The Need for a Repertory
John Henry Clarke once mentioned that "It is impossible to practice homoeopathy as it should be practiced without the aid of repertory."
Dr. Grimmer, a famous American homoeopath, also mentioned that "repertory prescribing makes for the greater accuracy and in the long run is a time saver and with its use one grows in the knowledge of materia medica."
A rare person may have a computer-like memory for rubrics and remedies. But for almost all homoeopaths, a repertory is indeed an essential tool.
The repertory is the only source of information about the relative value of the symptom. For example, only through the repertory can we discover that China is the only remedy under Mirth, on waking or that only Nitric acid and Staphysagria have anxiety, walking rapidly when.
Because there are more than 3000 remedies and each remedy may have 100 to 500 symptoms, we can see how Herculean a task it would be to memorize all those symptoms and relationships. So use of a repertory is a must for good homoeopathic practice.
Basics of Good Repertorization
When we use software to repertorize a case, the key is often what information we choose to feed into the program. As it is commonly said, "garbage in, garbage out."
No matter which repertory we use, it will never, ever give us the right remedy in a straight shot. So, we must use the repertory from the perspective of a certain philosophy and principle, and never use it simply as a mechanical tool.
Selection of the right remedy depends on many factors.
- The patient's narration or expression of their symptoms
- The physician's ability to make keen observations of symptoms
- The physician's skill in interpreting symptoms.
We should always remember the caution given by Dr. Borland, who said:
There is no repertory in existence which is complete in all respects. In spite of all the defects of the existing repertories, and in spite of all the traps which repertory work lays for the uninstructed and the lazy, there is a need which a repertory alone can supply.
Without such work, the homoeopathic materia medica is an untracked wilderness. What mind can master, retain, and reproduce at will our hundreds of drugs and thousands of symptoms?
Translating the Patient's Language
Now let's consider how we are going to convert the patient's symptoms into the language of the repertory.
A repertory is the index of symptoms from the provings. A repertory's author describes these symptoms and puts them in a particular format - depending on the philosophy the author follows, for example Kent or Boenninghausen.
I firmly believe that the Synthesis repertory, authored by Dr. Fredrick Schroyens of Belgium, is one of the best repertories that you can lay your hands on - whether you refer to the printed book or the computerized version, as found in RADAR software.
Knowing the Repertory's Background
To select the right rubric we should fully understand the repertory's background. If we use Kent's repertory then we should know its background and philosophy.
Likewise to use the Synthesis repertory, we should know its complete background - the philosophy involved and the structure on which it depends.
So it is essential that we do not ignore the Introduction - especially because so many of us tend to do exactly that. The credit goes to Dr. Fredrick Schroyens for writing an exceptionally informative Introduction to Synthesis edition 8.1. These 180 pages describe the complete blueprint for the Synthesis repertory.
Rubrics in Unexpected Chapters
When we study the repertory we learn which rubric appears in which chapter. We also discern which rubric the author wants to highlight in any particular chapter. However, any given rubric may pop-up in unexpected places and not where we would naturally expect.
Take for example, Uncleanliness. Almost anyone would expect to find this rubric in the chapter of Mind. Unfortunately, it is in the chapter of Generalities.
Another example is Cheyne-Stokes respiration. Of course we expect this rubric to be in the chapter Respiration. Only repertory study teaches us that it lies in the chapter Generalities.
It is also essential to study cross references, becuase rubrics may appear both in the most obvious place and somewhere else in addition. For example, we expect Restlessness to be in the chapter of Mind. Yes, it is there — but it is also in the chapter Generalities.
Let's take another example - a patient with gangrene. We can investigate the rubric directly by looking at Gangrene under Skin, and that does give us a few remedies. But gangrene can also be looked up under -
- Emaciation of affected part
- Skin, discoloration, black
- Coldness, of skin etc.
So we see that finding cross references plays a large role in selecting the correct remedy. Combining related rubrics is also very important because we want to consider all the possible remedies in our analysis.
If a patient's nature is extremely fastidious, then we may take the rubric Fastidious, which appears in the chapter Mind. But it is also important for us to take the rubric Rest, cannot when things are not in proper place and combine it with Fastidious so that we do not leave out certain remedies.
The Value of a Dictionary
Another important point is to understand the exact meaning of the rubric - and we can only be sure we understand if we use a good dictionary. Kent always recommended keeping Webster's dictionary by our side.
It's a good practice to look up definitions as a routine, even when we think that we already understand. Just this simple action alone may well lead us to new insights.
After teaching Materia medica for 23 years, I can say that even a group of senior homeopaths with a collective practice of several hundred years will often not know the exact meanings of common physical or mental rubrics.
Let me give a simple example under the chapter Extremities. Here we see the rubric Walking and sub-rubrics under this are gressus gallinaceus and gressus vaccines. How many practitioners know the real meaning of these two rubrics?
Gressus gallinaceus means somebody who walks like a bird, and gressus vaccines means somebody who walks like a cow. You see, it is very important that we try to understand these literal meanings.
The Subtlety of Dreams
Let's look at another example in the chapter of Dreams, where there are many shades of meaning. If we do not have a thorough knowledge of the English words being used, then we may easily miss valuable information that we come across under Dreams.
For example, let's look at dreams of Armageddon. In the Christian scriptures Armageddon is the place of the final battle on the day of the Last Judgement. So Armageddon under Dreams refers to a decisive conflict on quite a vast scale.
Similarly, dreams of 'genealogy' involve the science of the descent of the family. Or dreams of 'goblins' would refer to dreams of an evil or mischievous spirit.
So we must first understand the exact dictionary meaning of various rubrics to be able to convert the symptoms of our patient into the language used in the repertory.
It is most essential that we not miss the PQRS symptoms directly described by the patient.
Whenever we come across something that is very, very peculiar - something that is quite striking and strange - then no matter how minor it may seem, we cannot neglect it. Let's take a few examples -
- Dreams of his youth
- Remorse from trifles
- Voice lost from anger
- Coldness in oesophagus
- Frosty deposit of discharges
These symptoms are so peculiar that we should be aware where they are located in the repertory. They do not require any interpretation - what they require is a real search so we know where to find for them.
The Life Story Helps Us Understand
The best interpretations come from understanding the situation of the patient. This usually must be understood in the form of a story or in a form of an evolution. Lets take an example.
A boy wants to become an artist. From a very young age he loves to read books related to the arts, he loves to draw and paint, and is very excited on seeing related television programs. He is enthusiastic about taking part in art competitions and he loves to visit museums and art galleries.
Added to this, he has a very dominating father. The father says "Look, you cannot make money by studying at a school of arts. You have to study business so you can get a good job and make lots of money."
Then conflict starts in the mind of the child, regarding his burning desire to be an artist against the restrictions from his parents to pursue commercial education.
The Patient Must Confirm Your Language
Now, how are we going to interpret these symptoms? Never assume you have a correct interpretation of the symptom without confirmation from the patient - that is, never ever interpret from your own imagination.
In the case I gave above, we must understand that the child wants to do something but the dominating parents restrict him - and ultimately the child surrenders.
In this case the rubric we select may be:
Mind -Contradictory, actions are contradictory to intentions
- or it may also be
Antagonism with self
- or we may also take the rubric
Ailments from domination
Once we decide on one of these rubrics, we must confirm its accuracy with the patient. Then can we take it in the case analysis.
We are not going to read the rubric in front of the patient, but we are going to discover in our case taking interview whether the patient agrees with the meaning we have chosen.
Only when the patient agrees with the language should we should accept it as valid and take it in the analysis.
There are people who say things to make a particular impression on other people, but in their heart they don't believe in what they are saying. They may be very nice to someone on the outside, but deep within their heart they don't like the person; they may even hate him.
For such a person we can take the rubric Mind - Contradictory, speech intentions are contradictory. Now, this absolutely describes diplomacy. We don't have diplomacy as a rubric, but still, this rubric conveys diplomacy.
Sometimes there are cases where it is difficult to find the exact feelings of the patient in the form of a rubric. Let's take the example of a person who is in many ways an extrovert, but he does not share his feelings with anybody.
Is it correct to take the rubric Reserved? Or should we take Reserved displeasure? Because this person is primarily an extrovert, he is not well described by these choices. So the correct rubric may well be Hides his inner feelings.
As another example, consider a person who has a strong aversion to quarrels, violence, arguments etc. Here, it is not always correct to take 'Quarrel, aversion to'. Depending on the situation, 'desire for harmony' may be a better rubric.
Some cases require translation with a more Jungian type of analysis. For example, consider a man who cannot separate his libido from his mother. He should be referenced in the repertory under Mother fixation. Or a man who still competes childishly with his father for his mother's attention would be looked up in the repertory under Oedipus complex.
Trying Alternative Chapters
It also pays to be flexible by looking for an appropriate rubric in different places.
For instance, if we cannot find insight into the patient's feelings in the chapter of Mind we may more fruitfully look under Delusions or Dreams.
Through intelligent application of these principles, the practitioner will find a path from the expressions of their patient to the language of the repertory. Choosing that path well leads one steadily to the proper remedy.