Category Archives: Repertory
By Vera Resnick
I must own up to being old fashioned. However much computers may have helped us in referencing many books, in finding correct rubrics, in the process of repertorization – it has reduced us to a bunch of small-screen addicts with heavy-duty tunnel vision.
One of the central flaws of science, replicated in the use of a computerized repertory, is that we determine what we’re looking for, and we look for it. Peripheral vision becomes irrelevant. Apart from synonyms, which can sometimes be useful, either what we’re looking for is there – or it isn’t. Anything interesting that may be lurking in the background becomes effectively invisible. Our gaze is honed in to what we’re looking for, what we find, and then to a search for alternative expressions of what we’re looking for.
I invite you now, if you will, to put down the mouse (or take your finger off the touch pad) and pick up the nearest book (no, no, a Kindle absolutely does not count). Flip through the pages without even looking for anything. Do you notice some ideas as you do so, some words that just jump out at you? If you’re doing this with a homoeopathic text, or something that interests you, you may even find yourselves noticing things you want to go back to, look at in more depth. It’s true – this can happen on the computer, but it’s a much easier process when you know what you’re looking for is sitting in your hand within the pages of the book you’re holding, and is not something you’re going to have to hunt through your browsing history to get at.
Tunnel vision is considered a problem because we are hard-wired to give importance to peripheral vision, although as a race we seem hell-bent on destroying any abilities we have in that area. We are programmed to notice something that is moving which should be still, something that has a different colour, a different shape, and our brains process a tremendous amount of information beyond that which lies in our direct focus.
The new P&W book allows us to do both. On the one hand, the book is quite large in terms of page size and lettering, and all sections are very clearly presented. When I’m looking for something specific, it’s very easy to find it. On the other hand – as I leaf through the Cough section looking for sweetish expectoration, I cannot help but notice all the other forms of expectoration appearing on the page. As I take a broader look at the page, I cannot help but notice how frequently Phos and Puls seem to stand out in their four point bold capitals, and notice the incidence of other remedies in these rubrics too. Looking at the page on Leucorrhea, I find myself wondering why I’m seeing much less of the Sepia I expect, and more of Mercury and other remedies to think about.
The point I’m trying to make is that while you can turn every computerized repertory search into a learning experience if you choose to do so, a hard copy book search will bring things to your attention just by looking through the book’s pages.
Another plus of the book is that it brings the Concordances section into focus and allows for clearer study and use of that section in repertorisation and case management.
The editors have kept their intervention to a minimum, and thus I know what I hold in my hands is faithful to Boenninghausen’s 1846 Therapeutic Pocketbook. To quote from the editor’s introduction:
“…We translated from the original German of the published first edition and had use of the handwritten printer’s edition in Boenninghausen’s own hand. We translated each rubric to bring it into modern English but retained the original meaning of each word and sentence…” P&W’s Synopsis program also has the original German edition, so it is possible to check back to the original rubrics as desired…”
Since I wrote most of the above, my software was knocked out by my antivirus gone rogue. Until I worked out the problem, which ultimately was easy to resolve, I was dependent on the book – and extremely relieved that I had it at hand. I think that for those of us who work constantly with computer software, having a hard copy which offers a faithful non-electricity non-computer dependent version is crucial for those days when nothing is working properly.
The book is available from firstname.lastname@example.org
Drop an email and he will invoice you via PAYPAL for $85 plus delivery, usuallyabout $10.
I present this post originally posted by Vera Resnick on her blog.
One of the things Vladimir Polony and myself try to do, is explain what we learned when researching the meaning of words in the Therapeutic Pocket Book during translation to English. The meaning of words have change tremendously since the 19th century. Vera did some research on the word erquickendem and gives her finding below. I would also like to add one description that was found in our research, and that was “nervous stimulation”. In itself it means nothing but when combined with other phrases, a rounded comprehension of the meaning can be deciphered. We also refer to each remedy noted in the rubric, and see how the symptom is described, and compare with the other remedies.
Yesterday I was working on a case of a 17-year-old girl who has an eating problem . She does not seem to be anorexic, but has difficulty with eating.
– She does not get hungry – she gets stomach cramps which is how she knows she must eat. She also gets a “mouth” sensation that she wants something “with a lot of taste”, but when questioned it turned out that some of the foods she likes that fall into this category include pasta with olive oil and mild flavouring, cheese Danish, and similar. Her concept of “a lot of taste” did not mean highly spiced or strongly flavoured.
– After she has eaten a small amount, she feels both full and disgusted with the food she has eaten.
I mentioned this case to Gary, and he asked “have you considered the rubric for desires refreshing food?”
Remedies for this rubric: Carb-an, Caust, Cocc, M-art, Ph-ac, Phos., Puls., Rheum, Valer.
The word “refreshing” has always put me in mind of watermelon, cucumber salad, chilled fruit juice, or (like the Brit I am), a strong cup of tea. But however much I love a really good shepherd’s pie, I have never considered it “refreshing”. However Gary’s question got me thinking: what does “refreshing” mean? And are the foods and drinks that come under this definition more or less objective – or is it an issue of why the patient requires a food (to refresh himself), rather than the nature of the food itself?
In this particular case I had considered remedies such as Lyc, Calc and Puls – which I had given to the patient on several occasions but which had never quite touched this symptom.
I did some research. The original German word is “erquickendem”, which a German linguist informed me is probably connected to Middle English terminology of “the quick and the dead”. Looking at thesaurus options for the word “refreshing”, I came across words such as “revive”, “restorative”, and I found myself remembering soporific events which people attended lured in by the hallowed words “refreshments will be served”… which often were far from refreshing in the sense I had understood it, unless insipid tea and dry buns fit the description.
I’m also reminded of the way my father would say sitting back in his chair after eating something substantial that he had really enjoyed, “that was fit to revive the dead…”.
Back to our (refreshing?) onions…
I took two rubrics in this case:
Hunger and Thirst, Desire, Refreshing (306)
Hunger and Thirst, Hunger, Appetite without (274)
These rubrics led me to Rheum, a remedy I had not considered at all in this case. The Materia Medica Pura includes these symptoms, amongst others, and in general Rheum reads very well for many of the other symptoms in this case.
49. Great appetite, but the food though tasting nice soon becomes repugnant. [Gss.]
50. Whilst he loathes certain things (such as fat, insipid food), appetite for a variety of things, but he cannot eat much of them, for they immediately become repugnant. [Gss.]
51. The food does not taste right, and soon becomes repugnant, though he has tolerable appetite. [Gss.]
53. Hunger, but no appetite.
54. He feels qualmish (squeamish, loathing and inclined to vomit).
There are two issues that I wanted to highlight in presenting this case:
1. Our understanding of remedies and symptoms are inevitably complicated by nuance of language, by the way the sensations are literally lost in translation, first from the sensation itself into spoken language, and second from one language to others. This applies both in the way our patients report their symptoms, and in the way the symptoms of the provers were reported as presented in the Materia Medica. It emphasizes the need to look at older meanings of words we may think we understand when using the repertory and when reading provings on which the repertory was based. And it also means that we have to use the question “what exactly do you mean by that” frequently in our case-taking.
2. The repertorization is not intended to summarize the case in two rubrics, and in this example, not even to identify all the most important aspects of this case. It is really a tool, intended to find some essential salient elements that will point a guiding finger towards relevant remedies that we need to look at in the Materia Medica.
One of the most useful features of computers is in data examination. From the simple level of being able to count letters, numbers, duplicate of words, how many of a symbol exist, how many occurrences of an instance, percentages of occurrence etc etc to much more complicated routines which are limited only by lack of imagination or inexperience with being able to write routines.
P&W are fortunate to have the P part as a highly gifted and talented JAVA computer Engineer with a background in mathematical extraction and accounting. This has enabled us to examine in detail any body of work that contains an analysis module and insert applied criteria to it and see where the database differs or deviates from the stated purpose mathematically. In this way we can rectify non compliance of data when following a ‘rule’ or examine the reason for its non compliance and ‘excuse’ it and still keep it inserted within the routine.
During our testing phase of the T.P.B. as inputted data, we were able to extract information on so many levels. The most amazing thing was that we could lay out all the work based on percentages of occurrence. How many times remedy X was used overall, Which was the most used remedy, Which was the least, which remedy occurred most in an ailment concerning a particular location etc etc.
We made several models to test different approaches, we made a “Polarities”* module and trialed it in the program for nearly a year. We examined the resulting criteria against prescriptions made using the standard procedure and concluded that mathematically and in real terms, it was misleading. Being aware that a program was only as good as the data inputted, I personally checked against a German version of a Polarities based program with 10 of my cases, and 8 out of ten results it came to the same suggestion for remedy choice. I concluded that our program was following a correct criteria for analysis and as such, the results were not as useful as suggested. As you can see here, we left in the link to the Polarities* module in our preferences/setup menu (but removed the module) in case we ever decide to return to the module later with a fresh criteria for making it useful.
We found that in the T.P.B. that Boenninghausen had in several of the chapters, placed rubrics with different symptom descriptions but contained the same remedies for selection within. Vladimir ran comparisons based on ‘exact’ match criteria, and also on a variety of percentages of similar found in the remedy lists of each. In this way were able to cross reference EVERY occurrence of rubrics that contained the same data, for the purpose of preventing insertion into a case analysis so as to not give a false repertorisation result numerically.
The original intention of this work was to find rubrics we could merge if the criteria was the same, but in the event, we took the decision to NOT do that as some rubrics contained additional remedies or a variance of the grade assigned and we did not feel qualified to make a judgement on reassigning the indicated grade up or down. Whilst mathematically, an even across the board change of a remedy within a rubric to the higher grade would appear to be a valid option, the fact remains that when Boenninghausen split a symptom into components, he assigned the same numerical grade to all the components. We did not feel that is was of benefit to alter this arrangement arbitrarily in one rubric component only.
However, we do indicate in the program where a similar rubric could be found for checking. We also indicate where a smaller rubric is contained in its entirety within a larger rubric if expansion of the symptom is required.
We also ran into a problem with the term Tetters. In discussions with others, and in research, we were unable to find an exact meaning for the term. Our comparison tests showed where we COULD merge certain rubrics with a rubric for eruptions of a similar description, AND we understand that the smaller rubric is contained in entirety in the larger one, however, Boenninghausen differentiated the terms. We do not feel qualified or feel we have enough information to merge the rubrics for Tetters with eruptions (where additional medicines are present) so we erred on the side of caution and leave it to the practitioners to make that decision. We continually look for explanations of 1800’s terms for absolute definites and when we can justify in our research that we can merge a rubric for clarity, we will do so. It does not mean we are correct to keep the rubrics distinct and separate, it means we are unsure and cautious and accepting of our lack of knowledge on the matter.
One other area we continually work on is making a Materia Medica direct symptom search repertory. Back in the mid 90’s I was working on a concept of bypassing the Repertory altogether, and searching in the Materia medica’s only with a computer for a symptom detection and analysis.
This is one of the main reasons that I compared the 1846 edition of Boenninghausens rubrics against the Materia Medica for accuracy of comparison. (It was a long and laborious job which involved a lot of photocopying and typing. During the Hurricanes in Florida, I lost my residence and my computer and most of my research photocopies and typed notes. 3 years of work gone in an instant. Fortunately later I was able to replace the copies via Google Books).
Later Vladimir and I, in discussing the concept, were able to use our Materia Medica databases and extract symptoms direct via reference to the Materia Medica and extract a list of medicines that had the collected total of the symptoms inputted. Most homoeopathic computer programs will search for symptoms in medicines, but we were aiming for a totality of several symptoms to give the answer directly cutting out a repertory. For various reasons, it does not work. We believe Boenninghausen knew this. That is why his repertory is a synthetic approach based on an amazing technical understanding of Hahnemanns logic and observation. When Vladimir has time, his mind returns to the complexity of the issue and he mulls over different approaches to the extraction of information to give an accurate indication of which medicine is required. So far, it does not seem possible using the criteria we have formulated.
What we did get out of this exercise was an understanding of each and every rubric singularly and collectively, ie a joining together of the complete symptom via combination of rubrics. We matched the individual symptom in the Materia Medica with a grouping of 2 or 3 rubrics that described that symptom collectively, and were sure of the accuracy of our choices because the GRADE for each rubric would be the same.
We have so many projects that we would like to do with the information that we have, but time, money and the reality that most practitioners prefer the inaccuracy of other repertories, constrain our enthusiasm.We have to be content that the work we have done is as accurate as we can make it as a working and totally useful representation of the 1846 Boenninghausen Repertory for the practitioner. We have spent a lot of years individually and together on this project. We wanted something we could trust for our patients.This is Boenninghausens work. This is Hahnemanns approach to case taking. This has been an interesting journey and one we enjoyed, but would not want to undertake again. Its done, its updated and it works well.
*approach suggested by Klaus Henning Gypser
Using their respective skill sets, nearly 4 years of work was inputted solely to the Therapeutic Pocket Book of Boenninhausen. It was never the intention to rewrite the book, more to correct any errors. In the event, it became obvious that we needed to correct so many errors of translation in English, that it was easier to re do the whole translation. Along the way, we corrected wrongly attributed remedies to rubrics and some incorrectly assigned values between the original handwritten printers copy and the first printed edition.
We do not consider the work as anything else other than an accurate facsimile of the ORIGINAL Boenninghausen Therapeutische Taschenbuch, corrected and translated carefully into English, Spanish, Italian and Hebrew. (German is the original language and included).
Vladimir and Gary worked with the English translation for 8 months after completion of the translation in the clinic individually and together, correcting minor errors of translation and comprehension before collating the work for inclusion in the OpenRep SYNOPSIS program. As a German speaker, Vladimir compared the English rubric to the German rubric in every selection of symptom chosen for each case, and in this way, we ensured that the meaning was identical in intent.
Another problem that arose is one associated with the passage of time. Words used in the 1800s had different meaning compared with today. Language development and medical descriptors have changed considerably. This entailed the use of 1800s medical dictionaries and a careful observation of both the words used, knowledge of the symptom/disease state as understood in the 1800s, and comprehension of the modern understanding of terminology today.
To this end, P&W took pains to ensure that the words used by Boenninghausen conveyed HIS meaning and understanding, and where necessary P&W have added the modern comprehension in brackets so as to aid in the fullness of repertorial analysis.
Every rubric is allocated an ID number. The ID is used in all languages for the corresponding rubric. So rubric ID 1232 is the same in German, Hebrew, Italian, Spanish and English.
If an English speaking practitioner sends a case to a practitioner in Spain, he can send just the (autosave function included in the program) example: rubric numbers: 31;121;2367;790; and the Spanish practitioner can copy the numbers in the search bar and bring up the case rubrics IN SPANISH on his or her machine.
This is just one of the features of the program.
An in depth look at WHY the T.P.B. is the repertorial work of choice in a later article.
Ever experienced this? You prescribe Platina for a homoeopathy student, or for someone who has read up about remedies.
She looks up and raises an eyebrow (or tries to), with an attempt at an arch smile.
“Really?” she asks, incredulously but with a measure of pure delight, “Platina? I’m Platina?” (in itself a wrong description, no person “is” a remedy)
It’s tantamount to telling a female patient she still has “it”. And try telling a homoeopathy-savvy patient that Platina is definitely not for her – she will often be deeply insulted…
Definitely time to read the proving, Hahnemann’s notes, and some others who didn’t allow the illusion of Platinum-coated sexuality go to their… well… minds…
The proving symptoms are really fairly tame. There are some extreme-seeming mentals, such as the classic:
35. Illusion of the imagination ; on entering the room after walking for an hour, everything around her seemed very small and all persons physically and bodily inferior to her, but she herself great and lofty in body ; the room appears to her gloomy and disagreeable ; attended with anxiety, gloomy and cross humor, a whirling vertigo and discomfort in her surroundings which before were pleasant to her ; in the open air, in the sunshine, everything vanishes at once.[Gr.].
Quite frankly – I was disappointed…with 15 mentions of flatulence (which can ameliorate), no seriously lascivious dreams, more of a strong emphasis on localized discomfort than anything else, the proving just didn’t live up to my lurid expectations (just read any modern materia medica and you too will have lurid expectations…)
What about this one then:
847. Extraordinary sexual impulse (aft. 6 and 14 d.).
Oops – that’s Lycopodium. No one gives an arch smile when prescribed Lycopodium.
Hahnemann noted in the introduction:
“When Platina is properly homoeopathically indicated in a case of disease, it relieves simultaneously the following ailments, if present : Lack of appetite ; eructation after eating ; constipation while traveling ; emission of prostatic juice ; induration of the uterus ; weariness of the lower limbs ; cold feet ; stuffed coryza.” (bold print is mine – vr)
Still not very exciting. But what does “properly homoeopathically indicated” mean here? Does it mean if there are no extreme mentals or the kind of sexuality that comes more from those teaching Platina rather than the proving itself – Platina cannot be prescribed?
I’d like to quote Carroll Dunham (1828-1877) here. His words reverberate through the centuries with the steady tone of common sense:
“Whether Platina is suitable only for irritable, excitable females, with predominant activity of the sexual functions, as the majority of writers assume, and among them Stapf and Gross, the provers of it, who, by the way, made their provings on a very excitable young woman, I shall leave undetermined.
For myself, I have had frequent occasion to administer Platina, and have obtained the very best curative results in… phlegmatic women of lax fiber…. On critical review… we find that all or by far the greater part of its symptoms bear the character of depression, but not that of erethism...”
And by the way, in case you were wondering:
1. Excessive sensitivity or rapid reaction to stimulation of a part of the body, esp. the sexual organs.
2. A state of abnormal mental excitement or irritation.
For a homoeopathic physician, this is a fairly routine complaint that will come up in a busy clinic. The disease is so endemic in the western world that, Im surprised when a month goes by and I havent seen a case.
Firstly, I want to address the disease process, or miasms as Hahnemann called them, and put them in perspective using his model which follows the modern approach to disease in use today. Hahnemann classified disease and/or infection into 3 named divisions. There is Psora, containing a host of disorders, and then there is Sycosis and Syphilis, acquired and formed by venereal infection. So in Hahnemanns model, Sycosis and Syphilis are the entire disorders of a venereal nature. All other disorders are not, ie Psora.
This simplistic explanation, not taking into account mixed miasms etc, is the basis of my approach to dealing with patient ailments when faced with any acquired STD. I treat the infection totally for what it is and bear in mind that it is a singular disease of a venereal infection, and thus has to be isolated in terms of other symptoms and dealt with within the confines of an STD. I try not to confuse the symptoms of an STD with any others, but ALWAYS take into consideration a totality of the presenting problem.
Here is an example out of my clinic.
Female patient in 40s. Had been under treatment for various health issues for which Lycopodium had proven its worth over a 18 month period, exceptionally so.
I was contacted recently that a recurrence of genital herpes was in evidence. The herpes was contracted in her early twenties and had been treated with Valtrex about 10 years ago and there had been no outbreaks of herpes since. In looking at the case and noting that the patient had suffered on and off with respiratory disorders and lots of influenza and not feeling well, which Lycopodium cleared up very quickly and effectively, I surmised that her body had been treated effectively through the existing layers of ill health, and now, the herpes virus was the top most layer, perhaps even the causation (or the suppression of the herpes) of her poor immune response to influenza and recent ailments.
How do you treat herpes? What can realistically be done to prevent re infection and outbreaks? First, and logically, there cannot be any suppression of the expression or of the symptoms. It has to be treated homoeopathically, to support the body and organism to clear itself of the virus. It is not going to happen overnight, and it not going to happen in one outbreak. However it will happen, and it can be eradicated if treated correctly.
First, a physician has to note the symptoms of the expression carefully, VERY carefully.
This was the case as presented to me.
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