entanglement in provings
TRANSCRIPT
ARTICLE IN PRESS
Homeopathy (2005) 94, 69–70r 2004 The Faculty of Homeopathy
doi:10.1016/j.homp.2004.11.015, available online at http://www.sciencedirect.com
LETTER TO THE EDITOR
Entanglement in Provings
I applaud the Walach et al for their attempts atapplying quantitative methods to qualitative research1.Having myself conducted 70 homeopathic drug prov-ings following GCP guidelines, one with 110 subjectsand an equal placebo group, I view this research asimportant in trying to evaluate whether or not it ispossible, in a proving, to distinguish reliable symptomsspecific to a medicine from random, non-specificsymptoms. Many well-proven and commonly pre-scribed homeopathic remedies have ‘keynotes’ thatdid not appear in a homeopathic drug proving.However, I have some questions. Since we know that
placebo symptoms in conventional medical researchvary significantly across clinical trials for the samedisease and also among different organ systems I amunclear how the authors concluded that what wasexperienced during the proving period was differentfrom background noise.The sharp increase in both atypical and typical
symptoms could be explained by the fact that subjectsin this study went from a medicine free baseline periodto a period of taking a homeopathic remedy. Inaddition the subjects were students in homeopathicschools which suggests that they may have been
Reply to D Riley
I am grateful to Dr Riley giving me the opportunity toexplain some elements of our study more clearly.I agree with him: If the ‘‘typical’’ Cantharissymptoms, as determined by the homeopathicexpert, were symptoms commonly associated with non-specific or placebo responses then the increase insymptoms could be explained by other causes. Theproblem here is the if. There is no way to determinewhich symptoms are specific for placebo, because there isno standard. Placebo can generate virtually any symp-tom. Hence, we have no external standard to answer thisquestion, only the internal comparison within a givenstudy. In our study, more symptoms typical for Canthariswere observed in both groups, compared to atypicalsymptoms.
unusually sensitive to homeopathic remedies and,perhaps, suggestible and likely to experience symptomsduring a proving.There was a trend for Cantharis to stimulate more
symptoms typical of that remedy than atypical ones. Ifthe typical Cantharis symptoms, as determined by thehomeopathic expert, were symptoms commonly asso-ciated with non-specific or placebo responses then theincrease in symptoms could be explained by othercauses.The local and non-local hypotheses are also not
mutually exclusive, both could operate at the sametime and may be dependent on a variety of factors.Thank you for this thought provoking article.
Reference
1 Walach H, Sherr J, Schneider R, Shabi R, Bond A, Rieberer G.
Homeopathic proving symptoms: result of a local, non-local, or
placebo process? A blinded, placebo-controlled pilot study.
Homp 2004; 93: 179–185.
David RileyE-mail address: [email protected]
Bear in mind the following: the potential number ofsymptoms not typical for Cantharis, i.e. placebosymptoms, is unlimited, while the number of Cantharissymptoms is limited. Thus, baseline probability for atypical Cantharis symptom is very low compared to allother symptoms that could potentially be experienced.It is true that the symptoms could also be commonlyassociated with placebo responses, but in fact theywere not. Symptoms were generally quite specific, anda lot of them were in the area of mind and dreams(possibly due to attention bias, or because this provinghappened to be more effective in this area; incidentallyone of the reasons Cantharis was not identified by thehomeopathic expert was that it does not have anextensive mind-symptoms proving picture). But the