Case taking in Homeopathy–A Repertorial Approach

Dr Saji K
This is an attempt to explain how each part of a well taken case can be utilized while searching for a similimum in the repertory. Majority of the students and practitioners are taking the case in detail but not utilizing many of the points available from the interrogation

Problem faced in Homeopathic Prescriptions

• Paucity of symptoms
• Many symptoms
• Difficulty in Confirmation of Symptoms
• Time Factor

Hahnemannian case taking (From Lesser Writings — Medicine of’ Experience)

• Symptoms Which Are Constant, Frequent, Strongest And Most Troublesome To The Patient
• Seat, Course And Sensations
• Confirmation By Re-questioning After The Completion Of Case Taking.
• Assumed Aetiology Should Not Be Considered For Remedy Selection

Why Repertory?

• Medicines Represent group of individuals & The Case Before The Physician May Be One Among
• Correct Prescription Without Reference Is Impossible In Most Of The Cases
• Reference of Materia Medica Is Time Consuming And Confusing.

Age Related Rubrics
Infants

• Abdomen, Inflammation, umbilicus,infants
• Children, Respiratory affections, infants in
• Eye& inflammation,infants
• Mind, Crying, children, in babies
• Nose, Obstruction,children,nursing infants
• Rectum, Constipation,children, in,infants
• Rectum, Diarrhea, children in,infants
• Rectum, Diarrhea, nursing, after, infants
• Skin, lntertrigo,infants in
• Rectum, Fissure,infants
• Nerves, Convulsions, children, in,infants
• Fever, Children, in,infants
• Lungs, Pneumonia, infants
• Abdomen, Hernia. umbilicus
• Generals, Nursing children, ailments in

Children

• Abdomen, Enlarged,children, in
• Abdomen, Hernia, inguinal,children, in
• Bladder, Bedwetting,children, in
• Bladder, Urging, to urinate,ineffectual,children
• Ear, Boring, fingers in,children
• Cough, Chronic,children in, emaciated boys
• Fevers, Children, in
• Food, Appetite, ravenous,emaciation with,children, in
• Generals, Obesity,children, in
• Generals. Touch, general,agg,children, in
• Generals, Walking, late learning to walk.
• Generals, Weakness, general,children, in
• Lungs. Asthma, general,children
• Mind, Abusive insulting,children,insult parents
• Mind, Anger general,children in
• Mind, Capriciousness,children, in
• Mind, Complaining,children in
• Mind, Crying, weeping.children. in
• Mind, Cursing, swearing,children in
• Mind, Depression sadness,children
• Mind, Destructive, behaviour,children, in
• Mind, Development of children, arrested
• Mind, Disobedience,children in
• Mind, Concentration general,difficult,children,in
• Mind, Dullness mental,children
• Mind, Fear phobias general,children, in
• Mind, Fear phobias general,night,children in
• Mind, Fright, ailments from,children. Mind, Gloomy morose,children in
• Mind, Hyperactive children
• Mind, Irritahility,children
• Mind, lrritahility,sleep,after in children
• Mind, lrritahility.sleeplessness with.children
• Mind, Jealousy feeling,children between
• Mind, Jumping behaviour.children in
• Mind, Moaning groaning,children, in
• Mind, Obstinate, stubborn,children
• Mind, Play general,aversion to in children
• Mind, Restlessness,children in
• Head, Headaches, general,school girls in
• Mind, Screaming, shrieking, shouting,children in
• Mind, Sensitive, general,children
• Mind, Slowness, mental,children in
• Mind, Striking,childrcn in
• Mind, Wriiing,inability for,Iearning to
• Mouth, Aphthous, ulcers,children. in
• Nerves, Convulsions, general,children, in
• Skin, Boils,children disposition to
• Skin, Eczema,children, in
• Skin, Rash,children, in
• Skin, Urticaria, hives,children, in
• Tecth, Decayed, rotten, hollowed,preniature in children
• Teeth, Pain,children, in
• Children, Fingers,mouth in the, children put
• Nose, Nosebleeds, epistaxis,chuldren. in
• Nose, Discharge general,purulent,children
• Nose, Obstruction,children
• Mind, Talk general,slow learning to
• Rectum, Prolapsus, of rectuin,children
• Rectum, Constipation, painful, compels child to desist from effort
• Throat, Adenoids problems with
• Sleep, Sleeplessness,children, in
• Sleepiness, general,children, in

Adolescence & Puberty

• Bladder, Bedwetting,adolescence
• Children, Puberty, ailments in
• Glands, Thyroid, gland,goitre,puberty, in
• Mind, Depression sadness,puberty, in
• Mind, Hysterical hehaviour,puberty, at
• Mind, lrritability,puberty in
• Mind, Sensitive, general,puberty, in
• Abdomen,enlarged, in,girls, at puberty
• Breasts, Nodules,girls, puberty, before

Young People

• Generals, Hair, baldness, head,young
• Generals, Obesity, people, in
• Skin, Warts, general,girls, in young
• Female, Menses, irregular,painful,girls,young in
• Varicose, veins, general,young persons, in

Menopause

• Female, Menopause general
• Blood, Congestion, of blood,menopause.
• Mind, Depression sadness,menopause.
• Mind, Hysterical behaviour,menopause at.
• Head, Headaches, general,menopause.
• Sleep, Sleeplessness,menopause period.
• Rectum, Diarrhea. -general,menopause,
• Rectum, Hemorrhoids,menopause agg

Old Age

• Generals, Elderly, people
• Head, Headaches, chronic,elderly people of
• Lungs, Asthma, general,elderly, people, in
• Rectuili. Constipation general,alternating, with diarrhea,elderly people in
• Rectum, Constipation ,elderly, people
• Rectum, Dianhea, general,elderly, people
• Mind, Dullness mental,elderly people
• Breathing, Rattling,elderly, people
• Skin, Discoloration skin,dark spots, in elderly people
• Skin, ltching,elderly people
• Prostate, Enlargement,elderly men, in
• Eyes. Cataract,senile
• Hearing, Deafness, general,elderly, people.
• Female. Bleeding, uterus, metrorrhagia,elderly. women
• Mind, Insanity, general,elderly people, in
• Mind, Memory ,forgetfulness,elderly people, of
• Mind, Slowness, mental,elderly people, of
• Generals, Emaciation, general,elderly people
• Generals. Obesity,elderly people
• Generals, Weakness, general,elderly people

Gender

• Eyes, Cataract,women in
• Rectum, Constipation general,women in
• Mind, Gloomy morose,women, in
• Mind, Jealousy feeling,women, between
• Mind, Restlessness,women in
• Mind, Rudeness,women, in
• Mind, Sexual, behaviour,homosexuality,men
• Mind, Sexual, behaviour,homosexuality,women
• Generals,Weakness, general,women

Presenting Complaint

• Every symptom related to CLSCM can be converted to rubric.

HPC
Give Us Idea About

• Recent Aetiology
• Diagnosis
• Nature Of The Disease
• Onset And Progress Of The Disease
• Extension And Alternation

Aetiology

• Generals,Convalescence, ailments during or since
• Rectum, Diarrhea, general,vaccination, after
• Headaches, general,injuries, mechanical, after
• Cough, Measles,after
• Eye, lnflammation,sand and dust from
• Chills, Exposure,rains, during

Nature Of’ Disease

• Acute
• Chronic

Acute

• Heart, Endocarditis,acute
• Eyes, inflammation,acute
• Liver, Jaundice,acute
• Lungs. Tuberculosis,acute
• Generals, Abscess, suppurations,acute
• Generals. Cancer. general,leukemia,acute
• Stomach, Gastritis, inflammation stomach,acute

Chronic

• Coughing. Chronic
• Generals, Chronicity, of complaints
• Head, Headaches, general,chronic
• Larynx, Laryngitis, inflammation, of larynx,catarrhal, chronic
• Liver, Hepatitis,chronic
• Liver, Jaundice,chronic
• Nose, Coryza,chronic, long.continued
• Prostate, Prostatitis, inflammation of,chrunic
• Kidneys, Nephritis, inflammation, kidneys,chronic, parenchymous nephritis
• Kidneys, Nephritis, inflammation. kidneys,interstitial nephritis, chronic
• Nose, Obstruction,chronic
• Rectum, Constipation general,chronic
• Rectum, Diarrhea, general,chronic
• Skin, Urticaria, hives,chronic
• Sleep, Sleeplessness,clironic
• Stomach, Gastritis, inflammation stomach,chronic
• Throat, Inflammation, sore throat,chronic
• Back, Pain lumhar,chronic tendency

Recurrent

• Throat, Tonsillitis, inflammation of tonsils,chronic recurrent
• Nose, Coryza,recurrent
• Eyes, lnflammation,recurrent
• Generals, Abscess, suppurations,recurrent
• Skin, Boils,recurrent tendency

Onset And Progress

• Vertigo, Sudden
• Mind, Anxiety, general,sudden
• Headaches, general,sudden, pains
• Nerves, Paralysis, general,gradually, appearing
• Stomach, Vomiting, general,diarrhea,hefore

Extension And Alternation

• Generals, Pains, general,directions of pains…
• Generals, Sides, of body…
• Obstruction,alternating sides
• Chest, Alternating, with…
• Skin, Eruptions,alternating with…

History of Past Illness
Give Us Clue About

• Remote Aetiology
• Diagnosis
• Development Of The Disease
• Miasm

Hpi- Aetiology

• Lungs, Asthma, general,eruptions, after suppressed
• Emergency, tnjuries, genaral,chronic effects of

Hpi- Diagnosis

• Heart, Endocarditis,rheumatic
• Swelling, testes,mumps from (in infertility)

Development Of The Disease
Surgically Treated Diseases in HPI

• Cataract
• Fistula
• Tumors
• Adenoides
• Enlarged Tonsils
• Varicocele
• Varicose Veins
• Hernia
• Fibroids
• Fibroadenoma
• Cysts
• Polyps
• Deforomities
• Hemorrhoids

PERSON AL HISTORY
Mile Stones

• Mind, Talk general,slow learning to
• Children, Walk, slow learning to
• Teeth, Dentition, difficult

Occupation

• Emergency, Stone-cutters, ailments in
• Rectum, Constipation general,sedentary, habits, from
• Asthma, general,dust, from inhaling
• Skin, Urticaria, hives,cement, of

Habits

• Toxicity, Alcohol, general,abuse of, ailments from
• Toxicity, Tobacco, ailments, from
• Toxicity, Narcotic,ailments from

Obstetric History

• Abdomen, Enlarged,mothers, in
• Pregnancy, Miscarriage spontaneous, abortion,tendency, to
• Legs, Varicose, veins, legs,pregnancy, during
• Female, Infertility

Family History

Give clue towards

1. Diagnosis – consanguinity in parents of a child with mental retardation suggest chromosoamal defects

2. Miasm

Treatment history
We can utilize rubrics related to treatment history  from different repertories
GENERALS – MEDICINE –
GENERALS – REMEDIES

GENERAL
Materiological

• Cold
• Uncovering <
• Warmth Desire For
• Warm <
• Heat Sensation Of
• Clothing Intolerance Of
• Warm Clothing <
• Air Open >

Time

• Morning 5 Am To 10Am
• Forenoon 10Am To 12Pm
• Afternoon 1 Pm To5 Pm
• Evening 5 Pm To 10Pm
• Night 10Pm To 5 Am
• Nose, Sneezing, general,evening 15 medicines)
• Nose, Sneezing, general,night (8 medicines
• Nose, Obstruction, evening night.

Food

• Eating Agg, Amel
• Fasting
• Hunger
• Desires
• Aversions
• Ailments From

Rectum

• Bowel Habits
• Ailments Before, During Or After Character Of Stool
• Organs

Urinary Organ

• Urine Stream & Flow
• Before, During & After Urination
• Character Of Urine

Sleep

• Before,During & After Sleep
• Character Of Sleep
• Dreams
• Position

Menstrual History

• Before,During & After
• Character Of Menstrual Blood
• Nature Of Flow, Duration
• Leucorrhoea, Character, C>
• Before, During & After Discharge D
• Before. During & After
• Character

Observation and examination

• Eyes,Discoloration around,bluish circles,
• Eyes, blueness.
• Face, Acne,
• Face, Discolouration, brown,spots
• Face, Expression.
• Face, Pale, spots in
• Generals, hair, auborn, baldness, gray, hairy.
• Joints, Cracking, of
• Nails, Discolouration.
• Neck, Brown, neck and nape
• Skin, Hardness of skin
• Skin, Discoloration,dark spots, in elderly people
• Teeth, Discoloured

Diagnostic terms

• Throat, Adenoides.
• Throat, inflammation, follicular.
• Urine, Sediment,oxalate of lime
• Urine, Sediment,phosphates
• Urine, Bile,containing

Analysis and Evaluation of Symptoms
Common Symptoms
Symptoms Common To Most Of The Diseases And Most Of The Drugs.
In Repertory, Rubrics With jjy Medicines. Eg.
o Appetite, wanting
o Thirst, increased
o Anxiety
o Fear
o Forgetful.
o Breathing difficult,
o Headache,, eto

Peculiar Symptoms
Symptoms Peculiar To Certain Drugs And Diseases. In
Repertory, Rubrics With Moderate Number Of Medicines

Reference Rubrics
Rubrics With A Minimum Number Of Medicines Should Not
Be Taken For Repertorisation. They Could Be Considered
For Reference

REPERTORISATION
Selection Of Repertory

• Selection Of Repertory On The Basis Of Nature Of The Disease Is A Absurdity.
• Outdated Repertories Should Not Be Used For Repertorisation Proper.
• Special Rubrics In Each And Every Authentic Repertory Could Be Considered For Reference

Modern Repertories
Synthesis
Murphy’s Repertory

Some Valuable Rubrics in Murphy’s Repertory.

• Rectum, Constipation, hemorrhoids from
• Mind, Crying, children, babies
• Bladder, Bedwetting, children in
• Rectum, Constipation, chronic
• Abdomen, Pain,constipation, from.
• Abdomen, Distension, constipation during
• Abdomen, Pain, hemorroids from
• Back, Pain, weakness with, before or during vaginal discharge.
• Back, Pain, exertion from
• Mind, Obstinate, children.
• Mouth, Fingers in the mouth, children put.
• Generals, Weakness, hunger from.
• Generals, Herpes zoster. neuralgic pains remaining after.

Merits of New Repertories.

• Increase in number of medicines under frequently used rubrics. ( Characteristic rubrics
• Correction of errors

COMPARISON — MURPHY & SYNTHESIS
Number of Medicine Under Some Rubrics
 Synthesis                             Murphy
Endometriosis 2                 38 (Acute),45 (Chronic)
Tonsillitis, recurrent 17              33
Constipation, chronic 2               13
Obstinate children 19                  27
Varicose ulcers 14                         9
Cracks on feet 6                          14
Hypertension 100                        79
Hypotension 32                           25
Male Sterility 36                           2
Asthma in children 21                  29
Kidney stones 20                         32
Appendicitis 40                           25

ERRORS COMMON TO MOST OF THE REPERTORIES

• Incomplete Main Rubrics ( Murphy)
•  Breathing, Panting.
• CALC CARB a first grade medicine under the subrubric ascending, agg. is not found underthe main rubric.
• Feet, Eruption, back of feet.
• CaIc carb and Sepia are found under the subrubric itching, but not under the main rubric
• Nose, Coryza, chronic, long continued.
• Ars a is found under sub rubric asthma causing’, but, not under the main rubric.

RUBRIC SELECTION
Chronic Case

• Number of rubrics selected should be moderate Eklov, 10 or best result) –
• Two or more rubrics from the same sphere or chapter should not bc taken for repertorisation, unless unavoidable. If Selected, two from the same chapter should not be considered fur elimination process
• Common symptoms should not be considered as such for repertorisation. They may be used in a synthesized’ form.
• Fixed and confirmed particulars should he given more value than assumed causatives and general symptoms ( Mental or Physical
• Symptoms represented in a scattered manner in the repertory should not be considered for repertorisation. ( Eg.. Renal Calculi
• Surgically treated symptoms in the past history are to be considered as confirmed presenting complaints
• Hot and Chilly’ fractions & Side’ symptoms should be grouped or synthesized to make a sensible combination

Examples Of Synthesised Rubrics

• Appetite wanting, thirst with
• Emaciation, general,appetite,good
• Abdomen, Pain,constipation,from
• Nose, Coryza,fever, with
• Back, Pain,weakness with, before or during vaginal discharge
• Vomiting, general,food,fever,as a concomitant of

Acute Case
Even Confirmed Part Of The Pc (Clscm) Could Be Considered For Repertorisation, Giving Emphasis On The Most Annoying Symptoms

REPERTORIAL RESULT
Evaluation & Interpretation
Criteria Of A Good Repertorial Result

• A Minimum Number Of Competing Medicines
• Related Medicines Number Of Medicines
• Less Than Five Is The Best
• Many Medicines With Almost Similar Coverage- Results From Repertorisation Of Common Symptoms

Related Medicines

• Rr Containing Inimical Medicines Is The Best
• Rr Containing Complimentaries Is Next
• Rr With Antidotes Is Last
• Rr With Unrelated Remedies-

Relationship Of Remedies
Inimicals :Maximum Similarity. Eg.

• Rhus-t, Apis
• Phos, Caust
• Calc-c, Bar-c
• Psor, Sep
• Bell, Dule
• Merc sol, Sil.

Antidotes : Moderate Similarity Eg.

• Bell, Hep
• Borax, Cham
• Canth, Apis
• Graph, Nux
• Ipecac, Ars
• Nat mur, Phos

Complimentary: Similar With Contradictory Modality Eg.

• Rhus-t, Bry
• Ars, Phos
• Lach, Lyc

Methods Of Analysis Of Repertoial Result
First Method

• By studying the symptomatology of each and ever medicine under the repertorial result in the Materia medica and finding out the most similar one, based on the symptoms present in the case.
• Demerits : Tedious and Time consuming.
• Each case presents a fraction of symptoms of a medicine. Comparing the-whale medicine as found in Comparative materia medica is very easy but comparing fractions seem difficult
• Reading the drug pictures of similar medicines yields nothing but confusion.

Second Method
By preparing a potential diftèrential field ( PDF), by finding out all the symptoms of the case other than those taken for repertorization and analyzing the repertorial result by referring for these PDF symptoms in the repertory or materia medica

Merits   Takes less time
Yields a confident result

Verifying Repertorial result 
One Among The Medicines In Will Cover All Or
Almost All Of The Rubrics Under Pdf , If Not, It
Reveals That There Occurred Some Error In Our
Repertorisation. ( Rubric Selection Error, Repertory
Error Or Mechanical Error)

Potency selection
In Chronic Diseases, Higher The Similarity, Higher The Potency.
In Acute Diseases, More The Case Is Acute, Less The Potency To Be Administered.

Repetition of medicine
Depending On The Case
Depending On The Medicine