Study of Kent Repertory



So with all common symptoms, whether general to the patient, or particular to his parts-diarrhoea, vomiting, localised pain, headache-the very ailments for which the patient comes to you for help! See what long rubrics, with almost every drug in them! They will not help you one scrap.

Never start on these. They are absolutely useless unless you can get something that qualifies, that distinguishes, that is peculiar to THIS patient with diarrhoea, or headache; if so, a common symptom, qualified, may help you in your work.

But if we may not take the ailments complained of by the patient, and if we may not take the urgent and distressing symptoms dependent on a lesion, what in heaven’s name are we to take? What are the symptoms that do denote the patient? What are the symptoms on which we may start? And how are symptoms to be graded, as to their relative importance?

Kent (closely following Hahnemann in this, as in all things) is most definite as to the symptoms of first grade; the symptoms of supreme importance to the case, as expressing most absolutely the patient. These are the MENTAL symptoms. They, if they are marked, dominate the case

You may find that a patient is intensely jealous, or suspicious, or tearful, or indifferent to lived ones, or reserved and intolerant of sympathy and consolation. In sickness these things come out. Often in sickness the very nature seems to change; the rash and reckless become timid for themselves and others; the good tempered, snappy; the irritable and restless, patient. If a mental trait is marked, and especially if it denotes change from the patient’s normal, it is of the utmost importance to the case; and you know that it must be in the same type in rubric as in patient; which means that only remedies in the higher types are likely to fit the case. If the symptom is not very marked, beware how you use it to eliminate drugs; if the rubric is very small, take it, but take a larger rubric with it, that more or less includes the trait. Do not risk missing your remedy for an ill-marked mental, or a very small rubric. But if it is very marked mental, or a very small rubric. But if it is very marked, you know that the remedy you are in search of must be among the drugs in that rubric; so here again you may be able to limit your work.

Kent says, “When you have taken a case on paper you must settle upon the symptoms that CANNOT be omitted in each individual.” Such a marked mental-mental being of the highest grade! would be one of the symptoms that you CANNOT omit for this individual; therefore your remedy must be here. And therefore you can use it as an eliminating symptom, to compare with all the subsequent rubrics you consult; from which you can often discard the drugs that do not appear in this first essential list. With this guide, this strong eliminating symptom, straight from “the heart of the patient’s heart,” as it were, you can go through the rubrics of the patient’s symptoms in their order (i.e., mentals first, then generals, then particulars with modalities), taking from each list only the remedies that appear in this first rubric, (insane jealousy, or whatever it be), but taking all these jealous remedies from every subsequent list. In this way you can work rapidly down, till you are satisfied that you have found the remedy that fits the patient as a whole.

But this means much! To eliminate with safety, you must take symptoms seriously, not lightly. You must be absolutely sure that your symptoms are real and marked; that they do actually express the patient. You will have to ask many questions in order to elicit a few telling symptoms: and you must be quite sure that you and your patient mean the same thing. There are many pitfalls!

But even the mental symptoms are graded. Of highest rank in importance are those that relate to the WILL. with loves and hates, suspicions and fears. she hates her child-is jealous-fear of disease-of solitude-these are among the highest mentals.

Of second grade, those that effect the UNDER STANDING, with delusions, delirium; loss of the sense of proportions, with exaltation of trifles, delusions of grandeur, or persecution. Of third and lowest mental grade, those that relate to MEMORY.

Then those symptoms, as Kent puts it, “strange, rare and peculiar, therefore among the highest generals; because strange, rare and peculiar must apply to the patient himself.”

These must take a high place in the search for the remedy; but a place depending perhaps on their grade; for a peculiar mental would rank higher than a mere peculiar local symptom. Many of them are indicative of one or two drugs only. Write them down high in your list, but use them with care. As Kent says, “the great trouble with keynotes is that they are missed. The keynotes are often characteristic symptoms: but if the keynotes are taken as final, and the generals do not conform, then will come the failures.” As a matter of fact. wiping out a symptom, and curing a patient, are not synonymous.

A drug in its provings can only evoke in each case what was there already, latent in the prover-even as disease brings out weak points, and therefore does not affect two patients exactly alike. It requires many provers of different types, and different defective resistances, to bring out the whole picture of a drug pathogenesis. Had more drugs been more extensively proved, many more “rare, peculiar and distinctive” symptoms would probably have seen the light. A patient’s own individual remedy, prescribed on mental and general symptoms, will often wipe out peculiar symptoms that it has never been recorded as having evoked and which are the striking keynotes of some other remedy. Therefore beware how you take rare and peculiar symptoms, with only one or two drugs to their credit, as eliminating symptoms. This is easy, but often fatal. they may put you straight on to you drug (if the rest of the case fits!)- they may put you straight off it! You dare not use them, ever, to throw out drugs; though where there is nothing in the generals to contradict, they afford a strong reason for the exhibition of a remedy that has been known to produce and cure them. They are invaluable often to giver the casting vote.

As Kent says, “Get the strong, strange, peculiar symptoms, and then SEE TO IT THAT THERE ARE NO GENERALS IN THE CASE THAT OPPOSE OR CONTRADICT.”

But there may be no very marked mental symptoms, but the patient may be a very chilly patient, utterly intolerant of cold. In such a case you may limit your labour often, by throwing out from each rubric the hot remedies, intolerant of heat, as you work down your list. Or conversely, if the patient is a hot patient, and intolerant of heat in every form, why only the hot remedies in each rubric need to be considered: you can throw out the chilly ones. But to be safely used, such symptoms must, of course, be general to the patient as a whole, not particular to some part (for general and particular symptoms are often flatly contradictory), and they must be very marked. If too lightly used, there is always the risk of throwing out the remedy you need from the very start. It is this dread of missing the remedy that leads some of us to expend such an the remedy that leads some of us to expend such an enormous amount of labour on our cases, and to use methods that Kent describes as “hard and arduous, entailing an enormously larger amount of work than he does in his cases.” This he stigmatises as “working uphill.”

Besides hot and cold remedies, Kent has a smaller rubric of remedies affected by both heat and cold. It us useful where patients are intolerant of both extremes of temperature. You will observe that there are both hot and cold remedies in this list. It occurs on p.1312 of the Repertory.

And here, with a plea for criticism and pronouncement, I will insert a list of grades, as we more or less understand them; for Kent says in a private letter from which I have been quoting, “The student and physician must work to settle the generals, common symptoms and particulars to the fullest extent, If he wants to save work”. And a realisation of the relative importance of the marked symptoms of a case is essential for the best and quickest work.

MENTALS;

WILL; with loves, hates fears.

UNDERSTANDING; with delusions, delirium.

MEMORY.

STRANGE, RARE AND PECULIAR: These may occur among mentals, generals or particulars, a nd must therefore be of varying importance and rank.

PHYSICAL : Sexual perversions (loves and hates, physical) or those referred to stomach, as desires and aversions for foods; for hot and cold foods and drinks; appetite; thirst. PHYSICAL GENERALS;

Reactions to HEAT AND COLD

To TIME

Damp and dry

Electricity

Oxygen and carbon di-oxide.

To menstruation

To position, gravitation

Pressure, motion, with train-sickness,

Food aggravations and ameliorations.

CHARACTER OF DISCHARGES.

PARTICULARS; (relating to a part, and not the whole;qualified, always).

Of these last Kent says, :Do not expect a remedy that has the generals must have all the little symptoms. It is a waste of time to run out all the little symptoms if the remedy has the generals. Nothing disturbs me so much as the long letters I get from doctors who show how they have wasted time on useless particulars. Common particulars are generally worthless.”

Margaret Lucy Tyler
Margaret Lucy Tyler, 1875 – 1943, was an English homeopath who was a student of James Tyler Kent. She qualified in medicine in 1903 at the age of 44 and served on the staff of the London Homeopathic Hospital until her death forty years later. Margaret Tyler became one of the most influential homeopaths of all time. Margaret Tyler wrote - How Not to Practice Homeopathy, Homeopathic Drug Pictures, Repertorising with Sir John Weir, Pointers to some Hayfever remedies, Pointers to Common Remedies.