Counting Polar Symptoms: How to Represent Results?
Background Polar symptoms (PS)—symptoms with opposite values—are frequently used in homeopathy, but have many misleading entries in the repertory. This is caused by using absolute occurrence of symptoms, causing the same medicine to appear in both (opposite) symptom rubrics, and by lack of comparison with other medicines. Some PS, like ‘aversion/desire for sweets’ have a frequency distribution that is not evenly distributed around the neutral value: a desire for sweets is much more common than aversion. A desire for sweets is an indication for a specific medicine only if this desire occurs more frequently in this specific medicine population than in the remainder of the population. We need to find the best way to represent this difference.
Methods A multi-centre, explorative, prospective, observational study was conducted by nine centres of the Central Council for Research in Homoeopathy. Two-hundred and sixteen patients were enrolled with chronic cough lasting more than 8 weeks, and received usual homeopathic care. During intake, 30 general PS, 27 polar cough symptoms and 3 non-polar cough symptoms were checked. Different ways of representing results were explored, including two quantities borrowed from mechanics: Centre of Mass (CoM) and Leverage.
Results At the fourth follow-up, three medicines with more than 10 cases with good results were identified: 20 Phosphorus, 19 Pulsatilla and 13 Sulphur. The mean value of the frequency distribution of some symptoms in the whole sample was considerably different from the neutral value. Comparing a medicine population with the remainder of the respective population can give results that differ from polarity analysis. For some symptoms, the ‘distance’ (Leverage) between the CoMs of the medicine population and the remainder of the population was clearer than the likelihood ratio (LR).
Conclusion If the LR value is not clear about the prognostic value in PS, notions from mechanics such as CoM and Leverage can clarify how to interpret a polar symptom.
Keywordspolar symptoms - prognostic factor - Bayes' theorem - homeopathy - likelihood ratio - centre of mass - leverage
• Polar symptoms are crucial in homeopathy, but badly represented in the repertory.
• The centre of the frequency distribution of many symptoms, such as desire for sweets, is not the neutral value: desire for sweets is more common than aversion.
• Polarity analysis does not consider this asymmetry of opposite poles.
• Bayesian analysis of PS requires comparison of the frequency distribution in the medicine population with the remainder of the population.
• This comparison of frequency distribution is sometimes more clearly represented by the ‘distance’ (‘leverage’) between the ‘centres of mass’ of the medicine population and the remainder of the population.
LR and RKM devised the study; LR provided the concept note of the study, based on which PO, CDL and HK developed the study protocol. LR and HK contributed to all facets of the work throughout the study. JS assisted in coordination of the work at nine centres. RKM and AK co-assessed the trial for feasibility of its running at nine centres. JE and LR conducted data interpretation. LR, HK and JS prepared the first draft of the paper. AK critically assessed the manuscript. SR, SC, VS, VER, CK, PPP, RGK, ARS, BR, RCS and NM investigated the patients at nine study centres, enrolled them after thorough assessment as per the inclusion criteria and ensured protocol adherence and patient compliance. They also evaluated the manuscript before the final submission. All authors have approved the final manuscript.
Received: 19 January 2020
Accepted: 02 April 2020
10 August 2020 (online)
© 2020. Faculty of Homeopathy. This article is published by Thieme.
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