A Supplement to Clarke's Dictionary of Practical Materia Medica
by Peter David Fraser
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Homopathy has a great affinity to the Phoenix. It has a tendency in time to become tired and grubby; but it also has the ability to rise clean and strong from its own ashes. Its current incarnation of well over thirty years, has had two distinct stages.
The first which owes much of its strength and success to George Vithoulkas was a reclaiming of the homopathic history and tradition. Most obviously this was through a new understanding of the Organon and particularly its Kentian interpretation. Less obvious but equally important was the rediscovery of in depth materia medica and a holistic understanding of the patient and the remedy pictures. Again Kent's Lectures were central to this but the work that was perhaps most useful was Clarke's Dictionary of Materia Medica.
The second stage was one of innovation in the understanding both of case taking and materia medica. The materia medica has been expanded partly through new ways of extrapolating the properties of known remedies onto unknown or barely known remedies through an understanding of the periodic table and botanical and zoological relationships; but more important has been the return to the proving of remedies by healthy volunteers.
There has been an enormous variety in the type and quality of provings, from the most carefully conducted Hahnemannian proving to the sketchiest dream and meditative provings. It should be remembered that the traditional materia medica grew out of information of extremely variable quality, and some of the most used remedies have never been adequately proved. These provings have also given rise to debates on methodology and to new understandings of group dynamics. What Clarke called "pandering to the allopaths" has resulted in the anomalous and often counterproductive use of concepts such as double blinding and particularly of placebo. In spite of this in what has been barely more than a decade since the first important new provings were published there have been provings of several hundred new remedies, many of them of the highest quality. Whole new groups of remedies have been discovered and many of them are proving to be of great importance. A notable example is the birds. Birds were completely unknown as remedies until well into the final decade of the last century yet we now have several dozen remedies which are showing themselves to be of great clinical importance.
With so many new remedies to study on top of the new ideas and new approaches and the enormous traditional materia medica, the very thought of keeping abreast of the state of modern homopathy becomes a daunting one. Many homopaths are not confident in their ability to understand published provings, especially if they are large ones. The collator of provings has to tread a fine path in order to not over-interpret or leave things out and still make the proving readable and intelligible. However, as a form of research the primary objective must always be to record the information and ease of understanding must be secondary. There is therefore a need for a work that does simplify but still manages to convey the important characteristic features of the new remedies.
Clarke's Dictionary, though now in its second century, is still the ideal model for a work of materia medica. It is certainly the title I would select if I was only allowed one work with which to conduct my homopathic practice. The reason that the work is so useful and has stood the test of time so well is Clarke's clear approach "Homopathy is from first to last an art of individualising. We have to individualise patients, and individualise remedies." Though he was the author of the Prescriber and the Clinical Repertory, these works are useful because they come from a person who knew that "However convenient it is to think of remedies in connection with the diseases in the treatment of which they are most frequently called for, it must never be forgotten that this is a convenience and nothing more. To allow our conception of our remedies to be limited by any list of nosological terms is to accept again the mental fetters of old-school therapeutics."
It is therefore without any hesitation that I turn to Clarke for both the structure and the approach in presenting the new remedies.
There are several factors in working with the new remedies that are significantly different than they were for Clarke working with the traditional remedies and these require that this work have a certain change in emphasis.
Over the last century mind symptoms and particularly the symptoms coming out of dreams and imagery have been seen as much more important while physical symptoms are more likely to be neglected. Some provings have concentrated almost entirely on the mental aspect of the remedy's picture and even in some of those provings conducted in a classical manner there appears to be an under-recording or under-reporting of physical symptoms. Physical symptoms are further from the essence of the remedy or a patient and so are less directly connected to it. Mental or image symptoms are closer to that essence and so more directly representative of it. However, they are further from the physical reality and so more open to speculation and misinterpretation. Just as in understanding a case the physical and the mental symptoms illuminate each other and so reveal the essential truth so it is difficult to understand a remedy without both aspects of its nature. In some modern remedies we therefore have a primarily mental picture; whereas in Clarke's Dictionary there were many remedies with a purely physical picture.
We have a much smaller body of clinical experience with these remedies. In some way this is a catch 22 situation since we don't have as many clinical cases because the information on the remedies is not widely available. It therefore seems sensible to go with what we have and to add more clinical data in the future.
Without clinical confirmation it is very hard to grade the value of symptoms and so it is doubly important to follow Clarke in not grading symptoms. "It will possibly be remarked that I have seldom indicated the relative importance of symptoms by difference of type. My reason is this: while not denying the utility of emphasising by conspicuous type symptoms of proved characteristic value, this can only be done at the cost of apparently depreciating symptoms not so marked. I have so often found my indications in symptoms not distinguished by special type at all, that I hesitate to put any under this ban."
With less clinical experience we also have less knowledge of the clinical relationship of remedies and this section will often be less detailed. We do, however, have a more detailed understanding of the relationships arising out botanical, zoological or chemical similarities. These connections were important to Clarke and his Repertory of Natural Relationships in the Clinical Repertory was perhaps the first major venture into this area. It is therefore quite appropriate to include alongside the entries for individual remedies entries for groups or families of remedies which outline the feature that appear to be common to the group and the features that individualise the various members of the group.
The range of authorities used by Clarke was much smaller, mainly because the bulk of the proving information had already been collected by Hering, Allen and Hughes. The information on the provings of the last few decades are scattered through a a vast number of works that are to be found in a vast variety of printed and electronic media. It is therefore more important that the sources of information used are carefully listed.
Finally the developments in publishing media through the Twentieth Century allow a more interactive approach. The descriptions for each remedy will be published on the internet first and I would welcome comment and reports of clinical experience from the world wide homopathic community so each entry can be updated and clarified before it is put into a more permanent form.