T H E B R I T I S H H O M ( E O P A T H I C J O U R : N A L 211

PROVINGS AND LABORATORY TESTS

DEAR SIR,--Is it the case tha t subjective symptoms always precede observable pathological tissue change ?

Is it advisable to push provings to the point of producing observable: pathological tissue change ?

Is it possible to ascertain at what point, or degree of damage, induced tissue changes or disordered metabolism become irreversible or irremediable ?

I t is obviously essential to avoid the risk of inducing either pe rmanen t functional disorder or irreparable structural damage.

Can this be guaranteed if provings are pushed to the point of producing observable pathological effects as revealed by laboratory tests on k idney function, blood chemistry, h~emopoiesis, basal metabolism and the like ?

These are questions which it is difficult not to ask. Moreover, such effects as are revealed by the performance of laboratory tests are likely to be in the category of " common symptoms " and, therefore, not of high value in remedy selection.

The chief usefulness of " planned provings " is to enhance the accuracy of " symptom-matching " and remedy selection. I t is stressed tha t for this purpose " common symptoms ", i.e. those resulting from crude pathological changes, are of very low value. I t is the mental and emotional factors in the case, the prominent personal and peeuhar features of the total symptom picture, that count and rank high in prescribing value. These are for the most part clinical and subjective.

Pathological findings are, of course, essential when at tempting to a r r ive at a diagnosis, but there is no getting away from the plain t ruth tha t diagnosis, even when arrived at, is often provisional and, regarded f rom the angle of understanding the disease state of the body-as-a-whole, inadequate. In other words pathological findings, though of interest in tracking down the cause and nature of the disease state, are of minor value in the selection of the homoeo- pathically similar remedy.

Information as to pathological changes in the tissues in connection with reactions of the body to individual drugs or substances may be obtained by " accidental provings ". These may be therapeutic, or pharmacological, or toxicological in nature ; they provide valuable data concerning the effects of various foreign substances when introduced into the body.

But the value of " planned provings " is, surely, the observation and recording of subjective or clinical effects corresponding to the symptoms of incipient disease at a stage before much in the way of observable pathological change has OCCUlTed.

One would feel, therefore, tha t weight should be given to the observation by Dr. Templeton in his recent address at Glasgow on the subject of provings tha t " our limited experience does prove that most is to be expected from symptoms as opposed to laboratorial examination ". The considerable t ime and expense involved in carrying out laboratory tests and control tests may produce only evidence which is in the c'ategory of " common symptoms " and, as such, is of little value in assessing the case from the point of view of homceo- pathic prescribing.

Assuredly one wants to know what is going on in the body, both in health and disease, but present methods and tests leave much to be surmised especially in the realm of invisible, perhaps non-visualizable, bio-physical reactions. The most valuable evidence, therefore, to be obtained by " planned provings " is probably tha t obtained by careful recording of clinical reactions rather than t h a t provided by routine laboratory tests. These, if carried out, might serve two purposes : one, to safeguard the " prover ", and the other, to provide informa- tion on " tissue affinities ", but as an aid to prescribing they would probably be disappointing. 1). M. GIBSON.