When a case only presents one or two complaints, often a clinical remedy serves better than an incomplete totality. Illustrations are : Granatum for dizziness Uva ursi for pyelitis, Kali mur. for follicular tonsillitis, Magnesia phos. for crampy pain, Naphthaline for whooping cough, etc.
Use of the Repertory
In complicated cases, where the symptoms do not point clearly to any one drug, it is necessary to make use of the repertory. A repertory is a compilation of symptoms arranged for ready reference where all drugs having a particular symptom are grouped under such a heading. This heading or caption is know as a rubric. A rubric then is followed by a list of drugs which have this particular symptom.
As all drugs have symptoms in greater or less degree, the quality of type denoting the drug also shows how characteristic this symptom is. The secret of successful use of a repertory is to acquire thorough familiarity with any one of the numerous ones by constant reference to it.
This is necessary because the language of the repertory may be different from the language of your patient who describes his symptom, yet both mean the same thing. The use of the repertory is certainly an art in the highest sense, calling for nice judgment and sound evaluation of symptoms. Time consumed is great, but no more so than in many diagnostic procedures which do not pay such valuable dividends.
There are a number of repertories on the market. Boenninghausen, Boger, Kent, and Knerr are general in type and there are a number of special repertories dealing with certain disease only such as Bell on Diarrhoea, Pulford on Pneumonia, and several Materia Medicas also have abbreviated repertories as part of their text, such as Royal, Neatby and Stoneham, Pierce, and Boericke.
The ideal repertory deals only with symptoms yet there are also so-called clinical repertories which, instead of using a symptom as a heading or rubric, employ the name of a disease, thus grippe or influenza would be followed by such drugs as Gelsemium, Rhus, Eupatorium.
Certain general characteristics are common to all. In the first place, the case must have been taken in detail, preferably on a chart of the “B” type (page 155). Having obtained an adequate list of both classes of symptoms, we can now proceed to select one which will serve as an eliminative symptom.
Elimination is the object of all repertory work. We cannot consider all drugs. An eliminative symptom is usually (not always) a determinative symptom, one which is a feature of that person’s individuality of his reaction to environment. Given such a symptom, we argue that inasmuch as the drug to be selected must have this particular symptom, being such an integral part of the picture, it follows that we need only those drugs which do have this eliminative symptom and use this as a major list.
It will be seen that we assume that in this list there is one drug which has the totality of symptoms. This is a tremendous shortcut and very convenient if the eliminative symptom fulfills the requirements, but it is easily seen that a mistake here invalidates all subsequent work, hence, it is usually wise to add to the eliminative or major list such drugs as are seen to recur consistently in the various rubrics consulted. A satisfactory eliminative symptom then should have two characteristics:
1. It should be an individual or vital attribute of the disease in question.
2. It should be followed by a moderate number of drugs. Usually they are to be found among the general modalities, the mentals, or qualified common symptoms of the case.
Having obtained our list of drugs by means of the eliminative symptoms and added to this list other likely drugs from our general knowledge of the case, our next step is to pick out the symptoms which we will use for repertory reference. These are arranged at the top of parallel columns in order of importance. (See Chart C, appendix.)
The determinative symptoms make up the bulk of this chart but enough basic symptoms should be included to clearly picture the case. For instance, such basics as, vomiting, dyspnoea, weakness, fever, cough, polyuria, should be included in repertory analysis.
If several drugs have the majority of the determinative symptoms then, of course, the one which has the basic symptoms most marked is to be selected or vice versa.
A beginner is always inclined to choose the wrong eliminative symptom for repertory work. Thus, he picks out representative basic symptoms such as the above and checks these against the modalities, etc. This is an unsatisfactory and tedious process and has been the cause of many physicians abandoning the repertory as impracticable. Always work from ” General ” to common symptoms. If we keep in mind to deal only with generals in repertory work, our task will be cut in half and we shall find that the common basic symptoms fit in a marvellous manner when our choice has been made.
We have tried to emphasize the importance of the initial or major list of drugs with which to work. Once this is obtained, as indicated above, we have but to check against this list the other symptom in the case. In practice, the list of drugs is usually written in a long column at the left margin of the page, the top is reserved for a symptom list in order of importance. (See Chart C, Appendix.)
Every symptom will have a list of drugs in alphabetical order, some in bold type and others in fine. Now, all we do is put a check mark opposite those drugs in our original major list which appear again under the caption of this new symptom. We pay no attention to the rest in that particular rubric. Thus, we find that perhaps half the drugs in our original list have also this second symptom.
We proceed with the other symptoms in exactly the same manner, and finally, we find that one or two drugs have almost all of the symptoms making up the repertory analysis. Then our choice is determined by referring to the Materia Medica in prescribing that drug whose pathogenesis suits best.
In very large rubrics, and where a particular symptom is a very marked characteristic of the patient, we only consider those drugs which are in bold faced type or italics. This is simply matching relative importance of symptoms and has already been mentioned above.
For instance, if weakness were a marked characteristic of one case, on looking up in the repertory, weakness, we find innumerable drugs but only a few are in black type. We would choose these, abandoning the rest. In cases where there are more than one eliminative symptom of seemingly equal value and further, each symptom calls for a very different set of drugs, it is best to combine them both and use the resulting list rather than run the chance of missing the proper drug. To illustrate the above method in detail, a short case is given in the appendix. (Appendix D and E.)
Dietary Treatment – Hahnemann held most enlightened views of diet and hygiene. He recognized and protested the wholesale use of coffee, tea, tobacco, and alcoholics, yet withal he was practical and his advice well balanced. He pointed out that diet can do much but not all.
He warned against the overuse of condiments and sauces and was against adulteration of food. He also pointed out certain substances which impair action of Homoeopathic drugs. In acute diseases, he pointed out that the instinct of the patient usually guides him aright and his cravings can be judiciously gratified. Adjuvant and Local Treatment
Simple measures are permitted, Hydro-therapy, massage, and physio-therapy in suitable cases. Local applications should be soothing rather than stimulating: Epsom salts, flaxseed, cornstarch, and olive oil. This is especially true of skin disease unless frankly parasitic in nature. “Suppressed eruptions” refer to the possible complications in other organs and symptoms from a skin eruption which has been healed locally.
Thus, untoward constitutional effects though not invariable and possibly delayed are none the less real and furnish at times valuable etiologic data for constitutional treatment. Such necessary application to allay itching, absorb exudate, and soothe denuded surface, should always be of simple nature. Highly medicinal lotions and ointments have no place in proper Homoeopathic treatment.
In these days of highly advertised patent medicines, it is well to bear in mind that camphor is a frequent constituent of sprays, rubs, salves, etc., and this is a general antidote for Homoeopathic drugs. Many Homoeopathic remedies are used locally and at times along with internal administration, thus Calendula is one of our most prized dressings. Hydrastis, Thuja, Hamamelis, Capsicum, and Sulphur are all used externally and internally in suitable cases.
Progress of the Case
The sequence of events from the therapeutic stand-point depends a good deal as to whether it is acute or chronic.
In acute cases, amelioration follows in direct proportion to the closeness of the Homoeopathic relationship bearing in mind of course the natural course of the disease in question. Fortunately this relationship is a relative thing and a reasonably similar drug acts favorably or palliatively leading to a satisfactory though possibly delayed recovery.
American homeopath - Ann Arbor - Michigan.
Son of William Boericke.
Books:
A Compend of the Principles of Homeopathy.
Homoeopathy