Gem of homoeopathic repertories A concise repertory of homoeopathic medicines by Dr SR Phatak

Dr Ami H Chandarana

ABSTRACT
There is a range of repertories we use in homoeopathy out of that, one of the gem is “A concise repertory of homoeopathic medicine by Dr S. R. Phatak” which is clinical, versatile and alphabetical. It is the idyllic repertory for the probationers to practising homoeopathy.

KEY WORDS Phatak’s repertory, alphabetical, concise, clinical, gem.

INTRODUCTION
Dr Phatak perceived the idea of preparing and arranging the repertory in alphabetical order while teaching to their fellow doctors that repertory should be handy and clinical. He felt that repertory should lessen the difficulty of a physician to hunt for the rubrics which is presented with the help of one case of fever where the repertory showed that every case of fever has some common symptoms and some individualistic symptoms and with the help of individualistic symptoms homoeopathy works excellently.(1)

ABOUT PHATAK REPERTORY
Dr Shankar Raghunath Phatak had an idea of preparing a repertory which he pursues with the help of his friend Mr. S.L.Kapadi, which he was not able to pursued because of his disturbed health. Mr. S.L.Kapadi came with the skeletal copy of this repertory the author systematize it in a proper way and made many editions. Dr (miss) Homai Merchant typed the hand written copy and this copy was present at author’s table for almost 10 years. During that time many useful editions were made with the help of Mr. Kapadi. Author’s son Dr D.S.phatak went through all the sections did the preliminary spade work and with the help of Mr. Datay first edition was printed. (1)

DIFFERENT EDITIONS OF PHATAK REPERTORY
1st edition was published in September 1963 by Mouj printing press, 2nd edition published in 21st October 1977 by M/S Jokap printers, 3rd edition published in June 2000 by B.Jain, 4th edition published in 2005 by B.Jain. (1)

PLANNING AND CONSTRUCTION OF PHATAK REPERTORY
Uniqueness of this repertory is that it is printed in 2 columns. The repertory is arranged in alphabetical order and rubric wise there are no separate sections like in other repertories such as Kent and BTPB. (1) All the present rubrics like mental, physical generals, physical particulars, pathological and physiological condition, clinical symptom and modalities are arranged in alphabetical manner. From A to Z- Abdomen to Zygomae.(2) Sources of this repertory are Boericke, Kent, BTPB, Dr Clarke’s dictionary etc. Dr Phatak followed the concept of generalisation of Dr Boger.(2) Essential cross references are given in the repertory, (1)  it contains 393 medicines and 1971 rubrics.(3)

Arrangement and construction of rubric 

  • Location / sensation affection in general
  • Sides,
  • Alternating sides,
  • Radiating to,
  • Alternating with,
  • Sub-location/sub-sensations, aggravation, amelioration, concomitants are intermingled as they are arranged in alphabetical manner. (1)
  • Following 3 grades are used in Phatak in following typography, 1st grade – CAPITAL, 2nd grade – italics and 3rd grade – roman. (1)
  • Total single remedy rubrics are 9375, where 3marks, 2marks and 1marks medicines are as follows 17, 223, and 9136.(4)
  • Total drug occurrence is 66155 where 3marks, 2marks and 1marks medicines are as follows 2804, 10244 and 53107.(4)
  • All the GENERAL MODALITIES are given in capital, like AGG and AMEL. And all the PARTICULAR MODALITES are given in small, like agg and amel.(2)
  • In 3rd edition, numbers of pages have increased partly because of bigger type, still the book is handy. New additions are marked with ‘+’ mark. (1)

SPECIAL FEATURE OF PHATAK

  • Rubrics like, CRAVING and DESIRE are given differently, CRAVING is related to food and drinks while DESIRE is related to mental symptom means MORE THAN NEEDS.(1)
  • While AVERSION covered both mental as well as physical, like AVERSION TO CHILDREN and CHOCOLATE ETC. (1)
  • A separate rubric FOOD & DRINKS AGG & AMEL is given, which covers INDIAN FOOD also like SUGARCANE JUICE AGG. (1)
  • CAUSATIONS seen under rubric Aggravation either in the GENERAL OR PARTICULAR like, tobacco AGG, urticaria; fish agg.(4)

SPECIAL RUBRICS OF PHATAK

  1. Direction of symptoms
  • Ascending, 
  • Backward, 
  • Diagonal,
  • Here and there, 
  • Increased gradually, 
  • Decreased gradually,
  • Up and down.

Thus, all the rubrics related to direction are found at one place in this repertory which is not found in another repertory. (2)

  1. Periodicity is given under the rubric of DAY 
  • Every 4th aggravation,
  • Every 7th aggravation ,
  • Every 10th aggravation,
  • Every 14th aggravation

Except to this in every another repertory it is found under the rubric periodicity (2)

  1. Never well since with various sub-rubric is present 
  • Never well since abortion,
  • Never well since burns,
  • Never well since diphtheria,
  • Never well since infectious disease(2) 
  1. Another good rubric of a POSITION is given in this property for example,
  • Position change of amel,
  • Position odd amel,
  • Position rest cannot in any(2)
  1. One more good rubric of prophylactics from Boericke repertory,  example, 
  • Catheter fever 
  • Diphtheria 
  • Mumps etc. (2)
  1. Moon phases, full moon etc.
  • New AGG,
  • Full AGG, etc(2)

RUBRICS PRESENT ONLY IN PHATAK REPERTORY 

  • Abdomen, sides, sticking, in running when- Tuberculinum (2)
  • Affections stifled – Sepia (2)
  • Back, pressure by, end of stick, amelioration- Sepia (2)
  • Cough, whooping, violent, spasmodic, facial herpes with –Arnica montana (2)

MENTAL RUBRICS ONLY IN PHATAK 

  • Business, worry though prosperous (2)
  • Fear, green stripes, seeing on (2) 
  • Dotage : a state of one who is weak minded (2)

LIMITATIONS OF PHATAK
Phatak is a concise repertory so it cannot be a substitute of the exhaustive repertories like Kent and BTPB and others.(1) Given rubrics with their sub rubrics are very limited.(1) Limited number of remedies are given in rubrics as only those remedies mentioned which were used by the author himself.(2)  Mental rubrics are scattered throughout the book as there are no chapters or sections in the repertory, so we have to go through whole repertory which is time consuming.(1) Index is not given for the full remedy list.1 The remedies like Cannabis sativa and Cannabis Indica abbreviated by the same abbreviation ‘cann’ so it is difficult to know whether the author is telling about Cannabis sativa or Indica.(4) Mental symptoms are very few with very few sub rubrics. (1)

114 Remedies whose abbreviations are misunderstood (4) 

     E.g. Alumen – alum

       Alumina – alu

Same medicines used with two different names (4)

  E.g.  Cinchona – china

           Squilla – scilla

CASE EXPERIENCE WITH PHATAK REPERTORY
Patient was 19 years, male, hindu, staying in Jamnagar, he was a student of 1st year B.sc, came with the presenting complain of, fever with chill associated with weakness, body ache, fever started with the pain in centre of back (lumbar region) since evening of 28/11/18 and redness of skin. Patient was already on allopathic treatment, DOLO 650 TDS but still fever was not relieved. On examination, temperature: 102F, Pulse: 100/bpm, BP: 90/60 mm of hg.

PHYSICAL GENERALS:  Patient’s thirst was only of 2-3 glass /day (normal water), thirst only during heat, appetite was also decreased, he had desire for warm food, patient constipated, hard stool only with present complain. Urine: 5-6/day, 1-2/night dark yellowish, non-offensive, feeble stream.

MENTALS: 

Patient feels mentally very dull and weak since fever.

DIAGNOSIS: DENGUE FEVER, UNSPECIFIED (1D2Z)(5) 

ANALYSIS AND EVALUATION:

Sr. no. Type of symptoms symptoms Intensity
1 Physical general Thirst only during heat  2+
2 Physical general Poor appetite 2+
3 Physical general Weakness 2+
4 Common symptom of disease Erythematous skin  2+
5 Physical general Fever with chill 2+
   6 Physical particular Fever started with the pain in back (lumbar region) 3+
7 Common symptom of disease Body ache , soreness and bruised 2+

RUBRICS:

  • Thirst: heat, during: (2)
  • Appetite: lost, diminished, wanting: (2)
  • Pain, aching: (2)
  • Pain, bruised, soreness: (2)
  • Fever: intermittent, ague: (2)

pastedGraphic.png

Figure 1
Available investigation: on (29/11/18) MORNING

PLT: 108000 [150000-450000]
NS 1 AG: negative [negative]
Dengue-g: negative [negative]
Dengue-m: negative [negative]

PRESCRIPTION:
Eupatorium perfoliatum 200CH QDS
Patient got  hospitalised because of insecurity of relatives and for observational  purpose and continued  with homoeopathic medicines.

Eupatorium perfoliatum is indicated in violent, aching, bone breaking pains; back and limbs feels bruised, sore and aching. Indicated in dengue, influenza along with weakness. Pain and trembling in back during fever.(6)

Selection of dose and repetition:
200CH potency was selected because similarity found between the patient’s symptoms and medicine’s symptom and as there were no more mental symptoms available. As the homoeopathic science works upon law of similia, higher the similarity, higher the potency. Selected similimum was repeated in QDS and BD because it was an acute case of fever where no structural changes were noted, only functional changes occurs. In this type of cases patient’s susceptibility found  high naturally, there were sudden onset and rapid progress were found, here the repeated doses of the higher or medium potency prevent the case to progress further.(7)

In aphorism no. 247, it was stated that “In acute diseases we can repeat the medicine at very much short interval, 24hour, 12 hour, 8hour, 4hours, in the very acutest every hour , even every 5minutes we can repeat.”(8)    

In kent’s lesser writing , it was mentioned that, “the single remedy is my reliance. I give the selected remedy every  4hours in these fevers, night and day.”(9)

George vitholkas also stated that, “In an acute cases repetition should be more frequent because remedy action is quickly exhausted, potency from 200 to CM can be given, 200 would be choice of potency in quite obvious remedy.(10)

“If an exciting factor brings on an acute situation, according to indication appropriate potency should be used if the higher potency is required, I usually give 3times a day until the acute problem subsides.” – Rajan sankaran.(11)

“In an acute illness there is a change in the vital organs and susceptibility gives poor response to the low and medium potencies, in these situation remedy repeated frequently till a definite response seen and repeat about 12hourly.” (12)          

DATE FOLLOW UP PRESCRIPTION REPORTS
29/11/18

EVENING

Patient is hospitalised in the evening,
O/E: T: 101
P: 110/bpm
BP: 90/60
Fever got decreased, other complaints remained as it is.
EUPATORIUM PERFOLIATUM 200CH QDS
IV NS and RL for hydration.
PC: 94000

Figure 2

30/11/18 O/E:  P: 100/bpm
BP: 100/70
Stool: not passed
Fever decreased
Weakness not improved
Soreness better
EUPATORIUM PERFOLIATUM 200CH QDS
IV NS and RL for hydration
PC :93000

Figure 3

1/12/18 O/E: P: 100/bpm
BP: 110/70Stool: passed
Fever relieved
Soreness better
Weakness mild better
Thirst 3-4/day
EUPATORIUM PERFOLIATUM 200CH BD
IV NS and RL for hydration
PC : 99000

Figure 4

4/12/18 Patient recovered from weakness. Only healthy diet, orally liquids and rest advised. PLT: 162000 [150000-450000]

pastedGraphic_1.png

Figure 2

pastedGraphic_2.png

Figure 3

pastedGraphic_3.png

Figure 4

  • So, on the 1st day the destruction of platelets are 14000 but within one day, after the administration of the homoeopathic medicine Eupatorium perfoliatum 200CH destruction was only 1000.

Differentiation of medicines(5)

NUX.VOM  EUP-PER  CHINA  ARSENIC 
FEVER  Extremely chilly , must be covered in every stage of fever  Pain in the bones(as if broken) all over , before commencement of the chill Fever with drenching sweat  Externally cold with internal burning heat 
PERIODICITY No  Marked periodicity  Marked periodicity  Periodicity worse midnight 
THIRST  Not specific  Only during heat  Insatiable thirst  Desire for sips of cold water 
PAIN  Violent, lighting like  Sore , bruised feeling  Fever with headache Burning like fire 

CONCLUSION
So, Phatak repertory is simple, practical and to the point still it contains lots of gem rubrics in a huge range from mental to direct physiological and pathological conditions so it’s use is not limited for some particular type of cases we can use it in simplest case to the difficult cases and it is not complicated to hunt as it is arranged alphabetically and repertory is handy so effortless to carry bed side also. 

REFERENCES:

  1. Harindham k. Dr. – the principal and practice of repertorization (second reprint edition), New Delhi, Indian books and periodical publishers, April 2010, p. 140-143.
  1. Phatak s. R. – A concise repertory of homoeopathic medicine alphabetically arranged (fourth edition), New Delhi, B. Jain publishers (P) L.td, 2005, p. v, vi, 97, 90, 283, 311, 313, 268, 1, 9, 31, 84, 45, 145, 101, 395, 17, 298, 153. 
  1. Tiwari s. K. – essentials of repertorization (fifth edition), New Delhi B. Jain publishers (P) L.td, 2012, p. 486.
  2. Jawahar  shah Dr, enlighten education, Mumbai, enlighten education private limited, 5th July 2019     https://onlinehomoeopathycourse.com/Course/Phataks-repertory
  3. World health organization, ICD-11 mortality and morbidity  statistics, 18th June 2018 https://icd.who.int/ct11_2018/icd11_mms/en/release
  4. Phatak s. R. – materia medica of homoeopathic medicines (second edition), New Delhi, B. Jain publishers (P) L.td, 2007, p. 301, 83, 208, 518.
  5. Mandal Pratim Partha, B. Mandal– a textbook of homoeopathic pharmacy (second reprint edition), Kolkata, new central book agency (p) L.td, 2009, p. 232, 233.
  6. SARKAR B. K. – Organon of medicine (tenth reprinted edition),  Delhi, Birla Publication Pvt. L.td. 2009-2010, p. 242,243  
  7. Kent J. T. – kent’s  new remedies,  clinical cases, lesser writings aphorisms and percepts (reprint edition), New Delhi B. Jain publishers (P) L.td, 2001, p. 336.
  8. Vitholkas George – the science of homoeopathy (reprinted edition), New Delhi B. Jain publishers (P) L.td, 1993, p. 217.
  9. Sankaran Rajan – the art of follow- up (first edition), Mumbai, homoeopathic medical publishers, 2018, p. 112.
  10. DHAWALE M. L. – Principles & Practice of Homoeopathy (Fourth Edition), New Delhi, B. Jain Publishers Pvt. L.td, 2014, p. 363,364.

Acknowledgement:  I would like to thank my guide DR MRUGESH HARDE MD (HOM.) and my pg co- coordinator DR GAURI SHARMA MD (HOM.) for the inspiration of this work.

ABOUT AN AUTHOR
DR AMI H. CHANDARANA
PG scholar (MD – 1) Dept of Homoeopathic repertory
Ahmedabad homoeopathic medical college, Ahmedabad, Gujarat.
Contact no. 9558832012
amichandarana.a@gmail.com

DR GAURI SHARMA
Associated professor and PG coordinator
Dept of Organon of medicine.Ahmedabad homoeopathic medical college, Ahmedabad, Gujarat.
Contact no. 8949389196
drgaurisharma@gmail.com

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