Correlation of Phatak’s repertory and Boericke’s repertory in the management of COPD

Dr Nidhi Jain

ABSTRACT
In the recent years due to increasing air pollution, unhealthy habits like smoking, low immunity due to sedentary lifestyle, etc. all these factors have significantly contributed to the rise in the cases of Chronic pulmonary obstructive disease (COPD). Some of the symptoms include difficulty in breathing, shortness of breath, cough with or without expectorant, along with feeling of tiredness. People suffering from COPD are at a higher risk of other health problems. In this article we will be studying the repertorial approach in the management of COPD by correlating two repertories viz.  Phatak’s Repertory and Boericke’s Repertory.

KEYWORDS – COPD, Phatak’s Repertory, Boericke’s Repertory, Repertorial approach.

DEFINITION – Chronic obstructive pulmonary disease (COPD) is defined as a preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases. The spectrum of COPD includes chronic bronchitis and emphysema. ⁽¹⁾

EPIDEMIOLOGY – In India, COPD is the second most common lung disorder after pulmonary tuberculosis. The disease is frequently encountered in the middle-aged patients and is rare below the age of 35 years. COPD affects males more frequently because of smoking. It is equally prevalent in rural and urban areas. ⁽²⁾

MANAGEMENT
The management of COPD focuses on improving breathlessness, reducing the frequency and severity of exacerbations, and improving health status and prognosis. Reducing exposure to noxious particles and gases Sustained smoking cessation in mild to moderate COPD is accompanied by a reduced decline in FEV1 compared to persistent smokers, and cessation remains the only strategy that impacts favorably on the natural history of COPD. Bronchodilator therapy is central to the management of breathlessness. Combined inhaled glucocorticoids and bronchodilators. ⁽¹⁾

CASE STUDY – A 42 years old male patient came up with the following complaints –

Chief complaints – Dyspnea on slightest exertion, wheezing and coughing, stringy expectoration, chest tightness on and off since 5 years.

History of Presenting Complaints – He has been experiencing breathing difficulties for the past 5 years, which have worsened over time. He has a history of smoking (7-8 cigarettes per day for 30 years) and was diagnosed with COPD 3 years ago. Took many allopathic treatments, but temporarily relief and again the symptoms relapse.

Modalities – Aggravation – night, least cold air. Amelioration – covering

Past history – Recurrent respiratory infections.

Family history – Mother – Alllergic rhinitis. Father – Diabetes mellitus.

Physical generals –

• Diet – Mixed diet
• Appetite – normal
• Desires – sweet
• Aversion – N.S
• Thirst – small quantities
• Stool – once satisfactory
• Urination – NAD
• Sleep – disturbed
• Dreams – Does not remember.

Systemic examination –

R.S – Bilateral rhonchi.

Totality of symptoms –

1. Dyspnea on slightest exertion.
2. Wheezing and coughing, <night, least cold air; >covering
3. Stringy expectoration.
4. Chest tightness
5. Habit – Cigarettes
6. Desires – sweet
7. Thirst – Small quantities

Repertorial Totality –

Repertorisation from Phatak’s Repertory – ^{(5) (3)}

Repertorisation from Boericke’s Repertory – ^{(5) (4)}

Final Remedy Selection – Arsenic album 200 x 3 pills x QID.

After 2 weeks – Coughing was slightly better. Dyspnoea was much better. Expectoration was still there. So on follow up remedy given was – Antimonium Tartaricum 200 x 3 pills x TDS.

After 4 weeks – All the complaints were much better, Antimonium Tartaricum 200 was continued.

CONCLUSION – Phatak’s repertory is one of the reliable alphabetical repertories which is concise, handy & useful for ready reference. General modality represented in the capitals AGG or AMEL & modality related to a particular part is represented by small letters Agg or Amel. Boericke repertory is a clinical repertory which contains clinical symptoms & corresponding group of medicines.

Now if we correlate both the above repertories, we have come to the same remedy selection at the end. Both are clinical repertories but have different rubrics, and less rubrics in common. For me it was easier to found rubrics in Boericke as it is according to systems of the body, and I had to focus on respiratory system particularly. So I gave Arsenic album at first case taking and Materia medica being the final court in remedy selection, Antimonium tartaricum was given at follow up.

Both Boericke repertory and Phatak repertory facilitate the selection of remedies based on pathological similarity, causation, modality & concomitants. So either of the repertories can be used in management of COPD depending on the modalities and causations.

REFERENCES 

1. Davison’s 24th Edition.
2. API Textbook of Medicine (2 Volumes), 9^th
3. A Concise Repertory of Homoeopathic Medicines by Dr. S. R. Phatak 4th Edition.
4. Boericke’s Materia Medica with Repertory 9th edition.
5. Radar Software.

Dr. Nidhi Jain (MD-Part 1)
Department of Repertory, D.K.M.M.H.M.C. Chh. Sambhajinagar (Aurangabad)
Email: nidhi21nj@gmail.com

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