GAIT- Addition to Boger’s Repertory

Dr. Krishnendu maity

Gait signifies posture of the patient during walking. 

It is classified as

1. Due to diseases of bones – Limping Gait of Talipes equinovarous.
2. Due to diseases of joints – Limping Gait of Tuberculosis of Knee & Hip joints; Waddling Gait of Bilateral Congenital Dislocation of the Hip.
3. Due to diseases of muscles – Waddling Gait of Myopathies.
4. Due to diseases of nervous system

• Ataxia – This is the gait of sensory ataxia and typically found in Polyneuritis & Tabes dorsalis. In Polyneuritis, the gait is High Stepping; and in Tabes dorsalis, it is Stumping.
• Prosthetic Gait – This is due to walking with an artificial limb.
• Reeling Gait – It is found in Cerebellar diseases & Alcoholics. The patient walks on a broad base and the ataxia is present, irrespective of whether the eyes are open or closed.
• Spastic Gait.
• Scissor Gait – Typically found in Paresis & Congenital Paraplegia.
• Festinant / Shuffling Gait – In Parkinsonism, the gait consists of short shuffling movements with a posture of flexion and an inability to slop walking suddenly, if pushed from backward – as if the patient runs to catch his Centre of Gravity.
• Functional / Hysterical Gait – All types of gait may be present in combination or there may be bizarre movements. These are characteristically found in Hysteria; and absent when there is no observer.

 Another classification is as follows

Unilateral defect

1. Hemiplegic Gait / Circumduction Gait.
2. High-stepping Gait – Paralysis of External Popliteal Nerve, Peripheral Neuritis affecting one side.
3. Hysterical Gait

• Forward – either Scrapping of inner border (Organic Hemiplegic scrapes outer border of foot) or Whole foot is dragged along the ground.
• Side-gait – cannot move on paralyzed side (Organic Hemiplegic can move better towards the paralyzed side).

4. Limping Gait – Poliomyelitis.
5. Painful Gait – Sciatica or other injuries or Joint affections.

Bilateral Defect

1. Ataxic Gait – Tumour of Vermis & Foramen Magnum; Disseminated Sclerosis; Sub-acute combined degeneration of the Cord.
2. Bizarre Gait – Hysteria. Patient walks in zigzag fashion with bent knees or trunk.
3. High Stepping Gait – Polyneuritis; Muscular dystrophy; Tabes dorsalis.
4. Jaunty Gait – Chorea.
5. Maché Petits Pas – Advanced Cerebro-vascular diseases.
6. Reeling / Tottering Gait – Severe Vertigo; Diplopia; Alcohol intoxication; Cerebellar lesion.
7. Scissor Gait – Congenital Cerebral Diplegia in children.
8. Shuffling / Festinant Gait – Parkinsonism; Cerebral Arteriosclerosis; Instability; Lack of confidence.
9. Spastic Gait – (Spastic Paraplegia) Disseminated Sclerosis.
10. Stamping Gait – Tabes dorsalis; Carcinomatous Neuropathy; Compressive lesion of Posterior Column.
11. Vestibular Gait – Deviation to same side on walking forward and to the opposite side of the lesion when walking backward.
12. Waddling / Duck-like Gait – Muscular dystrophy; Dislocation of Hip-joint.

 Addition to Bœnninghausen’s characteristics & repertory by Dr. Cyrus maxwell boger [bbcr]

Note: – The existing rubric and medicines in BBCR for gait are presented here with black; and the new additions (medicines & rubrics) are presented by blue colour. The abbreviations and gradations of medicines are adopted, as done by Dr. C. M. Boger – i.e. CAPITAL – 5 marks; Bold – 4 marks; Italics – 3 marks; Roman – 2 marks; (Roman) – 1 mark.

In the BBCR, the following rubrics are presented for gait —–

1. Lower Extremities – Gait, anxious: Coff, Nat-m.

•  Awkward: Kali-n, lach, mag-c, saba.

2. Lower Extremities – Gait, cocks: Helo, LACH, nux-v.

•  Knock knee: Lathy, Pho.
•  Limping: Bell, Caus, colo, dro, dul, kali-c, kali-io, lyc, nit-ac, sul, syph, tab.
•  Shuffling: Arn, chin, colch, led, nux-v, Zin.
•  Slouchy, dragging: Mygal, nux-v, rhus-t, tab.
•  Spastic: Cup, gels, lathy, nux-v, ph-ac, pho, zin.
•  Stooped: Arn, calc-p, Lathy, pho, Sul, terb.
•  Stumbling: Agar, bell, calc, (caps), caus, colch, con, dro, (gels), hyo, ign, iod, ip,    Lach, lil-t, (mag-c), mag-p, nat-c, nat-m, nux-v, (op), pho, pho-ac, rut, saba, sil,   Verat, zin.
• Tottering: Alum, arg-m, aur, BAR-C, caus, cocc, colch, con, nux-v, pho, pic-ac,  Plb, rhus-t.
•  Tremulous: Cup, phys.
• Uuncertain, unsteady: Agar, arg-n, arn, bar-c, bar-m, carb-s, caus, cocl, gels, kali-bro, lol-t, mygal, nat-c, nux-v, old, oxyt, ph-ac, pho, phys, sec-c, sil, stan, sul, zin.
• Compare Walking 

3. Lower Extremities – Walking, backward: Canth, lach, mang-ac, oxyt, sil.

• Difficult: Aur, cact, chin, mang-ac, old, oxyt, phys, sil, ter.
• Falling easily: Caus, lyc, nat-c, nat-m, stra.
• Foot shoots out or turns: Acon.
• Gressus gallinaceus: Aur, ign, LACH, mag-p, Sil.
• Gressus vaccinus: Iod, sec-c.
• Heels do not touch ground: Lathy.
• Infirm: Caus, kali-c, mag-c, mag-p, nat-c, ol-an, pho, sul.
• Learning, slow in: Agar, bar-c, bell, calc-c, calc-p, Caus, merc, NAT-M, nux-v, sanic, sil, sul,
• Weakness with:  Chin, par, stro.
• Leg involuntarily thrown forward: Merc.
• Outer side of foot, with: Cic.
• Compare Gait

Sources:-

• Boger, Dr. C. M. – Bœnninghausen’s Characteristic and Repertory.
• Hutchison’s Clinical Methods (edited by Dr. Michael Swash).
• Kent, Dr. J. T. – Repertory to Homœopathic Materia Medica.
• Vakil, Dr. P. – A text Book of Homœopathic Therapeutics for Students and Practitioners (illustrated) (vol. I). 

Dr Krishnendu maityBHMS [Calcutta] MD (Hom. Repertory) [Pune]
Associate Professor & HOD I/c, Department of Practice of Medicine
Teaching Practice of Medicine, Materia Medica & Repertory
Lal Bahadur Shastri Homœopathic Medical College, Bhopal – 26 (MP)
Email: dr_krishnendu@yahoo.com