Notes on Provings and the Clinical use of Remedies

"Medicine is a science of experience: its object is to eradicate diseases by means of remedies." (Hahnemann, 1806, 726)

This essay explores and distinguishes between the effects of remedies on healthy people in provings and those effects that arise when the remedy is given to the sick person. It should be borne in mind by the reader that the points given here largely derive from my own observations made during personal use of remedies over a thirty year period, plus reflections about them, and thus my comments might not accord exactly with the experiences of other homeopaths. However, I would hope that they prove useful and insightful to others. The essay begins with a consideration of Hahnemann’s habitual reference to the word ‘experience,’ and what it meant to him, and closes with some thoughts about the concept of the vital force and how that helps us to grasp more clearly the often confusing clinical effects of our remedies.

Hahnemann and Experience

By way of introduction, it is worth considering Hahnemann’s attitude to experience, a word he uses very often indeed. It is a well-known fact that Hahnemann condemned almost every medical practice of his day: he was undoubtedly "a physician at war with the medical practices of his time." (Brieger, 241) He repeatedly unleashed the most vitriolic, "uncontrolled and abusive attacks on contemporary medicine," (Cook, 105) such as calling it the "most senseless mode of treatment…[and a] mischievous so-called art," (Organon, xxix) or "a pernicious practice," (Organon, xxix) or "an infinite kingdom of fantasy and of arbitrary assumptions, the parent of disastrous delusion and of absolute nothingness." (Ameke, 134) And those are some of his milder comments! It is easy to dismiss these numerous criticisms as flowing from some profound bitterness on his part and thus of not being rational or worthy of any serious consideration. However, the opinions he states seem to emanate from one thing: experience of using something and this provides a very useful insight into the man. Everything he says about any medical technique is rooted in his own use of it—and usually nothing more—no matter how logical it might seem, if it doesn't work for him then it is castigated and condemned by him as useless. This is an important aspect about him, and in 1806 he even wrote a long and important essay about medicine and experience, which is widely regarded as the forerunner of the Organon.

From this perspective we can begin to discern the genuine empirical roots of homeopathy in what he calls experience; when he condemns any and every medical practice of his day, he does so because he has used it personally and found it to be useless, dangerous or unreliable, palliative, uncurative or suppressive. Incredibly, what others dismissed as his wild impassioned rants, might also be viewed as accurate statements spoken from the heart reflecting one man’s struggle to utilise what he eventually realised were doomed and useless methods that could never cure anyone of anything. Either way, the word ‘experience’ meant much more for Hahnemann than any casual reading of his works might lead us to suppose.

And then we must consider very carefully exactly what he meant in his use of the term ‘experience,’ so we might more fully appreciate the methods and ideas that had led him to the discovery of homeopathy. What he meant by experience is the art of using something regardless of its theoretical merits or demerits. Of everything he asks one important question: does it work? In his view, if something works then it is useful and should be kept, even if we do not understand how or why it works. This perspective on Hahnemann is not new, it is not simply my own view, it is demonstrably what he thought and said himself, and is also the same evaluation that many others have made:

"The true healing art is in its nature a pure science of experience, and can and must rest upon clear facts and on the sensible phenomena pertaining to their sphere of action.' and that it '...dares not take a single step out of the sphere of pure, well-observed experience and experiment, if it would avoid becoming a nullity, a farce." (Preface to 2nd Organon, xiv)

Like William Harvey before him, Hahnemann professed to learn "not from books…not from the tenets of Philosophers, but from the fabric of Nature." (Porter, 215) In his construction of homeopathy, Hahnemann gives "pure experiment, careful observation and accurate experience alone," (Gumpert, 144) as the sole determining factors, the sole forces that shaped his new system. Hahnemann "was committed with all his mind to the observational method...he rejected in its entirety the clap-trap of medieval traditions and he made out an eloquent case for the pharmacological experimental method." (Cameron, 32) He exhorts that "facts and experience must be at the root of all revelations of truth." (Ameke, 134) What Hahnemann terms "experience is equivalent to investigation; 'sciences of experience' are the same as what are now called the 'inductive sciences'...or 'empiricism'..." (Ameke, 133) This refers to where Hahnemann says things like "true medicine is from its very nature a pure science of experience," (Ameke, 134) that medicine "should rest only upon pure facts," (Ameke, 134) and that medicine should be rooted in "pure experience and observation...and not venture a single step beyond the sphere of pure, carefully observed experience and experiment." (Ameke, 134)

Clearly, "in all these discoveries Hahnemann was guided by experience, to which he trusted solely." (Dudgeon, 49-50) He relied upon, “pure experience, the sole and infallible oracle of the healing art, teaches us.” (Organon, §25) His views were “based only on accurate observation of nature, on careful experimentation and pure experience,” (Organon, §52) which “pure experiment, careful observation, and accurate experience can alone determine.” (Organon, §278)

This arguably also shows that homeopathy is not by any measure a theoretical system of medicine, as is claimed by some of its critics, but in fact has definite empirical roots; yet of course Hahnemann’s empirical impulse was also strongly supplemented with and guided by theoretical concerns. By around 1784, soon after his move to Dresden, Hahnemann gave up the practice of medicine, (Bradford, 37; Haehl vol. 1, 267-8) and "devoted himself entirely to chemistry and writing, according to his own admission." (Haehl, vol. 1, p.268) He had abandoned medicine for practical reasons, it is true, but equally he still wanted to know why and how it didn't work and if it might be possible to devise, construct or discover an effective and curative medical system. Thus, he had both theoretical as well as practical concerns in mind. However, it remains baldly true: homeopathy arose almost completely as a product of his empirical, practical and experimental studies and investigations; it did not spring from any theory. This point seems incontestably true.

Notes on Provings and Clinical use of Remedies

"This spirit-like power to alter man’s state of health (and hence to cure diseases)...lies hidden in the inner nature of medicines." (Organon, §20)

The effect of remedies on the healthy subject—exploration of their health-deranging power—is what the proving is all about. It also forms an excellent exemplar of Hahnemann’s method of proceeding in his investigations by pure experience, by following his intuition and the breaking of new ground in the pursuit of new medical truths through a solely theory-free experimental method. Hahnemann rejected the authorised allopathic "Materia Medica based on conjectures and compound prescriptions," (Organon, §54) and sought through experience guided by principle, to create a new materia medica founded on the bedrock of pure symptoms induced in healthy persons by administering measured doses of a potentised drug under carefully regulated conditions; in other words, via proving drugs on the healthy. Though certainly inspired by the crude poisonings of old, the proving is more refined, rendered less dangerous and less crude and hence more subtle and detailed by employing smaller doses and a group of provers instead of a single individual:

“medicinal substances, when taken in their crude state by the experimenter for the purpose of testing their peculiar effects, do not exhibit nearly the full amount of the powers that lie hidden in them which they do when they are taken for the same object in high dilutions potentised by proper trituration and succussion…we now find it best to investigate the medicinal powers…[by giving] to the experimenter, on an empty stomach, daily from four to six very small globules of the thirtieth potentised dilution of such a substance, moistened with a little water, and let him continue this for several days.” (Organon, §128)

The effect of drugs on the sick is another subject in itself and is inherently more complex because, unlike the symptom-free healthy person, sick persons have active symptoms already. This difference is very important when we attempt to assess the effects of drugs in sickness as compared to the relative simplicity of observing drug effects on the healthy subject. How can one discern what the drug alone is doing amongst the dynamic chaos of already presenting symptoms? It must have been a realisation of this kind that led Hahnemann to insist that good, true and pure provings can only be satisfactorily undertaken on the healthy subject.

Provings, drugs and the healthy person

“all persons are not effected by a medicine in an equally great degree; on the contrary, there is a vast variety in this respect, so that sometimes an apparently weak individual may by scarcely at all affected by moderate doses of a medicine known to be of a powerful character, while he is strongly enough acted on by others of a much weaker kind. And, on the other hand, there are very robust persons who experience very considerable morbid symptoms from an apparently mild medicine, and only slighter symptoms from stronger drugs.” (Organon, §129)

·   whether in crude dose or in potency, a remedy will affect the healthy individual by creating symptoms, or not at all and changing nothing, each according to their sensitivity; while some effects are crude and very noticeable, others are very subtle

·   an ingested remedy will generally create many symptoms in a group of provers, and especially in those individuals who are highly sensitive once ingestion of the remedy is ceased then the symptoms will tend naturally to subside, fade and disappear completely

·   after terminating the proving a minority of provers do continue to experience some symptoms for weeks or months, while others don't have this type of experience at all, their symptoms fading fast and disappearing totally quite quickly

·   a tiny minority of highly sensitive provers can experience symptoms for weeks or months after terminating the remedy and an extreme minority can have symptoms permanently grafted onto their constitution from a proving, even after the use of antidotes to nullify such intense effects.

·   some homeopaths claim that proving remedies somehow strengthens the constitution and so improves health; perhaps using remedies stimulates and strengthens “the invisible vital processes?” (Organon, Preface to the 5th Edition)

·   the precise symptoms a remedy creates varies a good deal from person to person, but when all the symptoms are collated clear patterns tend to emerge and the overall image of the drug's 'sphere of action' (drug picture) can then be clarified and compiled

·   the ability to create symptoms is dependent not just upon the relative power, strength or toxicity of the remedy but also on the idiosyncrasies of the individual provers, such that it is impossible to predict who will be most sensitive to a certain drug and who will not, who will experience this symptom and who will not... the proving symptoms thus arise from the interaction of the drug with the ever varying nature of human constitutions

·   the symptoms created tend to be either entirely new to that person or similar to symptoms they have experienced before in the past

Clinical use of remedies

"it follows that when medicines act as remedies, they can only bring their curative property into play by means of this their power of altering man’s state of health by the production of peculiar symptoms; and that, therefore, we have only to rely on the morbid phenomena which the medicines produce in the healthy body as the sole possible revelation of their in-dwelling curative power, in order to learn what disease-producing power, and at the same time what disease-curing power, each individual medicine possesses." [Organon, § 21]

"That this derangement of the state of health, which we term disease, can only be converted into health by another revolution effected in the state of health by means of medicines, whose sole curative power, consequently, can only consist in altering man’s state of health - that is to say, in a peculiar excitation of morbid symptoms, and is learned with most distinctness and purity by testing them on the healthy body." (Organon, §70)

·   in truth, the sick person is in an entirely different position or situation from the healthy person; they are in a state of impaired health, suffering, dependency and disempowerment, enslaved, restricted, inconvenienced and incapacitated by their burden of symptoms and more or less susceptible to remedies; their case is also dynamic and changing through time as symptoms come and go or shift around. The sick person lacks freedom: "to establish freedom should be the aim of the physician, and if a physician's work does not result in placing his patient in freedom he cannot heal the sick." (Kent, 79)  Kent insisted that cure should: "leave the patient in freedom always." (Kent, 160-1)

·   it seems possible that the sick person is more susceptible to remedies than the healthy person? They are however very susceptible to ONE remedy in particular: their similimum!

·   the effects of a remedy on a sick person are far less predictable than its effects on a healthy person; this may be because their vital powers seem dulled in power and their energies already focused on their sickness, rather than on responding so sharply to the effects of remedies?

·   one imagines that because of the dynamic nature of sickness so the energies of the vital force are less available to receive the health-changing impressions of a drug and so only the similimum is capable of strongly influencing the health of a sick person.

·   in sick persons the effects of a remedy are even harder to predict, much depends chiefly upon the constitution of the person, and the overall similarity (or dissimilarity) of the remedy to the symptom picture of the person.

·   if the remedy is the wrong one it tends to accentuate the presenting symptoms and appears to make the symptoms worse, but in truth they just seem to stand out more sharply defined than before

·   if the well-chosen remedy is close to the similimum then it can induce a mixed response, suppressing some symptoms and palliating or curing others, while simultaneously leaving others unchanged; missing the mark, its power fades and any curative reaction tends to be patchy & short-lived

·   if the remedy is a close fit to the case totality then one usually expects a good reaction, a curative response, that is an improvement of all or most symptoms and a generally improved sense of well-being.

·   sometimes the remedy is not a close fit to the current superficial symptom picture, but does correspond to some deeper constitutional ones (or ones from the past) in which case it may create a 'splurge response' in which some symptoms improve while others remain unchanged, or in which some improve and some worsen. This might appear like a change of the case.

·   some more complicated constitutions, who have a long history of illness (and usually of allopathic drugging), may partially resemble two or more remedies and it will be hard to decide which remedy fits such a case the best. In such individuals any remedy given will tend to generate a mixed reaction, which contains some good and some bad responses

·   the principal medical value of a remedy lies not in the symptoms it can induce in the healthy person, but in the symptoms it can remove in the sick person; however, what Hahnemann was among the first to realise and demonstrate, the one is strongly connected to the other and forms the deeper basis of the true law of healing through similars, a principle which rests at the very root of homeopathy and which forms its absolute foundation, though it had been noticed prior to Hahnemann: "Within the infant rind of this small flower poison hath residence, and medicine power." (Shakespeare)

·   the activity of the vital force is different in a sick person from the levels of activity found in a healthy person, not necessarily more or less but certainly different.

·   regarding a case of longstanding pathology, it will be harder to cure and often hard to bring under the influence of remedies at all; it is also almost uniquely hard to predict what the effects of the remedy will be in such cases. The changes induced in such cases by a remedy are often very hard to interpret intelligently or to clarify what the remedy is doing and if things are progressing in a curative manner or not; it is also correspondingly frustrating and very time-consuming to treat such cases; they demand a maximum input from the homeopath of patience, skilled observation and deep reflection

·   The effects of the remedy on the sick person might be likened to having four different plays all being played on the same stage by different actors and using different scripts. Why is this? The effect of the remedy creates four overlapping images which the homeopath must monitor, scrutinise and interpret. Firstly, come the symptoms of the original presenting malady, some symptoms of which will usually linger on even after the remedy is given. Next come symptoms of a partial proving, which belong uniquely to the remedy given, but which were not present before. Thirdly, come symptoms from deeper down in the case stirred up by the reactions of the vital force, perhaps from the past and manifesting, as Hering stated, as ‘the return of old symptoms.’ Finally, there are probably some entirely new symptoms which belong to none of the above. These might indicate the next remedy that is coming up in the case, as if from a different layer in the case. The crucial task of the homeopath, once a well-chosen remedy has been given, is to observe and intelligently understand (make sense of) these manifold changes in the case. And that is not an easy task.

·               Somewhat surprisingly, the above changes to the case will tend to occur regardless of which remedy is given. If the right remedy is given then some partial proving symptoms might accompany some cured symptoms disappearing alongside some new symptoms coming to the surface. If the wrong remedy is given, then most of the four above changes will occur and then the case will revert back to the original presenting symptoms unchanged by the remedy given.

Vital Force

What Hahnemann realised from his clinical use of remedies and proposed as true, was that all sickness symptoms that we observe are products of an interaction between 'something' and the innate vital powers of the organism. In this scenario, the symptoms induced if the 'something' is a drug in a proving are essentially little different from the symptoms of a natural sickness, where the 'something' is an imputed miasm. In both cases, the flow of symptoms into the organism—the psychophysical totality—derives solely from the impact of the drug or miasm upon the vital force,   or what he termed: “the spiritual nature of life, and the spiritual dynamic power of the exciting causes of diseases." [Organon, p.9]

An interesting corollary of this position, therefore, is that no symptoms can manifest in the body or mind except via the vital force. Arguably this is precisely what he meant here: “the diseases of man are not caused by any substance, any acridity, that is to say, any disease-matter, but that they are solely spirit-like (dynamic) derangements of the spirit-like power (the vital force) that animates the human body,” (Organon, Preface to the 5th edition) here: “The affection of the diseased vital force and the disease-symptoms thereby produced constitute an inseparable whole they are one and the same,” (Organon, §15) and here: “It is only by the spiritual influences of morbific noxae that our spirit-like vital force can become ill; and in like manner, only by the spirit-like (dynamic) operation of medicines that it can be again restored to health.” (Organon, §16) And even here: “the morbidly affected vital force is the producer of the visible disease!” (Organon, Introduction) Or again here: “it is only the vital force, deranged to such an abnormal state, that can furnish the organism with its disagreeable sensations, and incline it to the irregular processes which we call disease.” (Organon, §11) “It is the morbidly affected vital energy alone that produces disease.” (Organon, §12, 6th edition) I have added the emphasis to reveal the strong and precisely-chosen insistence of Hahnemann’s words.

Because the vital force is both similar and different in each person, so the precise range of symptoms induced by the same drug or miasm will vary from person to person and show many idiosyncratic and individual differences as well as some broad underlying similarities. The key point, however, is that symptoms are always effects or products and never causes of themselves; Hahnemann clearly proposes that they flow from hidden causes such as a drug or a miasm; they can best be depicted as emanations of the activity of the vital powers as much if not more than emanations purely from the miasm/drug. In this way they are hybrid effects flowing from a combination of causes—the drug or miasm and its interaction with the vital powers. What this means for our understanding is that the vital force seems to act as a funnel or filter through which the symptoms have to pass to gain entry onto the 'stage' or arena of the body and mind. It can also be said to act like a mirror that deflects the energy of the miasm/drug onto the stage of the body and mind, such that the 'play' taking place on that stage does not derive solely from the drug or miasm, nor purely from the vital force, but it is more realistically a product of both. This would seem to be a useful depiction of what we might term 'homeopathic physiology.' It also illuminates a sentiment of Hahnemann when he said: "Every agent that acts upon the vitality, every medicine, deranges more or less the vital force, and causes a certain alteration in the health of the individual for a longer or a shorter period." (Organon, §63) And further:

"In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence." (Organon, §9)

Once we appreciate Hahnemann’s emphatic rejection of all materialist notions of sickness cause, and his emplacement of the vital force at the core of the conceptual fabric of homeopathy, maybe then we can begin to see how crucial the concept was in terms of explaining the actions of remedies and the formation of sickness symptoms.

The importance of all this seems especially clear when we consider giving a drug to an already sick person, where its effects are so complex and hard to predict. Two health-deranging ‘things’ are now vying for the attention of the vital force and it mirrors onto the stage of mind and body two different energies at play, one coming from the miasm or natural sickness and another coming from the drug energy. This creates a confusing situation. We have little way of knowing which symptoms derive from the natural illness and which derive from the drug. The vital force merely continues to reflect onto the stage whatever causes impact upon it, regardless of which causative factor it might be, be it drug or miasm. This confusing picture settles down into a more harmonious and steady state only when the drug and miasm images are the same and when the two symptom-causing energies blend into one, so neutralising each other. Such are true cures induced by the similimum, or "cures without much disturbance." (Organon, §154) By contrast, whenever the two energies are in discord so the vital force will continue to reflect these discordant energies and the case will remain in a confused state.

"It is undeniably shown by all experience that the living organism is much more disposed and has a greater liability to be acted on, and to have its health deranged by medicinal powers, than by morbific noxious agents and infectious miasms, or, in order words, that the morbific noxious agents possess a power of morbidly deranging man’s health that is subordinate and conditional, often very conditional; whilst medicinal agents have an absolute unconditional power, greatly superior to the former." (Organon, §33)

The web of symptoms that we see in a sick person who has taken a remedy is confusing and the precise ''play, actors and narrative'' being displayed derives partly from the miasm or natural sickness as cause #1, and partly from the effects of the drug as cause #2. It is confusing as if two different plays are being presented on the same stage at the same time. Only when the similimum is given will the same play, actors and narrative be played out on the same stage, and in that case they cancel each other out perfectly, or “a rapid and perfect cure,” (Organon, Introduction): “rapid, gentle and permanent restoration of the health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily comprehensible principles.” (Organon, §2) And as Hahnemann further noted, the concept of true, gentle, permanent cure only really comes to life within the notion of a vital force: "a cure can only take place by the reaction of the vital force against the rightly chosen remedy that has been ingested, and that the cure will be certain and rapid in proportion to the strength with which the vital force still prevails in the patient." (Organon, Preface to 5th Edition)


Wilhelm Ameke, History of Homoeopathy: Its Origins, its Conflicts, with a note on University Medicine, (translated by Alfred E. Drysdale, edited by Robert E. Dudgeon), London: E Gould & Sons, 1885

Thomas L Bradford, The Life and Letters of Hahnemann, Philadelphia: Boericke & Tafel, 1895

Johanna Brieger, Methodological Obstacles In Homeopathic Research, Brit Homeo Jnl 50, 1961, 239-45

Charles S Cameron, Homeopathy in Retrospect, Trans. Stud. Coll. Phys. Philadelphia., 27, 1959, 28-33

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Martin Gumpert, Samuel Hahnemann: The Adventurous Career of a Medical Rebel, New York: Fischer, 1945

Richard Haehl, Samuel Hahnemann - His Life and Works, 2 vols., 1922               

Samuel Hahnemann, The Medicine of Experience (1806), reprinted in The Monthly Homoeopathic Review, London, (issues 16.2:46, 17.2:49 and 18.2:52), 1857-8, pp.721-733, pp.769-784 and pp.817-832

Samuel Hahnemann, The Organon of Medicine, combined 5th/6th Edition, Translated by R.E. Dudgeon, and edited by William Boericke, c.1893

James T Kent, Lectures on Homeopathic Philosophy, California: N Atlantic Books, 1900, (1980 reprint)

Roy Porter, For the Benefit of All Mankind - a Medical History of Humanity, New York: Norton, 1998

William Shakespeare, Romeo & Juliet, Act 2, Scene 3, 1596



Wilhelm Ameke, History of Homoeopathy: Its Origins, its Conflicts, with a note on University Medicine, (translated by A. Drysdale, edited by R E Dudgeon), London: E Gould & Sons, 1885

Johanna Brieger, Methodological Obstacles In Homeopathic Research, Brit Homeo Jnl 50, 1961, 239-45

Charles S Cameron, Homeopathy in Retrospect, Trans. Stud. Coll. Phys. Philadelphia., 27, 1959, 28-33

Robert E Dudgeon, Lectures On The Theory And Practice Of Homeopathy, Jain 1978 Edition, India, 1853

Martin Gumpert, Samuel Hahnemann: The Adventurous Career of a Medical Rebel, Fischer, New York, 1945

Samuel Hahnemann, The Medicine of Experience (1806), The Monthly Homoeopathic Review, London, 1857-8, 16.2:46, 17.2:49 and 18.2:52, pp721-733, 769-784 and 817-832

Roy Porter, For the Benefit of All Mankind - a Medical History of Humanity, Norton, New York, 1998