Ever since the appearance of my Homeopathy Repertory in print many of my friends who use it have urged me to write out my own method of using a repertory. I realize that it is a most difficult undertaking, but shall attempt to explain my method. I doubt not but most careful prescribers will find that they are working in a similar manner.
The use of the repertory in homoeopathic practice is a necessity if one is to do careful work. Our Materia Medica is so cumbersome without a repertory that the best prescriber must meet with only indifferent results.
After the case has been properly taken according to Hahnemann’s rules it is ready for study. I do not intend to offer in this manner the ordinary rubrics, because all know them so well. A case that is well taken and ordinarily full will show morbid manifestations in sensitiveness to many surroundings, such as weather, heat and cold, also in the desires and aversions, mental symptoms and the various regions of the body.
When I take up a full case for study I single out all the expressions that describe the general state, such as the aggravations and ameliorations of the general state of the patient or of many of his symptoms. I next consider carefully all his longings, mental and physical, all the desires and aversion, antipathies, fears, dreads, etc. Next I look for all the intellectual perversions, methods of reasoning, memory, causes of mental disturbances, etc. All these I arrange in form together, in order to set opposite each one all remedies in corresponding rubrics as found in the repertory. By the cancellation process it will soon be seen that only a few remedies run through all these symptoms, and therefore only a few are to be carefully compared in order to ascertain which one of all these is most like the particular symptoms not yet lined up to be considered as the first ones have been considered. Hahnemann teaches in the 153rd paragraph that we are to give particular attention to such symptoms, as are peculiar and characteristic. He teaches also that the physician must pay his earnest attention to the patient. Now if these two things are duly considered, it will be seen that Hahnemann’s idea was that a characteristic symptom is one that is not common to disease but one that characterizes the patient. All the first lot of symptoms singled out for a more comprehensive view are such, as characterize the patient, and are predicated of the patient himself. By treating a portion of the symptoms in this way we have reduced the list of possible remedies to a few or perhaps only one. As it is necessary to consider the totality of the symptoms for a basis of the homoeopathic prescription, it is now necessary to examine all the rest of the symptoms in order to ascertain how these few remedies correspond with all the particulars.
It may be said that the above is only routine work and everybody does it just that way. True, but after so much has been accepted the more intricate problems come up. To work out a well-rounded case is the simplest part of repertory work, but when one-sided cases appear and when the patient states his symptoms in language that cannot be found in provings the case is far different. The record of the patient should stand as nearly as possible in his own language. From an extensive correspondence and many years of teaching graduates, I have come to the conclusion that it is a difficult matter for many to know when the record of symptoms contains the possibilities of a curative prescription. Many cases are presented with no generals and no mental symptoms-absolutely no characterizing symptoms only the symptoms common to sickness. When a successful prescription is made on such symptoms it is scarcely more than a “lucky hit.” It cannot be classed as scientific prescribing. Many records are presented with pages of vague description and one keynote that has served as a disgraceful “stool pigeon” to call forth a failure from many doctors.
Unless the symptoms that characterize the patient are brought out in the record the physician should not be surprised at a failure. The remedy must be similar to the symptoms of the patient as well as the pathognomonic symptoms of his disease in order to cure.
To show something about the requirements of repertory work, I will try to bring out hypothetical groups of symptoms such as come to every man. In a well-rounded case, or as an isolated group, we frequently meet with what is called “writer’s cramp.” This must be divided into many elements before it can be properly put on paper as a work out case or fragment of a case. If we should take “writer’s cramp” and say no more about it, we would have only a limited number of remedies to look to for cure. But our resources are unlimited, as will be seen. “Writer’s cramp,” when examined into, will be found to mean cramp in fingers, hand or arms, or all three. Sometimes numbness and tingling of one or all three; sometimes sensation of paralysis in one or all three; sometimes tingling of fingers and hand, and all of these conditions from writing or worse while writing.
Cramp in fingers while writing; Brach., Cocc., cyc., trill., mag-ph, stann.
Cramp in hand while writing: Anacardium, euph., mag-p., nat-p., sil.
Numbness in fingers while writing: Carl.
Numbness in hand while writing: Agaricus, zinc.
Paralytic feeling in hand while writing: Aconite, agar., chel., cocc.
Cramp in wrist while writing: Amyl-n., brach.
The above brings out about all that can be found in the Materia Medica on this subject, and failure often follows owing to the scanty clinical and pathogenetic records to which we have access; but we have just begun to consider that vexatious group of symptoms. It is true that sometimes the above scanty showing presents just the remedy required. But oftener it does not, and then we may proceed as follows:
Cramp in the fingers, hand and wrist or such parts as are affected: Use the general group on Page 938 of my Repertory-a long list.
Numbness of fingers and hand: Pages 999 and 1000, using also the general group.
Sensation of paralysis of hand and fingers: Use the general groups, pages 1118 and 1119.
After these have been carefully written out, turn to the general rubric in Generalities, on page 1287, “Exertion,” and write out such of these remedies as are found in the complex symptoms from exertion. Writing is nothing else but prolonged exertion. When this simple lesson is learned the physician will see at once that the same process will show the remedy in those who have lost the power of the hand and fingers, or have cramps, etc., from playing stringed instruments or playing the piano or the prolonged use of any tool or instrument. It is using in proper manner a general rubric.
Furthermore, after cures have been made with remedies selected in this way, such remedies may be added to the scanty list of particulars first referred to, and in this manner will our repertory grow into usefulness. This is the legitimate use of clinical symptoms. It is the proper application of the general rubric to the end that our scanty particulars may be built up. The new Repertory is the only one ever found that provides a vacant space for annotating just such information. If the large number of correct prescribers in the world would join in this extension, we could soon have a repertory of comparatively extensive particulars. Our generals were well worked out by Boenninghausen and much overdone, as he generalized many rubrics that were purely particulars, the use of which as generals is misleading and ends in failure. The success coming from Boenninghausen’s Pocket-book is due to the arrangement whereby generals can be quickly made use of to furnish modalities for individual symptoms, whether general or particular. This feature is preserved in my repertory, as all know who use it. But it is the generals that can be used this way. A large rubric made up of promiscuous particulars, none of which are predicated of the patient is a “hit or miss” when applied in general and usually a miss. For example, “aggravation from writing” is a rubric of particulars. In no instance is there one wherein the patient himself is worse from writing, but the eyes, the head, the hands, the back (from stooping), etc., make up this rubric. It is useless to resort to aggravation from writing when a headache is the symptom and find the remedy refers to a complaint in some other part wholly unlike headache. To make use of this modality for mental symptoms when it is applied to complaints of the hand is perverting the uses of circumstances. Aggravation from writing should be limited to the symptoms that are worse from writing and kept with them, as it is not a general. It is so done in my repertory. This is wholly different in the great rubric “motion.” If we study Bryonia from that rubric, and from the Materia Medica, we will see that such a large number of particular symptoms is aggravated by that remedy that it appears that the very patient himself is worse from motion.