The Prover and the Repertoriser

Abstract: As a result of the many new provings that have been introduced over the last few years, problems in the conversion of provings into repertory language have become increasingly apparent. In this article, some of these difficulties have been highlighted, and several solutions have been proposed. The following points will be discussed-

1. New provings are over-represented in the repertories.
2. Master provers often do not have the necessary expertise for repertorising their provings.
3. Professional repertory editors do not have the resources to understand what should be included from each particular proving.
4. There are several common mistakes in repertorisation.
5. There is a backlog of new provings waiting to be included in the repertories.

Introduction:

I would like to emphasise that this article is not a criticism, neither of the master prover (PI or primary investigator) nor of the professional repertory editor (henceforth the repertoriser). Provings and repertories are evolving at a tremendous pace, and it is challenging to strike a sound balance. However, it is essential to stop once in a while to examine the trends.

While researching this article, I have searched for prior literature on the process of conversion from proving to repertory, but was unable to find any.

Note: For the purpose of this article, the terms repertoriser and repertorising refer to converting symptoms into repertory language and introducing them into the repertory, rather than to the act of solving a case.

Over-conversion into repertory language

What do Hydrogen, Bamboo, Ozone, Triticum and Vanilla have in common? At some point over the last 30 years, they appeared in the repertories and, like the source substances themselves, they spread all over, popping up in nearly every repertorisation. These remedies appear the following number of times in our modern repertories (Synthesis[1]/Complete Repertory[2]):

Hydrogen 1770/3254, Ozonum 2175/4293, Bamboo 2302/4561, Triticum 3907/0, Vanilla 3987/1428

In contrast, Calcarea phosphorica, a much older remedy, has 3349/4794 symptoms.

What does this mean? Are these new remedies polychrests that deserve to equal or overtake the classical polychrests? Are the provings very large or have they just been ‘over-repertorised’? While some are undoubtedly important remedies, the trend seems to be exaggerated.

The many new provings that are now available are a true blessing, and they bring many cures to the world. I prescribe the Ozone, Bamboo, Vanilla and Triticum, and many other new remedies frequently in clinic, especially in AIDS cases in Africa where they are often indicated.

When a new remedy is needed there can hardly be a substitute. So it is wonderful to see the proliferation of provings. The website www.provings.com lists thousands of new provings. I am also very grateful to the repertorisers for their Sisyphean work in adding new remedies to the repertories.

Possible problems in of repertorising

When creating a new proving, there are many interfaces between prover and supervisor, supervisor and proving editor, editor and publication of the proving, prover and repertoriser. The latter is dealt with here – the interplay between the proving and the repertory. This is where the problems previously mentioned often manifest.

Several errors can occur when repertorising a new proving. I have made most of the mistakes listed below, and tried to learn from them:

1. Too many rubrics
2. Inaccuracy of rubrics
3. Duplication of rubrics
4. Meaningless symptoms and irrelevant rubrics

Probably the most common of these is the first, too many rubrics. Many homoeopaths have noticed that new provings flood the repertory, creating an imbalance between new and old remedies.

It is surprising and sometimes irritating to have new remedies appearing in every repertory analysis, when there is little or no information available on them, and hardly any clinical experience. This is like a five-year-old kid coming into town and trying to take over the local pub from all the ‘old-timers’. The result is an imbalance between new and old remedies.

I realised this after I first entered Hydrogen in the repertory. In those days (1990), there were few new provings, so the imbalance was painfully obvious. It was upsetting to hear that people were complaining about Hydrogen’s over-abundance in the repertory.

However, I soon realised this was a valid complaint. The remedy had been over-repertorised. Subsequently, I reduced all the 3rd-degree symptoms to 2nd degree, and all the 2nd-degree symptoms to 1st degree, as well as eliminating quite a few rubrics altogether.

Following that experience, I became much more cautious about adding too many rubrics and adopted a minimalist approach. Subsequent provings, for example, Neon (1993 – originally 411 now 2336 rubrics) or Germanium (1994 – originally 724 rubrics, now 2925 ) seem to be well-balanced in the repertory.

Originally minimalistic, nearly twenty-five years later they have slowly and organically been updated with confirmed symptoms and extensive clinical experience from the homoeopathic community.

There are several reasons for the over-repertorisation of provings. The first is that new provings contain much more information than older provings. Generally speaking, this is a good thing, because more detailed and accurate description of symptoms is obtained, mostly mental and emotional symptoms and dreams.

However, at times this is overdone in provings, so it becomes difficult to see the wood for the trees. More can be less. Much of what can be considered symptoms may actually be background information, useful when reading a proving but irrelevant to the repertory.

Provings can never be perfect, and neither should they be considered as such. Provings are a science, but they are a soft science. For example, suppose an extremely careful proving has been conducted: baseline, supervision, double-blind, cautious editing, etc. It might be proposed that this proving is a perfect representation of the remedy, 100% accurate.

Now, two additional provers’ accounts are added, and, a whole new array of new symptoms is obtained. The old proving is now only 90% accurate. The newly added symptoms have the same core meaning, but they are different, nonetheless.

This is in addition to all the random occurrences that might have taken place during the proving: A prover ate food with MSG (monosodium glutamate, a food additive), saw a scary movie, suffered grief or shock, or was subject to a nasty astrological configuration.

Provings and materia medica need to be differentiated. Provings contain quite a bit of superfluous information. It should be well understood what is meaningful, to separate the essential from the non-essential, to perceive what is curative in the remedy.

Therefore, the proving document is a primary suggestion for materia medica and not a final document. Materia medicas are forged through years of study and clinical experience. It will take a long time for that five-year-old ‘kid’ proving to mature into an ‘adult’ materia medica. This is not a problem; it is merely the way materia medica should evolve.

Throughout the history of provings, homoeopaths have always debated whether to include or exclude doubtful information. The consensus has been to include (see below). If symptoms do not appear in provings, there is no chance to confirm or deny them over time. There are many occurrences in which I found symptoms considered as doubtful to be essential features in the proving.  Here are some comments from the old masters:

No doubt it would be a great blessing to the practitioner to free the Materia Medica from all these and other unimportant symptoms; but where is the skillful pruner that can show his qualifications for the task?[3]

It is impossible to eliminate individual or personal traits from the symptoms of a proving, and it would emasculate it if it could be done.[4]

It is to be a law controlling this record that no fact is unimportant because … it may be of little significance to the diagnosis, while it is of the greatest value to therapeutics.[5]

The voyage from proving to materia medica requires many filters, semi-permeable membranes that separate true from false. These filters should neither be too strict nor too loose. Over-strict provings yield flat and often unusable results, eliminating much of the Strange, Rare and Peculiar symptoms, which may appear implausible to the proving editor. Careful supervision and editing filter out many false inclusions, but not all, and so it should be. One cannot perceive the truth of each individual symptom before one perceives the totality of the remedy.

Suppose a prover reports a headache on seeing a black cat. In that case, a supervisor may decide this is pure fancy and eliminate the symptom. If another prover with a different supervisor experienced the same symptom, it would never be discovered that both had experienced it, and the symptom would be lost.

These symptoms should be given a chance, while at the same time keeping inaccuracies out. The solution to this problem is to filter the proving in stages, each one stricter than the previous one. These filters are: supervisors, editors, materia medica and the repertory.  Hence the final and most strict filters of truth and accuracy of symptoms do not lie in the provings, but in repertories. This is an essential point. If a false symptom bypasses this barrier, it will remain there forever. Many symptoms are added to repertories, but hardly ever is a rubric removed. Therefore, provings must be permissive, yet the repertorisation of provings must be strict.

Repertorising by master provers

The parents of the new proving, the master provers, are eager to get their proving into the repertory as soon as possible. And there is a good reason for this. Without access to the remedy through the repertory, it will seldom be prescribed, and there will be no clinical cases to confirm and learn from.

But by repertorising too early, a proving that has not yet been ‘distilled’ is being used. So there is a Catch-22 situation. Repertorise too early and irrelevant or excessive information may be included. Wait too long, and the essential clinical experience and feedback would be delayed. I now wait for a few years before new provings are repertorised, to gain the necessary insight first.

The most significant cause of over-repertorisation is due to master provers who repertorise their own proving. This is especially true with first-time master provers. Like the parents of a first-born child, they love their new baby very much. And so they should; much work and care are invested in a new proving.

But like first-time parents, they are also obsessive, even neurotic, about getting everything right. They want to repertorise every ‘dot on the I and cross on the T’. No detail should be excluded. So if the symptom says, “Anxiety while reading the newspaper and eating muesli”, it will be repertorised in six different ways to ensure that nothing is missed out. It is a case of over-eagerness leading to over-doing.

With further provings, the master prover usually gains the necessary experience. Indeed, the fourth child isn’t treated like the first one, which is lucky for the fourth child!

However, many new provings are done by ‘one-time master provers’, perhaps as a school project or an interesting experiment. This means that the provers have little experience, which usually leads to inaccuracies and over-proliferation of symptoms.

There is nothing wrong with first-time provings because everyone needs to start somewhere. I did my first proving of Androctonus with very few guidelines during my second year as a student. But the first-timer mistakes enter our repertories, and that is a serious problem. Thus, semi-permeable filters need to be created that can protect the repertories.

Frederick Schroyens, of Synthesis Repertory, has requested that new provings be limited to 1000 rubrics. This is certainly a good start. But this solution provides a quantitative rather than a qualitative filter.

Common inaccuracies in repertorisation

The inexperience of repertorisers can lead to the duplication of symptoms. For instance, “Dreams of giant elephants in a car”, “Dreams a car of, with giant elephants”, “Dream giants of, elephants in a car”, “Dream elephants, giant of, car in”, etc. This is tedious and confusing and leads to overburdened repertories.

Another source of inaccuracy is insufficient knowledge of the repertories and their structure. Knowing repertory structure is essential to repertorising provings, but this requires a degree of expertise that takes many years to achieve.

Modern repertories are vast. Most first-time provers do not have this knowledge.  Repertorisers need to know where the rubrics are and to understand their deeper meaning. ‘Fastidious’ is not the same as ‘Conscientious about trifles’, and ‘Absentminded’ is not the same as ‘Forgetfulness’.

A common mistake is to do with time. Let’s say a prover lists “Headache at 6pm”. This is then repertorised as ‘Headache at 6pm’. But often the timing is inconsequential. Perhaps that is the time the prover’s husband came home, or the kids made a lot of noise, or she ate a spoilt hamburger at 5pm.

Timing is only meaningful if it repeatedly occurs with one, or preferably more provers. The timing should be listed in proving only if it is significant or repetitive, but this is often not the case.

The significance of a time modality (i.e. aggravation at 6pm) can sometimes only be perceived by the proving editor as she compiles many reports from different provers. But the inexperienced repertoriser will list a single occurrence of a time modality.

Once it enters the repertory, it remains there forever. Take, for example, the symptom’ Face, itching, afternoon’ with one remedy- Triticum. Was this one prover? Did they have the itch every afternoon or just once? Perhaps it was a random event?

Another issue is the inclusion of new rubrics. Let’s say a prover has a strong desire to fly to the moon. As this symptom does not yet exist in the repertory, a new rubric has to be created- “Moon, desire to fly to”. In fact, on paging through the repertory, many single-remedy rubrics are found.

Most of these were created specifically for a new proving (unless they were clinical additions). And most of the time, this is how it should be because, by definition, new provings create new experiences. However, single-remedy rubrics are challenging to find, and there are now tens of thousands of them.

There is a tendency to create too many new rubrics where old ones would do. This is due to lack of knowledge of the repertory or the over-eagerness of first-time master provers to include everything. This is much worse when it comes to the overcooked ‘Delusions’. These additions to the repertory should be made very carefully and selectively.

Repertorising dreams and delusions are a delicate issue. Dreams, by their nature, tend to be over-detailed and convoluted. We cannot repertorise every minute detail of each dream, or enormous and useless repertories would result. So only what is meaningful, essential or very strange should be repertorised from each dream. But deciding what is central to a long and complicated dream is not easy. The overall totality and meaning of the remedy must be understood to do this.

Furthermore, there is a tendency to repertorise what I call ‘nouns’. For instance, if the dream was of a blue dog flying in the sky, it could be repertorised as ‘Dreams of blue dogs flying’.

As a very rare symptom, this rubric would contain only one remedy and therefore be useful only as a reference and useless for repertorising. The symptom could be included in a broader, more general rubric rather than the specific one. But then it has to be decided whether it is dreams of dogs (the noun), dreams of blue (the adjective) or dreams of flying (the verb). The verb  is usually the most significant aspect of the symptom. Yet, it is the nouns that are most often emphasised in repertories.

As for delusions, far too many symptoms end up categorised as such. As an example, I remember a conversation with a colleague regarding the following symptoms of Androctonus:

“He had a feeling of black thunder in his chest and desired to rip himself open so as to let it out”. The colleague suggested that this should be repertorised as ‘Delusion black thunder in his chest’, whereas I maintain that it is a feeling and should be under ‘Thunder feeling of… etc.’

A delusion is not a feeling. A delusion is a function of the mind’s eye, whereas a feeling is an emotion, more visceral. ‘Forsaken feeling’ is not the same as ‘Delusion he is forsaken’, and ‘unreal feeling’ should not be the same as ‘Delusion unreal’. Besides, not every minor feeling or delusion needs to find its way into the repertory. There are far too many delusions listed as a result of the modern delusion of ‘delusions’.

Another fashion in modern provings is to go overboard in trying to ‘prove’ the proving source material. Let’s say there is a proving of a bat. In their exuberance, the master provers tend to overemphasise all ‘bat-like’ symptoms, for instance, ‘Delusion he can fly’, ‘Delusion he can hear echoes’, ‘Delusion he is upside down and dreams of Batman and Robin’ (all made up by me, not to be used!). There is no need to ‘prove’ that the proving reflects the source material. What is to be learnt from provings is the unexpected, not the expected.

Much of this is a result of the modern tendency to use the repertory as a materia medica. Many modern materia medicas use repertory symptoms as a guide, which is like using a map to describe the view. Far too many interpretations of remedies are based on repertory symptoms, and too much is read into the rubric.

Describing ‘Desire to be carried’ as a desire for ’emotional support’ may be right for some remedies and irrelevant for others. Following this trend, provers try to ‘describe’ the remedy through the repertory, rather than just making sure the main pointers are in place.

Repertories are calcified materia medicas and should be used solely as an index to materia medica. The purpose of a repertory is a tool for finding and pointing the way to the indicated remedy, not as a materia medica substitute.

Homoeopaths can and should read the original proving. This means that the repertory does not have to contain every symptom in the proving, only the most important and indicative ones, at least for the first few years.

Another source of confusion regards degrees. Most modern repertories are based on Kent’s Repertory. Kent emphasised that his degrees are based on frequency plus clinical verification and not on intensity.

Proving symptoms without clinical confirmation deserve a first or second degree at best, and very rarely the third degree. The higher degrees should only be the result of many provers experiencing an unusual symptom (and not a common one, such as irritability).

According to the Boenninghausen system, only the first and second degrees may be used for proving symptoms. Yet new remedies are found to be included with three or even four degrees. We should follow the published guidelines of the repertory authors on the use of degrees in their repertories.

An area that is deficient in repertorising is concomitants. In the repertory, concomitants usually appear with the pronoun with or accompanied by, as in ‘Eye pain with throat symptoms’. These are symptoms that span distant or unconnected parts of the body.

While knee pain extending to the legs is not a concomitant, knee pain accompanied by ear pain is. By definition, concomitants are peculiar, and therefore important. Because of the tendency to separate proving symptoms into parts of the body, this information is often lost, which is a shame.

Another aspect of this is syndromes, for example, influenza accompanied by sinus pain, sore throat, lachrymation and nausea. If these molecule symptoms are fragmented into ‘atoms’, the totality of the influenza picture is lost. This is somewhat limited by the structure of the repertory, but more concomitants should be included.

In conclusion, I would like to advise to those master provers who repertorise their own provings, to:

1. Wait a while before repertorising. Study and teach the remedy, see some cases, perceive what is meaningful.
2. Be minimalist, only repertorise the essential and meaningful.
3. Be cautious adding new rubrics, check carefully for existing ones.
4. Be careful with ‘times of day’.
5. Use ‘delusion’ sparingly.
6. In dreams look at the ‘verbs’, don’t just focus on the ‘nouns’.
7. Study the repertory and its guidelines carefully.
8. Include concomitants when available
9. Don’t overemphasise signatures (e.g a bat proving looks like a bat)

The professional repertorisers

Not every master prover repertorises their proving by themselves. It is a tedious and challenging task, which requires expertise. No one knows the repertory as well as the creators of repertories, and that is a lifetime undertaking. I am personally very grateful to Frederick Schroyens, Roger van Zandvoort and their teams, who do this thankless work. Having repertorised a few provings, I know how difficult this task can be.

Not only do these experts know the repertories inside out, but they also understand the delicate balance that must be kept: the balance between new and old remedies, big and small rubrics, generalisations and particulars, degrees etc.

For this reason, it may be wise to hand our provings over to the experts. They know what they are doing; they are the professionals in this field. They will know where to put that problematic symptom, when to create a new rubric and what degree to use. Being a doctor does not qualify one as a brain surgeon. Likewise, being a homoeopath does not qualify one as a repertory editor.

However, there are problems with this method too. One issue is the long queue for repertorising new provings, more of which appear daily. It might take years until your proving is repertorised. More seriously, the repertory experts have a considerable disadvantage: They do not perceive the essential nature of your proving.

New provings are notoriously tricky to understand, especially if they are poorly edited, which unfortunately many are. It could take a month of study to ‘perceive’ a new remedy, which is impossible for the professional repertorisers. Therefore, they proceed by repertorising every symptom in detail. They repertorise more masterfully than the prover, but with much less understanding of the proving.

When a professional repertoriser is presented with a  proving he is not familiar with, it seems as if all symptoms are equal. But that is not the case. This perception will lead to them trying to include every symptom in the repertory.

In my opinion, this is a severe mistake. ‘Minimum symptoms of maximum quality’ is a paradigm that should apply to professional repertory editors as well as to homoeopaths. Less can be more and more can be less. The number of symptoms should be limited until experience is gained. But this limitation must be done with intelligence. To make qualitative decisions of which symptoms to include, the repertoriser must select frequent, certain, indicative, or characteristic symptoms.

Most importantly, the symptoms should carry within them something of the meaning of the totality. No one understands a new proving as well as the master prover. Only a master prover has the knowledge, necessary to select the appropriate symptoms for inclusion in the repertory. It is up to them to choose the best symptoms for the repertory.

This is the essence of the problem, the disconnection in the interface between master prover and repertoriser . One understands the proving, and one knows the repertory, but few know both.

A person that does not know the proving well can only decide what to incorporate by frequency and signature. Using the frequency of appearance of a symptom will lead to including only the common symptoms, excluding all the Strange, Rare and Peculiars.

This is the paradox of homoeopathy – the strangest and most characteristic symptoms are produced by one person. As to signature symptoms (e.g. bats hang upside down), this is limited to a few rubrics, but excludes many other strange symptoms.

Some might claim that adding too many rubrics is not a problem because they will be confirmed or denied by clinical experience. This is wishful thinking at best. In theory, it sounds nice, but in practice, this does not work. Very few homoeopaths send in clinical confirmations, and hardly any symptoms have ever been eradicated from the repertories. One reason for this is that negative proof of a rubric is impossible. A homoeopath cannot advocate that a rubric be removed just because he hasn’t seen the symptom in practice.

As to a Strange, Rare and Peculiar symptom (e.g. delusion of a blue dog flying), it might take a hundred years for someone to confirm this clinically, and if they do, will they report it? It might be thought that clinical practice is a filter for repertories. It is not. The buck stops with repertorisation.

There is a certain degree of filtering that can be done by the computer repertory programs. During computer repertory analysis one can filter by degrees, levels of confidence, or other criteria that limit the number of remedies. While this is a useful tool, it cannot be a substitute for intelligent human filtering.

Some Suggestion for addressing these problems

I have attempted to come up with a simple solution to address some of these problems. Once the master prover has edited the proving, she ‘sits on it’ for some time, studying and teaching the remedy, and accumulating a few cases.

When this is done, the master prover highlights those symptoms which she feels are most important, most indicative, and most meaningful to the proving. She marks those symptoms that have been repeated in the proving or confirmed clinically, so as to indicate a higher degree.

It is this document that she hands over to the repertory experts, together with some general observation about the nature of the remedy. This makes the professional repertoriser’s work much easier and quicker.

They do not have to understand the proving themselves. It has been done for them by those who have created it. They can then go about their expert work and produce a more precise and meaningful results.

I have used this method with some recent provings, such as Olea Europea (olive) and Oncorhynchus (salmon) with very satisfactory results. As a solution to the problems mentioned in this article, I recommend that master provers try it.

It might be beneficial to review each new proving after five or ten years for clinical additions and confirmations, and even eliminate some symptoms. This should be up to the proving masters, but a reminder email from the repertory companies would also be useful.

As for professional repertory editors, I suggest higher transparency and better feedback mechanisms.  Here are several possible suggestions:

1. Transparency: It would be useful for the community to know which provings have been repertorised lately, which are in the queue, how many rubrics per proving, which symptom confirmation and clinical additions have been received or are being added. This would allow homoeopaths to know the current status of the process, which new remedies to expect, and which sources have been used. The information could be published on the relevant websites.

2. Feedback: Repertory editors could create a more accessible feedback system for the confirmation or denial of symptoms. By publishing the repertories online, homoeopaths could easily suggest additions or possible mistakes, which could be verified by all.

3. It would also be beneficial to publish more guidelines for master provers and repertorisers. This would help to raise awareness, improve communication and feedback.

4. Finally, it is absolutely necessary for the repertory companies to use the same abbreviations for remedies. There are hundreds of remedies with different abbreviations between the two major repertories. I believe that abbreviations should be decided by a neutral board of experts in related fields, and not by the companies themselves. Having different abbreviations for remedies creates practical difficulties and an energetic split.

Once again, I wish to thank everyone involved in the impressive achievements so far. There is much excellent work done, and this article is simply an attempt to fine-tune the process.

Thanks to Tina Quirk and Richenda Gillespie for editing

References

[1]    Frederick Schroyens, Synthesis, Repertorium Homöopathicum Syntheticum

[2]    Roger van Zandvoort, Complete Repertory 2019

[3]    Dudgeon, R E, Lectures on the Theory and Practice of Homoeopathy

[4]     Morgan, J C 1899, ‘Provings of hydriodic acid and iodide of sulphur’, The reliability of proving-symptoms,  American Institute of Homoeopathy, 42nd session

[5]     Wells, P P, Errors in drug provings

[6]     Clarke, J H Homoeopathy explained. Sensitivities, The case of Casper Hauser