[Lize de la Rouvière]
ABSTRACT The aim of this study was to elicit and document the effects, in the form of signs and symptoms produced in relatively healthy volunteers, of the venom of Hemachatus haemachatus, prepared in accordance with the methods set out in the homoeopathic pharmacopoeia. These signs and symptoms form the indications for the prescription of the remedy, according to the homoeopathic Law of Similars. A further aim of this study was a comparative analysis of symptoms produced by Hemachatus haemachatus 30ch with existing remedies derived from snake venom used in homeopathy, with the aim of highlighting the similarities and differences between them. The homoeopathic drug proving of Hemachatus haemachatus 30ch took the form of a double-blind, placebo controlled trial. The proving population consisted of 30 healthy subjects who met with the necessary inclusion criteria (Appendix B). Eighty percent (24 subjects) served as the experimental group, receiving the active verum in a randomised manner, while twenty percent (6 subjects) formed the placebo group, receiving non-medicated placebo powders in a randomised manner. Provers were unaware of either the nature or potency of the substance. Verum and placebo were indistinguishable from each other, and neither researcher nor volunteers knew who received verum and who received placebo. Intra-individual control was achieved through a pre-proving observation period of a week’s duration, during which provers recorded the signs and symptoms of their normal state. This symptom picture served as a baseline for comparison with symptoms noted after administration of the remedy.
Verum and placebo were dispensed in the form of six powders to be taken sublingually three times a day for a period of two days, or until the onset of symptoms. Data was primarily collected in the form of a diary or journal kept by each prover in which they recorded symptoms on a daily basis. Provers were closely monitored by the researchers during this period. Data collected by the researchers during daily telephonic contacts, as well as during the pre-proving consultation, was also considered. Information obtained from the journals was then assessed by the researchers for suitability for inclusion in the materia medica of Hemachatus haemachatus. The data did not require statistical analysis. In a concurrent study of similar methodology, Cahill (2008) conducted a comparison of the symptom complex produced in the proving of Hemachatus haemachatus, with other homeopathic remedies which scored highest on repertorisation. Symptoms from both studies were collated and included in the materia medica and repertory of Hemachatus haemachatus. The investigation supported the hypothesis that Hemachatus haemachatus would produce clear and observable signs and symptoms in healthy proving volunteers. During the course of this study provers experienced a wide range of mental, emotional and physical symptoms. The highest number of symptoms was produced on the mental and emotional level. Provers experienced elation, joy, increased confidence, enthusiasm and energy. On the other hand, there was lack of confidence, vulnerability, anxiety, decreased motivation, decreased concentration, lethargy, depression and indifference. There were sudden changes in mood and provers experienced marked irritability. On the physical level, many provers experienced headaches, irritation of the eyes, symptoms resembling allergic rhinitis, sore throats, nausea, heartburn, abdominal pain and flatulence, menstrual disturbances, lumbar pain, rheumatic joint pains, and skin eruptions. There were disturbances in normal sleep patterns, subjective perceptions of increased body temperature with hot flushes, and generalised tiredness and lethargy. Symptoms obtained from the proving of Hemachatus haemachatus were analysed as part of a comparative study with other remedies derived from snake venom: Lachesis muta, Naja tripudians, Elaps corallinus, Naja mossambica and Bitis arietans arietans. This comparison highlighted both the similarities and differences between these remedies and Hemachatus haemachatus.
Centesimal potency A potency scale with a dilution in the proportion of 1 part in 100 (Swayne, 2000:36). Indigenous Native to a particular area. An organism or species that occurs naturally in an environment or region (Cambridge University Press, 1987:194). Law of similars A doctrine that states that any drug which is capable of producing morbid symptoms in the healthy will remove similar symptoms occurring as an expression of disease (Yasgur, 1997:234). It is usually expressed as: Similia similibus curentur, from Latin meaning: let like be cured by like (Swayne, 2000:193). Materia medica In homoeopathy, a reference work listing remedies and their therapeutic action (Yasgur, 1997:144). The description of the nature and therapeutic repertoire of homoeopathic medicines; of the pathology, the symptoms and signs and their modifying factors (Swayne, 2000:132). Miasm Trait within a society, family or individual making them susceptible to a particular pattern of morbidity; an inherited or acquired disposition to be ill in a certain way (Swayne, 2000:137). Placebo In homoeopathic practice, it refers to a non-medicated substance that is relatively inert (Gaier, 1991:426). The inactive agent used for comparison with the substance or method to be tested in a controlled trial, and is indistinguishable from it (Swayne, 2000:162). Potency
The medicinal power of a homoeopathic medicine, released or developed by dynamisation or potentisation. The measure of power of the medicine based on the degree to which it has been potentised, expressed in terms of the degree of dilution. (Swayne, 2000:166) Prover Subject of a proving or a homeopathic pathogenetic trial. A volunteer, who should be in good health, who records changes in his or her condition during and after the administration of the substance to be tested (Swayne, 2000:174). Proving From the German Prüfung. The process of determining the medicinal/curative properties of a substance. This process involves the administration of substances either in crude form or in potency to healthy human subjects in order to observe and record symptoms (Yasgur, 1997:201). Rubric The phrase used in a repertory to identify a symptom or disorder and its component elements and details, and the categories of these, and to which a list of the medicines which are known to have produced that symptom or disorder in homeopathic pathogenetic trials, or to have remedied it in clinical practice, is attached (Swayne, 2000:186). Simillimum The single homeopathic medicine, the drug picture of which most nearly approaches the total symptom complex of the patient (Gaier, 1991:509). Succussion (dynamisation) Vigorous shaking, with impact or ‘elastic collision’, carried out at each stage of dilution in the preparation of a homeopathic potency (Swayne, 2000:201).
True, real or genuine (Yasgur, 1997:275). In the context of a
homoeopathic proving it refers specifically to the medically active substance
administered to provers as opposed to the medically inert placebo (
Homeopathic drug provings are one of the fundamental principles of homeopathy (Riley,1996 a). Vithoulkas (1980:144) defines the purpose of a proving as: „to record the totality of morbid symptoms produced by that substance on healthy individuals; and that totality will then be the curative indications upon which is to be prescribed the curative remedy in the sick individual’.
In Aphorism 143 of the Organon, Hahnemann (1982) insists that only the pure, reliable effects of substances are collected in a materia medica. There is no other method of accurately predicting the effect of any substance as a remedy (Sherr, 1994:7). It can thus rightly be asserted that homeopathic drug provings are the pillars on which homeopathic practice are built (Sherr,1994:7) (Walach,1997). Vithoulkas (1980:143) says that in order for homeopathy to advance, it is necessary to perform provings on new substances to expand the homeopathic armamentarium. In aphorism 162 of the Organon, Hahnemann (1982) says that in cases where the exact simillimum has not yet been proved, the homeopathic practitioner is forced to employ the most appropriate remedy. Only when a new remedy is proven well, can cases partially covered by existing remedies be cured (Sherr,1994:8). In aphorism 145, Hahnemann (1982) urges the discovery of a suitable remedial agent for every known disease. Increasing the number of remedies in the materia medica facilitates greater accuracy and individualisation when treating patients (Wright,1999). Herrick (1998) feels that the reason that some cases cannot be solved, is because „many of the most important remedies have not yet been developed. Foremost among these are the animal remedies’.
Sherr (1994:49) makes the point that the indicated remedy should be a
local one, as nature will always provide an accessible cure. The expansion of
the indigenous materia medica is thus particularly important for South African
homeopaths and patients, although local remedies may prove also to have
universal application (Sherr,1994). Furthermore, proving natural substances
1.1.1. Objectives of the study
The first objective of this study was to conduct a homeopathic proving
of Hemachatus haemachatus 30ch to investigate its effects on healthy provers by
recording the clearly observable signs and symptoms it produced, so that it may
in future be prescribed in accordance with the Law of Similars. The second
objective of this study was a group analysis of Hemachatus haemachatus in
relation to existing remedies in the materia medica that have been derived from
snake venom. This was achieved by comparison of the symptoms obtained from the
proving of Hemachatus haemachatus with characteristic symptoms of other
remedies within the snake family. The aim of this comparative study was to
clarify the specific indications of Hemachatus haemachatus in homeopathic
practice. It will also help to differentiate this remedy from other remedies in
the context of clinical prescribing (
1.2. THE HYPOTHESES
It was hypothesised that the 30ch potency of Hemachatus haemachatus would produce clearly observable signs and symptoms in healthy proving volunteers. It was further hypothesised that a comparison of Hemachatus haemachatus to existing homeopathic remedies in the materia medica that have been derived from snake venom would elucidate similarities and differences between these remedies. It was further proposed that the analysis of these remedies as a group would offer a clear understanding of the therapeutic indications of the proving substance in relation to other remedies in the snake family.
1.3. THE DELIMITATIONS
The study did not: attempt to explain the mechanism of action of the homeopathic preparation of Hemachatus haemachatus in its production of symptoms in healthy proving volunteers; determine the effects of potencies of the substance other than the thirtieth centesimal potency; compare the proving results between the provers in the two locations.
1.4. THE ASSUMPTIONS
§ The homeopathic Hemachatus haemachatus was prepared in accordance with methods set out in the German Homeopathic Pharmacopoeia (GHP) (1991) for the preparation of the venom of Lachesis muta: the venom was reconstituted with water in the ratio of 3 parts venom to 7 parts water, after which it was prepared by serial dilution and succussion up to the 30ch potency.
§ The venom was correctly extracted, freeze-dried and transported.
§ The allocation of the verum and placebo was correctly done according to the randomisation code.
§ The provers complied with the proper procedures as determined by the proving methodology outlined in Appendix E, Instructions to Provers. The provers would not deviate from their normal lifestyle or dietary habits immediately prior to or during the period of the proving. The provers would practice conscientious, accurate self-observation and symptom recording. The provers would take the remedy in the dosage, frequency and manner as instructed by the researcher.
2.2 Comparative materia medica
2.2.1 Group analysis The study of homeopathic materia medica has in recent years been enhanced by emphasising the method of group analysis. This method was pioneered by Scholten (1993) and Sankaran (2002). Here, remedies are not only studied separately, but in groups, and the common characteristics are extracted (Scholten, 1993:23). Initially, Scholten analysed composite chemical remedies, for example all remedies containing sodium. The common symptoms between these then became the theme of that group, expressed in certain key-words. Subsequently, Scholten applied this method of analysis to the periodic table, finding a theme for each period and each row (Scholten, 2004). The central theme of each remedy was found by crossing the central concept of each stage and that of each row. Scholten feels that this method not only adds to the understanding of well-known remedies, but allows for the development of a remedy picture of hitherto unknown remedies (Scholten, 1993:289).
Sankaran (2002) also devoted much time to the classification of remedies into various categories. One category is the miasm of the remedy, dependent on the pace and rapidity of the remedy.
A second classification is into natural Kingdoms - plant, mineral or animal, depending on the behaviour and reactions of patients needing those remedies. This was followed by a refinement into
subkingdoms, for example Mammalia, Arachnida, Insecta or Mollusca in the animal kingdom, each with particular behavioural characteristics. In the plant kingdom, Sankaran (2002) analysed remedies from each family for their common sensations, which he found is expressed in all remedies of that family. This classification was developed into a unique system of case analysis and remedy prescription.
2.2.2 The comparative study of the homeopathic materia medica is not new. Farrington (1995) asserts that the comparison of drugs is as necessary as the analysis of the drug itself, and Roberts (1942:139) maintains that the analysis of proving symptoms is not complete until a comparison is made with those produced by other drug provings. Smal (2004) also recommends a careful study,
and comparative analysis, of a proven snake remedy to determine its
place in the repertoire of snake remedies.
of Chamaeleo dilepis dilepis, especially in the context of newly proven remedies that have not yet undergone the trials of clinical use. Thakkar (2007:13) describes the application of a modified version of the Doctrine of Signatures in analysing a case and arriving at the correct remedy. The substance is studied in relation to the family and kingdom it belongs to. The characteristics of the substance are then matched to the characteristics of the patient and the homeopathic remedy required. Thakkar feels that this study is important in the exploration and understanding of homeopathic remedies.
Kulkarni (2002:6) stresses the importance of a thorough understanding of the differential materia medica for prescribing the simillimum and comprehending the unfolding of the case. Thakkar (2007:13) cautions against over-generalisation and loss of focus on particulars. Kulkarni (2002:26) warns that in the generalisation needed for group study, one may sacrifice individual attributes of remedies that do not fit, and that this may decrease the efficacy of the remedies.
2.3 Proving Substance
Common names: Rinkhals, spoegslang, swartrinkhals
126.96.36.199 Appearance Hemachatus haemachatus belongs to the family Elapidae, and is closely related to the true cobras, differing in having keeled scales like the adders and no solid teeth on the maxilla. It is the only member of the genus. It is a relatively stouter and shorter snake than the cobras (Visser and Chapman, 1978:49), reaching a maximum length of 150cm, with an average
length of 90 - 120 cm (FitzSimmons, 1974:167).
188.8.131.52 Habitat Hemachatus haemachatus is endemic to Southern Africa,
preferring grasslands of the highveld and KwaZulu-Natal up to 2500m (Visser and
Chapman, 1978:51), as well as the Southern Cape, Transkei, Free State, Lesotho,
western Swaziland and South-East Transvaal (Perry, 2007). They are restricted
to the cooler parts of
to extremes of below 7º C or above 38º C for any length of time. Most snakes prefer a range of 20 - 32º C (FitzSimmons, 1974:29).
Hemachatus haemachatus displays a relatively wide thermal tolerance (Alexander, Mitchell and Hanrahan, 1999). They are highly effective thermo-regulators and are able to raise their body temperature rapidly, even when the ambient temperature is low (Alexander, 2001). Under some circumstances, they select low body temperatures - so low that Alexander refers to them as "hypothermic" (Cool snakes, 2000). Hypothermic snakes use only a fraction of the energy of "normothermic" snakes to stay alive, so there is a clear benefit for snakes to cool themselves down.
Under other circumstances, such as when radiant heat is available,
Rinkhals selects body temperatures that are more typical of snakes, but are at
the upper limit of "normality" for snakes (32° C). Alexander (Cool
snakes, 2000) has observed specimens basking in the sun with spread hood to
increase surface area. Alexander explains that it has to do with the costs and
benefits of low and high body temperatures: snakes save energy when cool, but
are better at defending themselves or making a hasty retreat when their body
temperature is high. Snakes, including Rinkhals, hibernate, or more accurately
ruminate, during cold winter months. In the temperate areas such as
184.108.40.206 Diet Hemachatus haemachatus is diurnal, active from about 8:30am or 9am onwards. When their body temperature has risen sufficiently, they are able to move actively and start hunting (Perry, 2008). Well-watered areas, near vleis or dams, are favourite habitats, due to a fondness for amphibian prey (Visser and Chapman, 1978:51). Most snakes, including Rinkhals, are excellent swimmers (FitzSimmons, 1974:28) and inflate their lungs to increase buoyancy (Perry, 2008).
Perry (2008) says that Rinkhals are indiscriminate feeders, and will eat food rejected by other species, leading to obesity in captivity. Their diet includes eggs, rodents, frogs, and other snakes.
In common with other snakes, due to the loose attachment of the two halves of the lower jaw to each other and to the skull, as well as the distensibility of the skin of the neck and body,
Rinkhals is able to swallow large prey with ease (FitzSimmons, 1974:25). Prey is invariably swallowed head first. 220.127.116.11 Senses Snakes have fairly accurate vision at short range, but poor vision at greater distances when movement alone attracts attention (FitzSimmons, 1974:26). Their field of vision is also restricted due to the lateral positioning of the eyes. Smell through the nose is poorly developed. However, snakes use their tongues, which are capable of picking up minute scent and taste particles, with which to „smell’. The tongue is constantly flickered, and on withdrawal into
the mouth, the particles are transferred to the Organs of Jacobsen, sensitive hollow pits in the roof of the mouth. Snakes investigate any prey thoroughly with their tongues before it is swallowed (FitzSimmons, 1974:27). Snakes have no external ear canal or ear-drum, and thus cannot hear. They are extremely sensitive to vibration particularly that transferred through the ground, and can
detect approach of potential prey or predators at a distance (FitzSimmons, 1974:27).
According to Perry (2008), snake movement is determined by two factors - ambient temperature, and moisture. In spring, directly after the first summer rains, snakes emerge to hunt and mate.
Males track females via her scent-trial (FitzSimons, 1974). There is often much approach-play by the male, which investigates the female thoroughly with his flickering tongue. Actual mating is protracted and may last hours to days. Males are equipped with two hemipenes, one on either side of the tail (FitzSimons, 1974). Snakes are solitary animals. They have no contact with other snakes of the same species other than mating (Perry, 2008). If a male encounters a rival male, they will combat in a ritualized dance, twisting their bodies around each other, rearing up and striking, trying
to push their rival’s head to the ground. Neither snake is injured in this combat. In contrast to the majority of snakes, Hemachatus haemachatus is ovoviviparous (Branch, 1988), giving birth to 20
to 30 (exceptionally up to 60) live young during the late summer (FitzSimmons, 1974:167). Rinkhals young are born in the burrow. They develop within a membrane in the female’s body and are
born inside this membrane. After birth they pierce the membrane with a specialized tooth. The young disperse immediately and there is no maternal protection (Perry, 2008). 18.104.22.168 Behaviour
Visser and Chapman (1978:51) discuss the behaviour of the Rinkhals when threatened. When encountered, it flattens its body to appear larger. It is not an aggressive snake, but will rear up and spread its hood when provoked, displaying one to three pale bands on a dark background across the neck that give it its common name, Rinkhals (literally: ring around the collar), while hissing slowly and loudly. This serves as the first warning (The Rinkhals, 2003). It requires some provocation to „spit’, which it always does from the reared position, throwing the body forward and hissing. Spitting is the result of the internal structure of the venom canal, which is bent in an L-shaped elbow, causing the venom, which is forced down the canal under pressure, to be deflected forward
and outward at right angles to the fang’s surface (Visser and Chapman, 1978:45). The effective spitting range is 210 to 250cm (FitzSimmons, 1974:167). The venom is not directed at the eyes of
the threat, but ejected in a cloud, thus giving the snake a better chance of blinding the attacker while it makes its getaway (The Rinkhals: 2003). It causes blurred vision (Perry, 2007) and intense conjunctivitis with pain and photophobia which resolve completely in two to three days (Visser and Chapman, 1978:51). It also causes coryza and sneezing (Perry, 2008). Opthalmia has been reported, but has not caused the severe complications caused by the venom of the other indigenous snakes which spit, notably Naja mossambica (Perry, 2007). Immediate lavage with sufficient water or milk is necessary to prevent symptoms (Visser and Chapman, 1978:52). As with most snake venoms, the venom has an intensely bitter taste (Thakkar, 2007) (Perry, 2008). If aggravated further,
the Rinkhals will drop to the ground with its head and body twisted and contorted, the mouth agape and the tongue lolling out, very convincingly feigning death. Perry (2007) describes this behaviour as melodramatic. FitzSimmons (1974:167) reports cases where it has been picked up and thrown about in this state, but it remains very capable of biting at any moment. Soon after the assumed threat has left, the snake rolls over onto its belly and glides away (Perry, 2007). 22.214.171.124 Venom Snake venom is a specialised form of saliva (FitzSimmons, 1974:32). There are two venom glands, one on either side of the head behind the eyes. It serves three functions: to immobilise or kill prey; to aid digestion; and, in the case of the spitting snakes, defence. The venom of Hemachatus is less viscid than that of other African Elapids (Perry, 2007), as thinner venom is easier to spit. As with other front-fanged snakes, the venom is neurotoxic, but it is less potent than that of other Elapids, and more dilute when spit (Perry, 2007). It is, however, produced in copious amounts - yields average 80-120 ml (Perry, 2007). The estimated lethal dose for humans is 50-60 mg. All snakes have full control over whether venom is injected with a bite (Thakkar, 2007). One in six Elapid bites are dry bites, where no venom is injected, serving as warning bites to would-be attackers (Perry, 2008). When required, the venom is expelled from the glands by a muscular squeezing action (FitzSimmons, 1974:32). To inject venom, snakes have to hold on and chew - they chew on alternate sides, while emptying the venom sac on the opposite side to which they are biting down on (Perry, 2008).
Human bites by Rinkhals are rare, with fatalities unheard of (Perry, 2007). 25% of bites cause local swelling or bruising. Common general symptoms are drowsiness, nausea, vomiting, violent abdominal cramps and vertigo, as well as mild pyrexia. Neurotoxic symptoms are rare, and only diplopia and dyspnoea have been reported (Perry, 2007).
CHAPTER THREE METHODOLOGY
3.1 EXPERIMENTAL DESIGN The homeopathic proving of Hemachatus
haemachatus took the form of a randomised, double blind placebo-controlled
trial, using the 30ch potency. The proving was conducted at the Homoeopathic
Day Clinic at the
Collection of data was in the form of a journal kept by each prover in which their symptoms were recorded on a daily basis for the duration of the trial.
Data collected by the researcher from the case history and physical
examination was also considered. Provers recorded their normal state for a week
prior to taking the remedy. This ensured intra-individual control where provers
served as their own controls. The methodology in this study closely followed
the guidelines set by Sherr (1994), which has been followed in other provings
conducted at the Durban University of Technology, namely that of Taylor (2004)
and Smal (2004) in their proving of Naja mossambica, Thomson’s 2003 proving of Bitis gabonica and
that of Webster (2002) of Sutherlandia frutescens. In the proving of Bitis
arietans ariens, Wright (1998) used two prover populations, one at the Durban
Institute of Technology, and one in
3.2. THE PRINCIPAL INVESTIGATORS
This study was conducted concurrently with a similar proving of Hemachatus haemachatus. The two proving supervisors were Masters of Technology: Homoeopathy students, Lize de la Rouviere and Jodi Cahill. During the proving process the researchers were referred to as the proving supervisors, as they were directly responsible for supervision and management of the proving population during this study. The academic research supervisors or research co-ordinators were Dr. M. Maharaj (M.Tech:Hom) and Dr. A.H.A. Ross (M.Tech:Hom).
3.3 OUTLINE OF THE EXPERIMENTAL METHOD The methodology proposed in this study followed that recommended by Sherr in his Dynamics and Methodology of Homoeopathic provings (1994)
Provers were recruited from homeopathic students, practitioners and the general public.
Posters were displayed on the homeopathic notice board and other appropriate notice boards at the Durban University of Technology and the University of Johannesburg (Appendix A).
An initial interview was conducted with each recruited subject, during which they were screened in accordance with the inclusion criteria.
Prospective participants were given a proving information sheet. (Appendix F).
A pre-proving group meeting was held between all the selected provers and the two researchers. All aspects of the proving, including what is expected of them, was explained. They had the opportunity to ask questions on anything they do not fully understand.
Provers signed an informed consent form (Appendix C).
A date was scheduled with each prover for the pre-proving consultation and physical examination, during which each researcher took a thorough pre-proving case history and performed a physical examination on each prover under her supervision (Appendix D).
At this consultation, provers were allocated prover codes, and given a list of instructions (Appendix E), a blank journal, and medication in the form of six powders. A starting date and convenient daily contact time was agreed on.
Prover starting dates were staggered to ensure more thorough interaction between researchers and provers.
On the agreed date, provers started to record their normal state in their journals, three times a day or as symptoms occur. This was done for the first week, to serve as baseline and individual control for each prover (Sherr, 1994), and evaluate each prover for compliance (Riley, 1996a).
The researchers then contacted provers to assess the journal for accuracy of symptom recording and compliance.
One week after starting the diary, the provers began taking the proving remedy three times daily, continuing to record symptoms in their diaries, in accordance with the instruction sheet.
The prover stopped taking the remedy as soon as proving symptoms occurred, as experienced by the prover, or noticed by relatives or friends or the researcher.
If no symptoms arose the prover continued to take the remedy. If after the maximum of six doses, taken three times daily for two days, the prover experienced no symptoms, he/she stopped taking the proving medication but continued to record their symptoms.
Provers recorded their symptoms for four weeks after taking the remedy.
Daily telephonic contact was kept between the provers and the researcher for the first week so that symptoms could be described in detail while still fresh in the memory. The telephonic contact was then decreased to three times a week in the second week, twice in the third and once a week thereafter.
The prover continued to record symptoms in the diary until all proving symptoms disappeared.
The proving was considered complete if after one week no further symptoms appeared. This was followed by a one week post proving observation period.
The journal was collected from the prover and a post-proving consultation scheduled.
After all provers had completed the proving and all diaries collected, a group meeting and group discussion took place as expanded on below.
The proving was un-blinded to the researchers to enable them to distinguish placebo and verum groups.
Extraction and collation of the data was then performed.
All references to a prover’s symptoms was done using the code allocated to each prover at the beginning of the proving, which is known only to the researchers, the research supervisor and the technician of the homoeopathy department at the Durban University of Technology. The confidentiality of provers is thus maintained.
Statistical analysis of the data was impractical in this study (Riley, 1996a), other than age and sex analysis.
The extracted data was then organised and written up in materia medica and repertory format, compared with other snake remedies, and published.
3.4 THE PROVING SUBSTANCE
3.4.1 The potency Hahnemann (1982), in the 6th edition of the Organon, recommends that the 30ch potency should be used for provings. Sherr (1994:27) found that the 30ch produced the most mental and emotional symptoms in a proving of Hydrogen he conducted with a range of potencies. Sherr describes how he has used various potencies in his provings, and states that it is equally valid to use either only one, or a wide range of potencies. He further says that it is up to each proving committee to decide which potency to use. The 30ch potency was used in this study to produce the widest mental and general symptom picture.
3.4.2 Collection, preparation and dispensing of the proving substance A
sample of freeze-dried venom was obtained from Mr. Mike Perry, a herpetologist
§ The venom was reconstituted with water in the ratio of 3 parts venom to 7 parts water as per method 5a of the GHP.
§ The first three potencies were prepared by serial dilution and succussion in the dilution of 1 part in 99 parts 85% glycerol as per method 5a of the GHP.
§ It was then further potentised in alcohol up to the 30ch potency as per method 5a of the GHP.
§ This liquid potency was then used to triple impregnate lactose granules with 96% alcohol at 1% volume: volume as per method 10 of the GHP.
§ Ten of these granules were then added to each set of inert lactose powders designated for verum, which will then be administered to the provers in the experimental group.
This method, using the freeze dried venom, was used in the provings of
Bitis arietans arietans (Wright, 1999) and Naja mossambica (
§ The placebo was manufactured similarly to the verum, with the following exceptions
o Pure 85% glycerol was used up to the 3ch stage
o The 3ch dilution of glycerol was added to alcohol, and then succussed and diluted serially in the same manner as the verum up to the 30ch level.
o The 30ch potency in 96% alcohol was used to triple impregnate lactose granules, ten of which was added to each set of the inert lactose powders to be administered to the control group.
The placebo was thus exposed to the same manufacturing process as the verum. This ensured that the pure effect of the proving substance was tested. It also ensured that the placebo and verum were indistinguishable from each other to both provers and researchers, to guarantee the double-blind nature of the study. 3.4.3 Dosage and posology One powder was dissolved sublingually three times daily for two consecutive days, or until symptoms arose, but for no longer than two consecutive days (Sherr, 1994).
3.5. POPULATION CRITERIA 3.5.1 Prover Population Vithoulkas (1980) envisages that a thorough proving needs to include 50-100 provers. Sherr (1994) argues that this number is far too large, resulting in an over-proved remedy that produces an excess of common symptoms, overcrowding lesser proved remedies in the repertory. Sherr (1994) found that 5 provers were enough for a small project, and that 15-20 provers produce a complete proving picture. The Durban University of Technology research standards require at least 30 subjects, so this is the number that was used.
126.96.36.199 Experimental group 80% of subjects served as the experimental group, receiving verum in a randomised fashion. 188.8.131.52 Placebo group 20% served as the placebo control, receiving placebo in a randomised fashion.
3.5.2 Randomisation Randomisation was done by the supervisor, and dispensing was done by the Technician of the Department of Homeopathy. The verum and placebo were indistinguishable to ensure that neither researchers nor provers knew who received verum and who received placebo. 3.5.3 Inclusion criteria The subjects:
§ Were between the ages of 18 - 60 (Smal, 2004).
§ Were competent and able to sign the consent form.
§ Were able to comply with the keeping of the journal in a competent manner.
§ Were subjectively and objectively in a relatively good state of health (Sherr,1994) as judged by the researcher on the basis of the case history and physical examination (Riley,1996a).
§ Did not have any surgery or medical treatment planned for the duration of the proving (Riley,1996a).
§ Had not had any surgery for the six weeks before the proving commenced (Riley,1996a).
§ Were not pregnant or nursing.
§ Maintained their normal lifestyle and usual daily routine as closely as possible, and had no major lifestyle changes (moving house, diet, divorce) for the duration of the proving.
§ Practised moderation in the consumption of alcohol, caffeine and cigarettes.
§ Were not a user of recreational drugs such as cannabis, ecstasy, LSD.
3.5.4. Lifestyle of provers during the proving
Provers were advised to follow certain precautions while participating in this study, details of which were clearly explained in Appendix E, Instructions to Provers. To try to maintain their usual habits and lifestyle (Sherr, 1994:92). To avoid antidoting factors such as camphor, mint and menthol and discontinue the use thereof two weeks prior to starting the proving and for the duration of the proving (Sherr, 1994:92). To store the proving powders in a cool, dark place away from strong smelling substances, electrical equipment and cellular phones (Sherr, 1994:92). To exercise moderation with respect to work, alcohol, smoking, diet and sexual activity (Sherr, 1994:92).
To avoid taking any medication especially antibiotics, vitamins or mineral supplements, or herbal or homoeopathic medication (Sherr, 1994:92). To consult their doctor, dentist or hospital should a medical emergency arise and to contact their proving supervisor thereafter (Sherr, 1994:92).
3.5.5 Monitoring the provers Close contact was maintained between the researcher and the provers during the initial stages of the proving and as long as symptoms continued to appear. The researcher monitored each prover by daily telephonic contact for the first week or until symptoms started to abate. The contact was then reduced to three times in the second week, twice in the third and then once weekly until the proving was completed. This ensured:
§ that the researcher knew when the substance began to act, so that she could tell the prover to stop taking the substance.
§ that the prover did not neglect to record a symptom.
§ the safety of the provers by closely monitoring each prover for any reaction that may have needed to be antidoted.
3.5.6. Ethical considerations
The proving methodology of this study was approved by the Faculty of Health Sciences Ethics Committee, Durban University of Technology, prior to commencement, to protect the rights and safety of each prover. Each prover consented to voluntary participation in this study by signing an Informed Consent Form (Appendix C). Confidentiality was maintained throughout the study. Provers were made aware of the fact that they were under no obligation and were free to withdraw from this study at any point.
3.6. DURATION OF THE PROVING
3.6.1 Case history and Physical examination
Provers who were deemed suitable for participation in the proving attended a pre-proving consult. A thorough case history and general physical examination (Appendix D) following standard homoeopathic format was taken. This served to clarify and confirm the baseline status of each prover prior to administration of the proving substance.
3.6.2. Pre-proving observation
Each prover commenced the recording of their „normal’ daily symptoms for a period of one week prior to taking the first dose of the proving substance. This established a baseline of each prover’s ate of health and was used to confirm the validity of symptoms experienced by the prover while under the influence of the proving substance. It also served to make provers accustomed to self-observation and regular symptom recording (Sherr, 1994).
3.6.3. Commencement of the proving
The provers were dispensed six powders, to be taken a maximum of 3x day for two days, or until the onset of symptoms. The starting dates were staggered to allow for more effective supervision
of the provers. No further powders were required to be taken thereafter. Provers continued to record their symptoms daily for a period of four weeks or until no further symptoms were noted.
3.6.4. Post-proving observation
A further one week was allowed for general observation, in case any further symptoms arose during this period. At the end of the post-proving observation period, a follow-up case-history and physical examination was conducted with each prover. The journals were collected from each prover, and the researcher clarified any symptoms that the prover recorded. The proving was now considered complete.
3.6.5 Group discussion After all the provers had completed the proving and all the diaries collected, a group discussion was held in each location, at the Durban University of Technology and the University of Johannesburg. This allowed the provers an opportunity to discuss their ideas and questions. It helped the researcher to clarify issues and to confirm or discard doubtful symptoms (Sherr,1994). The process of amalgamating the separate provings into one totality, in which the symptoms of each prover are considered to have taken place in one person (Sherr, 1994:32), could now begin to take place.
3.7 DATA COLLECTION
3.7.1 Collection of data Data was collected in the form of a diary or journal kept by each prover, in which they recorded their symptoms on a daily basis for the duration of the proving.
The information collected by the researcher from the pre-proving case histories, physical examinations and telephone conversations during the proving period was also taken into account.
Data collected from the pre-proving case histories and physical examinations was used as a baseline control for the individual provers. The provers were asked to comply with the following in recording symptoms:
§ To note the concomitants , locality, times, sensation and duration of each symptom (Sherr,1994).
§ To write each symptom on a new line, leaving space for remarks (Sherr,1994).
§ To start each day on a new page, marking the day and date clearly (Sherr,1994).
§ To classify the symptoms into:
o (RS) - recent symptom - experienced in the last year.
o (NS) - new symptom - never experienced before.
o (OS) - old symptom - occurred more than a year ago.
o (AS) - altered symptom.
o (CS) - cured symptom - old or recent symptoms that have stopped.
§ To do the above in red pen alongside the relevant symptom.
§ To note the time of occurrence of each symptom with each symptom.
§ To record each symptom chronologically according to the day, and the number of hours or minutes since the proving began (first dose taken), as DD:HH:MM, where:
o DD is the number of days.
o HH is the number of hours.
o MM is the number of minutes.
§ After 24 hours the minutes became unimportant and were represented by XX. After a few days the hours became redundant and were marked by XX. (Sherr,1994).
3.7.2 Extraction and evaluation of data At the end of the proving, prover journals were collected and the recorded symptoms extracted and evaluated for conversion into materia medica and repertory format. The information collected by the researcher from the pre-proving case histories, physical examinations and telephone conversations during the proving period was also taken into account. After careful evaluation, symptoms were validated as proving symptoms or discarded according to the criteria set out below. 3.7.3 Criteria for including symptoms as proving symptoms
The following criteria were used:
§ If the prover was under the influence of the remedy (as can be seen by the general appearance of symptoms), then all other new symptoms belonged to the proving (Sherr, 1994).
§ The symptom appeared shortly after the substance (Riley,1996a).
§ The symptom appeared (with intermissions) over a period of several days (Riley,1996a).
§ The symptom occurred in more than one volunteer (Riley,1996a).
§ The symptom occurred with marked or specific intensity (Riley,1996a).
§ The symptom was unusual, striking or rare (Riley,1996a).
§ The symptom was not current or usual for the prover, unless intensified to a marked degree, with clear descriptions as to how it was markedly modified or changed (Sherr,1994).
§ The symptom occurred in association with other symptoms (Riley,1996a).
§ The symptom occurred in association with specific modalities (Riley,1996a).
§ The symptom could be precisely defined by the prover (Riley,1996a).
§ If the prover had a deep conviction that the symptoms did not belong to her, it served as a reliable indication for inclusion (Sherr,1994).
§ Symptoms present in the prover prior to the proving which disappeared during the proving, are included and noted as a cured symptom. The character of the symptom was clearly explained as to function, location and sensation (Sherr,1994).
§ Any symptom which had occurred in the prover’s recent history, i.e. one year or less, was discarded (Sherr,1994).
§ Any symptom which occurred a long time previously, especially five or more years, which had no reason to appear naturally but had reappeared, was included (Hahnemann,1982; Sherr,1994).
§ Accidents, coincidences and synchronistic events that happened to more than one prover (Hahnemann,1982; Sherr,1994).
§ If in serious doubt, leave it out (Sherr,1994).
3.8 COLLATING AND EDITING THE DATA The proving symptoms collected from the journals were collected and combined into a coherent, logical and non-repetitive format, to create a structured picture of the symptom-complex that Hemachatus haemachatus 30ch produced.
The data was, wherever possible, classified into the same chapters and sections, and following the same format, as the repertory. Similar or identical symptoms from different provers were grouped together but entered as separate, consecutive entries within the group, according to the following criteria set out by Sherr (1994), in order of importance:
1. Nature or meaning of the symptom.
2. Individual prover.
3. Sequence of development of the symptom.
3.9 REPORTING THE DATA The edited data was recorded into two different standardised formats, the materia medica and the repertory. This will ensure that the data produced by this proving
of Hemachatus haemachatus is usable in clinical homoeopathic practice and prescribed according to the Law of Similars. 3.9.1 The Repertory The data collected in this proving was converted into rubrics and sub-rubrics that conform to the format of the standard modern repertory: SYNTHESIS: Repertorium Homoeopathicum Syntheticum 9.1 (ARCHIBEL SA., 2006). 3.9.2 Materia medica The collated and edited data, in conjunction with known toxicological data, was written up in typical materia medica format, conforming to the chapters of SYNTHESIS: Repertorium Homoeopathicum Syntheticum 9.1 (ARCHIBEL SA., 2006).
Proving symptoms were entered under the following main headings:
Mind Vertigo Head Eye Vision Ear Hearing Nose Face Mouth Teeth Throat External throat Stomach Abdomen Rectum Stool Bladder Kidneys Prostate Urethra Urine Male genitalia / Sex Female genitalia / sex Larynx Respiration Cough Expectoration Chest Back Extremities Sleep Dreams Chill Fever Perspiration Skin Generals
4. THE RESULTS
The symptoms from the proving journals were extracted, collated and edited. The results were converted into the standard homeopathic referencing formats of materia medica and repertory. Symptoms listed under the materia medica sections are presented in the provers’ words. In the repertory section, symptoms have been translated from the provers’ words to rubrics and presented according to the Synthesis Repertorium Homeopathicum 9.1 (ARCHIBEL SA, 2006).
4.1.2 REPERTORY The conversion of proving symptoms to repertory rubrics was done in accordance with the principles laid down by Schroyens (2002:36-37). The method employed for grading
of symptoms is a combination of grading according to frequency of symptom occurrence (Sherr, 1994:85) and grading according to the number of provers experiencing the particular symptom (Schroyens, 2002).The average percentages, relating to 24 provers on verum, were calculated, resulting in the following grading system:
Table 1: Grading system
Number of provers
Heaviness of the head and pain in the forehead
Sensation of a lump in the throat and difficulty in swallowing
Abdominal flatulence and rumbling and a tendency to constipation
Sense of constriction and oppression in the chest, and heart palpitations
Pain in the cervical region and rheumatic pain in the extremities
Coldness of the hands and feet
Deep sleep, sleepiness
MIND: COMPANY - aversion to - > alone
COMPANY - aversion to - desire for solitude
COMPANY - desire for a friend
CONCENTRATION – active/difficult (cannot fix attention)/difficult studying
CONFIDENCE - want of self-confidence (self-depreciation)
CONSCIENTIOUS about trifles
CONTENT (with himself)
CONTRADICTION - intolerant of contradiction
DELUSIONS - she is not appreciated/way home were too long/being laughed at and mocked at/he is light [= low weight (when walking)]/love is impossible/he or she is neglected/he is persecuted/
of smell/is trapped/looks through some one else’s vision/is being watched/”As if observing”
DISORDER, sensitive to
DISTANCES inaccurate judged
DRUGS – “As if one had taken drugs”
DULLNESS with sleepiness
ELATED (# sadness)
EXHILARATION # sadness
FEAR [of accidents all day relieved after going to bed/of death during heart symptoms/of driving a car/something will (terrible is going to) happen]
HOME - desires to go
HURRY - in occupation
IMPATIENCE (about his children/driving)
INDIFFERENCE (to business affairs/to duties/work/with sleepiness)
IRRITABILITY (wishes to be alone/# with cheerfulness/towards children/driving a car/easily/inefficiency/before menses/from noise/with people/when
questioned/from trifles/when aroused by noise during sleep)
LAZINESS (with sleepiness)
LONGING - sense of/for good opinion of others/for repose and tranquillity)
LOVE – desires romantic love
MEMORY - weakness of memory (for everyday things)
MENTAL POWER increased
MISTAKES in speaking - misplacing words
MOCKING – sarcasm
MOOD – changeable (quickly/sudden)
ORDER - desire for
PROSTRATION of mind (with sleepiness/on waking)
REPROACHING – oneself/others
RESPONSIBILITY - aversion to
REST - desire for/cannot rest when things are not in the proper place
RESTLESSNESS – anxious
QUIET; wants to be
SADNESS - from disappointed love/about past events
SELF-CONTROL – increased
SENSITIVE [to emotions/(slightest) noise/rudeness]
SHRIEKING – in anger
SWIMMING - desires
THOUGHTS - repetition of/persistent/of the past
TRANSCENDANCE – sensation of
USEFUL; desire to be
WILL - loss of will power
VERTIGO: + heaviness in head
> CLOSING THE EYES
> after COLD drinks
< HEAT of the sun
> HEARING LOSS
< MOTION (sudden motion)
< after rising
“As if everything were turning in a circle”
HEAD: “As if COTTON WOOL in head”
EXPANDED sensation feels inflated
FULLNESS in forehead
ITCHING of scalp (vertex)
HAIR in falling in handfuls (combing the hair)
HEAVINESS (from headache)
LIGHTNESS; sensation of
PAIN – evening (stitching)/in forehead (r./shooting)/occiput (> lying/pulsating/ext. eye/l. eye/ext. temples)/+ numbness and tingling of nose/+ pain
in abdomen/+ complaints of lower limbs/< bending head/bursting pain/> coffee/> cold applications (drinks)/> closing the eyes/> darkness/
dull/ext. to eyes/ext. to teeth (canine)/< (artificial/daylight) light (shooting)/(<) before menses/pressing/“As from a nail”/paroxysmal/piercing/
> pressure (shooting)/pulsating/< sniffing/in temples and forehead/on waking “As from a blow”/< warmth/> warm drinks
PERSPIRATION of scalp on Forehead
EYE: > CLOSING EYES
Desires to CLOSe EYES
> COVERING eyes with hand
DISCOLORED - red in inner canthi
DRY – morning on waking/Lids (margins of)
HEAVINESS of Lids
ITCHING (l. eye/r. eye/< from light)/> rubbing/< (artificial/daylight) light
PAIN – “As from sand”/burning/raw
PHOTOPHOBIA (driving/during headache/< from (artificially/day)light
Must squeeze the eyes
“As if swollen” in lower lids
TIRED SENSATION (> closing the eyes)
VISION: BLURRED (closing the eyes)
EAR: DISCHARGES – earwax
FULLNESS, sensation of
ITCHING (l./> scratching/in eustachian tubes)
NOISE - <
NOISES - in ears during headache/ringing
PAIN – l./boring pain – tickling/< lying on the ear
LOST – short duration after masturbation
NOSE: < BLOWING THE NOSE
DISCHARGE bloody (l./r./morning/blood streaked)/clear (l.)/copious/sticky
DRYNESS (< in open air)
FULLNESS, sense of (in root)
NUMBNESS in tip
ODORS; imaginary and real (metallic/sweetish)
PAIN – burning (in morning/in sinuses)
SNEEZING (with itching/> rubbing/tingling in nose)
FACE: Jaw CLENCHED (l.)
> COLD applications
COMPLAINTS of face in maxillary sinuses - in corners of mouth (l.)
DISCOLORATION – red (flushes/with heat)
DRY (lips/maxillary sinus)
ERUPTIONS [acne/itching/pimples (blind/on chin/rough)/stinging, painful/above lips r.)
Hot with cold feet
ITCHING (on cheeks)
Swollen under eyes/”As if swollen”
< TOUCH (lips)
MOUTH: CRACKED - Tongue fissured in centre
CRAWLING on Tongue
DISCOLORATION (Tongue white)
DRYNESS [> morning on waking/> cold water/”As if sand in it”/during sleep/with thirst (not > drinking)/
ERUPTIONS - vesicles [on tip of tongue (burning)]
INDURATION of Tongue (knotty)
SALIVATION profuse (at night)
ULCERS on tongue (l./tip)/PAIN in tongue (stinging/”As if burnt”)/on hard palate/
TASTE putrid (water)
PAIN in canines
THROAT: CLUCKING sound, esophagus
DRYNESS (+ dryness of mouth)
> DRINKING in sips
HANGING in throat; sensation as if something were – thread
HAWK; disposition to
PAIN [l. sore/burning/lump/”As if raw”/”As from something sharp”]
PRICKLY - swallowing; only on empty
SWALLOWING difficult (from cold drinks)
EXTERNAL THROAT: ERUPTIONS – pimples
INDURATION of glands (cervical)
Inflamed cervical glands
NECK: > MOTION
APPETITE – capricious/easy satiety (after a few bites)/increased (+ rumbling in abdomen)/# loss of appetite/eating small amounts all day/wanting
> BENDING DOUBLE
EMPTINESS (> eating)
ERUCTATIONS; TYPE OF – bitter (burning)/< during stool
INDIGESTION (< after eating)
NAUSEA [after cough/< after eating/> after lying down/< motion/caused by odor of tobacco/in throat/< during stool]
PAIN [burning (morning/“As from hot coal”/< bread)/morning cramping (< fruit/from hunger)> pressure]
TENSION /in epigastrium)
THIRST (morning/night/cold water)
ABDOMEN: “As if bubbles were moving about”
DISTENSION (morning on waking/from flatulence/< motion/< stool/Region of umbilicus/> warm application)
ABDOMEN [PAIN (> bending double/burning/cramping (+ pain in bladder)/drawing pain/dull pain/> eructations/< eating/pressing pain/in iIliac
fossa (l.)/Lower abdomen (burning)/> lying/< pressure/pressing pain (“As from flatulence”)/radiating/sharp/> sitting/wavelike/> warmth
RECTUM: COLDNESS in anus
CONSTIPATION - ineffectual urging and straining
FLATUS – acidic/evening/loud/noisy/offensive (sulphur odor)
INACTIVITY of rectum
INVOLUNTARY urination < during stool
“As if anus open” (< after stool)
STOOL: evening/at night
like (mall) balls
DRY and hard
“As if full”
PAIN – aching/burning/cramping/ext. kidney/stitching pain
URINATION – frequent/dribbling – involuntary (if delayed/> during cough)
DREAMS: ESCAPING/FACE disfigured/FIGHTS/FLIES/FLYING/FRIENDS (old)/FRUSTRATION/GUILT/HIDING/HOME/HOMOSEXUALITY/
HOUSE (dirty)/JOURNEYS (by water)/MONEY (lack of, to pay bill)/NECK Slit/being obese/PLACES well known but changed/being PURSUED
(by murderers/by animals/by a bear/by police/being POISONED/PROSTITUTES/PROTECTING/QUARRELS/RAPE/goes back to old school/
SEEING AGAIN an old schoolmate/SEXUAL/SHIP/SNAKES/SPIDERS/STOOL/STUCK/SUFFOCATION/TUNNEL/being UNPREPARED/vivid/
CHILL: CHILLINESS – at night/“As if hair standing on end”/
SHAKING at night
PERSPIRATION: COLD at night
On COVERED parts
PROFUSE at night < during sleep
SKIN: “As if BITTEN by an insect”
CICATRICES - become red/sensitive
DRY – rough
ERUPTIONS – < warmth/acne/blotches/dry/eczema (< warm applications)/elevated/pimples/red (like insect stings)/rough/scaly/GOOSE FLESH
ITCHING (after bite of insect/> cold/> scratching/< warm bathing)
GENERALS: l. side/MORNING (on waking)
ACTIVITY – physical
AFTERNOON - 17 h.
EVENING (18 h.)
> BATHING (in the sea)
ELECTRICITY; sensation of static
ENERGY excess of
EXERTION; physical - aversion for/desires it
FOOD and DRINKS:
Desires: alcoholic drinks/chocolate/black coffee/fruit/meat/oil/salt/seafood/sugar (ed water)/wine/yoghurt
<: alcoholic drinks
Aversion to: vegetables
HEAT - flushes of – at night (in open air)/in preventing sleep/# sensation of coldness
LIE DOWN - desire to
< LIGHT – sunlight
MEDICINE - allopathic – “As if taken tranquilizers”;
RIDING in a car
> after (short) sleep
> STRETCHING (limbs)
exposure to the sun
aversion to/< (smell of) TOBACCO
< cold wet weather
CHAPTER FIVE 5. DISCUSSION OF THE RESULTS 5.1 INTRODUCTION This chapter deals with the discussion and overview of the proving results. The data collected from the proving, in the form of prover symptoms, provided information for a total of 901 rubrics. The rubrics were distributed throughout 33 sections of the repertory. There was a predominance of symptoms in the Mind; Head; Eye and Nose; Mouth and Throat; Stomach and Abdomen; Female; Extremities and Back; Skin; and Dreams sections. Figure 3 below provides a visual representation of the number of rubrics distributed in the various sections of the repertory. It was hypothesised that Hemachatus haemachatus 30ch would produce signs and symptoms on healthy volunteers. Data collected from this study serves as evidence to support this hypothesis and it is therefore concluded that the hypothesis is valid. 5.2 ABBREVIATION OF THE REMEDY The recommendations made by Schroyens in Blueprint for a New Repertory, Synthesis Repertorium Homeopathicum (2002:39-41) have been followed, in order to contribute to a logical coherent system of arriving at remedy abbreviations, and avoid ambiguity. The Latin name of a remedy serves as the basis for the abbreviation. The researchers have chosen the unique root Hem, and the extension „-h’, creating the abbreviation Hem-h for Hemachatus haemachatus.
5.3 THE SYMPTOMS In the discussion of the symptoms, an attempt has been made to unify the individual symptoms into a coherent whole, as if they had been experienced by one person. This follows the recommendation of Sherr (1994:32), to allow for the development of an integrated materia medica remedy picture. 5.3.MIND The greatest number of rubrics in the proving of Hemachatus haemachatus were created in the Mind section. An attempt has been made to organize these into prominent themes. Enthusiasm Many provers experienced a sense of elation (13 F 06), enthusiasm (03 M 01XX:XX), and positivity (14 F 02); a carefree, relaxed, bubbly mood (28 M 12, 22 F 04). There was an increase in productivity and alertness 22 F 03, 19 M 01, 29 M 09). There was an increase in confidence ( 07 F 01, 17 F 08), a sense of coping better. Provers felt more alert, focused and in control (11 M XX, 29 M 01). Lethargy The opposite symptoms were also experienced. Provers felt extremely lazy (04 M XX, 16 M 06), listless (07 F 24), lethargic. Many provers had a lack of motivation (15 F 04, 16 M 06, 30 F 02). There was an avoidance of and indifference to normal responsibilities (06 F 04, 13 F 26, 15 F 04, 18 F 14, 20 F 04). There was sleepiness (04 M 00, 22 F 05), and a many provers were tired, and felt heavy and exhausted (06 F, 07 F, 14 F, 15 F, 18 F, 19 M, 24 F, 27 M, 30 F). Provers just wanted to stay in or crawl into bed (06 F 04, 14 F 13, 15 F 04).
Tranquillity The remedy produced a sense of calmness (03 M 00:00:05) and relaxation (03 M 01, 27 M 09, 29 M 01), which was accompanied by a sense of alertness ( 03M 01, 29 M 00). Some provers felt spaced out, as if they had taken a tranquillizing drug (03 M 00:00:10, 15 M 00:05, 22 F 05), There was a sense of detachment (04 M 00, 29 M 00) and transcendence ( 04 M 00), but also a sense of deeper reconnection (04 M XX:XX, 20 F 21 ). Prover 4 described this as a sense of „observant spaciousness’ (04 M 03). Spaced out Provers felt spaced out and drugged (03 M 04, 15 F 00:00:05). There was cloudy thinking (03 M 00:00:15), and poor concentration (18 F 03, 27 M 07), and difficulty focusing (27 M 180 with erratic memory (20 F 09). There were repetitive activities (28 M 00), and the experience of a tune stuck in the mind (20 F, 28 M 00). There was also clumsiness (22 F 03, 28 M 02), with difficulty in accurately judging distances (13 F 05, 22 F 04). My Space, Home The theme of home and private safe space emerged strongly. Provers had a need to organise their personal space (05 F 06, 14 F XX, 20 01), and became irritated by mess (20 F 03), as well as people in their space (05 F 01). Provers had a need to be at home (15 F 04, 28 M 10), which felt like the safest place to be (20 F 09). Provers experienced anxiety on leaving home and especially when driving (14 F 13, 15 F 04, 28 M 06). There were dreams about home, with confusion about whose home it was (07 F 02) and dysfunctionality at home (18 F 04). There were also dreams of attack to the home (18 F 11). Vulnerability, insecurity
Provers felt fragile (27 M 07), sensitive (03 M 01) and non-resistant (03 M 00:00:10). They picked up on the moods of those around them
(27M 13, 30 F 05). There was a feeling of being unimportant (06 F 14, 13 F 26) and not good enough (13 F 21) in relationships. Prover 15 had an experience of feeling extremely vulnerable, as if others were able to see her deepest insecurities and use them against her (15 F 00). She felt insecure, vulnerable, childish, humiliated and embarrassed. Provers had a need to be appreciated (28 M 04), of being worth something to the world (29 M 07). Alone, Longing There was a strong desire to be alone (06 F 04:XX;XX, 15 F 00, 30 F 02 XX:XX). There was amelioration from being alone in a quiet atmosphere (29 M 00), in one’s own nest (20 F 21), pursuing one’s own interests (28 M 10). There was a reconnection with old friends (13 F XX) and a compassion for friends in need ( 20 F 09, 28 M 04). There were dreams of old friends (16 M 24) and old work colleagues (10 F 00, 11 M 01). Two provers felt as though there was something or some-one missing in their lives (03 M 03, 07 F 30). There were thoughts of past relationships, with a sense of deep longing (15 F 03), and a deep need to love with the feeling of being unable to do so (29 M 14). Changeability Provers experienced an alternation of moods (03 M 01, 13 F 06, 14 F XX). Sometimes the change occurred rapidly (22 F 07, 24 F 24). There was a lack of emotional stability (22 F 13), described as a roller-coaster (30 F 06).
Provers felt anxious, often a vague sense of anxiety (29 M 03) as if something felt wrong (27 M 10), or as if something was going to happen (18 F 12). Prover 14 had a panic attack when faced with a routine drive, as if something awful, such as an accident, was going to happen (14 F 13). Two provers experienced the anxiety in the stomach (16 M 24) or solar plexus (03 M 03).
Irritability 42% of provers experienced irritability, in many cases as a very marked symptom, resulting in 45 individual diary entries. This irritability was felt toward people (13 F 26, 20 F 21) and directed at who-ever was around (04 M 02, 15 F 02), or in their space (05 F 01), or at the provers’ partner (06 F 08) or children (07 F 33). There was specific irritation at being asked stupid questions (04 M XX), inefficiency (18 F 11), bad service (26 M 00:02:00), incompetence (13 F 07) and poor planning (28 M 02). There was also deep irritation at inconsiderate and incompetent other drivers (28 M 11). Some provers became snappy (20 F 02, 24 F 16) or sarcastic (05 F 01). In some cases the irritation led to anger and an impulse to physical violence, wanting to rip some-one’s head off (18 F 03) or punch them in the face (28 M 10). Frustration There was a sense of having a lot to do (06 F 05, 26 M 00:00:00), with an inability to relax and constant anxiety about what needed to still be done (26 M 00, 29 M 16). This was accompanied by a feeling of being stressed out (06 F 05) and frustrated (06 F 05 , 29 M 17) There was an urge to get things in order (20 F 11). There was impatience and a frustration if things fell behind schedule (29 M 17). There was also a sense of not being able to cope (06 F 04, 30 F 06). Some provers had a sense of being trapped with a need to get out (06 F 13, 28 M 09). There was also a sense of being picked on (06 F 21) and harassed (28 M 02). 5.3.2 VERTIGO
There were sensations of vertigo, described as dizziness or light-headedness. The vertigo was pronounced on sudden movement (03 M 01, 05 F 00) or suddenly rising form a sitting position (03 M 01, 21 M 02). Some provers experienced it as a sense of disorientation (10 F 01) or disconnection (03 M 03). There was also a description „as if head were in a cloud’ (21 M 16) or „made of feathers’(21 M 06). The vertigo was in some provers related to a spaced out feeling (15 F 00:00:05). 5.3.3 HEAD Many provers experienced headaches, predominantly in the frontal, temporal or occipital areas or around the eyes. Right-sided headaches were either frontal (06 F 10), temporal (06 F 03), or around or behind the eye (07 F 06). Left-sided headaches extended from the occiput to behind the eye (16 M 00) or neck to the temple (18 F 13), from the temple to the eye (18 F 20), or from the temples to the teeth (18 F 19). Some headaches extended to or from the neck or back (18 F 13), or were accompanied by neck stiffness or spasm (18 F 16). There were three main types of pain experienced: dullness (06 F 03); stabbing (05 F 00), piercing (16 M 02) or shooting (21 M 16), as if a nail was driven in (18 F 01); and bursting, throbbing (28 M 01) or pounding. Provers experienced headaches on waking (21 M 07, 24 F 05). Headaches were aggravated by light (12 F 12); while pressure (12 F 12, 29 M 21), and icy (21 M 18) or cool applications (29 M 02) provided relief. One prover experienced a sensation as if the head was wrapped in cotton wool (18 F 14) or under water (18 F 14). There was also a sensation of heaviness of the head. 5.3.4 EYE AND VISION Provers experienced itchiness (06 F 06), dryness (24 F 13) and scratchiness in the eyes. Eyes felt gritty (07 F 34), as if there was sand in them (07 F 31). There was also pronounced burning (18 F 11) and rawness (28 M 06), and provers’ eyes appeared puffy (07 F 31 ), red and bloodshot (29 M 05). There was a strong aggravation from any form of light (24 F 02): sunlight (20 F 00), artificial light (24 F 08), light from a computer screen (16 M 00) or from a camera flash (19 M 04). One prover experienced a blurriness or haziness of vision (21 M 15).
5.3.5 NOSE Provers experienced itchiness (06 F 17, 15 F 00:00:05) in the nose, as well as dryness (29 M 01). There was a burning (05 F 04) tickling feeling (18 F 08), as if there was pepper in the air (07 F 00:02:30), or as if irritated by chlorinated water (28 M 01). There was sneezing (07 F 00:01:30, 15 F 00:00:05, 22 F 00). The discharge was clear (18 F 08, 29 M 23), profuse (28 M 05) or in one case sticky (20 F 04). Sinuses felt dry (29 M 00), burning (10 F 01) and itching (14 F 00). 5.3.6 FACE Provers experienced dryness (28 M 07) and cracking (18 F 03) of the lips. One prover developed an eruption similar to a fever blister above the lip (13 F 01:03:45). There was also a dry scaly eruption on the eyelids (18 F 14). 5.3.7 MOUTH Provers experienced dryness of the mouth (11 M 00, 21 M 11) accompanied by increased thirst (06 F 03, 21 M 02 ). The opposite symptom of increased salivation was also noted (14 F 00, 18 F 04). One prover had a sandy taste in the mouth (21 M 01). Provers developed ulcers on the tongue, at the tip (06 F 06, 07 F 21) or lateral aspect (07 F 03). There was a sensation as if the tongue had been scalded (06 F 06, 07 F 21). There was also pain in the region of the hard palate (07 F 21). One prover had tightness of the left jaw (22 F 00) with a blocked sensation of the ear. 5.3.8 THROAT
Provers experienced difficulty in swallowing (06 F 02). There was a sensation of a dry throat (16 M 01:07:00, 28 M 07). Provers experienced throat pain, which was sharp (06 F 00:01:00), raw, or burning (10 F 01). There was tickling (13 F 04) and itching (29 M 26) in the throat. There were various sensations of something stuck in the throat (13 F 04), of a lump in the throat (06 F 02), or adherent to the throat (18 F 04), or of a mucous plug (06 F 00:01:15) which needed clearing (13 F 03). 5.3.9 STOMACH There was a strong influence on the gastro-intestinal tract. Many provers experienced a marked increase in thirst (13 F 02, 14 F 01, 18 F 02:XX:X, 24 F 21), with a sensation of a dry mouth (06 F 03, 21 M 02). Provers experienced a big increase in appetite (24 F 07) with hunger pains (06 F 08) or continuous nibbling (17 F 00, 22 F 08). Others experienced a decreased appetite (18 F 02:XX:X, 30 F 02) with easy satiety (30 F 06). Provers experienced nausea (06 F 05, 13 F 01). The nausea was aggravated by driving (06 F 11), 30 F 04) and flying (30 F 00). It was experienced after eating (06 F 05, 13 F 01), or relieved temporarily by eating (30 F 02). There was a tendency toward somatisation of negative emotions leading to nausea and stomach pain (06 F 11). Anxiety was also experienced as tension in the solar plexus (03 M 01, 16 M 24) or bubbles in the stomach (21 M 13). There was also a sensation of hollowness or emptiness in the stomach (18 F 01, 29 M 20), as if filled with air (21 M 16). Heartburn was experienced by provers (16 M 00, 20 F 01), with retrosternal burning like hot coals (18 F 08). There was an aggravation after eating (15 F 04). The sensation rose up in the oesophagus (29 M 12), causing scalding (20 F 05). It was accompanied by indigestion, bloating and stomach cramps (20 F 01, 28 M 01, 28 M 09). Stomach pain was relieved by pressure (29 M 12) or bending double (29 M 20, 29 M 27). 5.3.10 ABDOMEN
Provers experienced lower abdominal or suprapubic pain (13 F 18). The pain was compared to that of a bladder infection (06 F 02, 07 F 06). Female provers experienced premenstrual lower abdominal pain, and pain in the region of the ovaries (06 F 17), both on the left (06 F 17) and on the right (15 F 00:00:10). Pain was experienced as stitching or stabbing (16 M 16, 18 F 01). Pain was also cramping, coming in waves (07 F 06, 18 F 01), or burning (06 F 02), like hot coals or burning water (18 F 01). Pain was relieved by bending forward (18 F 01) or bending double (13 F 02, 13 F 18, 18 F 01 ) and by warmth (13 F 02). There was much bloating (13 F 02, 18 F 00:09:10, 21 M 02) and flatulence (18 F 04, 20 F 04, 20 F 10, 28 M 04). There was also a hollow, empty sensation (18 F 01, 18 F 17). 5.3.11
RECTUM AND STOOL There was an increase in the amount of rectal flatus (06 F 09, 24 F 16, 28 M 02, 28 M 03). Flatus was noisy (18 F 02, 20 F 04) and smelly (20 F 04, 28 M 01), like animal manure (07 F 00) or meaty (28 M 00). Provers experienced absence of the urge to defecate (16 M 01) or ineffectual urging (20 F 06, 28 M 01) and constipation (28 M 02). There was a tendency to diarrhoea (18 F 16) with a loose (07 F 00:02:00, 20 F 04), soft (20 F 04, 24 F 10, 28 M 02) stool. Passing stool provided relief (20 F 04, 28 M 02). There was also the opposite tendency to constipation with hard dry small stools (28 M 07), like raisins (18 F 01), which were difficult to pass (18 F 01, 18 F 02). 5.3.12 BLADDER, URETHRA AND URINE There was burning suprapubic pain compared to that of a bladder infection by provers (06 F 02). There was a sensation of a full bladder (07 F 06). Provers experienced increased urination (18 F 12, 20 F 06) with constant urging (18 F 01). Urine was hot and viscid (20 F 00:01:45). Prover 20 experienced urinary incontinence (20 F 02, 20 F 06) which was worse sneezing, coughing, or movement (20 F 03).
5.3.13 FEMALE GENITALIA / SEX Female provers experienced changes in the normal menstrual cycle and the character of the flow. There was an absence of their normal dysmenorrhoea (13 F 21, 17 F 15, 30 F 02), and normal pre-menstrual discomfort (14 F XX, 30 F 02). Menstrual pain was experienced as heavy (18 F 01), bearing down (18 F 30) as if the insides were going to come out (30 F 03), or lower pelvic cramping (22 F 09). There was also pain in the ovarian region (06 F 16, 15 F 01). Flow was lighter than normal (13 F 25, 17 F 15, 18 F 14, 30 F 04), dark (17 F 15, 18 F 14), fluid (18 F 30), with an absence of clots (15 F 02, 17 F 15, 30 F 04). There was also a dark, muddy brown, sandy leucorrhoea (13 F 13). Both male (16 M 12, 28 M 01) and female (07 F 33) provers experienced an increase in libido. 5.3.14
CHEST Provers experienced fluttering (20 F 01) or palpitations (24 F 04) in the chest. This was associated with a fear of death (24 F 04) , and one prover had palpitations during a panic attack (14 F 13). Palpitations were experienced on pausing or on lying down (20 F 02). There was a sensation of being short of breath (24 F 00). One prover had a sensation of constriction, as if a rope was being tightened around the chest (18 F 03). The ribcage felt bruised and tender (24 F 01), and there was burning parasternal pain as if fingers were dug into the chest (14 F XX). There was sensitivity of the left breast (14 F XX) . Prover seven had pain in the left breast resembling that of mastitis (07 F 35), which was worse for any movement including expiration, and better for support of the breast. It was accompanied by fever and rigors. 5.3.15
NECK AND BACK
There was muscle tension (05 F 02), pain and stiffness of the neck (21 M 12). Lumbar back pain was experienced, which was described as
sharp shooting (06 F 00:05:20), stabbing (26 M 10 ), as if pulled or stretched (16 M 03), or a tight stiff strained pain (29 M 03, 29 M 05, 29 M 18). The pain was aggravated by movement or a change in position, especially moving off centre (26 M 10 ), leaning forward (16 M 03), reaching or bending forward or over (26 M 10, 28 M 07). It was relieved by lying down (28 M 12) and by a bath (28 M 07). There was stiffness of the lower back (20 F 05) relieved by movement (20 F 05, 29 M 03). 5.3.16 EXTREMITIES Provers experienced weakness (05 F 00, 28 M 01), tiredness (28 M 01) and heaviness (21 M 00:21:00, 21 M 06) of limbs. There was tightness and stiffness of the neck (05 F 02, 29 M 15), shoulders (06 F 07) and upper extremities (21 M 22), as well as the calves (29 M 24) and the hamstrings (29 M 14). Stiffness was relieved by stretching. There was cramping of the calves (21 M 14, 27 M 14). Pains in the joints were experienced strongly. Joints affected were the predominantly the fingers (18 F 10, 18 F 19, 27 M 11, 28 M 08), wrists (27 M 08, 29 M 09), toes (20 F 05, 29 M 25) and ankles (26 M 02, 27 M 11), and also the shoulders (29 M 08) and knees (29 M 21). The pain was experienced as a deep ache (18 F 19), a stabbing pain (29 M 25), or a tight stiff pain (27 M 27, 29 M 21). There was dryness and itching (13 F 10, 18 F 04, 29 M 20) of the extremities. Provers developed blisters on the toes (18 F 17) and eruptions around the ankles (20 F 10). Prover 28 also experienced lightness of the body (28 M 00) and a sensation as if wading through water.
Provers experienced a change in their sleep cycle. Sleep was restless (18 F 03, 22 F 05) and broken (16 M 06), with tossing and turning (21 M 07). Provers woke often (18 F 13, 21 M 08) or remained aware of their environment (18 F 07, 20 F 05). Two provers, who normally sleep badly, experienced deep restful dreamless sleep as a cured symptom (14 F 03, 29 M 02). Many provers experienced overwhelming sleepiness (03 M 01, 04 M 00, 22 F 05 ) or tiredness (07 F 25, 15 F 04, 18 F 03, 30 F 00) during the day. There was also difficulty waking up in the morning (06 F 04, 07 F 07, 27 M 08, 30 F 01) with a strong desire to remain in bed (06 F 05, 14 F 13). Prover 21 had excessive yawning with a feeling as if the mouth were too small to accommodate the yawn (21 M 09). 5.3.18 DREAMS Certain themes emerged in the dreams that provers had. There was a theme of deceit (16 M 12, 18 F 13 , 27 M 04) and mistakes (11 M 02). There were dreams of embarrassment (04 M 04, 13 F 07), guilt (13 F 09, 16 M 04) and being unprepared (07 F 06), as well as of inappropriate sexuality (04 M 10, 13 F 09, 16 M 12, 24 F 18). There were dreams about home, confusion about whose home it was (07 F 02), disorder and dysfuntionality at home (18 F 04). The theme of travelling emerged, with dreams of driving (11 M 02), riding on a bicycle, even travelling in a pram (11 M 02). Provers dreamt about ships (17 F 01, 18 F 11 , 21 M 06) and spaceships (27 M 04). Provers dreamt of old friends (16 M 24) and old business colleagues (10 F 00, 11 M 01). There were dreams about communication and difficulties and frustration therewith (11 M 08, 16 M 17, 18 F 13).
There were dreams about rescuing and protecting animals (16 M 19, 24 F 10), and also dreams in which the object of protection was in some way deformed (24 F 09, 24 F 10). This tied up with the theme of deformity in other dreams (16 M 24, 24 F 05). There were dreams of cats (16 M 19) and snakes (07 F 12, 07 F XX), with a feeling that the snakes were in some way protecting the prover (07 F XX). There were dreams of pursuit: being pursued by dinosaurs (13 F 04), bears (14 F 08), the police (21 M 14) or murderers; or pursuing snakes (07 F XX).Provers strove to outwit the pursuer, as different pursuers required different techniques (13 F 04), and then tried to teach others how to escape (13 F 09). There were dreams of others in trouble and being involved in their protection (24 F 14). There were also dreams of attack (18 F 11), of rape (24 F 01), and of war (16 M 13, 27 M 12, 28 M 02). One prover dreamt of being poisoned by a liquid causing suffocation (21 M 11). 5.3.19 SKIN There was a lot of dryness of the skin - of the lips (14 F 05 , 18 F 18), on the face (28 M 04) arms and legs (18 F 04) and feet (18 F 06). Provers noticed itchiness of the skin - on the back (19 M 04), chest (22 F 08), arms(18 F 04), hips (26 M 01), legs (18 F 10, 29 M 20) and feet (13 F 10). Prover 17 described the skin as dry and lizard-like (27 M 02), prover 28 noticed that the facial skin was coarse like sandpaper (28 M 00), prover 29 described a tight feeling of the skin as if it had been in the sun for tool long (29 M 10:XX:X). There was an eruption above the lips resembling a cold sore (13 F 01:03:45). The face was affected with a break-out of pimples (20 F 08, 24 F 16). There were eruptions around the ankles with heat and swelling (20 F 10), and red maculo-papular eruptions on the arms (18 F 11). Old scars felt inflamed and the surrounding skin was red (27 M 04). One prover developed a red lesion resembling an insect bite on the chest (22 F 02). This echoed redness, swelling and itching of the leg „as if bitten by an insect’ (29 M 20).
5.3.20 GENERALS Some provers experienced an increase in energy levels (03 M 06, 20 F 01, 22 F 04) with an increased ability to do physical activity (17 F 00), or an urge to get things done (20 F 02). Others experienced sharply decreased energy levels with exhaustion (06 F 04, 07 F 06, 16 M 02, 27 M 07, 30 F 00). There was a change in subjective experience of body temperature. Provers felt hot (27 M 00) and bothered (26 M 07), preventing sleep at night (27 M 02 , 27 M 14). Provers suffered from hot flushes (18 F 02, 18 F 08:XX:X) to the face (20 F 01) and chest (27 M 27), even if hands and feet were cold (06 F 09). There was a marked aggravation on waking (05 F 04, 06 F 09, 18 F 02, 20 F 03, 21 M 02, 24 F 05) and also in the morning and evening between five and seven (13 F 03). There was a craving for salty (21 M 22, 27 M 19), savoury (13 F 03, 20 F 01) food and a desire for red meat (20 F 01, 21 M 06, 21 M 09). There was a craving for alcohol (21 M 17), specifically red wine (21 M 06), although an aggravation from sherry was noted (20 F 00). Provers 20 and 21 developed a strong aversion to tobacco smoke (20 F 02, 21 M 08, 21 M 14). Prover 20 was aggravated by exposure to tobacco smoke (20 F 02, 20 F 03). Patients experienced an amelioration of symptoms during a thunderstorm (28 M 05), and in cloudy overcast weather (28 M 05), although there was emotional resistance to rainy „miserable’ weather (04 M XX, 15 F 04). Patients experienced an aggravation from driving (06 F 11, 06 F 17, 14 F 13 , 15 F 04). One prover felt in increase in static electricity (13 F 07). Prover 27 had a desire to go swimming (27 M 05:XX:X), while prover 28 had an amelioration of symptoms after swimming in a salted pool (28 M 03).
4 ANTIDOTE In the event that any signs and/or symptoms attributed to the proving substance, (whether mental, emotional or physical in nature), cause excessive discomfort for the prover, the following methods of antidoting the effects of the remedy exist (Kerschbaumer, 2004):
a. A homoeopathic similimum based on the totality of symptoms of both the pre-proving case history and the proving.
b. If Method a. was ineffective, the provers “constitutional’’ homoeopathic remedy would be administered. If it were unknown, it would have been ascertained from the pre-proving case history.
c. If Method b. was ineffective, an “acute” homoeopathic remedy would be prescribed according to the smaller presenting totality of the proving symptoms.
d. If Method c. failed, the commonly known methods of antidoting i.e. applying camphor, coffee, mints etc. would be used.
Many provers experienced symptoms which were of a mild or transitory nature, or did not disturb the prover to the degree where they felt the remedy needed to be antidoted. However, prover 7 was affected to the extent that she produced strong ongoing symptoms for two months after the remedy. Finally, four months after starting the proving, prover 7 required antidoting. Her symptoms included ulceration of the tongue, dry lips, pain in the hard palate, and extreme emotional lability. Naja mossambica 30ch was administered, which provided rapid relief of all symptoms.
POSSIBLE CLINICAL CONDITIONS The symptomatology produced by Hemachatus haemachatus indicates that it may be useful in the following clinical applications: Depression Anxiety Allergic rhinitis Pharyngitis and tonsillitis Apthous ulceration
Heartburn Gastro-intestinal disturbances such as Irritable Bowel Syndrome Rheumatism Lumbar back pain Dry, scaly itchy skin eruptions Menopause
MIASMATIC ANALYSIS Hemachatus haemachatus produced symptoms which are characteristic of the sycotic miasm in homeopathy. In the mind, it produced feelings of inadequacy, embarrassment , humiliation, feelings of being stuck, avoidance of company and the withdrawal to a quiet, private space, repetitive thoughts, feelings of inadequacy and not being able to cope, avoidance of responsibility, depression and lethargy. These themes are echoed in the dreams, and there were also dreams of deceit, of mistakes, of embarrassment, and of being unprepared. Furthermore, there were dreams of intense sexuality, and inappropriate sexuality, with knowledge that there would be disapproval of these tendencies and a tendency to conceal them. There were
also symptoms consistent with the malarial miasm as proposed by Sankaran (2002): intense irritability, especially with inefficiency, resentment to being controlled, feelings of being harassed and persecuted, of being trapped with a need to get out, longing for past relationships, changeability. There were dreams of intense frustration, of harassment, attack, rape, of being stuck in a situation,
of protecting others and others being nasty or mean to one. There were dreams of being pursued. Pain was experienced as annoying, irritating. Vesicular skin eruptions were produced. Sankaran describes the malarial miasm as a combination of the sycotic and the acute miasms. It is thus proposed that Hemachatus haemachatus belongs to the malarial miasm.
Lachesis muta is the Bushmaster of lowland rainforests of Central and
gloom and fury, apprehensive irritability. There may be anguish and anxiety, which may be unbearable. Hemachatus haemachatus produced emotional lability, with rapid changes in mood. Provers experienced anxiety, a sense of apprehension and a fear that something terrible may happen, to the point of experiencing panic attacks. Thakkar (2007) identifies home and relationships as the two most important areas for Lachesis muta. There is great anxiety and care for relatives and friends, and great sympathy and affection for others. Their involvement with others and their relationships deepen very quickly, and their commitment and care leaves them very vulnerable to hurt and disappointment. The themes of home and friends also featured very strongly in the proving of Hemachatus haemachatus. There was a need to organise and sort out personal space, and a desire to go home or remain at home, as it felt the safest place to be. There was intense sympathy for friends and acquaintances in need, and a desire to reconnect with old friends, as well as dreams of old friends and work colleagues. Lachesis muta is a remedy for patients whose ailments follow disappointment in love, grief and death of family members. In health, they are communicative, vivacious, affectionate and amorous, craving amusement and entertainment. This relates to feelings of positivity, capability, joy, enthusiasm and elation seen in Hemachatus haemachatus, with a carefree, bubbly mood, and enjoyment of the company of friends. Lachesis muta becomes argumentative, opinionated, domineering, jealous and suspicious when unbalanced, and in the proving of Hemachatus haemachatus, feelings of jealousy and argumentativeness were produced. Lachesis muta displays clairvoyance, and can feel the energy of others. In Hemachatus haemachatus, we see sensitivity, vulnerability and provers absorbing the mood of others. There was a feeling of deepened spirituality, of reconnection with themselves, and of transcendence. This contrasts with Lachesis muta, who may become very religious, even dogmatic, moralistic or puritan (Vermeulen, 2000), praying fervently (Thakkar, 2007).
Lachesis muta sleeps into an aggravation and is aggravated after sleep (Gibson, 1987), with many symptoms being aggravated in the morning on waking. There is a marked tendency to insomnia, especially before midnight (Vermeulen, 2000). Symptoms are predominantly left-sided. Patients are warm-blooded (Vermeulen, 2000). There is an aggravation from the sun, and from heat and humidity, and a tendency to hot flushes. Lachesis muta patients crave alcohol but are aggravated by it, and have an aversion to tobacco as well as being aggravated by it (it is one of the remedies listed as useful to increase the disgust for tobacco). All of these symptoms were also produced in the proving of Hemachatus haemachatus. Lachesis muta has a particular affinity for the throat, causing tonsillitis/ pharyngitis which is left-sided or spreads from left to right. There is a constricted sensation in parts of the body, e.g. a sensation of a lump in the throat, which may be painful and returns after swallowing (Vermeulen, 2000). Hemachatus haemachatus produced sharp, raw throat pain with dryness of the mouth and throat. There was also the feeling of a lump in the throat, or something stuck to the tongue or to the sides of the throat. Lachesis produces headaches which are one-sided and spread to the neck and back. Pains may shoot down to the eye, or from the zygoma to the ear, or down the nape to the shoulders (Gibson, 1987). The pain is bursting, pressing and congestive, and is aggravated by motion, heat and after sleep. The headaches of Hemachatus haemachatus were predominantly in the frontal, temporal or occipital areas or around the eyes. They extended from the occiput to behind the eye, or neck to the temple, from the temple to the eye, or from the temples to the teeth. Some headaches extended to or from the neck or back, or were accompanied by neck stiffness or spasm. Congestive, bursting, pounding head pains were also produced, as well as sharp piercing stabbing pains. Headaches were aggravated by light, while pressure, and icy, cool applications provided relief.
The marked photophobia in Hemachatus haemachatus, with itchiness, dryness and scratchiness in the eyes, is also seen in Lachesis, which has
intense photophobia with pain, itching, stinging and sensitivity to touch, and a desire to rub the eyes (Gibson, 1987). Lachesis muta produces hard thumping palpitations of the heart, aggravated by lying down, associated with a sense of constriction or tightness of the chest (Gibson, 1987). There are episodes of oppression of the precordium. Hemachatus haemachatus produced palpitations, with anxiety, felt when pausing or lying down. There was a sense of constriction around the chest, and burning parasternal pain as if fingers dug into the chest. In the respiratory system symptoms of Lachesis, there is shortness of breath and asthma, with air hunger and an aggravation in a closed stuffy atmosphere. Hemachatus haemachatus produced a feeling of shortness of breath. In the female reproductive system, the most striking symptom of Lachesis muta is severe PMS which is markedly ameliorated by the appearance of the menses. Menses is thin, dark, scanty and offensive. Provers taking Hemachatus haemachatus experienced irritability and snappishness which was compared to pre-menstrual tension. Menses was dark, fluid, muddy or sandy, with an absence of clots, and a decrease in the usual pain. Both remedies have pain in the ovarian region. During menopause, Lachesis patients suffer from hot flushes, headaches, palpitations, dyspnoea, night sweats and severe mood changes (Gibson, 2007). These symptoms were also produced in the proving of Hemachatus haemachatus. Abdominal bloating is common in Lachesis muta patients, relieved by loosening the clothes round the waist (Gibson, 1987). There may be much ineffectual urging to stool. Bloating and flatulence were strong features in the proving of Hemachatus haemachatus, and there were also other digestive disturbances such as heartburn, abdominal pain, acidity, and constipation. There is a tendency to frequency of urination in both remedies, and in Hemachatus there is also lower abdominal pain likened to provers to that of cystitis, and incontinence.
Low back pain in Lachesis muta, as if the back was dislocated, is accompanied by weakness, fatigue and trembling. In Hemachatus haemachatus, lumbar pain was sharp shooting, stabbing, as if stretched or a tight, stiff, strained pain. The pain was aggravated by movement or a change in position, and was relieved by lying down and by a bath.
Naja tripudians is the Indian cobra, a member of the Elapidae, which produces highly neurotoxic venom with hardly any cytotoxic or haemorrhagic effects. Ross (2007) identifies the fundamental conflict in Naja tripudians as that between the duty and responsibility they feel due to life circumstances, and their own needs as a human being. Naja tripudians has strong maternal instincts, with a strong sense of duty and dedication toward their children, younger siblings and family members (Thakkar, 2007). Their duty is carried to the point of domination, and they may become bossy, impatient, controlling and dictatorial, which leads to conflict and disappointment, felt intensely by Naja tripudians. There are feelings of being disappointed in love, of being neglected, alone and forsaken, not being appreciated and betrayed by the loved one. Thakkar (2007) thus sees this conflict between the anxiety of neglecting their duty, and the apprehension of doing something wrong as the core issues in Naja tripudians. This is reflected in dreams of not protecting siblings or children or pets. Sankaran (1997) says that the qualities of nobility, morality and responsibility seen in Naja, are often in conflict with the feeling of being wronged, with anger, malice and an impulse to harm the offending person. The comparative extraction (Appendix H) shows rubrics which support this interpretation.
There is a lack of self-confidence in Naja tripudians, with a feeling everything they do is wrong, and that they cannot succeed. There is a tendency to sadness, introspection, and specifically brooding, even over imaginary troubles. There may be thoughts of suicide, and a feeling as though they are
not worthy of the gift of life. Naja tripudians has a fear of being alone with a corresponding desire for company, fear of accidents, and fear of death during heart symptoms. Naja tripudians patients display mildness and timidity, with a loss of will-power. They are sensitive, secretive and sentimental. There is an alternation in moods. There are delusions that they are being deceived, injured or wronged, and a delusion of being trapped. Hemachatus haemachatus produced feelings of sympathy for others, especially those in need. There were dreams of protecting the weak and abandoned, such as animals or babies. There was however a sense that the object of affection had something wrong with them, either it was deformed or had some offensive disease, and there was a sense of being trapped into looking after it. Hemachatus produced much greater irritation than Naja, even with members of the family, and there was an aversion to company, with a need to be alone in a quiet, restful, safe space. There was sometimes an effort to control the irritability and concomitant violent impulses, but often provers were snappish, shouting at offenders. Provers experienced a sense of not being good enough, especially in the realm of personal relationships, and easily felt rejected or not appreciated. There was also dwelling on past relationships with a deep sense of longing or yearning for love, and a sense of something or some-one missing in their lives. The lack of self-confidence was also expressed as a feeling of being unable to cope, of not managing. Provers felt sensitive and vulnerable, with a need to be appreciated, to be worth something to the world. In the proving of Hemachatus haemachatus there was a sense of being harassed, picked on, persecuted, and purposefully annoyed. There were dreams of others being mean to them. There was intense frustration with a feeling and dreams of being trapped or stuck, and a need to get out. Irritability was much more marked in Hemachatus haemachatus, and this was specifically directed at inefficiency, incompetence, others being slow or slack. The alternation in moods was marked, with moods changing rapidly.
The conflict between duty in responsibility in Hemachatus haemachatus manifested in an avoidance of responsibilities, which was coupled with great lethargy and lack of motivation. Responsibilities were perceived to be regarding work, and the aspect of duty toward the family did not arise in the proving. 5.7.4 Elaps corallinus Elaps corallinus is the Brazilian coral snake, a member of the Elapidae family. It is known in homeopathy primarily for a few leading or keynote symptoms - a desire to play (in the grass), a need to get into the country away from people, black discharges, a craving for oranges, salads, ice and yoghurt, and dreams of falling (Vermeulen, 2000). Thakkar (2007) has provided greater insight into the remedy. She identifies a feeling of isolation, of being separate and not belonging to the world as central to the remedy. There is a strong sense of independence, a need for freedom, with an aversion to being domesticated, held back or obstructed. Elaps displays intolerance to the pretence, dishonesty and lies of humanity, an inability to live in the city for too long, and a deep connection with nature and the outdoors. They are critical of themselves and others, and intolerant of others who are unaware and careless, hurting others because they are not mindful of their actions. They may feel rage, as of the blood boils, with a need to shriek or break things, together with a fear of losing control. Elaps may also be fastidious, and particular about cleanliness and order.
The comparative analysis in RADAR (Appendix H) identified some emotional characteristics unique to Elaps corallinus. There is a strong aversion to company, they cannot bear even the sight of anybody, with a need to get into the countryside away from people. At the same time, there is a fear of being alone, due to a fear that something may horrible happen. There is moroseness and taciturnity, and a tendency to sit wrapped in thought, dwelling on past disagreeable occurrences. There is anger and irritability, felt especially when disturbed or spoken to.
Hemachatus haemachatus produced intense irritability, but this was caused by perceived inefficiency, incompetence and poor planning. There was disgust with hypocrisy. There was anger with violent impulses to harm the offender - to punch them in the face, or rip their heads off, but these were controlled, and frustration was mostly vented by shouting. There were feelings of frustration, and of being deliberately harassed or picked on. Provers had a feeling of being trapped, and a need to get outside, into nature or go for a walk on a field. Hemachatus haemachatus displayed and aversion to company and a need to be alone, in a quiet restful space, but home was identified as that safe space, and provers retreated to their homes or rooms to pursue their own interests. Provers experienced a sense of anxiety, as if something bad, such as an accident, might happen, or as if something was just not quite right. There was a fear of driving, a sense of danger on the roads, even dreams of a massive accident. The playfulness seen in Elaps corallinus is echoed in the carefree, bemused, happy, bubbly feelings of Hemachatus, the enjoyment of the company of friends and the irritation felt by one prover at that fun being spoiled by a member of the group. Joyfulness, vivacity and a desire for entertainment seem, however, to be qualities common to all the snake remedies.
5.7.5 Naja mossambica
Naja mossambica is the Mozambican Spitting Cobra, an Elapid indigenous
to the north-eastern parts of
feelings of not caring about tests and work, just wasting to have fun. Very similar feelings were seen in the Hemachatus haemachatus proving. In Naja mossambica, we see heightened emotions, even emphasized to the extreme, with mood swings and a sense of being unbalanced. Provers felt somewhat manic and mad, with bouts of uncontrollable laughter and giggling and acting in a silly manner. There was restlessness and hyperactivity, a feeling of being rushed. While Hemachatus haemachatus also produced sudden changes in mood, the unbalanced, manic quality was absent. In Naja mossambica there was a feeling of being spaced out, light-headed, dazed or stoned, which seems similar to the spaced-out feeling of Hemachatus haemachatus, which had the feeling „as if taken tranquilizing drugs’. There was however a spiritual element of transcendence, of reconnecting to themselves or of observant spaciousness in Hemachatus haemachatus, while in Naja mossambica the feeling seems more out of control and dazed. In Naja mossambica there is anxiety and feelings of being overwhelmed and not able to cope. There was depression, a feeling of being low, and anti-social feelings. Similar emotions were experienced by provers in the Hemachatus haemachatus proving. Depression was also described as a feeling of being low or flatness. Both remedies show tiredness and lethargy and a lack of motivation, perhaps more strongly seen in Hemachatus haemachatus. While there was a need for private space in Hemachatus haemachatus, we also see an effort to connect with old friends, and dreams of old friends and work colleagues. The sentimental longing or yearning seen in Hemachatus haemachatus, as well as the sense of vulnerability and insecurity, was absent in Naja mossambica.
Naja mossambica produced irritability and frustration, with a desire to just be at home by themselves, a need for space and quietness. The irritability was directed at family, and everything they did irritated provers. It was also felt
towards authoritative people pushing them around, as well as when driving. The irritability produced by Hemachatus haemachatus was more central to the proving, as it was experienced more intensely by a greater number of provers. It was either causeless or triggered by trifles, or specifically felt in response to incompetence, inefficiency and poor planning; on the road towards incompetent drivers; when provers felt harassed by others; or when they felt emotionally hurt or neglected. There were many similarities in the dreams of the two remedies: dreams of fighting, being bothered or harassed by a man and then punching or attacking him, attack on one’s house, ships, strange but familiar places, sleeping or bathing in excrement, rescuing animals, vivid dreams, frustrating dreams about difficulties in communication, dreams of snakes, being pursued, being stuck. Physically, there are many points of similarity between the two remedies. Naja mossambica has feelings of lightness of the head, as well as light-headedness. Hemachatus haemachatus also has vertigo, and a feeling of heaviness of the head, as well as various strange sensations: as if the head wrapped in cotton wool, made of feathers, or is under water. The headaches of Naja mossambica were felt in the forehead and temple, those of Hemachatus in the frontal, temporal or occipital areas or around the eyes. Many headaches in Hemachatus haemachatus extended from one area to another: from the occiput to behind the eye, or from the neck to the temple, from the temple to the eye, or from the temples to the teeth. Some headaches extended to or from the neck or back, or were accompanied by neck stiffness or spasm.
Both remedies affect the eyes. Naja mossambica caused burning, redness, marked swelling, difficulty in focusing and even purulent discharge from the eyes, while in Hemachatus haemachatus, itchiness, scratchiness, a gritty feeling and photophobia predominated. Both remedies caused sneezing and coryza, as well as dryness of the mouth and lips, and a tendency to formation of vesicles in the mouth. Both remedies caused sore throat -sharp raw
scratchy pain in Hemachatus haemachatus, scratchiness in Naja mossambica. Both have the sensation of a lump in the throat, which we saw earlier is a common symptom in snake remedies. Both remedies have increased thirst and an increase in appetite. Naja mossambica had intense cramping in the stomach and abdomen, with mild symptoms of nausea and flatulence. Hemachatus haemachatus produced cramping, heartburn and marked nausea in the stomach; and cramping, burning or stabbing lower abdominal pain, and much flatulence. The lower abdominal pain produced by Hemachatus haemachatus, likened to provers to that of cystitis, the urinary frequency and incontinence, and the hot and viscid urine, were absent in Naja mossambica. Both remedies produce pain in the ovarian region. Hemachatus has dark red, almost black menses, with an absence of clots and pain, Naja mossambica has scanty menses, late in appearing, also with decreased pain. Hemachatus haemachatus showed increased libido in both sexes, not mentioned in Naja mossambica. Naja mossambica produced sharp pains in the chest, while Hemachatus had a sense of constriction, or a burning pain as if fingers dug into the chest. Both remedies have painful enlargement of axillary lymph nodes. The symptoms corresponding to mastitis seen in Hemachatus were absent in Naja mossambica. Low back pain and pain in the extremities were present in both, but more strongly so in Hemachatus haemachatus. Itchy, dry skin, with eruptions and redness, was also a more pronounced feature of Hemachatus haemachatus.
Both remedies had in increase in body temperature, with provers feeling hot. In Hemachatus haemachatus, it was experienced particularly at night, preventing sleep, and there were also flushes of heat to the face. Sleep was either restless and disturbed or deep, in both remedies. The intense lethargy and sleepiness seen in Hemachatus haemachatus was not as pronounced in Naja mossambica.
5.7.6 Bitis arietans arietans Bitis arietans arietans is the Puff Adder, Africa’s largest viper, responsible for most snake bites in Africa. The venom is haemolytic and cytotoxic. Wright conducted a proving of the venom in 1998. The feeling of being spaced-out and disconnected was prominent in the Bitis arietans arietans proving. Provers felt intoxicated, trippy, or stoned. There was difficulty in concentrating during conversation or attempting to think, read or write, and easy distraction. Similar sensations were seen in Hemachatus haemachatus. Provers taking Bitis arietans felt removed from reality, with everything seeming unreal, even feeling disconnected from themselves, while in Hemachatus haemachatus there was a feeling of reconnecting with their spiritual side. The sensation of „cotton wool in the head’ seen in Hemachatus haemachatus was also experienced in the Bitis arietans proving. Both remedies have clumsiness and a tendency to drop things, trip or bump into things. Lethargy and laziness were prominent symptoms in both provings, as well as depression and feelings of downness. Provers taking Bitis arietans arietans felt sensitive to the opinion of others, and feelings of being socially left out were experienced. Strong feelings of being socially embarrassed and humiliated were experienced by one prover taking Hemachatus haemachatus. We also see strong feelings of not being good enough, specifically in the realm of relationships. The sadness and yearning for love, dwelling on past relationships, sense of someone missing in their lives, and the dreams of old friends and acquaintances in Hemachatus haemachatus, are echoed in the sad, sentimental thoughts of the past of Bitis arietans arietans. In Bitis arietans arietans there was some anxiety, which was specifically felt while driving, to the point of panic attacks, which is also a feature of Hemachatus haemachatus.
There was an urge to clean and tidy and a need for order in Bitis arietans arietans, but in Hemachatus haemachatus the impulse was stronger, with
energy to get things at home sorted out and do major home improvements. The feature of retreating to the home or private room, seen as a quiet, restful, safe space, so prominent in the Hemachatus haemachatus proving, was absent in Bitis arietans arietans. Provers experienced irritability in the Bitis arietans arietans proving, which was worse in crowds or groups of people, and also felt when relatives were staying in the family home. This is similar to the irritation felt in the Hemachatus haemachatus proving, when friends of provers’ parents, or children of acquaintances, where in the home. Irritation was however a much more prominent feature of Hemachatus haemachatus, specifically felt in response to incompetence, inefficiency and poor planning; on the road towards incompetent drivers; when provers felt harassed by others; or when they felt emotionally hurt or neglected. Sometimes it was causeless or triggered by trifles. There are similarities in the dreams produced in the two provings. Both have dreams of pursuit, of escaping, of snakes, of children and babies connected to violence, and ambiguous or inappropriate sexuality. There was a dream in Bitis arietans arietans which is similar to a dream in both Naja mossambica and in Hemachatus haemachatus. It involves being in a swimming pool with a male, and spending time with or being pursued by him, even though the prover doesn’t particularly like him. Bitis arietans arietans produced a decrease in energy, tiredness and lethargy. Stiffness was a prominent feature. Provers became more chilly and cold-sensitive, the opposite of the heat and hot flushes of Hemachatus haemachatus. A sensation of being charged, with increased static electricity, was a feature of both remedies.
Bitis arietans arietans produced throbbing congested headaches, occipital, temporal or behind the eyes, and a heavy feeling of the head was prominent. The eyes were affected much less than in Hemachatus haemachatus: eyes
felt tired, overstrained and slightly itchy. Vision was blurred with difficulty in focusing. Mouth and lips were dry, but no blister formation was noticed. Appetite was mostly decreased with Bitis arietans arietans. There is abdominal cramping and a marked increase in flatulence, similar to Hemachatus haemachatus. There was urgent desire to pass stool in Bitis arietans arietans, followed by another loose stool some half an hour later, and also some ineffectual urging. Female provers experienced heavier than normal menses, with dark clots, which came on too early and without the normal warning signs. In Hemachatus haemachatus, menses tended to be dark, fluid, lighter than normal, with an absence of clots, and generally a decrease in the usual pain, but with pain in the ovarian region. Respiration was affected more in Bitis arietans arietans, with symptoms similar to asthma produced. Stiffness of the back, neck and extremities was a marked feature. The pain in smaller joints of hands, feet, wrists and ankles seen in Hemachatus haemachatus, was not as pronounced. Sleep was less restless and broken than that of provers taking Hemachatus haemachatus.
CHAPTER SIX 6. CONCLUSIONS AND RECOMMENDATIONS 6.1 CONCLUSIONS The homoeopathic drug proving of Hemachatus haemachatus 30ch produced a variety of mental, emotional and physical symptoms. Hemachatus haemachatus shows the potential to be clinically useful in treating patients presenting with similar symptomatology. It is hoped that clinical application of the remedy will provide verification of these indications. The comparative analysis of the symptoms of Hemachatus haemachatus with other remedies derived from snake venom used in homeopathy, confirmed the close similarity between remedies from these sources. It is hoped that as clinical information becomes available for the remedies more recently proven, the differentiating features will become clearer. 6.2 RECOMMENDATIONS 6.2.1 Prover Group
Hahnemann (1982) emphasised that provers must be diligent, honest, reliable and conscientious. Many homeopaths feel that the attention of the prover is crucial to the success of a proving (Scholten, 2007) (Sherr, 1994) (Vithoulkas, 1981). The long period over which a proving is conducted, requiring diligence in recording symptoms for a minimum period of five weeks, makes it thus of vital importance to recruit provers who fulfil the above criteria, and who also show high motivation and enthusiasm for the proving. Many provers were recruited from the body of homeopathic students, and it was noted that they made sensitive and self-aware provers who contributed greatly to the development of the remedy picture. Members of the public who participated did not respond to advertisements, and required more detailed personal introduction to the proving process. It is recommended that the advertisements placed to recruit provers should be interesting, inspiring and
motivational. These should also primarily be directed at potential provers who would be inclined to respond to advertisements in the proving context. Every effort must be made to motivate and inspire provers. It is recommended that in future provings, the researchers draw up a motivational letter, written in a non-academic style, establishing personal rapport with provers. This could serve to explain the proving process in an understandable, motivational manner. The use of inspiring quotes from old masters and modern homeopaths, who have experience in conducting provings, may be appropriate.
6.2.2 Supervision of provers
The value of maintaining constant personal contact throughout the proving process by the supervisors/researchers cannot be over-emphasised. The limiting of the number of provers that each supervisor is responsible for has been recommended by Kerschbaumer (2004) and Moore (2007). The staggering of dates that provers start taking the remedy is also highly recommended to ensure adequate supervision of provers by the researchers. 6.2.3 Publication of results The results of the proving of Hemachatus haemachatus indicate that it may be a remedy useful in homeopathic clinical practice. It is recommended that the results of the proving are published in homeopathic journals, and that the full proving is made available on the internet databases of existing provings. This will allow for the expansion of the clinical use of Hemachatus haemachatus and the continuous verification of its therapeutic use. 6.2.4 Indigenous substances
South Africa has a rich variety of indigenous flora and fauna. There is a wealth of plants used for their medicinal or poisonous properties by South African population groups, including the Khoisan, the indigenous Black populations and later the Dutch settlers (Van Wyk, Van Oudshoorn, and Gericke: 1997). South Africa has a unique and rich indigenous flora. The Cape Floral Kingdom has been designated one of the earth’s plant kingdoms,
as it hosts 8600 plant species of which 5800 are endemic, in an area of less than 90 000 square kilometres (Cowling and Richardson:1995). The succulent Karoo contains over 6000 species, the world’s richest collection of succulents, 40% of which are endemic. Wright (1994) recommended the proving of indigenous substances for purposes of creating a South African materia medica. Many indigenous substances have subsequently been the subject of homeopathic research at the Durban University of Technology, for example Sutherlandia frutescens [Cancer bush] by Kell, Low, Van der Hulst and Webster (2002), Harpagophytum procumbens [Devil’s claw] by Kerschbaumer (2004), Naja mossambica [Mozambican spitting cobra] by Smal and Taylor (2004), Chamaeleo dilepis dilepis [Chameleon] by Moore and Pistorius (2007) and Gymnura natalensis [Butterfly stingray] by Naidoo and Pather (2008). The researcher also recommends further provings of substances indigenous to South Africa to facilitate the creation of a South African materia medica.
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journal/entry/ theory_of_provings2/. [Accessed 5 March 2008] Sherr, J.Y. 2006. World Wide Proving Index. [online]
Available: http://www.dynamis.edu/eng/provings.htm. [Accessed 11 March 2008]
Warrel, D.A. 2005. The treatment of bites by adders and exotic venomous snakes. BMJ [online], 2005;331: 1244-1247.Available: ScienceDirect, Article Number doi:10.1136/bmj.331.7527.1244 [Accessed 5 March 2008]
Wichmann, J. 2007 Homeopathic provings [online]. Available: http://www.homeopathie-wichman.de/provings/provings-list.htm. [Accessed 11 March 2008]
Applicants are required to be between the ages of
18 & 60 years, in a general good state of health,
and interested in taking part in the
Research of a new Homoeopathic remedy at the
Durban University of Technology.
Lize de la Rouviere : 076 160 4199
Jodi Cahill: 083 946 6439
Homoeopathic Day Clinic: (031) 2042041
SUITABILITY FOR INCLUSION IN THE PROVING
All information will be treated as strictly confidential
PLEASE CIRCLE THE APPROPRIATE WORD:
1. Are you between the ages of 18 and 60 years? YES/NO
2. Do you consider yourself to be in general state of good health? YES/NO
3. Are you on or in need of any medication?
- Chemical/Allopathic YES/NO
- Homeopathic YES/NO
- Other (e.g. herbal) YES/NO
4. Are you pregnant or nursing? YES/NO
5. Have you had any surgery in the last six weeks? YES/NO
6. Do you use any recreational drugs such as YES/NO
Marijuana, LSD or MDMA (ecstasy)
7. Do you consume more than:
- 2 measures of alcohol per day? YES/NO
(1 measure = 1 tot/ 1beer/ ½ glass wine)
- 10 cigarettes per day? YES/NO
- 3 cups of tea, coffee, herb tea per day? YES/NO
8. If you are between the ages of 18 and 21 years do you have YES/NO
consent from a parent/guardian to participate in this proving?
9. Are you willing to follow the proper procedures for the duration
of the proving? YES/NO
10. Is English your first language and/or are you fluent in English? YES/NO
This appendix has been adapted from: Wright, C. 1999. A Homoeopathic Drug Proving of the venom of Bitis arietans arietans. M. Tech. Hom. Dissertation, Technikon Natal, Durban.
This appendix has been adapted from the proving by Smal (2004) and Taylor (2004) of Naja mossambica.
INFORMED CONSENT FORM
(To be completed in duplicate by the prover)
Title of the research project
A Homoeopathic Drug Proving
Name of the supervisor
Dr M. Maharaj (M. Tech. Hom.)
Names of the research students
Lize de la Rouviere and Jodi Cahill
Please circle the appropriate answer:
1. Have you read the research information sheet? YES/NO
2. Have you had the opportunity to ask questions regarding this proving? YES/NO
3. Have you received satisfactory answers to your questions? YES/NO
4. Have you had an opportunity to discuss this proving? YES/NO
5. Who have you spoken to? __________________________________
6. Have you received enough information about this proving? YES/NO
7. Do you understand the implications of your involvement in this proving? YES/NO
8. Do you understand that you are free to withdraw from this proving:
a. at any time
b. without having to give a reason for withdrawing
c. without affecting your future care? YES/NO
9. Do you agree to voluntarily take part in this proving? YES/NO
If you have answered NO to any of the above, please obtain the information before signing.
I ____________________________ hereby give consent for the proposed procedures to be performed on me as part of the mentioned research project.
Name: ___________________ Signature: ___________________ Date:____________
Name: ___________________ Signature: ___________________ Date:____________
Name: ___________________ Signature: ___________________ Date:____________
APPENDIX D Case History Sheet This has been adapted from: Wright, C. 1999. A Homoeopathic Drug Proving of the Venom of Bitis arietans arietans. M. Tech. Hom. Dissertation, Technikon Natal, Durban. Prover number: Name: Sex: Date of birth: Age: Marital status: Children: Occupation: Past medical history: Please list all previous health problems and their approximate dates: Do you have a history of any of the following? (please tick √)
Pneumonia / Chronic bronchitis
Tendency to suppuration / boils
Eczema or skin conditions
Arthritic / Rheumatic conditions
Surgical history: Please list any past surgical procedures you have undergone, and the approximate dates. (Including the removal of tonsils, warts, moles, appendix) Allergies: Vaccinations (Including any reaction to them): Medication (Including supplements): Estimation of daily consumption of: Alcohol: Cigarettes: Family history: Is there a history of any of the following within your family?
Arthritic / Rheumatic conditions
Please list any other medical conditions within your family: General Health: Energy: Describe your energy levels on a scale from 1 to 10, where 1 is the lowest and 10 is the highest. Stress: Describe your stress levels on a scale from 1 to 10, where 1 is the lowest and 10 is the highest. Sleep: Quantity
Dreams: Include any recurrent dreams and themes; and any significance related to life situations at the time of the dream.
Time modalities: Weather modalities: Temperature modalities: Perspiration: Distribution
Thirst: What do you normally drink
How do you drink (small / large sips…)
Specific Body Systems: Symptoms from each system will be concentrated on more than pathologies - these headings are just guidelines for the researchers. Head: Scalp, hair
Weakness / palsy
Balance / vertigo
Nose: Allergic rhinitis
Throat: Sore throats
Tonsils - IN / OUT
CVS: Hyper / Hypotension
Pain / discomfort (chest)
Phlebitis, varices, telangiectasias, anaemia, easy bruising…
GUT and Abdomen: Nausea / vomiting
Indigestion / heartburn
Constipation / Diarrhoea
Any organs particularly affected (Liver, pancreas, gallbladder…)
Any GI surgery
Urinary system: Urine output per day (quantity, color, odour…)
Fluid intake (what, how much, hot / cold…)
Male system: Libido
Female system: Contraception For how long?
Past history of… Libido
o No. days
o Amt. of flow
o Colour of blood
Last gynae appointment
Skin: General appearance
Musculoskeletal: Muscle pain / stiffness
Mental: Please describe your mental and emotional state as it is at this present time.
Physical Examinations: Vital signs: Pulse
Weight (any recent change…)
Cursory examination: Brief head to toe examination of all the systems. Skin
Head and neck
o Range of motion
o Muscle tone
INSTRUCTIONS TO PROVERS AND LETTER OF INFORMATION
Thank you very much for taking part in this proving.
As an active participant in this proving you will play an integral part in introducing a new indigenous homoeopathic remedy. This study provides an opportunity to utilize one of South Africa's natural resources for a medicinal purpose, which will benefit people for generations to come.
Risks and benefits:
You may experience some mild transient symptoms whilst taking the homoeopathic medication. You however will be in daily contact with the researcher and under constant supervision of a qualified homoeopathic physician, who will antidote any unpleasant intolerable symptoms if necessary. Please be reminded that you are under no obligation and are free to withdraw from the study at any stage.
As a participant of this proving you may experience some indirect benefits such as an increased awareness of yourself, an increased sense of well-being and a better understanding of how homoeopathy works. Homoeopathy students will gain a better understanding of homoeopathic provings and homoeopathy in general.
Before the proving:
Ensure that you have:
§ Completed and signed the informed consent form
§ Attended the pre-proving meeting
§ Had a case history taken and a physical examination performed
§ Been allocated a prover code
§ The correct journal
§ Been given a set of six powders
§ Read and understood these instructions
Your proving supervisor will inform you of the date that you may start the one week pre-proving observation period and of the date that you are may start taking the remedy. Please give your supervisor a convenient time at which she may contact you on a daily basis .
Should there be any queries or anything you don't fully understand, please do not hesitate to call your supervisor.
Beginning the proving:
After the supervisor has contacted you and asked you to commence the proving, record your symptoms daily in the diary for one week prior to taking the remedy. This will help you get into the habit of observing and recording your symptoms, as well as bringing you into contact with your normal state. This is an important step as it establishes a baseline for you as an individual prover.
Taking the remedy:
Begin taking the remedy on the day you and your supervisor have agreed upon. Record the time that you take each dose. Time keeping is an important element of the proving.
The remedy should be taken on an empty stomach and with a clean mouth. Neither food nor drink should be taken for half an hour before and after taking the remedy.
The remedy should not be taken for more than 3 doses a day for two days (six powders maximum). In the event that you experience symptoms or those around you observe any proving symptoms do not take any further doses of the remedy.
By proving symptoms we mean:
1. Any new symptoms, i.e. ones that you have never experienced before, or,
2. Any change or intensification of any existing symptom, or,
3. Any strong return of an old symptom, i.e. a symptom that you have not experienced for more than one year.
If in doubt phone your supervisor. Be on the safe side and do not take further doses. Our experience has shown that the proving symptoms usually begin very subtly, often before the prover recognises that the remedy has begun to act.
Lifestyle during the proving:
A successful proving depends on your recognising and respecting the need for moderation in the following areas: work, alcohol, exercise and diet. Try to remain within your usual framework and maintain your usual habits.
Please avoid all antidoting factors such as coffee, camphor and mints. If you normally use these substances, please stop taking them two weeks before, and for the duration of, the proving. Protect the powders you are proving as you would any other remedy, including keeping them away from strong smelling substances, chemicals, electrical equipment and cell phones.
Avoid taking medication of any sort, especially antibiotics, vitamin or mineral supplements, herbal or homoeopathic remedies.
In the event of a medical or dental emergency of course common sense should prevail. Contact your doctor, dentist or local hospital as necessary. Please contact your supervisor or proving coordinator as soon as possible.
It is important for the quality and credibility of the proving that you discuss your symptoms only with your supervisor. Keep your symptoms to yourself and do not discuss them with fellow provers.
Your privacy is something that we will protect. Only your supervisor will know your identity and all information will be treated in the strictest confidence. Your identity will not be revealed at any part of the study.
Contact with your supervisor:
Your supervisor will telephone you to inform you to begin your one-week observation period. When you start to take the remedy, your supervisor will contact you daily at the time you agreed on. This will later decrease to 2 or 3 times a week and then to once a week, when you and the supervisor agree that there is no longer a need for such close contact. This contact is to check on your progress, make sure that you aren’t experiencing any difficulties, and help you to record the best quality symptoms possible.
If you have any doubt or questions during the proving, please do not hesitate to call your supervisor.
Recording of symptoms:
When you commence the proving note down carefully any symptoms that arise, whether they are old or new, and the time of day or night at which they occurred. This should be done as vigilantly and frequently as possible so that the details will be fresh in your memory. Make a note even if nothing happens. Please keep the diary with you at all times to enable you to record symptoms as soon as they occur.
Please start each day on a new page with the date noted at the top of each page. Also note which day of the proving it is. The day that you took the first dose is day zero. Write neatly on alternate lines, in order to facilitate the extraction process, which is the next stage of the proving.
Please be as precise as possible. Note in an accurate, detailed, but brief manner your symptoms in your own language.
Information about location, sensation, modality, time and intensity is particularly important:
Try to be accurate in your anatomical descriptions. Simple clear diagrams may help here. Be attentive to which side of the body is affected.
Burning, dull, lancinating, shooting, stitching, etc.
A modality describes how a symptom is affected by different situations or stimuli, such as weather, food, odours, dark, lying, standing, light, people, activity, etc. Try different things out to see if they affect the symptom and record any changes. Annotate it as > for better from, and < for made worse by.
Note the time of onset of the symptoms, and when they cease or are altered. Is it generally > or < at a particular time of day, and is this unusual for you?
Briefly describe the sensation and effect of the symptom on you. You may want to grade it from 1 to 10, 1 being very slight and 10 being the most intense possible.
Did anything seem to cause or set off the symptom and does it do this repeatedly?
Do any symptoms appear together or always seem to accompany each other, or do some symptoms seem to alternate with each other?
This can easily be remembered as: CLAMITS
C - concomitants
L - location
A - aetiology
M - modality
I - intensity
T - time
S - sensation
On a daily basis you should run through the following checklist to ensure that you have observed and recorded all your symptoms:
Mind Vertigo Head
Eye Vision Ear
Hearing Nose Face
Mouth Teeth Throat
External throat Stomach Abdomen
Rectum Stool Bladder
Kidneys Prostate Urethra
Urine Male genitalia / Sex Female genitalia / sex
Larynx Respiration Cough
Expectoration Chest Back
Extremities Sleep Dreams
Chill Fever Perspiration
As far as possible try to classify each of your symptoms by making a notation according to the following key in brackets next to each entry:
(RS) - RECENT SYMPTOM i.e. a symptom that you are suffering from now, or have been
suffering from in the last year.
(NS) - NEW SYMPTOM.
(OS) - OLD SYMPTOM. State when the symptom occurred previously.
(AS) - ALTERATION in a PRESENT or OLD symptom.
(E.g. used to be left side, now on the right side)
(US) - An UNUSUAL SYMPTOM for you.
Please remember to use red ink for these notations and classify your symptoms accurately. If you have doubts, discuss them with your supervisor.
Mental and emotional symptoms are important, and sometimes difficult to describe, please take special care in noting these. Please give full descriptions of dreams, and in particular note the general feeling or impression the dream left you with. You may also wish to note the phase of the moon if you have symptoms that are affected by it.
Reports from friends and relatives can be very enlightening. Please include these if possible. At the end of the proving please make a general summary of the proving. Note how the proving affected you in general. How has this experience affected your health? Would you do another proving?
Please remember that detailed observation and concise legible recording is crucial to the proving.
“The best opportunity for exercising our sense of observation and to perfect it is by proving medicines ourselves.” (Hahnemann, 1982)
"The person who is proving the medicine must be pre-eminently trustworthy and conscientious... and able to express and describe his sensations in accurate terms," (Hahnemann,1982)
Thank you for participating in this proving. We are sure you will find that there is no better way of understanding and advancing homoeopathy.
Jodi Cahill and Lize de la Rouviere
This appendix has been adapted from
§ Jeremy Sherr’s „The dynamics and methodology of homoeopathic provings’ (Sherr, 1994)
§ Smal and Taylor’s proving of Naja mossambica (Smal,2004); (Taylor,2004)
Proving Information Sheet:
What is a proving?
A homoeopathic drug proving is a study in which people who are in a
relatively good state of health, take a homoeopathically prepared substance in order to observe and record any symptoms that are elicited. These symptoms are then said to form the drug picture for that substance and can be used as a basis for prescription, according to the Law of Similars, when a patient displays a similar symptom picture.
Why participate in a proving?
Provings are vitally important to homoeopathy as they represent the only truly accurate manner in which to ascertain the action of homoeopathic drugs. Hahnemann suggests in the Organon that all homoeopaths should take part in provings because they allow one to gain a practical and experiential understanding of homoeopathic medicines. He also feels that the process of having to accurately record all symptoms that are experienced in the proving can only serve to increase the physician's powers of observation - what he considered to be the physician's greatest and most important tool.
Are there any health risks in participating in a proving?
Homoeopathic drug provings are safe and pose no threat to one's health as the substance used in the proving is given in a diluted and potentised homoeopathic form.
Provings have been conducted for as long as homoeopathy has existed and it is seen in all provings that symptoms that are experienced during the proving are generally mild and exist only temporarily.
In addition to this, all provers are continuously monitored by the researchers throughout the proving process. If at any point a prover experiences symptoms that are causing discomfort these will immediately be treated homoeopathically, free of charge, under the supervision of the Research Supervisor.
What is expected of provers?
There are certain criteria that need to be met in order to enable you to participate in this proving:
§ Must be between the ages of 18 and 60
§ Must be in a relatively good state of health
§ Must be in what is considered, for yourself, to be a general state of good health
§ Must be willing to follow the proper procedures for the duration of the proving
§ Must be able to maintain your normal lifestyle and usual daily routine as closely as possible and have no major lifestyle changes (e.g. moving house, marriage or divorce) planned during the proving period. Any lifestyle changes should take place at least three weeks before commencing with the proving
§ Must not be on or in need of any medication: chemical, homoeopathic or other
§ Must not be pregnant or nursing
§ Must not have had surgery in the previous six weeks
§ Must not have any surgical or medical procedures planned for the duration of the proving period
§ Must not use recreational drugs such as cannabis, LSD or MDMA
§ Any consumption of stimulants (alcohol, coffee, tea, cigarettes) must be in moderation
A total of 30 volunteers, who will be the provers, will be randomly assigned to two groups. One group (80% of the total) will be given the proving substance and the other group (20% of the total) will receive placebo. This will be done in such a manner that neither the provers nor the researches will know who is in which group, and none of the provers will know what the proving substance is.
Provers will first need to record their 'normal' symptoms for one week to establish a baseline of health. You will then be required to take the given substance (or placebo) three times a day for a total of two days. During this time you may experience symptoms which you will be required to record in your proving journal. During the entire proving time the researchers will be in close contact with you to monitor your symptoms. This will be done under the supervision of the Research Supervisor.
If you choose to take part in the proving you will be provided with a detailed list of instructions as to exactly what the proving entails. Here follows the basic sequence of events:
1. You will contact either of the researchers to say that you would like to
participate in the proving and will be asked to meet with the researcher for a pre-proving interview
2. At the pre-proving interview you will be asked to complete the Inclusion Criteria sheet and provided with any information you require about the process. You will be given a date for a pre-proving group meeting.
3. The pre-proving group meeting will be held between all of the provers and both the researchers. This will serve as an informative session where any questions about the proving will be answered and you will be given a complete break down as to what the proving entails
4. At the end of this group meeting you will be asked to arrange a time with a researcher for a 1½ hour consultation and physical examination You will then be asked to sign the informed consent form.
5. At the consultation you will be given your prover code, journal, medication and a starting date will be agreed on
6. On completion of the proving there will be another 1 ½ hour consultation with a researcher.
7. Once all provers have completed the proving there will be another group meeting between provers and researchers to compare individual experiences.
If at any point you decide to withdraw from the proving you are perfectly entitled to do so without having to give any explanation. You may be asked to withdraw from the proving if there is any conflict with the criteria listed above, as these are the criteria that have been set to define the study.
Please be aware that confidentiality will be maintained throughout the proving. On completion of the proving any identifiable data will be removed and destroyed. Proving symptoms that are recorded will only be published using the prover code.
If you have any questions, require information or would like to participate in the proving please contact one of the following people:
Lize de la Rouviere Jodi Cahill
(031) 764 0867 (031) 266 3006
076 160 4199 083 946 6439
Supervisor: Dr Madhu Maharaj
(031) 204 2041
If you have any questions at all please do not hesitate to contact us.
Thank you for your time
Jodi Cahill and Lize de la Rouviere
This Appendix has been adapted from the proving by Smal (2004) and