British Homeopathic Journal (1999) 88, 84±85 ß 1999 Stockton Press All rights reserved 0307±0565/99 $12.00 http://www.stockton-press.co.uk/bhj
SOCIAL AND HISTORICAL
20 years ago The British Homoeopathic Journal, April 1979 ST Land1* 1
8 High Bungay Road, Loddon, Norwich, UK
Problems with symptoms Dr Campbell's editorial makes some rather disturbing observations about dif®culties in the evaluation of symptoms. He said `It is perhaps easy to forget how dif®cult it is to describe symptoms accurately, even for intelligent and articulate people; yet a great deal of homeopathic theory is based on the assumption that it is possible to draw extremely ®ne distinctions between various shades of meaning'. He felt dubious about many of the descriptions in Kent's Repertory, for example, What is a `drawing' pain? What is a `jerking' pain, and how does it differ from a lancinating one? He questioned the frequency of their occurrence. The author pointed out the range of problems produced by the need to translate from the original German; and the inevitable vagueness of much terminology in standard works which rendered the terms unusable. He concluded that a good deal of prescribing must be intuitive rather than rigorously logical; a fact which we should be prepared to admit. Finally, Dr Campbell disputed the frequency of occurrence of individualising symptoms; considering most cases to have little or nothing in the way of useful prescribing features. This led him to speculate that the whole concept of constitutional prescribing might have arisen because of the paucity of individualising symptoms.
Chronic Brucellosis Dr V S Shuttleworth made a thorough and interesting examination of this topic in nine pages. He described the condition (alias undulant fever, Malta fever, Neapolitan fever) as a complex disease, dif®cult to diagnose and very dif®cult to treat. He outlined the history of the disease, with its interesting episodes, from its discovery in 1863 by a Colonel D. Bruce (hence the * Correspondence: Dr Sylvia Land, 8 High Bungay Road, Loddon, Norwich, NR14 6JT, UK.
name) to the eradication schemes of the 1970s. In 1904, a Mediterranean Fever Commission made a detailed, extremely thorough scienti®c survey of the causes, and studied every possible aspect of the disease. There follows a section on epidemiology, which cautions that there is still a large gap in knowledge of the disease, and that proven cases are probably the tip of the iceberg. The section on diagnosis stresses its ability to mimic other conditions (144 different diagnoses in a study of 1500 cases), and the importance of the frequent false negative in serological testing: `What is needed is clinical perception and awareness of the symptom patterns. Sophisticated tests are more often confusing than helpful'. One investigator concluded that `The soundest way . . . seemed to be a thorough clinical examination and disregard of serological ®ndings'. The author commented that it was refreshing to read such a trenchant assertion of basic principles. More than two pages are devoted to the clinical picture. The most prominent is the tubercular trio of tiredness, night sweats and loss of weight; but these are unfortunately not common in long-standing cases, where the diagnosis depends on `an obsessive awareness of other symptoms'. These cover a wide range, including some which are bizarre, for example, skeletal aches which do not ®t the physiological pattern; sudden vomiting on exposure to cold air; insomnia relieved by alcohol (leading to misdiagnosis); a compulsion to sleep while driving; and an impairment of vision which produces dazzle from lights, with confusion and severe anxiety in even young, sporty drivers. Dr Shuttleworth discussed various aspects of treatment; and cited 11 patients which he treated with Hepar sulph (which has a reputation in this disease), followed by Brucella abortus Vaccine 30. Apart from one failure, there was an observable response followed by remission. The remedies seem to contain, but do not cure. He gave case histories for two of them. The most striking feature of this paper is the emphasis on the highly individual response of the
20 years ago S Land
patient. Each has his personal pattern, especially for periodicity, which in itself is diagnostic. This demands treatment which is carefully attuned to the particular needs of each patient.
The Popper debate and the Arnica trials Two letters were received dealing with the ®rst topic. PK Sholapurwala wrote a long and strongly worded letter in defence of ®ndings in clinical homeopathy, psychology and allied disciplines against what he saw as the limitations of Popperism. In his reply, Dr Campbell stressed that modern scientists were increasingly Popperian in their outlook. He stated `Any serious scientist who puts forward a theory today must expect to have to defend it against his colleague's criticism, and the only way he can do this is by making predictions on the basis of his theory and showing that these are ful®lled. Mr Sholapurwala appears to concede that the similimum principle is not testable, but he maintains that it is nonetheless scienti®c. On this point, he and I must agree to differ'. In a third letter, EG McIvor expressed dismay at the negative conclusions drawn from the trials of Arnica 30 and 10M by Drs Savage and Roe,1,2 where only 4 out of the 80 patients had an Arnica picture. He deplored the conclusion which would obviously be drawn by a reader in general medicine. He considered it high time that research on a world-wide basis was organised if homeopathy were to survive. With the much larger numbers involved, it should be possible for the similimum to be employed. At the same time, an in-depth evaluation of the effectiveness of the various remedies might be achieved.
Proving of Kali carb. Dr Trevor Smith carried out a proving of the remedy in London over a period of two months. Nine volunteers
took part in a double blind study: six were given potencies of 6x, 30C and 200C consecutively for a fortnight each, with one week breaks; three were given Sac. lac. tablets. There are four pages of details, with results and discussion. The Sac. lac. volunteers produced marked mental symptoms quickly, but they were short-lived. On the other hand, the provers produced both mental and physical symptoms which were marked, and increased in intensity as the experiment progressed. The picture was largely the same as in previous recordings; but there were certain differences. There is a long and detailed summary of the ®ndings.
Midland Branch Symposium At this symposium, the proportion of new doctors represented 45% of the 70 present. They included a consultant psychiatrist, ®ve GPs with higher degrees, and six trainees. A paediatrician, Dr DM Lewis from Aberystwyth, who described the results of his recent experimentation with homeopathy, was believed to be the ®rst NHS consultant outside the established homeopathic centres to use it. Dr Blackie was presented with a gift in recognition of her inspiration, encouragement and very generous ®nancial support for the group; and much applause greeted the announcement that Dr RAF Jack of Bromsgrove had been elected Fellow of the Faculty in recognition of his services to homeopathy over many years.
References 1 Savage RH, Roe PF. Arnica montana in acute stroke illness. Br Hom J 1977; 66: 207 ± 220. 2 Savage RH, Roe PF. A further double-blind trial to assess the bene®t of Arnica montana in acute stroke illness. Br Hom J 1978; 67: 210 ± 222.