repertorisation & different method of homoeopathic repertorisation

Reperto r i s a t i on & D i f fe rent Reperto r i s a t i on & D i f fe rent Method o f Homoeopath i c Method o f Homoeopath i c Reperto r i s a t i onReperto r i s a t i on

Compiled by:- Dr. Shuchita Chattree Compiled by:- Dr. Shuchita Chattree B.H.M.S, M.D. (PGR)B.H.M.S, M.D. (PGR) Jaipur, IndiaJaipur, IndiaEmail: [email protected]: [email protected]

18/11/14REPERTORISATION & DIFFERENT METHOD OF HOMOEOPATHIC REPERTORISATION BY

DR.SHUCHITA CHATTREE 1

“The best repertory anyone can have is in his own memory.” -John H. Clarke | The Prescriber.

18/11/14Repertorisation & Different Method of Homoeopathic Repertorisation by Dr.Shuchita Chattree 2



Repertories were introduced into homeopathy because the

expanding Materia Medica became, too voluminous to

allow quick and easy reference, even in Hahnemann’s

lifetime, As mention in various literature.



Dr. Samuel Hahnemann:- “First realised the need

for some form of index to recalling the symptoms of

our ever increasing provings data, appending an

alphabetical index.”

-mention in his Fragmenta de Viribus

Medica mentorum Positivis Sive in Sano Humanis

Corpore Observatis, 2 parts, 269 & 470 pages,

J.A.Barth, Leipzig, 1805:- His work contains the

provings of twenty seven (27) substances.



• Hering states in Hering, C.: Analytical Repertory of the

Symptoms of the Mind, second Edition, Philadelphia,

1881.:“It is true that Hahnemann added to his first

collection (his ‘Fragmenta’of 1805), an index where every

word could be found; but it was altogether out of

proportion … The text, in large type spaciously printed,

filled 268 pages; the index, in small type condensely

printed, filled 469 pages.”



In Systemic Alphabetic Repertory of Antipsoric Remedies Preface (1st ed., 1832): Boeninghausen says about Repertory:

“… which fact caused me, even at the beginning of my study of this excellent and invaluable treatment, to think of expedients which would make the choice of suitable remedies easier and more certain, by this means bringing the symptoms of each one more clearly into view;”



Dictionary meaning of Repertory = index, list, catalogue.

This method embraces a variety of techniques whereby a repertory

is employed to determine a small group of remedies, from which

the most similar one to the case may be chosen.



DEFINITION DEFINITION OFOF

REPERTORISREPERTORISATIONATION

As Given in different booksAs Given in different books



“Art of repertorisation is based on the art

of proper elicitation of symptoms with the

fullest possible expression of each of

them, then their proper evaluation,

categorizing and classification.”

Patel.R.P : The art of case taking & repertorisationPatel.R.P : The art of case taking & repertorisation

DEFINITION:-DEFINITION:-



“Repertorisation is not only a mechanical process

of counting rubrics & totality marks obtained by a

medicine; it also includes the logical steps to

reach the proper repertory & finally

differentiating the remedies with the help of

materia medica.”

Castro : Logic of repertoriesCastro : Logic of repertories

DEFINITION:-DEFINITION:-



Method of Repertorisation:-Method of Repertorisation:-



There are 2 Main methods of repertorisation:

1. Aggregation method.

2. Elimination method.

METHOD OF REPERTORISATION:-METHOD OF REPERTORISATION:-



1. Aggregation method / scientific method:-

In this all the analyzed symptoms are written one after another and

the indicated remedies are written against them depending on the

process selected. The frequency of the appearance and the sum of

marks scored by the medicines are calculated. This is the repertory

value.




Commonly as use in daily routine.Commonly as use in daily routine.



Advantage:

1. No symptom however insignificant not neglected.2. Final outcome is the faithful reflection of the symptom expression in the drug pathogenesis.

Demerits

1. Laborious & time consuming2. Both the prominently expressed symptom & vague symptoms are awarded the same

status.




Elimination method / artistic method:-

Dr. Margeret tyler introduced this method.

In this method the symptoms are arranged in a hierarchy in accordance to the schools of philosophy of the selected repertory.

Eliminating symptoms are those symptoms which through of all the medicines that are not needed for the patient and bring only those medicines which are required for the patient.




The eliminating symptom is very important in the exercise of repertorisation because it dictate & determine the medicines that compete for the mantle of the similimum.

It act as safe shortcut to the prescription in the hands of the experienced physician.




The elimination mode can be:-

1. Single step elimination

2. Cascading elimination





Single step elimination:-

The elimination of the medicine is done only once, at the beginning of the exercise.

The most prominently characteristic symptom is selected as the eliminating symptom.

The medicines indicated for this are noted down. For the next rubric / symptom ,only these medicines which are common to the eliminating symptom are considered.

Medicines outside the eliminating symptom whatever be its grade is not considered for repertorisation.




In this method elimination is carried out thro’ the whole process.

Each symptom became the eliminating symptom for the next symptom.

Extreme caution & care should be taken in structuring the hierarchy of symptoms.

The symptoms have to be arranged in the descending order of importance.

Cascading elimination:-




The medicines in the first symptom / rubrics are noted down, for the second symptom only

the medicines covers the first symptom are considered.

On working out the third symptom only the medicines those are indicated against the

second symptom are selected.




So first symptom is the eliminating to second symptom, second symptom is

eliminating for third symptom and so on.

Thus each symptom is the eliminating symptom for the next symptom.

The repertory value of each medicines is worked out in exactly the same

manner as in aggregation method.




ADVANTAGE:

Labor & time consumption greatly reduced

DIS-ADVANTAGE:

If one is not thorough & effective while structuring the hierarchy of symptoms,

He may fail.




By various authors:By various authors:




1. Kentian method:

This method of grouping from generals to

particulars with important to mental generals &

Physical generals is called Kentian method of

repertorisation.

It is commonly used method.




2. Hahnemann & Boenninghausen method:-

When there is lack of clearly indicated mental symptoms and

particulars with associated concomitants / complete symptom

present.

We can use Therapeutics Pocket Book as our aid.

This method is called Hahnemannian or Boenninghausen method.




3. Working on peculiarity:-

Cases having one or more peculiar symptoms with few generals &

undefined symptoms.

Our aim is to find out the medicine which have that peculiar symptom

and then proceed with vague or common symptoms.




Any repertory which deal with the peculiarities can be used for this purposes.

This method of finding a medicine with the help of a peculiar symptom

is called Keynote symptom method.




4. Working on pathological generals:-

When we come across patients with a few common symptoms or pathological symptoms only. The following details will help in the selection of medicines:

I.Patients personal history & family history.

II.Temperament.

III.Complexion, color & texture of skin.




IV. Particular organ or tissue affected.

V. Location, character & physical aspects of lesion.

VI. Possible cause of illness.

VII. When all the available symptoms are put together they may direct to the

medicines.



Working on technical nosology:

Prescribing on nosological diagnostic terms or lab investigations.

When nothing to prescribe upon and the patients presenting with diagnostic terms

without any symptoms eg. aneurism, atheroma etc. we can use any of the clinical

repertories.

These would not help in the choice of medicine but will bring us close to a set of

medicines.




Dr.B.K.SarkarB.K.Sarkar in his book Lectures in Homoeopathy ( 1956 ) has described the following

methods of working out the cases :

1) Hahnemann and Boenninghausen’s method= where complete symptoms are available.

2) Kent’s method = Where Generals ( mental and physical ) and particulars are available.

3) Third method = Where mental symptoms are lacking. Here one starts with physical

generals; next mental symptoms and then particulars.





4) Fourth Method = Where Generals are lacking. Selection of a striking, peculiar as a

key symptom, and then medicines are differentiated with the help

of other symptoms.




5) Fifth Method = Where the case presents only common symptoms or pathology.

Here physician makes use of every means at his command.

(a) Patient’s personal and family history ,

(b) Temperament,

(c) Complexion, color and texture of skin,

(d) Particular organs and tissues affected,

(e) Location, character and physical aspect of lesions, and

(f) Probable etiological factors.




(6) Sixth Method= Technical nosological terms are selected as main headings.

The methods described above have their own advantages and disadvantages.



Boenninghausen Boger Kent Boenninghausen’s

Therapeutic Pocket Book (BTPB)

Boenninghausen’s Characteristics and Repertory (BBCR)

Kent’s Repertory of Homeopathic Materia Medica

The philosophical The philosophical

background is based background is based

on the following on the following

conceptsconcepts

All methods have All methods have

their origin in the their origin in the

Organon and Organon and

prescription is based prescription is based

on the Totality of on the Totality of

Symptoms.Symptoms.

Doctrine of Complete Symptoms,

Doctrine of Analogy,

Doctrine of Concomitants and Modalities, Evaluation of Remedies, concordances, Principle of Grand Generalization, i.e. each symptom (sensation and modality) present in one part is predicated to be a symptom of the whole.

Doctrine of Complete Symptoms,

Doctrine of Concomitants and Modalities, Pathological Generals, Causation and Time, Clinical Rubrics, Evaluation of Remedies, Fever Totality, Concordances,

Principle of Generalization (if sensations or modalities are present in more than three parts).

From Generals to Particulars, with highest emphasis on the Mental Generals and strange, rare and peculiar symptoms.

Particular symptoms are used for further differentiation and the final selection of the remedy. They must be qualified.

The place of Generalization and Concomitants is very limited in Kent’s view of the totality.



Boenninghausen Boger Kent



AdaptabilityAdaptability For Cases representing: Complete symptoms, prominent Concomitants, marked sensations and modalities, when generals are lacking or strongly marked mentals are not available, cases having suffering in few parts but no modalities for all the suffering parts or scattered modalities, one-sided diseases with paucity of symptoms (if the totality of the state can be filled out), useful to get related remedies by working on the chapter on Concordances.

Cases rich in particulars with marked modalities and concomitants, pathological generals, clinical symptoms, one-sided diseases (if the totality of the state can be filled out), objective symptoms and pathological symptoms (with absence of characteristic symptoms), cases without many mental symptoms, fever cases, useful to get related remedies by working on the chapter on Concordances

Cases having generals and characteristic particulars, when mental symptoms or physical general symptoms are marked, useful in treating mental or emotional disorders, In cases with lacking Mentals, the Physical Generals and Characteristic Particulars will make the totality. If Generals are lacking, Characteristic Particulars should be used for repertorization, or, Boenninghausen’s or Boger’s repertorization

Boenninghausen Boger Kent



Techniques of RepertorisationTechniques of Repertorisation



Techniques of Repertorisation:-Techniques of Repertorisation:-

1. Thumb finger method / Book mark.

2. Plain paper method.

3. Repertory chart / Sheets.

4. Cards.

5. Computers.




Thumb finger / book mark technique:

This method is meant for quick reference in a busy practice, for those who

have more experience with the repertory.

Usably 2 or 3 characteristic symptoms are taken.

Book marks or thumb & fingers are placed at the pages where the selected

rubrics are present.

This rubrics are scanned visually, and the frequently occurring medicines

which have higher grades are short listed for selecting the similimum.




Advantage:

I. Useful when the symptoms are less in number.

II. Useful when the rubrics indicate less number of medicines.

III. No necessity of writing symptoms or medicines but only mental work.

IV. Time taken is very less, useful for busy practitioners

Dis-advantage

I. Visual errors can leads to failures

II. Little use when number of symptoms are more.




Plain paper method

The symptoms are written down on a plain paper, and the indicated remedies are

written against them on the basis of the method and process selected.

The similimum is selected on the basis of repertory value.

This technique is very time consuming for the aggregation method, as each

symptoms and its medicines have to be written down.

The elimination method can be conveniently and easily worked with the plain paper

technique.




The medicines are written one below the other and the grades are marked against them.

The first column of the grades represent the value of those medicines in the eliminating

symptom. Subsequently the grades of the medicines of the other symptoms are marked.

If a medicine found under the eliminating symptom is not indicated for any of the

subsequent symptoms a zero mark is indicated at the symptom number against the

medicine.

This is for single step elimination.

For the cascading elimination as soon as the medicine hits a zero,

It is disqualified from further repertorisation, thus eliminating it.




Repertory graph technique:-

This is simple, more refined and scientific method.

In this technique repertorisation is done on sheets when are skillfully and carefully

devised to save the time and hard work and are specifically prepared for the

repertory that is to be used.

The chart having number of rows and columns.

Medicines are printed on the first column and the symptoms are written on first

row.




The marks scored by the medicines are represented in the blocks at the intersection

of the symptoms and the medicines.

The similimum is selected on the basis of repertory value.

This technique is useful for the aggregation method of repertorisation, because time

consumption is very less.

It is unnecessary to use this technique for the elimination method for obvious

reasons.




De-merits:-

Medicines represented in the sheets are less in number.

Only polychrests are predominantly represented.




Card system method:-

These are repertories which are in the form of prepared cards.

Each card represent a symptom, cards are arranged together and

the similimum is found out.

There is no need of writing down or book markings, only the

cards are shuffled together.

This system is outdated on the arrival of computers.




Computers

The utility of computers has extended to the various aspects of Homoeopathic treatment.

The result of repertorisation can be instantly projected on the screen, with the rubrics

repertoriesd, the medicines indicated and their value in each symptom, also display the

repertory value of medicines repertorised.

The result can also printed as a hard copy on the printer.

Advantages are limitless, the aggregation method can be conveniently used on the

computer.




Dr.Patel’s auto visual repertory system:-

It is a mechanical device, practically no paper work is required.

It is all automatic, marks are denoted by three different colors and visual

throughout repertory work.

You can even read your medicines which come automatically.

The auto visual repertory consists of 5505 auto strips and auto visual

apparatus having 435 medicines on in numerical order from above

downwards.




Each medicines is provided with a code number.

Each auto strip has a number on the top representing the rubric /

symptom number in auto visual homoeopathic repertory.

Auto strip is grooved at several places, which represent the medicines,

this grooves are in different colors or markings which indicate the

gradation of drug in Kent’s repertory.




References:

I. Patel.R.P : The art of case taking & repertorisation

II.Munir Ahmed : Introduction to repertorisation

III.Castro : Logic of repertories

IV.Tiwari : Essentials of repertorisation

V.Dhawle : Princilpes & Practice of Homoeopathy.

VI.Ritu : Study of repertory

repertorisation & different method of homoeopathic repertorisation

Health & Medicine

shuchita chattree b

analytical repertory

alphabetical index

form of index

small type

small group of remedies

hering states

large type