Study of Repertory in Post Graduate Level-An Overview

Study of Repertory in Post Graduate Level-An Overview

Dr Shashi Kant Tiwari, DMS, DIP  NIH, MD(Hom)
Former Principal, Fr. Muller Homoeopathic Medical College, Mangalore
Former Director, National Institute of Homoeopathy, Kolkata

INTRODUCTION;
Study of repertory is an essential  process at all levels of learning if someone desires to understand Homoeopathy in its totality and  to practice it  in true sense to serve the suffering humanity without harming the natural flow of life process .

Repertory has been a guide and essential tool for practicing Homoeopaths from the time of our Master Hahnemann itself. It is a product of logical thinking and intelligent applicability of vast data of Materia Medica into clinical practice. The logical mind of human being is always in search of finding a device to make the task easier and simpler which is truly applicable to Homoeopathic practice also. When the number of symptoms started increasing as the number of medicines increased, it became difficult to trace the exact similar medicine in the vast ocean of Materia medica, therefore a need was felt to find some way or some kind of means to find out the correct simillimum for the suffering person based on the totality without which a cure is not expected.

 Our master, a brilliant personality first faced this problem and understood it as a problem for all the practitioners of this rational system of medicine. Hence he thought of preparing first the simple index which could help a physician to find a similar remedy through referring the index. Then he did not rest at this point and further suggested how the process should be worked out in finding a suitable remedy to the case. Thus he suggested a method what we call is a paper sheet method-write all the important symptoms on a paper and write all the medicines which cover those symptoms in front of each one and see which of the medicine covers maximum symptoms.

Boenninghausen called it as expedient which literally means something which expedites the process. Hence repertory should be considered as a companion in a form of device which makes our work (study of materia medica and finding a simillimum) easy, simpler and faster. Thus the use of repertory should become essential part of our practice.

In fact, Repertory is the witness and the mirror of the growth of Materia Medica from the primary recording of the facts in Fragmenta de Viribus Medicamentorum Positivis  to the present voluminous books of Materia Medica. It has walked parallel to the materia medica successfully, systematically and logically. This special discipline of Homoeopathy has also kept pace with the  modern technology  and given many software to the profession. Hence, this ever growing subject of repertory not only needs to be understood perfectly but also to be mastered properly in order to be a conscientious homoeopath.

Repertory is higher branch of homeopathic study and practice which should be learnt and practice with cautiousness. 

SOME FREQUENT ASK QUESTIONS;

What is repertory?
Repertory is a simple device which helps to find simillimum and it could be in the form of book, card or software . It indexes homoeopathic remedies in a logical and systematic way following a certain principle or philosophy. The main sources of repertories are materia medica of all types including proving, toxicological, physiological and clinical.

What is repertorization?
It is a logical process which leads to the selection of a right remedy following certain steps. It starts with a broad choice and narrows down to a small group of remedies so that a final selection is made through the knowledge or reference to materia medica.

Why the name ‘repertory’?
To know the exact reason for this, we have to go back to the Hahnemann’s era. Our master gave the unique name to this discipline due to a good reason. It means a treasure where you can find things arranged in a systematic way so that the things could be found out whenever the need comes. Repertory in homoeopathy serves the similar purpose to find out most precious thing i. e. simillimum.

Is it required to do repertorization in every case?
As such this process is a logical process of coming down to a similar remedy to the case in hand which is mostly done mentally by a busy physician and also by masters of materia medica. Hence, in a case where the picture of remedy is very clear and sure about a remedy, the mental process of repertorization is already done. It is required to be done mechanically where we are not sure about a clear picture of a remedy be it a chronic or acute case.

Does repertory help in other ways to a Homoeopath?
Yes, it helps a Homoeopath in a multiple ways. It is very much obvious from the title of the book by the Father of repertory, Boenninghausen; Therapeutic pocket book for Homoeopathic Physicians to use at the bed side and in the study of the materia medica. He has highlighted two main purpose-finding simillimum and the study of materia medica. The repertory can help a physician to refer any symptom any time without much difficulty, it helps to study comparative materia medica, also in study of relationship of remedies thus in selection of second prescription. The modern repertories have reference for each remedy mentioned under the rubrics hence the repertories can help a physician to know the source of information.

When to study repertory and how much to study repertory?

This is very clearly stated by Dr. J T Kent-

A physician must study the homoeopathic principles until he learns what it is in sickness that guides to the curative remedy.

He must study materia medica until he learns what is needed to meet these demands. 

He must then study the repertory until he learns how to use it so that he can find what he wants, when he needs it.

Is study of repertory and repertorization a difficult proposition?

No, in fact it is easy and a comprehensive helpful proposition to find our highest goal i. e. to select a right remedy. The process is easy and logical so that each case can be repertorized without much difficulty. With advent of Computer the work has become more and more easy as well as less and less time consuming.

What are the steps to be followed in repertorization?

It follows the exact process of a homoeopathic way of selection of a remedy. Hence the following steps should be followed carefully and not mechanically at any of the steps-case taking, recording and interpretation, defining the problem, analysis , erecting the totality, selection of the repertory and repertorization proper, Repertorial result, analysis of Repertorial result and prescription.

Who are the pioneers of repertory?

Master Hahnemann, Boenninghausen, J T Kent, C M Boger

What are the basic repertories?

Boenninghausen’s Therapeutic Pocket Book

Repertory of Homoeopathic Materia Medica by J T Kent

Boger’s Boenninghausen Characteristics and repertory

What are the modern repertories?

• Synthetic repertory
• Complete repertory
• Homoeopathic Medical Repertory
• Synthesis 
• Phoenix Repertory, etc
• Repertorium Universale

What are the methods of repertorization?
The methods of the repertorization are purely based on the dimension of the case. It is the case which decides the method and not the physician. The variations of the totality of the case decide the methodology which becomes clear after we arrive at the totality of the case. It could be one of the followings-

• If case is rich in generals and have a few characteristics-the Kent’s methods should be followed i. e. Generals to Particulars.
• If the case has Causation, Modalities, Concomitants and Pathological Generals -the Boger’s Method can be followed.
• If the has complete symptom-Location , Sensations,  Modalities and Concomitants – Boenninghausen’s method can be followed
• If the case has only common symptoms of a disease, wherein the characteristics are not available-clinical methods can be followed.

PRACTICAL ASPECT; WORKING OUT A CASE

A case of ovarian cyst; CASE TAKING;
Mrs. S 42 year old lady who was operated for fibroid uterus (29^th Dec 2018) reported on 4^th March 2019 for continuous uterine bleeding for 45 days.  First 15 days the bleeding was very profuse along with back pain and general body ache followed by watery blood mixed with clots and now for last 15 days she is troubled with blackish and continuous bleeding. She also complained of severe pain in the left iliac region, which comes and goes.

After the operation she has also developed leg pains and headache sometimes especially if she goes out in sun.  Though she has lot of discomfort after operation and she is tired of bleeding but she feels discomfort more when bleeding stops. Pains as well as mentally, she feel better during bleeding. She went for a checkup with the same gynecologist last week who examined her and asked to go for USG investigation. The USG investigation revealed that she had Left Ovarian cyst with debris; hemorrhagic cyst with partial torsion. She was advised immediate admission and Pan Hysterectomy. But the patient did not want to go for 2^nd operation hence she preferred Homoeopathic treatment.

Some details were taken about the patient – 

She has a son who is 18 years old. She told about her son that he was not good in study. Because of his poor intellect the son could not study science and he studied in commerce section. But he could not clear the final PUC exam even with change of the subject. He appeared for the supplementary exam but he failed in that also. He has been showing no interest in mingling with any one.

• He has no friends and no much interest in any extracurricular activities. Whereas mother is very social and very good in communication so much so that many of her friends comment that he does look like your son. Her son has more interest in cooking and does some work related to house hold things. He likes to help her in cooking but she does not encourage that. She is very jealous to her friends and their children especially when she listens to their good performance in different field.

She has decided to send her son for Hotel management course. Since he could not complete the required qualification for admission to BHM she has decided to put him in Diploma course and simultaneously also get him prepared for PUC exam so that next year he can join BHM with more ease in study.

She feels hot and likes cold weather, AC but soon she feels chill. She told that she can’t tolerate more heat as well as cold. Sweat not much even if she feels hot but her arm pit sweat has yellowish stains. She has likings for salty, spicy and non-veg food but she prefers vegetarian food as she is conscious about her weight.

Another fact she shared that her very close friend died in the month of October (2018)in a road accident. She said I just can’t accept it even now. I feel she is still alive. She was almost broken and she feels that her all the problems ,mainly the bleeding problem started after that

Past history; Recurrent cold and throat pains with hoarseness of voice. No DM, No BP and other systemic disorders.

Family history; Father 75 years, with  old age D M, Mother 67 years with OA . one elder brother with no health issues.

Moderately built, fair, Teacher by profession

ANALYSIS;

Common symptoms;

• Ovarian cyst, with hemorrhagic debris
• Irregular, continuous, profuse, clotted, blackish  bleeding
• Tiredness during bleeding
• Leg pain
• Headache
• Sadness 
• Diagnosis –ovarian cyst with DUB

Uncommon symptoms;

• Feels better during menses
• Pains are better by menses
• Mentally better during menses
• Headache <sun
• Craving for salty food, spicy and non- vegetarian food
• Hot patient, Perspiration stains yellowish 
• Ailments from grief
• Jealousy while listening to others well performance
• Left ovarian cyst 
• Menses dark, copious, clotted and protracted but extremes of temperature are bad

EVALUATION OF SYMPTOMS;

• Complaints caused by grief——qualified mental
• Jealousy about others improvement –mental state 
• Feels better in all aspects during menses-physical generals 
• Desires salty food and meat products-physical generals 
• Sun aggravates her headaches –characteristics particulars 
• Left ovarian cyst –common with side

Discussion; what is available in the case?

• Clear mental state and qualified mental symptoms
• Physical generals 
• Characteristics particulars 
• Therefore the Kent’s repertory may be the choice for repertorization-

TOTALITY;

• Ailments from grief
• Jealousy 
• Menses ameliorates
• Craving for salty food
• Craving for meat 
• Perspiration stains yellow
• Headache aggravated by sun
• Left ovarian cyst

REPERTORIZATION  PROPER ;

Prescription; 

4-3-2019

She was prescribed  Lachesis 200/ once a week empty stomach in morning  along with some nihillinum pills twice daily. She was asked to report after a month .

10-4-19

Menses better, bleeding for  7days with moderate flow and spotting for another 3 days . a total of 10 days bleeding. Not much discomfort. No headache in last month

11-5-19

Bleeding for 10 days , 5 days moderate bleeding. There was slight headache one day before menses. She was given two months course of Lachesis 200/weekly as she was going out of town. She was confident of travelling. She was asked to report with USG in her next visit.

9-7-19

She reported that her last two menses were regular with moderate bleeding of 5-7 days duration. There were no complaints in and around menses.

Her  USG report shows no cyst. She was advised to discontinue the medicine as she was cured.

CONCLUSION; 

• Repertory is a higher branch in study of homoeopathy and no physician can do homoeopathy without the knowledge of repertory
• Every case needs repertorization- an expert, senior physician and masters of materia medica can do it mentally without help of any aid. Others requires aid –books are computers.
• Repertorization is essential part of the process to find out a right remedy.
• Dr. P Schmidt, No one knows everything and that is why in all honesty one must admit that no conscientious homoeopathic doctor can practice homoeopathy in a serious and really scientific way without  a repertory.