Comparison of Chapter Heart of Knerr’s Repertory with Murphy’s Repertory

Dr Jayadeep.B.P  BHMS MD

KNERR’S REPERTORY

• Full name – Repertory of Hering’s guiding symptoms of our materia medica
• Author –Dr. Calvin B Knerr, M D
• A concordance repertory based on Hering’s guiding symptoms of our materia medica.
• Published in 1896. Published in India by B Jain publishers
• Reprint edition in 2002 and Augmented & Revised edition in 2006
• Old edition contains 408 remedies in 48 chapters. New edition contains 419 remedies in 33 chapters.

Gradation of remedies used

• In old edition – 4 gradings which denotes as II, I, II, I in  hierarchial order
• In new edition 5 gradings are given as

1. 5 mark – BOLD CAPITALS
2. 4 mark – ORDINARY CAPITALS
3. 3 mark – Bold roman
4. 2 mark – Roman italics
5. 1 mark – ordinary roman

MURPHY’S REPERTORY

• Full name – Homoeopathic medical repertory
• Author – Dr. Robin murphy
• A modern alphabetical repertory mainly based on Kent’s repertory and Knerr’s
• First edition – 1993, 2^nd edition – 1996
• 1^st Indian edition – 1994 by Indian books & periodical syndrome, New Delhi
• 2^nd Indian edition – 2002 by Jain Publishers, New Delhi
• 3^rd Indian edition – 2010 by B Jain publishers with 74 chapters with more number of medicines

Gradation of remedies  in 3^rd edition

• 4 mark – BOLD CAPITALS
• 3 mark – BOLD CAPITAL
• 2 mark – Italics
• 1 mark – Roman

COMPARISON OF CHAPTER HEART OF KNERR’S REPERTORY & MURPHY’S REPERTORY

In Knerr’s repertory

• In old edition – Heart, Pulse and Circulation are given together as a single chapter – 29^th chapter
• In new revised edition – they are considered along with inner chest, lungs, outer chest under chapter CHEST [24^th chapter]

In Murphy’s repertory

• They are given separately.
• In new 3^rd edition – Heart is the 34^TH Pulse is the 54^th chapter. Circulation is given as a rubric under chapter Clinical [14^th chapter]
• In old edition – Heart was 35^th Pulse was 56^th chapter. Circulation was given under chapter Blood, as a rubric

Here for further comparison, old edition of Knerr’s repertory and 3^rd edition of Murphy’s repertory are used.

Knerr’s repertory  – Heart chapter

• Has 6 main sections – BLOOD, BLOOD VESSELS, HEART, PALPITATION, PERICARDIUM, PULSE.
• Rubrics are arranged alphabetically under each sections along with symptoms in original form as sub-rubrics
• Sub rubrics are expressions of symptoms as it is without much change.
• Majority of the sub-rubrics are single medicine rubrics.

In Murphy – Heart

• There is no arrangement as sections.
• 283 main rubrics are given, starting with a rubric of ‘Heart, general’ then arranged alphabetically from ‘aching’ to ‘wounded’ along with sub-rubrics in alphabetical order.
• Rubrics are well systematically arranged with more number of medicines for the purpose of repertorisation.
• Important main rubrics are  Anemia, Aneurism, Angina pectoris, Congestive heart failure, Dilatation,  Edema, Endocarditis , Fatty degeneration, Heart attack, Heart beats, Hypertrophy, Inflammation, Menopause,at,heart troubles, Murmurs, Myocarditis, Pain, heart, Pain, region of heart,Palpitations, Paralysis, Pericarditis, Rheumatism, Systole,extra, Valvular heart disease etc

 Knerr’s repertory – sections

1. BLOOD
   Blood is the 1^st section  with  rubrics

• Anemia, Carbonized, Chlorosis, Circulation, Coagulation, Color
• Congestion, Corpuscles, Cyanosis, Decomposition, Ebullition, Fibrin
• Hemorrhage, Hyperemia, Leukaemia , Oxidation, Plethora, Septicemia
• Serum, Thick, Thin, Uneasiness, Zymosis

In Murphy

• Blood is given as a rubric in chapter Clinical which is upgraded  with more number of useful clinical sub rubrics like,
  – Blood letting, ailments from, Transfusion, ailments from, Venesection, ailments from,
  –  Embolism, Eosinophilia,  Leucocytosis, Poisoning, Polycythemia, RBC cells, WBC cells etc

• Rubrics like Chlorosis, Circulation, Cyanosis, Bleeding, Hyperaemia, Leukemia, Septicemia, Zymosis are given as direct rubrics in chapter Clinical with more no. of medicines.

Rubrics common in both repertories

• Congestion, Plethora, Serum

Some useful rubrics in Knerr, not seen in Murphy’s repertory

• BLOOD, anemia: amenorrhea, with
• BLOOD, anemia :childbirth after
• BLOOD, anemia : climacteric period in
• BLOOD, anemia : consumption in
• BLOOD, anemia: diabetes in
• BLOOD, anemia: scurvy
• BLOOD, circulation: Excited during menses -Sulph
• BLOOD, circulation: Impeded,gives raise to edema – Cocculus
• BLOOD, circulation: Affected in Menopause – Lach
• BLOOD, circulation: deranged,portal – Card.m
• BLOOD, circulation: Stoppage, sensation of, at night, with fright and then sweat (angina pectoris):- Lyco
• BLOOD, coagulation: Formation of clots,causes plugs – Kali-m
• BLOOD, coagulation: partly clotted,in haemorrhage – Ferr
• BLOOD, coagulation: Difficult – Phos
• BLOOD, coagulation: Easy- Merc
• BLOOD, coagulation: Slow,or not at all – Dig
• BLOOD, color: Black – Anthrac
• BLOOD, color: Black, coagulated [viper bite] – Camph
• BLOOD, color: Dark,cherry red – Anthrac
• BLOOD , color: Violet – Amyg-am
• BLOOD, corpuscles: Smaller and irregular [ascites] – Apis
• BLOOD, corpuscles: White, abnormal number of – plb
• BLOOD, Cyanosis: Angina pectoris in – Chin ars
• BLOOD, Cyanosis : Asthma during fit of – Ipec
• BLOOD, Cyanosis : Bronchitis in – Lobel
• BLOOD, Cyanosis : Dyspnea with – Ipec
• BLOOD, Cyanosis : Emphysema with – Lobel
• BLOOD, Cyanosis: Fever in yellow – Carbo veg
• BLOOD, Cyanosis: Forman ovale,non closure of – Dig
• BLOOD, fibrin: augments and transforms into connective tissue: Deficient: Phos
• BLOOD, haemorrhage: Abortion,threatening – Cinnam
• BLOOD, haemorrhage : Abortion at 3^rd month – Trill
• BLOOD, haemorrhage:Anemia,causes – Ferrum
• BLOOD, Leukemia (leucocythaemia):Corpuscles normal as to quantity, but lack color:- Ferr P
• BLOOD, plethora: In old people,in well nourished – Nux v
• BLOOD, plethora: Venous – Carb v,sul ac
• BLOOD, septicemia: Child bed in – ars

BLOOD VESSELS

• With rubrics like
• Aneurism, Atheroma, Capillaries, Distended, Elasticity, Fatty degeneration, Circular fibres, Induration, Inflammation, Injuries, Murmurs, Naevus, Stenosis, Thrombosis, Varicose veins

In Murphy

• Blood vessels are given as a rubric in Clinical chapter with similar subrubrics but with more no. of medicines and asked to consider rubric  ‘veins’ as a cross reference.
• Aneurysm, thrombosis and varicose veins are separate rubrics under ‘Clinical’ chapter

Rubrics in Knerr but not seen in Murphy

• BLOOD VESSELS, aneurism: Aorta,arch of, Kali-I
• BLOOD VESSELS, aneurism: Aorta,of descending – Ran s,spong
• BLOOD VESSELS, aneurism: Flat – Carb v
• BLOOD VESSELS, aneurism: of large vessels near heart – Lycopus
• BLOOD VESSELS, aneurism: Round – Carb v
• BLOOD VESSELS, aneurism: Syphilitic – Iod,kali I
• BLOOD VESSELS, aneurism: Vagus and its branches, involving pressure on – eucalyptus
• BLOOD VESSELS,atheroma : Morbus, brighti – Phos ac
• BLOOD VESSELS,atheroma:Obese persons in – Caps
• BLOOD VESSELS,atheroma: Old people in – Lac
• BLOOD VESSELS,atheroma: Pulmonary arteries, dilatation of right heart (cerebral oedema) – phos
• BLOOD VESSELS,capillaries: Net like appearance – Caust
• BLOOD VESSELS,Distended: Carotid – Bell,glono.verat v
• BLOOD VESSELS,Distended: Jugular veins – Camph,amyg-am
• BLOOD VESSELS,Distended: Veins, arms, legs – Eucalyptus
• BLOOD VESSELS,Elasticity: – Sumb
• BLOOD VESSELS,Fatty degeneration: – Calc
• BLOOD VESSELS,inflammation: Vena cava,superior – Phos
• BLOOD VESSELS,thrombosis: In Albuminaria – Calc-ars
• BLOOD VESSELS,thrombosis: Of Great veins of region of groins(pyaemia):- Ars
• BLOOD VESSELS,thrombosis: Hydrogenoid constitutions, in, particularly with affections of glands – Nat-s
• BLOOD VESSELS,Varicose veins: esp from alcohol – Crot h
• BLOOD VESSELS,Varicose veins: Blue – Carb v
• BLOOD VESSELS,Varicose veins: in left leg – Ambr
• BLOOD VESSELS,Varicose veins :on legs – Puls
• BLOOD VESSELS,Varicose veins: Women, especially in, who have borne many children, obstinate – Fl-ac
• BLOOD VESSELS,Varicose veins: In Young persons – Ferr p

III. HEART

• with rubrics like

Aching, Action, Affections, Aneurism, Angina, Anxiety, Arms, Asthma, Beat, Breathing, cavity, Dilatation, Dropsy, Ears, Ebullition, Inflammation, Fatty degeneration, Foramen ovale, non closure, Functional disorder, Gout, Haemorrhoids,  Inflammation, Paralysis, Percussion sound,  Rheumatism, Sounds, Stenosis,  Valvular affections, Weak action etc

• rubrics are arranged alphabetically, with many clinical & pathological rubrics
• rubric ‘mental conditions’ are unique to this repertory are worthy to note.
• rubric Heart ‘Sounds’ with many sub rubrics like Bellowing, bruit, deep, diastolic, friction like, knuckle, metallic, murmurs, Systolic etc and the rubric  ‘percussion sound’  are more clinically useful

Some important Cross references made are

• Angina – inner chest, angina
• Dilatation – organic affections
• Endocarditis – inflammation
• Enlargement – organic affections
• Failure – paralysis
• Foramen ovale,non closure of – Blood, cyanosis
• Hypertrophy –organic affections
• Murmur -sounds

In Murphy

• Almost all rubrics of Knerr’s heart section are able to recollect under Heart chapter with definite order and more number of medicines.
• Many more clinical rubrics are added as direct rubrics like

Angina pectoris, Congestive heart failure, Dilatation of heart, Fatty degeneration of heart, Endocarditis, Heart attack, Heart beats, Hypertrophy, Inflammation, Murmurs, Myocarditis, Palpitations, Paralysis, Pericarditis, Rheumatism, Extra systole, Valvular heart disease etc

Rubrics not seen in Murphy’s repertory

• HEART, affections: Right, of, with venous stagnation – Phos
• HEART, affections: As of something alive running – Cycl
• HEART, anxiety: In climaxis – Ther
• HEART, anxiety: With attacks of pain in chest – Psor
• HEART, anxiety: Crime, as if she had committed a, and restlessness, or some misfortune were in store, drives her from one place to another (amenorrhoea from fright) – Rhus t
• HEART, anxiety: Facial neuralgia, with – Spig
• HEART, Beat: Excessive, in exophthalmic goiter – Iod
• HEART, Breathing: organic disease, with spasmodic asthma:Cardiac dyspnoea – Amyl-n
• HEART, Fever: rheumatic, with cardiac complications – Lyco
• HEART, Functional disorder: Idiopathic – ars
• HEART, Functional disorder: Over exertion from – Coca
• HEART, Head:pain extend to – Lith c
• HEART, Inflammation: Acute,idiopathic or rheumatic – Naja
• HEART, Inflammation: bad effects of acute – Naja
• HEART, Inflammation: Chronic – Cactus
• HEART, Kidneys: Cirrhotic, with heart disease – Plb
• HEART, Kidneys: Organic disease of heart in morbus brightii – tereb
• HEART, Lying down,can lie only on left side (disease of heart): – Ars met
• HEART, Lying down: painful,on left side – Lach
• HEART, Menses: cardiac trouble at menopause – Crot h
• HEART, Metastasis;
• HEART, Paralysis: seems to be paralyzed – Anan
• HEART, Paralysis: From inflammation of spinal cord – Oxa ac
• HEART, Paralysis: threatened, in pericarditis – Chlol
• HEART, Paralysis: threatened, In pneumonia – Ant t phos
• HEART, Stenosis: – aur

PALPITATION

• Starts with a group of medicines with different gradings which can consider medicines in general
• Then rubrics are arranged alphabetically from ‘abdomen’ to ‘with, worms’
• Modality rubrics like afternoon, bending, eating, exertion etc and Causative modalities like anemia, climacteric period, fistula in ano, Epilepsy etc also  well represented
• Nature of palpitations also considered like audible, frequent etc

In Murphy

• Palpitation is under chapter Heart
• Starting with the rubric ‘palpitations in general’ to ‘young girls in’
• Almost all rubrics of Knerr’s repertory can see in this chapter too with with more modality rubrics and more number of medicines

1. PERICARDIUM

• With only 3 rubrics

–  Ecchymosis
–  Effusion [dropsy, hydropericardium]
–  Inflammation [pericarditis] with many useful sub rubrics

In Murphy

• There is no section or direct rubric as pericardium
• Effusion can be seen as a rubric ‘Edema, pericardium’ in Heart chapter with a group of medicines
• Pericarditis is given as a direct rubric in Heart chapter with only 4 sub rubrics including ‘Chronic’ and

‘Rheumatic’ but with more number of medicines

Rubrics not in Murphy

• PERICARDIUM, Inflammation (pericarditis):Idiopathic: – verat v
• PERICARDIUM, Inflammation (pericarditis):nephritis,with – Coc.c
• PERICARDIUM, Inflammation (pericarditis): Pneumonia, in complication with croupous – Iod
• PERICARDIUM, Inflammation (pericarditis): Rheumatism, with acute articular – Iod
• PERICARDIUM, Inflammation (pericarditis): Second stage – Kali m
• PERICARDIUM, Inflammation (pericarditis): Subacute – Asc t

PULSE

• Last section, starts from rubric ‘absent’ to ‘wiry’
• Some important rubrics are – Absent, Accelerated, Dicrotic, Feeble, Frequent, Full, Intermtting, Irregular, Quick, Rapid, Small, Soft, Synchronous, Thread like, Weak etc which expressed different nature of pulses.

• Under rubric ‘Accelerated’ pulse rate is given from 80 till 200 with corresponding medicines  and under rubric ‘Slow’ pulse rate from 30 to80  are also given
• Pulse rate in different clinical states are also given along with medicines
• Rubric ‘intermittent’ gives intermitting nature of pulse under many sub rubrics like ‘every 3^rd beat’, ‘every 4^th beat’ etc and also in some clinical states
• Pulse section was quite an useful section for reference purpose in clinical application

 In Murphy

• PULSE is a separate chapter starts from  rubric ‘Abnormal pulse’ to ‘Wiry pulse’
• with 61 rubrics
• Almost all rubrics are reproduced here too with more no. of medicines
• Pulse rate is given here under rubrics ‘fast’ and ‘slow’
• Intermitting nature of pulse given here as two rubrics under same name ‘intermittent’ – for different clinical states and for different nature of intermittency separately.

Additional rubrics not seen in Knerr are

• Abnormal
• Audible
• Excited
• Feels pulse
• Flowing
• Imperciptible
• Thumping

Rubrics not seen in Murphy

• Feeble, Wavy

CONCLUSION
Knerr’s repertory is a concordant repertory in which rubrics are direct expressions of symptoms without much change, which gives unique expressions of patients or provings as it is, which can be able to see as reproduced more systematically in Murphy’s repertory.  Majority of the symptoms or rubrics of Knerr’s repertory are adapted for the making of Murphy’s repertory by giving them proper rubric language. And thus aptly added Knerr’s repertory as one of the major source of Murphy’s repertory and substantiated it by deducting many unwanted rubrics and adding more number of medicines .