Understanding sensorium and its importance of Knerr repertory

Dr Anusuya M Akareddy

Abstract:
Homoeopathic case taking and case solving considers sensorium as the important aspect to arrive at the similimum. In this article an attempt has been made to understand what should be considered regarding sensorium and rubrics related to sensorium of Knerr Repertory.

Introduction:
The term “sensorium” comes from Latin ‘Sensus’, the faculty of perceiving.

Sensorium is defined as the parts of the brain or mind concerned with the reception and interpretation of sensory stimuli broadly. In medicine sensorium is sometimes used as a generic term for the intellectual and cognitive functions.  Sensorium according to Psychologists is the totality of those parts of brain that receive, process and interpret sensory stimuli, the supposed seat of sensation, the place to which impressions from the external world are conveyed and perceived.

A clouded sensorium, also known as altered sensorium is characterized by the inability to think clearly or concentrate. It is usually synonymous with or substantially overlapping with, altered level of consciousness.

Major causes of altered sensorium:

• Stroke
• Sepsis
• Cerebral malaria
• Tubercular meningitis
• Bacterial meningitis
• Meningoencephalitis
• Hepatic encephalopathy
• Uraemic encephalopathy
• Other metabolic encephalopathies like Hypoglycaemia and Hyponatraemia
• Intoxication

Signs and Symptoms of Altered Sensorium:

• Confusion
• Amnesia
• Loss of alertness
• Disorientation
• Defects in judgement or thought
• Unusual or strange behaviour
• Poor regulation of emotions
• Disruption in perception, psychomotor skills and behaviour

Importance of sensorium in Homoeopathy:
Every patient receives and responds to stimuli in their own way and according to their reception, the disease takes its seat. Hence the reception capacity is most needed to be understood in the individual patient and that perception is what we call as sensorium.   

H.A.Robert while explaining “Remedy Reaction” says that in incurable cases, medicine acts upon the sensorium and do not act upon the deep recesses of the vital force itself, and yet make the patient much more comfortable by relieving the symptoms annoying through the sensorium. From this it can be inferred that palliation can be achieved in incurable cases by considering the level of sensorium.

SENSORIUM CHAPTER IN KNERR REPERTORY:
In the Repertory of Hering’s Guiding Symptoms of our Materia Medica by Calvin B Knerr, the second chapter is dedicated to SENSORIUM. As this is one of the puritan repertory, rubrics are given as they are presented from provers, which makes this repertory more reliable to refer.

In sensorium chapter the rubrics related to altered sensorium are given.

For the beginners all the rubrics mentioned in this chapter gives the similar meaning but they are not the same. Hence, differentiation of the rubrics needed to obtain the clarity in taking the rubrics into consideration for repertorisation.

RUBRICS OF SENSORIUM IN KNERR REPERTORY WITH THEIR MEANINGS ARE MENTIONED BELOW:

• Confusion-the state of being bewildered or unclear in one’s mind about something
• Dizziness-it is an impairment in spatial perception and stability
• Falling-it is an action of a person losing their footing and ending up in a lower position, often on the  ground
• Giddiness– it is the feeling of being unbalanced
• Intoxication-state of being affected by one or more psychoactive drugs
• Lightness-it is the sensation of being light especially in terms of  weight of head in which patient is at the verge of fainting
• Reeling-sensation of whirling
• Staggering-resultant of deep shock ,which makes the patient to stumble around uncertainly 
• Swaying –state of imbalance where the patient swings slowly and rhythmically back and forth or moving gently from an upright to a leaning position
• Vertigo– a sudden internal or external spinning sensation, often triggered by moving your head too quickly 
• The sub-rubrics for above mentioned are given, which includes causation, modalities and concomitants of that particular rubric, which makes the task of searching for rubric easy.
• There are disease conditions mentioned against some rubrics, which are resultant of that particular disease in parenthesis, Example: Dizziness, on being aroused: (Encephalitis)
• Cross references to some rubrics are given in this chapter, denoted by Hand sign.

Example: Drunkenness-Intoxication, Fainting-Chapter 36

Conclusion:
In this article the attempt has been made to understand the sensorium and Homoeopathic approach to Altered Sensorium through Knerr Repertory. Hopefully, this article will enhance the confidence among beginners in the Homoeopathic profession, to take up cases with altered sensorium.

References:

1. Knerr BC. Repertory of Hering’s Guiding Symptoms of our Materia Medica.1e.New Delhi: B. Jain Publishers Pvt Ltd; Reprint 1986.p 83-92
2. Robert H A.The Principles and Art of Cure by Homoeopathy.New Delhi:B.Jain Publishers Pvt Ltd;2002.p 126
3. https://www.medicinenet.com/sensorium/definition.htm

Dr Anusuya M Akareddy
Associate Professor
Department of Repertory, Government Homoeopathic Medical College and Hospital, Bengaluru 560079