Prescribing on the Basis of Repertorization

The repertory can be defined as: "An index of symptoms arranged systematically."

The art of homoeopathy includes the ability to match a disease picture with a drug picture in as much as the Simillimum consists of a drug which, when proved in a healthy person, elicits, the same symptoms as though displayed in the patient by his disease.

Classification of repertories:

1. Repertory based on Individualization of the Sick from general characteristic symptoms to particular characteristic symptoms; Kent's, Lippe's and Lee's Repertories

2. Repertory based on Totality of Characteristic Symptoms with special importance given to symptoms of sensations, location, modalities, concomitant;  Boenninghausen's and Boger's Repertories.

3. Clinical Repertories based on greater importance to symptoms of disease; Bell's Diarrhea, Allen's Repertory on Fevers, Morgan's Repertory on urinary disorders, Lutze's Repertory on Neuralgias, Repertory of Rheumatic remedies by Robert's and Clinical repertory attached to Boericke's Materia Medica.

4. Concordance repertories is based on the symptoms as developed by the provers in exact words. The whole symptoms have been broken in parts and so listed. For e.g. "Mental Terrors, singing, shouting, and dancing in a grotesque manner" are  found under seven separate headings. Due to this this repertory is considered most complicated and voluminous. But it is very useful for finding queer symptoms; Repertory of concordance by Gentry in 6 volumes, Knerr's Repertory to Herring's guiding symptoms and Allen's symptoms register.

5. There are certain repertories devoted to certain symptoms and not to any parts of the body or the disease; Sensations as if by Dr. Ward and Roberts, Times of Remedies and Moon phases by Dr. C. M Boger, Illustrated Repertory by Gray with illustrates the directions of pains.

6. Punch card repertories. These repertories consist of many card which are punched in holes. Each card has one rubric.  The card gives all remedies used in the repertory but only the remedies which as the symptoms, in their proving's are punched. The name of the remedies is printed in such a manner that they will overlap each other when cards are put together in a uniform way. Hence a remedy which is common to all rubrics in a list will be found though without any obstruction. Such a remedy would be considered simillimum if there is no other remedy to challenge it. There are several such repertories available like Dr. Juggal Kishore's Punch card repertories, Dr. Dhawale Boger -  Boenninghausen punch card repertory, Fields punch card repertory, Parle's punch card spindle repertory, Dr. Markos Jimentz's Punch card repertory etc.

7. Software packages for Repertorization. These software's  principally adopted the method either  of Dr. Kent or  Dr. Boenninghausen. There are many packages available which includes all the possible available repertories, with the flexibility to choose any single method of repertorization or all.

Here we are going to discuss the Kent's Repertory as it is used by homoeopaths worldwide. To study Kent's repertory one should keep in mind the following:-

1. Philosophical Background

2. Formation

3. Limitation

4. Adaptability

1. Philosophical Background: In lesser writing Dr. Kent presented human sickness in forms to be perceived to understand homoeopathy as a science.

1. From center to circumference

2. From head to feet

3. From within out

4. From highest to lowest

5. From the vital centers to the periphery

This may be said to be the vertex presentation whereby one thinks from things first to things last perceiving the loves and hates as the first and deepest of any sickness in man. A sickness can be perceived in:

1. Perversions of the desires and aversions

2. Perversion of the intelligence

3. Disturbed memory

4. Physical sensation perverted

5. Disturbed functions or organs with the attending circumstances

6. Perverted sensations and suffering of parts

7. Tissue changes and pathological conditions

8. Sensations and suffering dependent upon the pathological conditions

9. Causes that excite each of these are parallel to the perverted state themselves in each sphere.

Any physician who can view a sick man in this way from first to last will able to get evidence that will enable him to adjust MM so that order will certainly be reestablished.

Some physicians are unable to perceive that the mental symptoms are first will and understanding perverted and are unable to perceive that the man himself have been unbalanced by heat, cold, light, electricity in instance of excess of defect or of perversion. They utterly unable to perceive that the man as a whole as of himself, may be perceived in a grasp collectively and mentally analyzed by the measures of excess, defect and perversions. Such men always see ultimate tissue changes on a pathology as both cause and ultimate, because they do not perceive. 

The first cited vision is to be perceived; the last can be seen and touched. This latter might be termed breach presentation. These two classes of men must always differ. The first are philosopher and rational one. The others are materialist. That is why Dr. Kent points to cure the sick individual rather than the totality characteristic symptoms as advocated by Dr. Boenninghausen or pathological nature of symptoms corresponding to the drugs as advocated by Hughes.

2.Formation: The formation of Kent's repertory is based on the following ideas:

1. Indexing of sections: The repertories made convenient by grouping the pages for main sections. For e.g. Teeth, Eyes, Extremities.

2. Ranking of symptoms: There are three ranks of symptoms; a) CAPITALS, b) Italics and c) Roman letters. The CAPITALS are of the highest rank, Italics are lowered to the capitals and Roman letters are the lowest in rank from the point of the evaluation of the remedy.

3. Grouping of headings and subheading of rubrics: Under the heading there are a number of subheadings like - Sensitive to certain persons, to all external impressions, to music, to noise etc. By means of such heading and subheadings the modalities, characteristic nature of the symptom is found at the same place which helps a great deal in the selection of the remedy.

4. Cross Reference is given with most of rubrics they are not provided separately: With the heading constriction- Tension ( see also Drying, Pressing) are given.

5. Schema: The Schema of Kent is like that of  Boenninghausen accepting a few sections. It is as follows:

Dr. Kent advises to repertorise from the general symptoms to the particular symptoms. As such the ranking of the symptoms are very important and the selection of the rubric depends upon the arrangement from the highest ranking to the lowest ranking particulars.

 In his lesser writings he states "When I take-up a full case for study I single out all expressions that describe the general state such as the aggravations and ameliorations of the general state of the patient or many of his symptoms. Next I consider carefully all his longings, mental and physical, all the desires and aversions, antipathies, fears and dreads etc. Next I look for all intellectual perversions, methods of reasoning, memory, causes of mental disturbances etc. All these I arrange in form together, in order to set opposite each one, all remedies in correspondence to rubrics as found in the repertory. By the cancellation process it will soon be seen that only a few remedies run through all these symptoms and therefore a few are to be carefully compared in order to ascertain which one of all these is most like the particular symptoms not yet lined up to be considered as the first ones have been considered. Dr. Hahnemann teaches in the 153 Para that we are to give particular attention to such symptoms as are peculiar and characteristic. He also teaches that the physician must pay his earnest attention to the patient. If these two things are to be considered, it will be seen that Dr. Hahnemann's idea was that a characteristic symptom is one that is not common to disease but one characterizes the patient. All the lot of symptoms single out for more comprehensive view such as to characterize the patient and are predicated of the patient himself. By treating a portion of the symptoms in this way we have reduced the list of possible remedies to a few or perhaps only one. As it is necessary to consider the totality of symptoms for the basis of homoeopathic prescription, it is not necessary to examine all the rest of the symptoms in order to ascertain him these few remedies correspond with all the particulars."

How to use Kent's Repertory?

Regarding this in his lesser writings Dr. Kent states "As homoeopathy includes both science and arts, repertory study must consist of science and arts. The scientific method is the mechanical method taking all the symptoms and writing out all the associated remedies with grading, making a summary with grades, mark at the end. There is an artistic method that omits the mechanical and is better, but al are not to use it. The artistic method demands that the judgment be passed on all the symptoms after the case is most carefully taken. The symptoms must be dealt as to their value as characteristic in relation to the patient. They must be passed in review by the rational mind to determine those which are strange, rare and particular. 

Symptoms most peculiar to the patient must be taken first, than those less and less peculiar until the symptoms that are common and not peculiar are reached in order from first to last. These must be valued as they relate to the patient rather than to its parts and used instead of ultimate and symptoms pathognomonic.

Hence the symptoms to be taken should be in the following order.

• Are those relating to Love's and Hate's or desires and aversions

• Are those belonging to rational mind, call intellect

• Are those belonging to the memory

The mental symptoms must be first worked out by the usual form until the remedies best suited to his mental conditions are determined, omitting all symptoms that relate to the pathological cause and all that are common to disease. When the sum of these has been settled, a group of 5 or 10 remedies or as many as appear, we are then prepared to compare them and the remedies found related to the remaining symptoms of the case. 

The symptoms that are nest most important are those related to the entire man and his entire body, or his blood and fluids; as sensitiveness to heat, cold, storm, rest, night, day, time. They include both symptoms and modalities. As many of these are found also in the first group the mental summary are to be retained. There is no need of writing out the remedies not in the mental group or summary; these symptoms relating to whole patient cannot be omitted with any hope of success. Nest we must look over all the records to ascertain which of that group are most similar to the particulars of  the regions of the body; of the organs of the body; of the parts of the extremities. Preference must be given to discharge from ulcers, from uterus during menstruation, from ears and from other parts, as those are very closely related to the vital operation of the economy. Next must be used, the modalities of the parts affected, and frequently these will be found to be very opposite of the modalities of patient himself. A patient who craves heat for himself generally, and for his body, may require cold to his head, to his stomach, or to the inflamed parts, hence the same rubric will not fit him and parts. Hence to generalize by modalities of isolated particulars lead to the incorrect remedy or confound values place upon certain remedies.

There are rare and strange symptoms, even in parts of body which the experienced physician learn are so guiding that  they must be ranked in the higher and first classes. These includes some key notes which may guide safely to a remedy or to the shaping of the results, provided that the mental and generals do not stand contrary, as to their modalities, and therefore, oppose the keynote symptoms.

Any remedy correctly worked out, when looked up in the Materia Medica, should be perceived to agree with and to fit the patient; his symptoms; his parts; his modalities. It is quite possible for a remedy not having the highest marking in the anamnesis to be most similar in image as seen in Materia Medica.

The artistic prescriber seems much in the proving that cannot be retained in the repertory, where everything must be sacrificed for the alphabetical system. The artistic prescriber must study Materia Medica for long and earnestly to enable him to fix in his mind sick images which when needed will infill the sick personalities of human beings. These are too numerous and too various to be named or classified.

Case Study by Dr. Kent 

A case of acute tonsillitis in a child of 4 yrs. Symptoms recorded:

• Timid - Ars Alb, Cal Carb, China, Iod, Kali C, Merc, Plb, Sil
• Aversion to touch - Ars Alb, Cal Carb, China, Iod, Kali C, Merc, Plb, Sil
• Enlarged abdomen  - Cal C, Sil
• Cervical glands enlarged - Cal C, Iod, Kali C, Merc, Sil
• Subject to ear aches - Cal C, Kali C, Merc, Sil
• Grinds teeth -  Cal C.

Treatment: Cal C which came through the Repertorization was given in 10M potency in a single dose and the patient was cured without any other remedy.