When the doctor closes the discussion, I would like him to give us some idea of what he means by an index of materia medica.
DR. A. PULFORD: May I be allowed to ask one question? I think it will be of interest to all. Is a patient who is relieved from a cold bath of necessity aggravated by a warm bath? I have not found it so, but if it is so, then Kent was justified in leaving that rubric out.
DR. BOGER: We might talk until this hall would be empty about repertories and wouldnt have settled anything.
There are two or three little facts about using repertories that I would like to call your attention to. That is, a symptom occurring in a single part is often general and the modifier of a symptom, heat or cold, or whatever it may be, in one part of the motor system is very often also general. That is, suppose you have a cutting pain in your little finger. Heat or cold, or some other modality will refer to any cutting pain that that patient may have in any part of his muscular system, and the modality for a cutting pain in the calf of the leg, which is highly special, will hold true for the back or the other leg. The modality of a cutting pain in the lumbar region will be just as good as for a cutting pain in the leg.
Kent often took the modality out of one symptom and applied it to another symptom, to a totally different symptom in the same region. Perhaps you never though of that. For instance, he will take a modality out of symptom 560 and apply that same modality to an entirely different symptom; maybe the symptom that he is talking about will be tearing pain, and he will apply it to a burning pain — pick the modality out of one symptom and apply it to another symptom in the same region.
Now, for that reason it is absolutely necessary to get a complete symptom picture of your case and not try to prescribe on two or three symptoms which unfortunately, we are sometimes compelled to do.
About concomitants, we must remember one thing about them, and that is concomitants occur in the materia medica text in rather a limited way as compared with the possibility of the number of concomitants we have. We may have any possible combination. They ought to be called coincidences and not concomitants. Coincidence is the right term. For that reason your concomitants can be only of minor value, unless you join them together otherwise.
When it comes to building repertories, the current repertoires are the only true and real repertorial way of doing things, because that does it the way it occurs and the way it goes through your mind, that is, you are continually occupied in trying to fit symptoms together. Isnt that what you are doing ? You are continually occupied in trying to fit that picture puzzle together. That is just exactly what you are doing with a card repertory, you are putting those parts together.
To make a card repertory feasible, you are compelled to reduce those large rubrics which you see in the Boenninghausen and Kent book to comparatively few remedies, but you clarify the matter while you are doing it. Every large rubric, and some contain more than 200 remedies, is an impediment for finding the similimum. To work up that large rubric into minor rubrics is not the work of a few minutes; that is the work of many hours. Then you come to the reverse process. You can take half a dozen of the minor symptoms and fit them together and see which remedies run through most of them. Those are two common ways of doing it.
I hold, and I think I have had a little experience in that, that a card repertory more closely simulates your way of thinking than all the repertories that we have, and prevents waste of time. Unfortunately, a card repertory is always limited in the number of cards that you can use, or will use, and the number of remedies on those cards. Whenever you have gone beyond a certain limit, you make a card repertory like the one here that our friend in New York built; it is just as hard to use it as other repertories, or a little harder sometimes.
DR. DIXON: I know you all think I am going to get up here to defend Kent, but I believe I will defend Pulford instead of Kent, because I know how much that boy thinks of Kent, and he, like everybody else, knows the shortcomings of a repertory, which, on the face of it, never can be complete. It has to be open to improvement all the while. Nobody knows that better than Dayton, so I am just going to speak a good work for Dayton on that.
I have studied repertories for years, and it always pleases me when somebody gets up and criticizes them, because I have always been full of criticism myself. I remember a few years ago Dr. Wright Hubbard, who is now present, decided she would write a new repertory. I havent heard a thing about it for about five years, isnt it, Dr. Hubbard?.
DR. HUBBARD: I have been writing a few other things in the interim. I am still on it.
DR. DIXON: It is an ambition that I feel like encouraging, but I hope some time somebody will be colossal enough to write a better one than Kents, and I think Kents is the best one still. They are all good, and all are needed.
The trouble we have with our repertorizing is better case taking. When I have trouble with a repertory case, I always feel the necessity of calling the patient back and retaking the case and picking up some loose ends that I had skipped.
Another word about indexes. I tell my patients that a repertory is an index. You have changed the thing you are looking for, instead of a symptom, into a rubric, that is about all the difference.
DR. LEWANDOWSKI: One of the most important things to consider in prescribing homoeopathically is the saving of time, and, unfortunately, that seems to be the biggest hindrance to the practice of pure homoeopathy. Given a long line of patients (this is an unusual occurrence in this present age of depression), how can you practice homoeopathy properly and dispense, with the number of patients that are waiting in your office, anxious to get out ? I have adopted a very peculiar method. Purchasing three books of Bogers Synoptic Key, I have taken the face of each printed page and pasted it in a little room off my office. The entire Synoptic Key is pasted on a side wall there. Each symptom has a number. This number corresponds to an index that I have on my desk.
A patient walks into my office and immediately on observation I class him, and without much trouble I pick out the number rather than write the symptom. I question him further. If I find that the patient is restless ( and it must be restlessness in the highest degree) I pick out this as an important symptom and jot down the number rather than the symptom. This saves time in writing out the full history of the patient, and if I want to go into investigative work, I look up the number to find out what it represents. Then the patient is given a thermometer in his mouth, and asked to walk into the next room.
I go into my room, with a checker in my hand, and with this history of numbers rather than symptoms, I jot down each number that is on that board. By that time I take the thermometer out of the patients mouth, read it, and ask him to undress for further examination. While he is doing that, I begin with the most important basic or outstanding symptom and check it, say, for instance, Pulsatilla, give it four checks, then go down to the next symptom, and on through, and then I write down “Pulsatilla, value of 25.” Then I go through the rest of the symptoms and complete my examination with the patient, and immediately I have the information.
Almost every case, whether acute or chronic is given the advantage of that sort of repertorial study. Unfortunately, many times the remedy that you are seeking, and you know is indicated, does not come out in the value in this examination. This probably is due to a faulty history taking. Then if I am faced with such a fact, I give the patient a placebo and wait until I can further study the case. I find this a very simple idea in doing a repertory study, without letting the patient know what you are doing. Although I have not used it very long and cannot quite the results I have received, I am confident that I am studying and practicing homoeopathy as nearly pure as it can be.
DR. UNDERHILL: It seems that we often think we have to hurry and prescribe for the patient the very first time he comes, or certainly the second time or the third time, whereas in chronic cases we have all kinds of kinds of time. At each interview we gather together data and get acquainted with the patient. In the meantime, you are doing something for him, and what are you doing? You are removing the obstacles to recovery, untangling and simplifying his life, correcting his diet, improving his daily routine, and helping him a great deal, and then when you are ready to give him the remedy, you have no particular obstacle to overcome except the disease itself.
DR. ROBERTS: Miss Wilson teaches the Boenninghausen system in Boston at the post-Graduate School, and I should like to ask if she has something to say.
