What remedy does this describe? Sepia, of course. We all know that Sepia is better for lots of exercise. Don’t we?
This is where it gets interesting. In the proving, for the most part when any physical exertion is mentioned, it’s actually a cause for aggravation. Not amelioration. Walking is mentioned over 90 times in this proving. Around 7 instances are in the introduction, and amelioration from walking appears around 8 times in a proving containing 1655 symptoms. All the rest – approximately 75 mentions of aggravation from walking by my count. Around 21 on these mentions relate to walking in the open air, and Sepia provers did note sensitivity to cold, but that still leaves us with over 50 instances where walking aggravated.
The opening sentences are quoted from Kent’s lectures – most of those reading this probably first met Sepia through Kent. We met this unfeminine female, who is cold, angular, depressed, worn out, and needs violent exercise to keep her human. Add to that the image of the ink-spitting cuttlefish, attacking with sudden sarcasm and retreating – it all gets very picturesque, so to speak. The problem with all these images is that they stick so firmly in memory that even once you know they are fallacious they are very difficult to dislodge. I remember a live case where the homoeopath pointed at the patient, who shrank back in dismay, and declared in tones that brooked no argument – “behold Sepia, fix the image of this patient in your memories!” Needless to say (after such an intro) Sepia didn’t work…
It gets even more interesting however when we look at the therapeutic pocket book, where Boenninghausen included Sepia in amelioration from physical exertion – in 4 points. This brings us to the issue of the grading in the TPB, which is often erroneously considered to reflect the intensity of the symptom. The significance of the grading relates to the extent to which that symptom was verified in clinical use. A symptom appearing in 1 point is a completely valid remedy symptom – just one which has been used less and therefore verified less in the clinic. Sepia in 4 points in amelioration from physical exertion means that Boenninghausen saw this amelioration over and over again, sufficiently so to include it in his carefully and meticulously crafted TPB. Sepia also appears in the TPB under different expressions of aggravation from physical exertion, but only appears in one, two or three points.
So we have the proving – pointing to aggravation from physical exertion, repeated over and over again by provers and by Hahnemann himself in his introduction to the proving. And we have Boenninghausen’s TPB weighting the balance in the direction of amelioration from physical exertion. What’s the “take home” from all this?
I’d suggest the following:
1. Blank out the Kentian “image” (and those presented by other homoeopaths before and since). This image is not helpful for accurate, focused prescribing.
2. Amelioration from physical exertion was presented by Boenninghausen – a master clinician. This strengthens a modality which only found moderate expression in the proving. There is nothing to negate the symptom, and many clinical cases, together with Boenninghausen’s grading in the TPB, to support it.
And possibly most importantly:
3. If Sepia looks like a good fit but the patient is not ameliorated from physical exertion, or is even aggravated by it – don’t rule out Sepia. If it looks like the best remedy for the case, give it. Even if the patient is fair, round, has blue eyes, and is a 15 year old boy…