The greatest single book in homoeopathy is, perhaps, kents Repertory, which, to the ever increasing number of physicians who use the Kent method of repertorizing, is absolutely indispensable. Every physician needs this mammoth index, this concordance of our craft, not only to work out chronic cases in his rare hours of leisure, if any, but also for immediate reference at the bedside in acute, desperate and obscure cases. The student and the novice especially need it constantly, although no master mind is retentive enough to dispense with it entirely.
Yet, how unwieldy a book it is! Five pounds in weight, ten and a quarter by seven by two and a quarter inches in size and costing twenty-five dollars! These disadvantages in format, harassing as they are, are as nothing compared to the obstacles to swift and precise prescribing in the text itself. For the sake of those who are not thoroughly familiar with the kent Repertory I will explain its present plan.
1. MIND, being the innermost and most important stands first.
2. VERTIGO, unreasonably enough, comes next.
3. HEAD, which includes scalp, follows.
4. EYE and VISION.
5. EAR and HEARING.
7. FACE, including lips, salivary glands and sinuses.
8. MOUTH, including tongue, taste and speech.
10. THROAT, including uvula, tonsils, oesophagus, but not larynx.
11. EXTERNAL THROAT, including thyroid, glands, torticollis.
12. STOMACH, including desires and aversions to food but not food aggravations. Thirst in general is found here.
13. ABDOMEN, including groins, hernia, liver, dysmenorrhoea (also found under GENITALIA, FEMALE).
14. RECTUM, including constipation, and diarrhoea.
16. URINARY ORGANS: Bladder, including urination; kidneys; prostate gland; urethra; urine.
17. GENITALIA: Male; female (menses are also found under generals).
18. LARYNX and TRACHEA, including throat-pit and voice.
22. CHEST, including heart, lungs, breast and axillae.
23. BACK, including cervical region and spine.
25. SLEEP, including dreams.
30. GENERALITIES, including physical generals; pathology; convulsions; fainting; aggravations or ameliorations from food; certain sensations; types of pain, direction of pain, pain in certain tissues, such as bones, cartilages, glands muscles, periosteum; pulse; aggravations before, during or after sleep, menses, coition, etc.
Let us enumerate a few of the obstacles:
1. Many rubrics are out of place from the point of view of common sense. For instance, things pertaining to the neck are found both under external throat and under back; pulse is under generals instead of being with heart under chest; sinuses are divided between head, face and nose; salivary glands are found under face; and lips are also under instead of under mouth. These are matters of anatomical classification which should be simplified and corrected. There is no section for the circulatory system, the glandular or lymphatic system, nor for the nervous system.
2. Even under the existing arrangement certain headings are misplaced; Awkwardness under generals when it is a mental; desires and aversions to food under stomach when they should be under generals for they indicate the whole patient; and the type of menses, so characteristic of the whole person, should be under generals instead of under female genitalia as at present. These, of course, are instead are only a few examples.
3. Pathological and diagnostic headings and many objective symptoms are now sprinkled through the book. These should be collected, classified and placed in a special section by themselves.
4. Many common symptoms, such as vomiting, restlessness, sadness, etc., have such large rubrics as to be practically useless. Moreover they consume much space. These should either be deleted or put in at the head of the particulars related to them, with only the third or highest degree remedies given.
5. Repetitions abound. These are often due to the use of synonyms in different places with somewhat different remedies. These could either be cross referenced or combined under the most usual synonym, or grouped under the most usual heading, the other symptoms as sub-headings and the varying remedy rubrics distinct under each. By this last method one does not blur the shades of meaning and one provokes discrimination on the physicians part. For example, haughty, insolent, contemptuous, defiant, scornful, arrogant. dictatorial, presumptuous, domineering, dogmatic, etc.
6. The Repertory is based on only about 540 remedies. This should, of course, be brought up to date, but that is an herculean task, not really within the scope of an abridgement and rearrangement of the present Repertory. There are some important remedies, however, which should be added.
7. Confusion arises in the mind of the novice until it is realized that where nothing is mentioned after the heading of the rubric it often means “aggravated from”. For instance, under GENERALITIES, FASTING, is meant “aggravated while fasting”. The ameliorations are always mentioned and the aggravations sometimes are, which makes it a bit confusing.
8. Many rubrics could with profit be omitted from an abridged version of the Repertory to be carried in ones bag. For example, such a rubric as cheerfulness. It is the abnormalities of cheerfulness that are noteworthy, such as over-exuberance which might be classed as hilarity, or too little cheerfulness which should come under depression.
9. Last, but by no means least, comes the lack of an index and of cross references. These are essential for proper use of the Repertory. At present the physician has to write in the page numbers of the cross references for himself.
These are some of the main criticisms but there are many others. Every systematic physician would have his own preference as to arrangement, his own evaluation of the meaning of words, especially in the section on mind, and his own ideas of what would constitute a workable repertory.
In proposing the following schema for an abridged working Repertory we proceed from the premise that a novice taking up a difficult new book should find it arranged in a logical and common sense order which, while true to the best of homoeopathy, should be consonant with current medical teaching. Our fundamental thesis is the arrangement of our new Repertory according to the schema of the value of symptoms, emphasizing those which pertain to the patient as an individual personality.
This implies that the mental generals come first, the physical generals next, and the pathological generals third as indicative of the tendency of the constitution. Immediately after these and before the details of any systems or organs should come the other general sections such as vertigo, sleep, chill, fever and perspiration. Ideally “the strange, rare and peculiar”, characteristic particulars should come next in a separate section. It may seem insuperably difficult to window these out from the chaff of common symptoms but at least a very helpful and suggestive “keynote” section of these could be compiled.
In this first volume, including the above, should appear an index to the new Repertory with certain essential cross references. All of the above we feel should constitute volume 1. Volume 2 would then be devoted to the symptoms of the separate systems, anatomical regions and organs, with the modalities, the sensations, etc., separated. This second volume would then be of special use in acute work and the first volume would almost be sufficient for the working of a chronic case, at least in the first stage which is based on the generals.
These two volumes should be on bible paper, thin and tough, about six by four inches, with a tough, black, limp leather binding much like Boerickes Materia Medica with Repertory, which stands hard usage, and can be carried in the bag or pocket. The price of the two volumes should not exceed ten dollars. At the back of the first volume would be a list of synonyms, not only in English but also in French and German and possibly in Spanish. This would make the work available internationally. A list of correct remedy names with pronunciation marks and carefully standardized abbreviations should be added, and a brief section on remedy relationships appended.
It is impossible in the scope of this paper to give the complete details even as far as already worked out, but this tentative schema is offered.
1. MIND OR MENTAL GENERALS.
a. The WILL which includes the loves, hates, emotions, suicidal thoughts,loathing of life,lasciviousness,revulsion to sex, sexual perversions, fears, homicidal tendencies, jealousy, suspicion, greed, obstinacy, depression, loquacity, impatience, conscientiousness, etc., dreams, (which, though highly indicative of the patients mental state, are now listed under sleep), desire or aversion to company, family, friends, etc. Under this heading should come ailments from emotions, now scattered throughout the book, and aversions, similarly dispersed.
b. The UNDERSTANDING which includes delusions, delirium, hallucinations, loss of time sense, mental confusion, etc., and some mental pathological conditions such as idiocy, imbecility, insanity, hysteria, mania, etc.
c. The INTELLECT which includes concentration, memory, mistakes in writing and speaking precocity, etc.
d. Certain OBJECTIVE symptoms such as biting, desire to hide, grimacing, etc.
2. PHYSICAL GENERALS.
a. Constitutional types which include such rubrics as dwarfishness, emaciation, lack or excess of vital heat (cold or hot blooded), obesity, blonde or brunette (rubrics from earlier edition of Kent), sensitiveness, lack of reaction, etc.
b. Suppressions-emotions, discharges, eruptions, diseases, pathology, etc.
c. Menses, habitual type and recent changes in type, aggravation or amelioration before, during or after menses.
d. Other discharges, type, better or worse from, etc.
e. Modalities of the patient as a whole including time, periodicity, seasons, moon phases, temperature and weather (scattered in numerous places), bathing (dread of bathing should be put under mentals), rest, motion, position, external stimuli (touch, pressure, clothing, light, noise, etc.), eating and drinking, coition, etc.
3. PATHOLOGY including disease diagnoses.
4. OBJECTIVE SYMPTOMS.
5. VERTIGO, FAINTING.
6. SLEEP, Dreams, see mentals.
7. CHILL and FEVER.
9. STRANGE, RARE AND PECULIAR SYMPTOMS. This should be placed here because, when present, they are of great value in pointing to the patient.
All of the rubrics should be classified, combined, deleted, arranged alphabetically, and scattered rubrics brought under one heading.
The second volume will contain the PARTICULARS anatomically arranged under anatomical locations, systems and organs. The missing systems, such as circulatory, nervous, locomotor, etc., will be added and the rubrics belonging under them reclassified in their proper places. Certain regions such as neck, breast, etc, will be separated for readier reference. Certain rubrics such as sinuses, pulse and glands will be rationally placed. All of the pain section rubrics and rubrics on sensations should be carefully gone over and standardized.
As all Repertory users know, this revision is a gargantuan task and I shall spare you the wealth of detail. Dr. Lyle and I have been working on this project and hope to have the manuscript for presentation at next years meeting of the Association. Constructive criticisms and suggestions are eagerly solicited both in the discussion and by letter. It is impossible to fit a repertory to the needs of every individual mind but it is hoped that the proposed revision will at least make a workable and lucid reference book for a larger number of homoeopaths.
CHAIRMAN J.W. WAFFENSMITH: I want to thank Dr. Wright for this valuable paper. It shows a very fine sense in repertorial analysis. And I also want to take advantage of this opportunity to thank the doctor for the series of articles in the Recorder which I have appreciated very much. The paper is open for discussion.
DR. E.B. LYLE: It may be of interest to the Association to know that in the last number of the British Medical Journal [The British Homoeopathic Journal, Vol. XX, April 1930, p. 11-0. Dr. Frank Bodman has an article on partial-I dont know just what to call it-I will call it revamping of the general section of kents Repertory, which is very good. It is discussed by a number of very prominent homoeopaths in England and is well worth everybodys reading if they are interested in this particular subject.
Dr. C.M. BOGER: The practical difficulties of working with a repertory is a thing that I want to talk about a little bit. I have had a little something to do with repertories, and I have found in my won work that most repertories are deficient in this respect. You can rarely get a rubric and then the concomitants belonging to it. That is a very great fault. That is only found in Boenninghausens Characteristics (Boger) and in the British Cypher Repertory, Often I am obliged to go to me or the other to get my concomitants and the case is often solved only in that way. They are not found in Kent or in any repertory that we edit. It is easily enough seen that a concomitant may be found in some other place, but that is like looking for ten needles in a haystack and hitting on the right one.
Then there is another thing. Take the section on the MIND, You cant find the aggravations from the mind in general under any repertory that I have ever seen. I have it in my private copy. The aggravations found are applied to individual rubrics or to symptoms at most, but the general aggravations and ameliorations are not found in one section. When you want to take a case from particulars to generalities or the reverse those two features are essential, absolutely essential, to generalities or the reverse those two features are essential, absolutely essential, and you stop right there if you havent those two features. You must hut some other place for what you want.
If Jane Smith has a very prominent mental symptom and I havent an possible way of finding her aggravations of the mind, what must I do? I have to look under aggravations and ameliorations in general, then the various rubrics, to find what I want. I flounder around there, and the job is endless. How much shorter it would be if you had a chapter on aggravation and amelioration of the mind itself.
Those are two very knotty problems for repertory users and cannot be easily worked out unless you have the British Cypher Repertory and this requires a knowledge of their abbreviations and how they work them. I would suggest to these two doctors, if they want to perfect their repertory, that they incorporate The Cypher Repertory because that is pure gold, every bit of it, and very much to be depended upon. I find things there that I cant find any other place, and I couldnt do without it.
DR. W.W. WILSON: Is that still being printed?
DR. C.M. BOGER; No, you have to get second-hand copies. They are difficult to get.
There are other points about repertory that I should like to answer if somebody would ask the questions, being concerned in the manufacture of repertories.
DR. G. ROYAL: I should like to make one suggestion also, and is that when you get at these different sections, you arrange them according to the value of symptoms. That is the trouble with Kent especially in his Materia Medica. I said to him once, “Why dont you put in an index, and why do you have something flap right along with not one single symptom differentiated from another”? He said, “A man with brains wont need it” I sat down.
I think you ought to have your symptoms arranged by numbers, numbers 1, 2, 3, etc., or emphasized by being put in italics, or something like that, especially for the student.
DR. C.M. BOGER: I think the lack of an index is a dreadful drawback.
DR. E. WRIGHT: I should just like to say that those are grand suggestions from Dr. Boger and Dr. Royal. I expected that at least two-thirds of the present company would jump down the throats of the children for their temerity in hoping to abridge Kent, and I had hoped that same of you would say whether you thought it would be of any practical help to abridge it. I want to say that we have no intention of superseding the present Repertory.
DR. C.L. OLDS: I think this is a wonderful project and I think the doctors have a great deal of courage to start a thing life this. I suppose they hardly have a conception of the immense amount of work involved I hope they will be successful.
ESSENTIAL: Gnawing, hungry, faint feeling at epigastrium, tendency to overeat. If appetite is gratified distention of stomach and abdomen and palpitation follow. Craves meat, pickles and other coarse food. Irritable and dizzy.
IMPORTANT: Right lung and liver feel small and hard. Pain under right scapula. Lies with legs drawn up Shivering as if blood were cold water. As if uterus were soft.
CLINICAL: Any disease which includes the above essentials, PROLAPSED uterus from defective nutrition, funds sore, better pressure (compare: Calc, phos., aching in uterus: Helon., tired backache; Lac. deft., throbbing frontal headache and obstinate constipation, and Nat. hyp, soggy, heavy uterus).
MISCELLANEOUS: Compare Abies nig.-A. and D. PULFORD.