Dr Mona Whatkar
Dr Boenninghausen’s Approach
According to Dr. Boenninghausen a complete symptom has 4 aspects i.e., location [ ubi- seat of disease], sensation, modalities [quomado], and concomitant [ quibis auxilus]
Dr. Boenninghausen’s greatest contribution has been raising particulars sensation and modality to general by analogy on the basis that ‘Man as a whole’ is sick-only expresses through parts [ locations] thus in one stroke he raised all particulars to general level. This was his concept of GRAND GENERALISATION. By this he helped to complete incomplete symptoms in Materia medica as well as in cases. His second important contribution has been the concept of CONCOMITANTS. Concomitants are those symptoms which come along with chief complaint but doesn’t have any relation with chief complaints except time relation.
Following features characterize his approach.
- Generalization on grand scale
- Prime importance to modalities
- High evaluation of concomitants
- Importance of physical generals
- Use of mentals for
As usually perceived, it is not that Dr. Boenninghausen gave any less importance to mind. In fact, in his lesser writing, he deals extensively on this subject. Acc to him, he preferred not to break them, as they are highly specific. He smartly uses them at the end to clinch the choice of similimum. He also stressed that it is not easy to find mentals in many cases, esp for novice. Mind is also subject to interpretation; hence he relies on FACTS, which are not likely to be modified by interpretation. Factual data is easy to find at physical level.
This ensured safety and reliability, in landing at similimum esp for novice and in difficult cases.
SYNTHESIS REPERTORY
Synthesis has been the most favored repertories of the modern era ever since it first appeared on horizon. The repertory which started its journey as an updated kent’s repertory has now become so much more. Synthesis now included information on nearly all new medicines, clinical information from a variety of established sources, data from works of Hahnemann, Boenninghausen, boger, phatak and many others.
Case
Preliminary data
Name: XYZ Age: 40 yr Sex: male
DOC: 05/05/2022
Marital status: Married Occupation: Construction worker
Chief complaint: Pain in stomach since 4 hrs
Patient was apparently alright 4 hrs back, suddenly started with complaint of severe burning agony in stomach since morning. Patient approached clinic shouting { potat aag lagli ahe, me marto ki kay ata}. Also since morning frothy vomiting twice with constant nausea and sour bitter eructation’s. Unable to retain water n food. On further enquiry got to know patient has consumed deshi daru {alcohol} without food yesterday night. Pain slight better after eating n drinking water.
Associated complaint: Nothing specific Past history: Typhoid at age of 20 yrs. Family history: Mother – diabetic Personal history:
Appetite- normal Thirst- normal
Urine – normal Bowel – once a day Thermal – chilly
Perspiration – Profuse
Mind – Patient was terrorized by suddenness of complaints. Fear of disease, shouting as if he is going to die.
Classification of disease– Acute disease
General examination / local examination:
Poorly built, lean, dark complexion Temp- Afebrile
Pulse- 90/min
Bp- 110/70 mmhg RR- 20/min
Systemic examination:
CNS- conscious and oriented
P/A- Inspection- umbilicus centrally, no distention, no scar or pigmentation. Palpation- mild tenderness at epigastric region, no organomegaly.
Percussion- tympanic except liver dullness Auscultation – peristalsis increased 3-4 /min RS- AEBE clear
CVS- S1S2 heard
Diagnosis: Acute Gastritis Investigation: USG abdomen Analysis:
| Location | Sensation | modality | concomitant |
| stomach | Burning as if there is fire2+.
Frothy vomiting |
A/F-
Abuse of Alcohol |
Shouting as if he is going to die. |
| Sour bitter
eructation’s |
>eating after | ||
| Mind/ general | Fear of disease2+ Terrorized by suddenness of complaint2+ | ||
| Profuse perspiration |
Evaluation and Repertorial totality:
| Evaluation | Type/ reason | Rubrics |
| 1. Shouting as if going to die2+ | Characteristic mental concomitant with 2 mark intensity | Mind – shrieking
Mind – delusion -dying he is |
| 2. A/f – abuse of alcohol | Causative factor | General – food and drinks- alcoholic drinks- ailments from |
| 3. Sensation burning in stomach as if there is fire2+ | Characteristic SENSATION with 2 mark intensity | General – pain- burning- as from a burn |
| 4. Terrorized by suddenness of complaints2+ |
Common mental symptom with 2 mark intensity |
Mind – fear – terror |
| 5. Fear of disease2+ | ||
|
6. Frothy vomiting
7. Sour bitter eructation’s |
Common sensation with
2 mark intensity Physical particular
Physical particular |
Mind – a disease of
impending Stomach- vomiting- type of – frothy Stomach- eructation’s; type of – bitter sour |
Repertorization:
