Criteria for symptom-remedy-cure correspondences: a critical approach of clinical verification with examples from dental praxis

Clinical verification in homeopathy is necessary to ameliorate the tools we are working with, in order to obtain cognition based homeopathy. Cognition based homeopathy is depending on experience, experiment and a pool of verified clinical cases.

The ‘Guidelines for clinical verification of homeopathic symptoms’ (Michel Van Wassenhoven 2010,ECH subcommittee Research) ) is en excellent paper about clinical verification and an extended version of the Five Steps of Hering.

Hering’s 5th step to obtain a verified symptom is the clinical verification (at the bedside, with the sick). The first step in clinical verification, before any other steps, is to check the reliability of the symptom-remedy- cure correspondence.

This implies the importance of the reliability of the symptom-remedy- cure correspondence. Is the result after the administration of the remedy always due to this remedy (only)?

Which are important criteria for a reliable symptom-remedy-cure correspondence in general practice in verification of (proving) symptoms? Is it possible to elaborate a checklist, and/or is this desirable? Anyway it’s an important step to avoid too much “wishful thinking” about the effectiveness of a remedy or an intervention and to make fysicians and dentists more aware of this.

The elaboration of criteria to determine the relationship of the treatment (remedy) with the cure is necessary. In medical science, reliability (and verification) can only be measured in levels of probability; a 100% certainty in treatment is only obtainable in specific situations.

How do we distinguish a placebo effect from a real effect?

Combining of technical intervention and homeopathic remedies makes clinical verification in dentistry more complicated, even changes in hygienic behaviour can strongly influence clinical results. Reliability of the remedy-cure correspondence and hence the verification of a homeopathic remedy is only possible if it’s the only therapeutic measure taken.

Even the proposed criteria cannot avoid mistakes in a single case, but a pool of several similar cases can exclude errors in interpretation and renders the reliability more consistent.

In cases where different remedies were used in a consecutive manner in order to have a ‘complete’ cure, it is necessary to take all remedies into consideration (would the 4th remedy have had a result if the first 3 remedies weren’t taken before, or one of them?).

Every remedy can be verified apart on the next consultation after the administration. Alternation of remedies with only short relapses of time makes correspondence and verification troublesome (as is in cross-over provings) and can only be done as a ‘global’ verification as complex remedies can only be verified as a ‘single’ remedy Concerning proving symptoms the verification can be on the level of the single or particular symptom, not necessarily on the totality or several symptoms although this would be preferable.
In case of the administration of a blank or placebo, results can be considered as circumstancial effects. Clinical verification of blanks seems to be a very interesting topic.
Checking these correspondences can afford the therapist a level of probability that the
cure is related to the remedy.

Remedy-Cure Correspondences:

Pre-administration: symptoms lead to the choice of the remedy and the dose

• Totality of the symptoms correspondence: the principle of homeopathic prescribing is the similarity to the totality of the symptoms. What is this totality? In acute prescribing do we consider lifetime symptoms? Different kinds and levels of similarity are possible. Considering only totality is quite complicated

• Etiological correspondence: cause-remedy relationship Relation etiology and the chosen remedy: trauma, coldness, warmth, moist , food, emotions…
E.g. Hypericum in trauma of nervous tissue, Bellis perennis in cases of pathology
arising after sudden cooling down after being heated.

• Seat of action correspondence: local affinity of the remedy A remedy can have local affinities (tissue, organ…), known from toxicology, phytotherapy, clinical experience and provings.
Rademacherian organopathy is strongly included in homeopathy.
E.g Hekla lava is a remedy with affinity to bony structures, especially the jaws, and proves to be an important remedy in its pathology.

• Kind of action correspondence: how is the remedy acting Known physiopathological action of the remedy: causes inflammation, irritation, paralysis, ulceration… .
The physiopathological action can be observed in toxicology, which provides the ‘raw’ material and by provings, which give more refined symptoms.
E.g. Cantharis causes irritation of the bladder. One can verify if this specific irritation is cured by Cantharis if the remedy is prescribed on these premises.
This includes also the evolution of the pathology/symptoms, which can be expected (e.g. inflammation leading to ulceration)

• Therapeutic idea correspondence:
Treatment planning according a therapeutic theory (e.g.similarity), methodology or strategy. This has to be stated before the treatment or intake of the remedy.Therapeutic idea: e.g. a nosode is necessary to cope with hereditary problems.
Preventive measures: e.g. Belladonna is a preventive for scarlatina.
Use of signs leading to the remedy which is effective: morphologic constitution. Range of action: a remedy has a ‘stop spot’ and a pathology beyond the range of action of a remedy can not sufficiently cured by it.

Dose- effect correspondence: results depending on dose The effect is only obtained by a specific dose or potency (in a specific case:
patient and symptoms): e.g. organic problems need a low potency and a frequent intake.

Post administration/ check:

• Time related correspondences:
1. Promptness of the result in relation to the normal evolution of the illness or the symptoms (time and space): in acute diseases the effect has to be prompt and in the increasing phase. In the decreasing phase effects are more dubious. The normal evolution and duration of the illness/symptoms has to be taken in consideration.

2. Before and after relationship: relation between duration of illness/symptoms and intake-effect: a symptom or illness of long standing, e.g. several years, disappears in short time, a few days or weeks. In this category also, so called, incurable diseases with no spontanuous healing to be expected.

3. Moment of intake and normal evolution: increasing and decreasing phase of
illness (see above).

4. Administration of remedy and result correspondence: intermittent administration of the remedy: every dose is followed by a comparable result.

5. Duration of the result/effect: follow-up of long enough duration depending on
symptoms and pathology.

6. Periodicity/alternation of symptoms: short, long intervals

• Lifestyle and environment correspondence: effects of changes in lifestyle and environment.
Changes in lifestyle and diet, strong emotional events, even climatic changes can be troublesome for reliability and verification. They have to be taken in consideration.

• Biochemical correspondence and clinical results.
E.g. Laboratory tests return to normal X-ray’s show amelioration…

• Level of amelioration correspondence.
Amelioration, disappeared, change in appearance… Emotional, mental, fysiological, leasional

• Level of cure correspondence.
Total cure, partial cure, single symptom cured, general wellbeing, intellectual and emotional changes…

Cheirantus cheiri:

This small remedy, not well known in homeopathic world, has not been proved yet.
In my experience, while I prescribed it for about 360 times during the last 30 years, it was beneficent in almost every case of ailments from cutting ( or eruption of) wisdom teeth in the acute phase. Pain disappeared or was greatly improved in most cases in less than two days.

Concomitant symptoms as nose obstruction, ear and hearing ailments, rendered the results more confident after one or two intakes of the remedy.
In cases of obstruction to the erupting wisdom tooth, a mineral remedy was needed (often calc carb, sil.) or the surgical extraction of the tooth.
Nevertheless many cases (about 50%) are less valuable because I complemented Cheirantus with a local phytotherapeuthic remedy when there was swelling, redness and painfulness of the gingiva in order to have a faster alleviation of these ailments (Plantago, Echinacea, Calendula).
Laterality seems of no importance
In Synthesis are only few rubrics with Cheirantus. This includes this remedy will be seldom or not at all found in a general repertorisation, but only if based on locals (wisdom teeth).
Rubrics in fat are clinically verified in practice.

MIND – IRRITABILITY (common during problematic eruption of wisdom teeth)
EAR – DISCHARGES
EAR – DISCHARGES – left
HEARING – IMPAIRED ( in 6-7%)
HEARING – IMPAIRED – measles, after
HEARING – LOST
HEARING – LOST – wisdom teeth, from cutting
NOSE – OBSTRUCTION – night (in 21-22%)
FACE – DISCOLORATION – yellow
TEETH – DENTITION – difficult
TEETH – DENTITION – difficult – Wisdom teeth (leading to prescription in almost all cases)
TEETH – WISDOM teeth, ailments from eruption of (id.)
STOMACH – COMPLAINTS of the stomach
BACK – PAIN – Lumbar region

Pain can come and go very swiftly in these cases, but clinical investigation in loco rendered the correspondence remedy-result more sure.

….

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References:
F. SCHROYENS, Radar/Synthesis, Encyclopedia Homeopathica (EH):
B. VONARBURG, Homoötanik, Haug Verlag 1996
J. C. BURNETT? Curability of tumors, Jain Publishers
C. HERING Guiding Symptoms of our Materia Medica, Vol.1, preface. B. Jain
Publishers: New Delhi(1974).
H. KIENE, Komplementäre Methodenlehre der klinischen Forschung, Springer Verlag,
2001
MICHEL VAN WASSENHOVEN,ECH SUBCOMMITTEE RESEARCH, Guidlines Clinical
verification of homeopathic symtoms, 2010.


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