Understanding the chapter ‘stages of life and constitution’ from Knerr’s repertory and its practical utility

Dr Shriraksha B

INTRODUCTION
Repertory of Hering’s guiding symptoms of our Materia medica by Calvin B Knerr is a concordance type of repertory based on Hering’s Guiding Symptoms published in the year 1896. This repertory has symptoms in their original form without modifications.

 There are 48 chapters and 408 medicines, where the arrangement of chapters is in Hahnemann’s anatomical schema. It has 4 grades of distinction which has same significance as given in Guiding symptoms.

 The repertory starts with the chapter Mind and disposition and ends with Drug relationship. This article throws light on the understanding of the 47^th chapter, that is Stages of life and Constitution.

 In this chapter Knerr has given rubrics related to various age groups, different complexions, constitutions, temperaments, diatheses etc which can be used in cases of different  stages of life

CONSTRUCTION OF THE CHAPTER STAGES OF LIFE AND CONSTITUTION

      This chapter has following sections

• Age
• Complexion
• Constitution
• Habit
• Occupation
• Size
• Temperament

SECTIONS

Age is further divided into different subgroups such as Boys, children, climacteric period, girls, men, old people, puberty, women, young people, youth.

They include some complaints, sensations or disease conditions of that particular age.

It also includes rubric related to mind, body types or appearances, miasms, growth etc

Eg:

• Age, boys, epistaxis( hydrocele)
• Age, children, want to be carried
• Age, children, psora
• Age, girls, blonde, red cheeked, scrofulous
• Age, old people, emaciated
• Age, young people, asthma
• Age, youth, overgrown with weak chest

Complexion (including color of the eye and hair) includes complexions like dark, fair, florid, freckled, pale, sallow etc

It also includes colors of eyes such as black, blue, dark grey… and colors of hair such as black, blonde, light, sandy

The rubrics, along with these complexion traits involve some conditions, sensations and also some mentals

Eg:

• Complexion, dark, ophthalmia,
• Complexion, hair, blonde, irritable, weakly
• Complexion, eyes, dark, disposed to sluggishness and indolence

Constitution section contains mostly diathesis, tendencies, constitution types, miasms

Subrubrics involve subjective and objective symptoms of those constitutions and diatheses, and also some age groups or persons who are affected

Eg:

• Constitution, anemic, faceache
• Constitution, gouty, mercurial ulcers
• Constitution, hemorrhagic, ovaritis
• Constitution, psoric
• Constitution, rheumatic, women
• Constitution, weakly, bookworms, sensitive romantic girls, onanists, rakes and drunkards

Habit – this section has some of the habits and indulgences of the people and some of the complaints associated with them

There are some diagnostic symptoms, subjective symptoms, physical appearances and also certain tendencies in the subrubrics

Eg:

• Habit, drunkards, eczema
• Habit, drunkards, heartburn
• Habit, drunkards, rednose
• Habit, dirty persons
• Habit, high living, gluttony
• Habit, drugged subjects
• Habit, tobacco

Occupation section involves rubrics related to different occupations and the complaints they suffer from

Eg:

• Occupation, actors, sore throat
• Occupation, bookworms
• Occupation, business men, wearing out
• Occupation, singers, nervous dread
• Occupation, servants, girls from the country become chlorotic in the city
• Occupations, students, cough
• Occupation, washerwomen, toothache

Size : in this section includes rubrics of different size and types of the body such as dwarf, large, tall, thin

Subrubrics also include some body appearances and also conditions and complaints in them

Eg:

• Size, dwarfed, stunted
• Size, large, fat and sluggish, fat body but legs thin
• Size, tall, slender, phthisical
• Size, thin, predisposed to lung and hepatic affections
• Size, thin, weak and melancholy

Temperament section has different types of temperaments as rubrics and subrubrics involve physical and mental features in those temperaments

Eg:

• Temperament, bilious, asthma
• Temperament, mild, submissive, yielding
• Temperament, melancholic, constipation
• Temperament, nervous, hysterical, spasmodic dysuria
• Temperament, phlegmatic, indolent
• Temperament, sanguine, good natured

PRACTICAL UTILITY OF STAGES OF LIFE AND CONSTITUTION CHAPTER

• As the repertory belongs to puritan type all the symptoms in the chapter are given in provers’ language and hence it’s very useful for both beginners as well as experienced practitioners.
• This chapter has rubrics of different constitutions, temperaments and also different physical make ups therefore is very helpful in selecting remedies for constitutional prescription and also in ruling out non similar remedies
• This also makes it useful in bedside for the quick reference and easy retrieval of the remedy
• Along with the constitutions and physical appearances it includes mental characteristics too in one place which makes it easier for one to refer

• Eg: Size, thin, irritable, choleric, dark hair, make great mental exertion, or lead a   sedentary life.

• As this chapter has many characteristic and guiding symptoms, it helps in keynote prescriptions
• One single rubric contains diagnostic as well as characteristic symptom which is useful in selection of similimum

• Eg: Temperament, hysterical, spasmodic asthma, caused by anxious dreams, sensation as if   clothing were too tight

• One more important part of this chapter that has great practical value is the tendencies and diatheses. In the section Constitutions, there are many diatheses, dispositions and body tendencies which give therapeutic idea and helps in selection of similimum
• There are many concomitants along with the main complaint in a single rubric hence is good for both reference and prescriptive purpose

• Eg: Age, women, nervous, vomiting during menses

• Since there are cured symptoms, they are very valid and reliable from practical and clinical point of view
• The temperament section has rubrics which contain more than one temperaments in one single rubric, this can be taken in practice when the patient does not belong to one clearcut temperament i.e when he/she shows features of 2 different temperaments

• Eg: Temperament, sanguine, choleric

CASE

A girl aged 11 years presented with headache, weakness, and easy fatigue since the time she attained menarche (i.e, 1 yr).

All her complaints were worse after exertion and the characteristic feature of the headache was it would appear sometime after she goes to sleep and she would wake up with sudden, bursting, exploding headache.

Mentally she is an extrovert, jovial, talkative, sensitive girl and was very mature for her age.

Physically she is fair, tall, lean, thin with emaciation and muscular weakness.

On examination pallor was present and her Hb was 8g%

In Knerr’s repertory following rubrics were considered

• Temperament, sanguine
• Constitution, anemic
• Size, thin
• Complexion, fair
• Age, puberty, precocious, chlorosis, anemia, with excessive muscular debility
• Head, headache, sleep, after retiring when just losing herself, roused her with shattered sensatiojn as if something had exploded

And based on these Phosphorous was selected and the girl improved with Phosphorous 200

REFERENCE

1. Knerr C, Repertory of Hering’s Guiding symptoms of our meteria medica. 1st ed. NEW DELHI: B. JAIN PUBLISHERS; 2006.
2. Tiwari SK, Essentials of Repertorization, New Delhi: B Jain publishers; 2012.

Dr Shriraksha B
MD Part 2, Department Of Case Taking And Repertory
GHMC Bengaluru