As no one person can carry all the symptoms of all the remedies in his mind, a concordance or index is needed. We term a symptom index a repertory. There are about half a handed of these, general or special, based on different systems of studying the case. The two most vital to know are the basic ones of the two main methods, the Kent Repertory and the Boenninghausen.
THE KENT REPERTORY; ITS CONSTRUCTION.
The Kent Repertory is a compilation of materia medica, certain prior repertories, such as Lippes and clinical symptoms verified. In order to successfully search in the Kent Repertory for the symptoms of your case as evaluated in accordance with our last lecture you must be thoroughly familiar with the plan of the book, it rationale, and also its inconsistencies. The plan of the book is to work from generals to particulars,m a general rubric first in most instances. The book is based on anatomical divisions, (see Table of Contents, p. VII), with certain exceptions such as the first section on MIND; the last one,GENERALITIES; discharges,m such as STOOL,SWEAT, URINE and EXPECTORATION,which appear as separate sections next to the anatomical region producing them; and certain general conditions,such as VERTIGO, COUGH, SLEEP, CHILL and FEVER,which are also separate.
Under each anatomical section the rubrics run in alphabetical order regardless of whether they are pathology, sensations,modalities, or objective symptoms (such as “bores head in pillow”, page 108) Each such main heading is followed by modifiers,(if there by such) in the order following: ?Time, circumstances in alphabetical order, extensions (the point from which a symptom extends is the one under which it will be found, not the point to which it extends), location with its time, circumstance and extension modifiers,and lastly, sensation with its modifiers.
For instance, the main section HEAD is anatomical, but under that you will not find an anatomical section for occiput, rather must you look under the sensation in the occiput, as for instance, COLDNESS or PAIN, OCCIPUT, in.
It is to be noted that certain anatomical regions have no corresponding section in this Repertory, for instance, NECK, which is found under THROAT, EXTERNAL THROAT, and BACK, EXTERNAL THROAT contains the rubrics pertaining to the anterior neck,such as goitre,glands, torticollis, etc., and BACK contains nape and posterior cervical region. Furthermore, lungs, heart, aorta, axillary glands, breast and milk appear under CHEST; posterior chest appears under BACK; impulse under GENERALITIES; head sinuses are divided between NOSE and FACE; salivary glands are found under FACE instead of under THROAT; lips under MOUTH; oesophagus is found under Stomach and liver under ABDOMEN.
There is no section for the circulatory, glandular or nervous systems, as this book is not based on systems, (Boerickes Repertory is in part), but the parts of these systems are found scattered throughout the book under allied anatomical headings. Many symptoms which one would expect to find under the nervous system appear under GENERALITIES as they indicate a tendency of the whole organism, such as ANALGESIA, CHOREA, CONVULSIONS, PARALYSIS, TREMBLING, etc. Twitching of the parts appears under the anatomical part, such as FACE, EXTREMITIES. Nervous symptoms having to do with the spine appear under BACK. such as OPISTHOTONOS. Meningitis appears in two places, under HEAD, INFLAMMATION, meanings of,and BACK, INFLAMMATION, cord, membranes of.
Similar or allied rubrics often appear in two or more different places, as for instance: Dysmenorrhoea under GENITALIA, FEMALE,MENSES painful: ABDOMEN, PAIN, hypogastrium, in, menses, during; and ABDOMEN, PAIN,menses, during.
It must be noted that many rubrics which appear as particulars under the proper anatomical sections or main headings also appear in the last section, GENERALITIES, in their relation to the body as a whole, for instance, under GENERALITIES, MENSES, comes aggravation or amelioration of the whole person before, during or after menses,while under GENITALIA FEMALE appears the type and circumstances of the menses, or, so to speak, the particulars. Similarly under GENERALITIES, PERSPIRATION, appears amelioration or aggravation of the body as a whole from sweat,whereas under the section PERSPIRATION are given the quality, occurrent and modalities of the discharge itself.
Sweat of any especial apart is found under the anatomical section in which the part is located, such as, ABDOMEN, PERSPIRATION on. Perception of the scalp is not under HEAD, scalp, perspiration of, but under HEAD, PERSPIRATION, scalp of. General amelioration by, or distress from, the act of eating appears under GENERALITIES, EATING; and under GENERALITIES, GOOD, are the aggravations and ameliorations from the different articles of food, but under the section STOMACH,aversions and desires for special articles of food appear.
Pathological diagnoses are found frequently in GENERALITIES and occasionally as hazings under other sections but more often as sub headings under the CHEST, INFLAMMATION, pleura of, and appendicitis under ABDOMEN, INFLAMMATION, appendicitis. On the other hand empyema is found under CHEST, EMPYEMA, directly, and goitre under EXTERNAL THROAT, GOITRE. Certain pathological states which re symptoms rather than diseases,such as CHOREA, CONVULSION, CYANOSIS, DROPSY, ETC., APPEAR UNDER generalities. Objective symptoms are scattered all through the book and are often small unclassified rubrics, such as BRITTLE NAILS, GESTURES under MIND, BITING under MIND,and red lips under FACE, DISCOLORATION, red, lips.
THE KENT REPERTORY; ITS USE.
This Repertory is built to work the cases from general symptoms to particular symptoms to particular symptoms. We have already spoke in our lecture on the evaluation of symptom of Kent;s method of grading, MENTALS being the most important, and GENERALS next. Most chronic cases and many acute ones can be worked out by the Repertory on the MENTALS and GENERALS alone to within three to five remedies., The beginner should take at least eight of these symptoms,although expects often solve the case on three to five.
The beginner must be very sure that these MENTALS and GENERALS are really true of the patient, and that he has not warped the symptom in translating the patients colloquial expressions into the language of the rubrics. Moreover a symptom must have the same mass of importance in the patients case as is assigned to it in the symptom hierarchy. If an important symptom can not be found in the Repertory it can often be found under a synonymous rubric. It is to be understood that the headings in the under GENERALITIES WHICH are not pathological and not marked “ameliorated by.” of otherwise explain,d and which are not sensations or conditions, mean aggravation from.,” for example, EATING,before,mens worse before eating, COITION,after, means aggravated after coition, etc.
Many of the ameliorations are omitted and you must look for them under aggravation under their opposites,for instance, there is no better in summer. This is considered equivalent to worse in winter. Sometimes two or more rubrics must be combined in order to be equivalent to a given symptom. If the rubrics are very small it may be worse to add all the remedies.
If at least one of the rubrics is large and the others fair size, only such remedies as run through all the component rubrics of he is symptom should be taken. Certain symptoms have so large z group of remedies that they are almost useless except as eliminating symptoms. Such a one is cold bloodiness of the patient,which appears under GENERALITIES, HEAT, lack of vital, and would serve to eliminate any markedly hot blooded remedies which had otherwise come through the generals high in a given case.
The student will recall from out previous lecture that the common symptoms, or the unqualified big,main rubrics, such as SADNESS, VOMITING, etc., are of little or no use on repertorizing,and that among both GENERALS AND PARTICULARS, a strange,rare and peculiar symptom ranks high. A strange rare and peculiar general would be “during cold state craves cold,.” or “during hot stage craves heat”, as in Camphor a strange, rate and peculiar particular would be “a thirst for ice water only during chill” Eup. per.).
We have said that the beginner should locate in the Repertory his eight or more main GENERALS AND chart the remedies appearing under each of these, putting 3 for the bold face (heavy black type), 2 for italics and 1 for to man (plain type), this being done for all the fraction being the numerical totality of the remedy grades and the denominator being the number of symptoms in which the remedy appears.
Now the PARTICULARS come interplay, beginning with the most peculiar one, and case should be taken knot to use too small rubrics. In fact it is safer to use a more general, medium sized rubric than the more exact particular rubric. The occurrence of these particulars in the few remedies which have stood highest in the GENERALS, and in these only,being taken. you can now see which few remedies are fairly similar to the GENERALS of your case,and which few of those most resemble the PARTICULARS of the case., Add the particular title general fraction and reduce your list tot he three to five remedies which stand highest in their grand to,al. If one remedy totals 16/7 and another 15/8, the former is to be preferred.
As you have taken your symptoms in the strict order of their importance according to the Kentian schema your first two or three symptoms should appear in the remedies that come,high, and where they do not the remedy should be looked on with suspicion. It is to be remembered that certain remedies, like Sulph., Calc., Nux., Puls., etc., almost always come out high numerically because they gave been so thoroughly proved and unless the beginner discounts this and bases his final judgment on materia medica and especially the mentals and type of the patient he will prescribe these well proved poly crests too often.
Conversely, it must not be forgotten that some remedies, like Tub., have but a fragmentary part of their proving in the repertory,and that only a little more than 500 remedies are mentioned in the Repertory,. and very few of the nosodes and double salts are adequately stressed. When the remedies have been reduced numerically to from three to give, these must be read in the Materia medicas,especially their MENTALS ,and the original case as taken reviewed and competed to peach of the remedies. The miasmatic relationships of the patient and of the remedies that come out high must be considered.
For future reference in treating the case in acute as well as chronic prescribing, a list should be made on the chart of the constitutional remedies which come high, of the nosodes which most nearly apply,and of the acute remedies ranking highest. These, or, complements of these will often be found to fit any illness of that patient in the future, unless an epidemic remedy be called for.
Ideally, on the repertorizing record each symptom should be stated in the words of the patient in the symptoms couldnt restated in the exactly corresponding rubric in the rubric column,and the page where this is found after it. There are repertorizing sheets These are obtainable from the American Foundation of Homoeopathy, 38 Elizabeth Street, Derby, Conn.,, for a reasonable sum. on graph paper with the main remedies printed on, numbered places of writing in symptoms, etc., which are a great convenience and a time saver.
THE BOENNINGHAUSEN REPERTORY; ITS CONSTRUCTION.
Boenninghausens Therapeutic Pocket Book, one of the earliest repertories, is based largely on Hahnemanns Materia Medica Pura and the idea of it was approved by Hahnemann himself. The book falls into seven distinct parts. Although each of these is complete in itself, “yet each one gives but one portion of a symptom, which can be completed only in one or several other parts.” For example,the seat of pain is found in the second section according to timed or circumstances in the sixth,and the necessary concomitants in the various sections.
The seven sections are: I The Mind and Disposition: 2. Parts of the Body and Organs 2. Sensations and Complaints in alphabetical order, in general and then specially, of the glands, of he bones, and of the skin and exterior parts: 4.Sleep and Dreams: 5. Fevers with Chill,Circulation and Sweat(the 2nd, 4th and 5th sections have concomitants);6. Aggravations and Ameliorations from time and circumstances: 7. RElationship of Remedies. In section seven under each drug the previous section headings, I through 6,are given and under each the remedies applying in that section which are related to the drug in question.
At the end of each drug is given a list of other related remedies and the antidotes.
THE BOENNINGHAUSEN REPERTORY; ITS USE.
This Repertory is based in GENERAL;S even much more than the Kent. The rubrics in the different sections dealing with the different aspects of one symptoms are used to eliminate all remedies but such as run through them all. This is a swifter, easier method than the Kent, but too general, and a great many symptoms cannot be found in it at all. Also there are very few rubrics under MIND, only seven pages out of 482. Bogers General Analysis is based on this repertory and his unique method of working cases by it is also deserving of study.
THE BOERICKE REPERTORY.
The Kent Repertory in its present form is unwieldy for the physician to carry with him to the bed side. Neither the BOENNINGHAUSEN nor Kent repertories have any materia medica. Two books which combine Materia medica and repertory are handy in the pocket or medical bag. One of these is Bogers Synoptic Key, of which his General Analysis is an abridged form,and the other is Boerickes Materia Medica with Repertory. the Boericke Repertory resembles the Kent rather than the Boenninghausen but boericke has reclassified some for the anatomical section.
For instance, vertigo appears under HEAD; census are grouped together under NOSE; lips are under MOUTH instead of FACE; tongue has a section to itself as have gums; esophagus is under THROAT instead of STOMACH; foods that disagree are in STOMACH with the cravings and aversions; rectum and stool are under ABDOMEN; all the URINARY SYSTEM is together under that heading; breasts are rightly classed under the FEMALE SEXUAL SYSTEM;there is an admirable section on PREGNANCY, LABOR and LACTATION; after GENITALIA comes the section on the CIRCULATORY SYSTEM including pulse; then comes the LOCOMOTOR SYSTEM including extremities,gait, neck,inflammatory rheumatism and arthritis,back, and axilla; then comes RESPIRATORY SYSTEM, including lungs, cough, expectoration, larynx,. voice and respiration, larynx, voice and respiration;following this is the SKIN.
The FEVER section includes chill and sweat,the exanthems and various fevers such as influenza, typhoid, malaria, etc. The NERVOUS SYSTEM follows and includes epilepsy, paralysis,sleep,dreams, weakness,convulsions, goitre, sea- sickness, neuralgia, sciatica, spine, meningitis,etc. The GENERALITIES section is much reduced and contains mainly diseases tissues,poisoning,suppressions (under CHECKED discharges), glandular affections including mumps, goitre a very interesting section on COMPLAINTS from winds,damp places, sudden,gradual,injuries, prophylactics,and tumors. The section has been relieved of much misplaced matter and has added to it a great deal of interesting and valuable material. The last section is MODALITIES,first aggravations and then ameliorations and time under these appears in alphabetics order under morning, night periodicity, etc., instead of altogether at the beginning o the section as in Kent.
Under all extensive heading such as HEADACHE, appear definite captions in the following order; Cause, Type, Location,Character of Pain, Concomitants, Modalities, i.e., Aggravations and Ameliorations.
The book is a clinical rather than a symptomatological index and has many technical terms as main headings., A tremendous number of remedies sure given in the materia medica section,and well given,with plentiful mentals. Owing to its small size a great many symptoms have had to be omitted from the repertory. Its pretensions are not great but its usefulness within its sphere is tremendous.
This gives the beginner a birds eye view of three of the most usable general repertoires. It is strongly advised that every student master the Kent method, as if will reward familiarity more than any other. To the advanced student it should be added that navy strange and peculiar symptoms can not be found in those three repertories and must be searched for in Gentrys Concordance, Knerrs Repertory, Lippe, Jahr, or some of the Special repertories.
Card repertories have not been mentioned. There is one by Field, based largely on the Kent, but inaccurate. It is useful for hurried acute prescribing in the office. A new card repertory, exactly following Kent, is now under construction by the Doctors Pulford of Toledo, Phil., Bogers cards closely follow his Synoptic Key.
These different methods of repertorizing will appeal to different types of minds and will also be suitable for different types of cases, the Boger method suiting those with much pathology and few other symptoms; the Kent method suiting those4 with marked mentals and an intricate anamnesis; the Boenninghausen suiting conditions with acute pains and clear cut modalities, cases repertory study we would reiterate, STUDY THE KENT METHOD, FIRST, LAST, AND ALL THE TIME.
This theory of the specific tension of the ultimate action, when treated by the Hahnemann method of trituration and succession seems to us the crowning glory of our system. That the; last possible sub division of he material mass contains its proper proportion of the specific qualities which gave a character intensified, and while under this tension may communicate itself to substances formerly foreign to it, and this too with an immediateness which is almost electrical; and thus the specific life of a man may be directly reached by the specific quality of a remedy; all these seem to us revelations- American Homoeopathic Review, 1859.
Here comes the fact. Away with all theorizing and explanations. It is a positive truth,one which admits of no question in the minds of candid experimenters,that drugs which have passed through the process of frictionization according to the Hahnemannian plan., which involves the necessity of dilution and attenuation, do possess the same specific powers as when in crude mass. It is also perfectly well settled that these specific properties are really intensified by this process-ROGER G.PERKINS, M.D., 1859.