there are also hidden problems with this idea, such as the ED/LD seperation level. For a certain drug, the ED will be different for any given individual. So will the LD. However, the LD will not raise at the identical rate as the ED for someone who has resistance to the chemical in question.
This method does not take into account the build-up of resistance over time, nor does it deal with risk factors associated in simply increasing dosage until an effect occurs.

 

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Timokay

Well, it's just wrong to say that anything and everything happening after an experimental intervention is caused by it. Random things happen anyway; things happen due to causes other than the one I actively produced; unless the test is blinded people make stuff up, evein if unintentionally. Dr H was writing before the revoutions in experimental design that happened later in the 19th century, but now we know it it's obvious. Working out causes has much less to do with rigorously applying a treatment by a certain method and much more with match the subjects with controls.

Let's give you an example.

Day 1 Took Bryonia 30C. Expecting some effect

Day 2 Felt nauseous. Maybe I was expecting to feel nauseous, so did. Maybe I ate a bad oyster after (or before) I had the Bryonia so was coming down with food poisoning because of it.

Day 3 Struck by meteorite. Symptoms of severe squashing can hardly be blamed on the Bryonia. Probably need to accept that something else cause my flattening.

From his description of a proving Dr H would have accepted the nausea as caused by Bryonia, but common sense would doubtless make him see the squashing as being caused by something else. But just because he can see the meteorite and can't see the bad oyster does not make a case for blaming the Bryonia for the nausea.

Without methods that were not developed until later in the 19th century you can't say that anything he found was more than coincidence.

Your saying that he 'cured' thousands of patients counts for nothing when one of his basic principles was Aph 138.

I know you sort of know this, which is why you talk about DBPC trials, but at the same time you point to Aph 138 and don't see it as a problem. So what I think is that you think DBPC trialling is window-dressing pedantry to convince nit-picking scientists, but really you basically agree with Aph 138 and can't see why we don't.

I know. Simple Q. Do you believe Aph 138 is true? If so, why?

Cheers. F.x

(You feeling better. Better to do this without rudeness?)

 

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Contemporaneous blinded controls and reproducibility eliminate this problem.

F.x

 

Francine,

No, No, No! These idiosyncratic symptoms are known to that prover. If they happened a long, long, time prior to the testing, and then suddenly re-appear during the medicine testing, then the symptoms are related to the medicine's action.

Hahnemann had checks for "making things up"...the doctor sniffs these out at the prover's daily meeting.

Aph 125: "During the experiment the diet must be carefully regulated. It should consist as much as possible of simple, nourishing food without spices, and one should avoid green side dishes, roots, all salads, and soup herbs (all of which always retain some disturbing medicinal properties no matter how they are prepared). Young peas in the pod, green beans, steamed potatoes, and if need be, carrots can be eaten. They are permissable as the least medicinal vegetables.

Beverages should be those usually taken and should as much as possible not be stimulants. The subject of the experiment must not be in the habit of taking wine, spirits, coffee, or tea and should long before have given up the use of these stimulating, medicinally harming beverages completely. "

You should realise that most proving experiments barely last a day. Hopefully, a day without meteorites. Don't you think a doctor who invented a medical system wouldn't recognize an abnormal situation at the daily consultation? THAT is the filter for everything accepted as a symptom of the medicine.

I still do not see the bone-breaking significance. But, I'll think about it. Here is the complete Aph 138. Changes anything?

"If the previously mentioned requirements for a good, pure experiment have been fulfilled (Aph 124 to 127), all complaints, symptoms, and changes in health of the experimental subject during the action of the medicine arise only from the medicine and must be regarded and recorded as belonging characteristically to it - must be regarded as its symptoms, even if the person has noticed similar symptoms in himself a considerable time before. Their reappearance during the testing of the medicine indicates only that the subject is especially predisposed to them by his particular physical constitution. As far as we are concerned, this happens because of the medicine: symptoms that come on at this time, while the powerful medicine dominates the subject's economy, arise from the medicine and not spontaneously."

The italics above are his own emphasis.
Please look at my other points at the top of page 4 of this thread.

 

River-wind,

121: Medicines vary in strength:
1) Strong substances alter health even in small doses.
2) Milder one need larger doses.
3) Weak ones need sensitive people."

River: what is the difference between Mild and Weak?

Tim: It is MILDER...but your point is good..I should've used "Weakest" not "Weak" for 3).

Aph 121 "...the weakest ones, on the other hand, reveal their true action only when tested on delicate, susceptible, and sensitive people who are free from disease".

River: One item which isn't directly dealt with is long-term effects of the medication.

These substances are remarkable. Nothing like normal medicines. They produce the very real symptoms and then disappear very quickly. It's like they are almost nothing but a signal. Nothing to detoxify/excrete.

Hahnemann says this in "Doctor's self-proving", Last paragraph of Aph 141:
"Let him not imagine that the indispositions suffered from proving medicines could be at all harmful to his health. On the contrary, experience showa that these repeated assaults on the healthy economy of the prover only makes his organism better at warding off everything inimical in his environment, all artificial and natural disease agents, and also more resistant to any harmful effects of the controlled self-provings. His health becomes more invariable; he becomes more robust. All experience shows this. "

Hahnemann, himself, had done more provings than anybody else. And he lived a healthy life until his death at 88.

 

River-wind,

Rest of your points above:

Tim: Here is the whole of 135:

The total picture of disease symptoms that a medicine can produce approaches completion only after multiple observations have been made on many suitable persons of both sexes, with various constitutions.
One can be sure that one has exhaustively proved a medicine and revealed the disease states that it can produce, i.e., its pure power to alter health, only when people who prove it later notice in it very little new - almost always the symptoms already observed by others. "

River: But what about the effects of residual traces of the compound from the prior test? Taking the medication once and then taking it a second time are not allways going to result int he same thing- if the chemical is held onto by the body (in muscle or fat tissue), then the dosage levels will not reflect the actuall amount of compound actively in the body.

Tim: These medicines just disappear in a puff of smoke...that's the remarkable thing. Your point is important because this property must be a clue to their mechanism.

Yes, there are many experiments run, one after the other, on this same medicine by each prover. But the pattern of symptom presentation appears to be random in each prover. Prover 1 may present a certain symptom in experiments 1, 5, 6, 9, 14, but not in the other experiments. Similar random nature with other symptoms. NOTHING REMEMBERED from the previous expt.
So, NO residuals...if so, Hahnemann would certainly have reported it, and dealt with it.

River: Lastly: in ref to Francine's comment - What if the tester takes the medicine, and at the same moment, a cold virus is activated in his body? He will have to attribute the symptoms he sees to the medicine, even though the medicine didn't create those symptoms. This uncertanty can be largely eliminated by re-testing at a different time frame, but then we get back into the chemical storage issue again.

Every day, the Doctor sees every Prover, talks to him and questions his symptoms...the doc would certainly smell a rat if he started sniffling. The medicine will not produce such symptoms. We need to discuss these symptom types. Francine and you are assuming we are dealing with very real and visible "symptoms" like fevers and runny noses, and this is not the case.
The doc would immediately recognize such changes as invalid symptoms and abort the experiment for this prover, as he is no longer "Healthy", a requirement of the Proving.

Address your other points tomorrow.

Tim

 

Timokay

Why do experiments, any experiments in any branch of science, ever include controls? What are controls for?

F.x

 

I am puzzled about the control issue. Hahnemann writes:

Obviously, Hahnemann recognizes the great power of suggestion, yet he does not use blinding in such tests, in spite of his knowledge that persons expecting certain symptoms might induce them in themselves.

Is there any explanation for this apparant logic slip?

Hans

 

Francine,

Your questions are too general. I don't follow the specifics of what you have a concern with.

In any discussion, the person making a point should try to make his point understood by the other party. I can write a couple of pages on what controls are for but it will accomplish nothing if I don't understand YOUR perpective, or what you are getting at.

You need to state where in the proving protocols there is an issue. As I said, we should first focus on "control aspects" of new medicine provings of a pilot type. You mentioned other symptoms interfering with those reported by the prover.

Do you object to this process needing to record all NEW symptoms introduced by the medicine, as opposed to absolutely ALL symptoms the prover is perceiving?

You speak about the idiosyncracies being a problem. They are just symptoms like all others that appear when the medicine is administered. In APh 138, Hahnemann is just clarifying the difference between idiosyncracy symptoms which a person has all the time and idiosyncracy symptoms that occur very occasionally (and not for a considerable time before the proving). That's all.

I have a mild idiosyncracy symptom, twitching in my eyelids, more or less every day. If I were doing a proving, I would not include this symptom as attributable to the medicine. But if my twitching only occurred very occasionally, i.e., last perceived over 6 weeks ago, and the medicine brought it out, then it IS a symptom attributable to the medicine.

Remember that there is a doctor actually gathering and discussing, in person, the prover's reported symptoms. No guesswork gets through.

"139: The prover must write down clearly all his sensations, complaints, attacks, and changes in health the moment they occur, noting the time elapsed between taking the medicine and the appearance of each symptom, AND its duration if the symptom lasts a long time. The doctor examines the record of the prover, in the presence of the prover, immediately after the experiment is completed, or every day if it persists for days. The doctor questions the prover, while it is fresh in his memory, about the exact nature of each statement written down so he may amend it. None of the findings recorded should be guesswork or imagination, and they should as little as possible be obtained by close questioning: everything should be subjected to the precautions already specified for taking cases of natural diseases (APh 84-99)"

 

Nice writing Timokay! I don't want to interrupt the thread with a stupid question, but what is homeopathy?? I've always wondered. Thanks.

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Either is a problem. The problem is with your phrase (on this occasion) 'introduced by the medicine'. You can only tell whether something has been 'introduced' by an intervention under test by assessing whether it is different from control. Yes the control can be the same subject pre-test (but there are major drawbacks to this that need careful design to avoid), or other contemporaneous subjects, but you absolutely cannot say for any individual that something new arising after the intervention was for sure caused by the intervention.

You can only discover an average response for a group as a whole compared with controls. Also, contemporaneous controls in medical trials are essential because the mere fact of doing anything to a subject could alter their responses if you are only following individuals longitudinally with time instead in an unblinded manner. It's also why things must be randomised, so you mustn't give everybody the blank today and the substance under test next week.

I think i've just realized that you can't drop the idea that for a given individual you can say that something happened because of the test intervention rather than it just happening anyway. But you can't know, you really really can't. If you give me a drug that is meant to drop blood pressure and mine goes down, it might be because of the drug, because on average that it is what the drug does, but mine might have gone down anyway, or it might have gone down more, but in me the drug actually relatively raises my BP and really you shold have given me something tat worked properly. For me as an individual for many medical states you just cannot tell. There are obviously a few dramatic things like giving an anaesthetic where it would be hard to say that the patient falling asleep and letting someone cut her open was mere coincidence, but in lots of medicine you don't deal with such a clear-cut issue

Surely you did biochemical assays at university where a 'blank' or 'buffer only' or some such was used to reference any reponse in the active arm of the experiment. When the test materials are real people not test tubes then blinding is a necessary complication but the basic principles are all the same.

Trials reports differences over control NOT absolute events. Everything is relative to control, i.e. placebo.

This is all such basic stuff. Did you really not get taught this in a degree in experimental science? I mean it's school science really, but any first year undergrad practical classes involve these basic ideas.

Is this really really news to you? I think I'm just surprised that we aren't in easy agreement on this, but I guess if we were we wouldn't be disagreeing about the rest.

F.x

 

Oops duplicated again. Silly me.

F.x

 

Francine,

TIM: The problem is that you are following your own thread, and ignore all other interpretations. I have repeated several times that the BLIND and PLACEBO aspects of this are not to be addressed yet. The analytical approach is to take one step at a time and discuss it. But, since you insist:

FRAN: "You can only tell whether something has been 'introduced' by an intervention under test by assessing whether it is different from control."

TIM: The Provings in the DBPC trials will involve about 200 people. You seem to be saying we must test Prover A WITH medicine and WITHOUT medicine before we accept the symptoms he reports WITH the medicine. Do a kind of subtraction at the individual level. (Just showing the level of communication.)

FRAN: "but you absoutely cannot say for any individual that something new arising after the intervention was caused by the intervention."

TIM: The DBPC trials will not be based on INDIVIDUALS, but at the group level, as far as I understand it.

FRAN: "Also, contemporaneous controls in medical trials are essential because the mere fact of doing anything to a subject could alter their responses if you are only following individuals longitudinally with time instead in an unblinded manner. "

TIM: I do not know when or where I gave the impression that this would not be the way the medical trial would be handled.
We haven't even talked about it yet! You must have a scew loose. Yesterday we discussed Hahnemann's proving procedure, not DBPC aspects.

If that is what you were discussing, it was not made clear.

FRAN: "Is this really really news to you? I think I'm just surprised that we aren't in easy agreement on this, but I guess if we were we wouldn't be disagreeing about the rest."

TIM: What the problem is : 1. you go off in any direction assuming everyone else is going to do the same, 2. you communicate really badly, and 3. you are very irritating and arrogant - the reasons why Albert has been laying into you.

Tim

 

And I was still discussing it and why you shouldn't take Aph 138 as right, and showing you why it isn't right. I asked you explicitly whether you believed in it. You answered by saying you didn't understand why I was going on about controls, so I've been trying to explain why I was, but all in connection with you citing Aph 138 as a necessary starting point in a proving as if it was correct in itself. If Aph 138 is correct then a DBPC Trial is unnecessary. If Aph 138 is incorrect then Dr H was wrong, at least this once, and the whole basis of homeopathic experience based on it is wrong. I was giving you the arguments that show you why it is wrong, but you haven't given any back that show it is right, or instead said that you know it's wrong but it doesn't matter and gone on to explain why its being wrong doesn't matter to your argument.

Oh, dear, I feel the sunny spell has ended. Why do you keep doing this?

If Aph 138 is right why are you bothering with a DBPC test???

Fed up with it again and regretting rejoining the discussion. F.x

 

Re: Re: The Organon of Medicine

As can be seen from this example of extremes of ignorance, bias, misrepresentation, erroneous assumptions, third-grade reading skills, a clear anti-homeopathy agenda with some sort of vested interest in keeping it from the sick, and, among other foolishness, a totally unscientific nature, Persol needs to be totally ignored as a complete fool who should have been shut up long ago, at least a year before he was born!

 

Francine,

FRAN: "If Aph 138 is correct then a DBPC Trial is unnecessary. "

Supposing the patient writes down ALL his symptoms but identifies the ones he does not consider new ones. Healthy people DO have little idiosyncratic symptoms..they just live with them all their lives and ignore them. Can you see why Hahnemann does not want these? He wants the CHANGES to symptoms. Surely this can be accommodated. People are individuals.

Or are you only bothered about the idiosyncracy only experienced a considerable time before from being included?

A prover either 1. has no idiosyncratic symptoms, OR 2. has continuous idiosyncratic symptoms OR 3. has idiosyncratic symptoms that rarely appear.

Type 2. should not be reported as attributable to the medicine. Type 3 should because the medicine brought it out.

Tim

 

This is correct and true, but his method means that changes that have nothing to do with the remedy being proved will get themselves allocated to the remedy
when they might be chance happenings that have nothing to do with it. This is where his method fails and is the error that DBPC trials correct.

Yes?

F.x

 

Francine,

Just logged in again.

Thank you for clarifying. Let me think for a mo.