Importance of repertory of Hering’s guiding symptoms of our materia medica in clinical practice

Dr Sana Shahid

Introduction to the concept of puritan and concordance

ETYMOLOGY

  • Puritan word origin from Late Latin pūritās means purity

                 Or, a person who adheres to strict moral or religious principles, esp. one opposed to luxury and sensual enjoyment.

History of puritan

  • Puritan 1560s, “opponent of Anglican hierarchy,” later applied critically to “person in Church of England who seeks further reformation” (1570s), probably from purity. After c.1590s, applied to anyone deemed overly strict in matters of religion and morals.
  •  In the late 16th and 17th centuries ˈanyone of the more extreme English Protestants, most of whom were Calvinists, who wished to purify the Church of England of most of its ceremony and other aspects that they deemed to be Catholic. The roots of Puritanism are to be found in the beginnings of the English Reformation. The name “Puritans” (they were sometimes called “precisionists”) was a term of contempt assigned to the movement by its enemies.

PURITAN REPERTORIES

SYNONYM:  CONCORDANCE REPERTORY

            NON-PHILOSOPHICAL REPERTORY

WORD MEANING Of CONCORDANCE

  • Agreement
  • Harmony
  • A Complete Index                                                                    
  • Arrangement of ABC order of important words used by the author or in a book.
  • “A repertory based on alphabetical arrangement of original symptoms of Materia Medica i.e. indexing the symptoms without much modifying them.”
  • “Symptoms as developed by the provings and clinically have been unbroken into parts and so listed.”
  • “Symptoms without much variation in the language of provers.”

History of Word concordance

  • Dr. Boenninghausen first used this word in the Homoeopathic literature in the earlier edition of therapeutic pocket book.
  • This section contains the various relationships of remedies under different subheadings.
  • But to make the title more comprehensible Concordance title was replaced by relationships of remedies.

A REPERTORY OF HERING’S GUIDING SYMPTOMS OF OUR MATERIA MEDICA

  •  Author:  Calvin B. Knerr
  • Year of Publishing: 1896
  • Place of publication: Philadelphia
  • No. of Remedies:  408 (in repertory) [Abies nigra to Zizea aurea]
  • Based mainly on:  Hering’s Guiding Symptoms of our Materia Medica
  • This repertory was first time published by F. A. Davis and Co., 1232 pages.

A brief introduction about C. B. Knerr
Calvin Brobst Knerr was born on December 27, 1847. His father was a lay homeopath and an uncle who knew Hering at the Allentown Academy. He attended the Allentown College Institute and graduated from Hahnemann Medical College in 1869 (along with Cowperthwaite and T.L. Bradford), then entered the office of Dr. Constantine Hering as his assistant. The diary he kept while living in Hering’s house became The Life of Hering, published in 1940. From 1873-4 Dr. Knerr studied in Berlin, Vienna, and London. In 1874 he married Melitta Hering, one of Hering’s daughters, and resumed his duties as Hering’s assistant. In 1878 and 1879 he published 2 editions of his book, Sunstroke and Its Homeopathic Treatment.

Upon Hering’s death in 1880 Knerr became responsible for the completion of the 10-volume Guiding Symptoms. Originally working with Dr. Charles Mohr and Dr. Charles Raue, and later working alone, Knerr completed Hering’s masterpiece in 1895. Dr. Knerr spent 5 years writing his 2-volume Repertory to the Guiding Symptoms, which was published in 1896. This repertory to Hering’s Materia Medica never saw widespread use. Knerr compiled this repertory from Hering’s 10 volumes. Knerr used the same structure throughout as found in the Guiding Symptoms, even to including the “relationships” at the end of the book and giving the remedies the four lines of grading.

For a considerable length of time Knerr’s repertory remained out of print. After a prolonged correspondence Dr. Knerr agreed to grant Messrs’ M. Bhattacharyya and Co. the exclusive right of publication. He revised the whole work, portions of which he wrote anew for this edition. His was a life of unceasing work, and even when confined to bed he actually prescribed for his patients. He died on September 30, 1940.
To quote Pearson again, “Dr. Knerr lived a long and useful life and we should rejoice that he fulfilled a very important mission so ably.”
Julian Winston writes: Although it mixes pathogenic and clinical data, it contains several rubrics that cannot be found anywhere else.
His works will live after him; coming generations will profit by them, and like the present will honour his memory.

Philosophical background
In his preface: “It is the only alphabetic arrangement possible that will not scatter and separate what should be collective and contiguous. As in the guiding symptoms, so in the repertory, original readings, the word of the prover and the clinician are preserved to the letter, it being thought preferable to retain the most delicate shades of meaning, occasionally even different wordings of the same symptom, by taking refuse in an extra rubric or cross references, sooner than amalgamate, fuse or commingle in vague generalization at the sacrifice of individuality’’.

Seeing the arrangement of the chapter, section and rubrics one can perceive that the repertory is constructed on the basis of general to particular philosophy, though this repertory is considered to be one of the Concordance repertory.

It has the following sections-

  • Preface
  • Table of contents
  • List of remedy abbreviation with their names
  • 48 chapters including like stages of life and constitution and drug relationship.
  • Index.

Gradation of Remedies

  • Four gradations (As that of Hering’s Guiding Symptoms )

I:   Single light line is the lowest, occasionally confirmed symptom.

II:   Double light line, frequently confirmed or if but once confirmed, strictly in character with the genius of the remedy.

I:   Single heavy line, symptom verified by cures.

II: Double heavy line, symptom repeatedly verified.

These degree marks tallies in the main with the four styles of type used by Boenninghausen in his repertory. 

Other Symbols Used In This Repertory Are As Follows

Θ (Theta) indicates pathological and physiological terms.  For the purpose of economizing the space they are given in Parenthesis in the Repertory, by enclosing the pathological or physiological term in parenthesis; it is to be remembered that the presence of the term by no means shuts out the usefulness of the symptom in other forms of disease. Ø is not used in the repertory.

For Eg.:-

  • Page No. 17 – Mind and Disposition – (Insanity), (hydrophobia)
  • Page No. 20 – Mind and disposition – (Pneumonia), (in childbed), (influenza), (in children), (rheumatism of heart), etc.
  • Page no: 19, Chapter 1, Mind and Disposition, Answer with difficulty (anasarca): π Hell.
  • Page no: 964, Chapter 33, Lower Limbs, Legs, muscles: harder than normal (Duchenne’s pseudo-hypertrophic paralysis), I Phos.

Sometimes synonyms are given within brackets.

  • E.g. Page no: 26, chagrin (mortification)

the perpendicular dotted line, taken from the old school, such as harmonize with law of cure.

For Eg:-

  • Page No. 261 – Nose – Ozaena ⁞  Chrom. ac.
  • Page No. 96 – Inner head – Brain Hydrocephalus ⁞  Sal. ac.
  • Page No. 31 – Mind and disposition – Delirium fever – in typhoid ⁞ Chloral.
    Page no: 1031- Nerves- Paralysis mental condition of the insane    Chloral
  • Page no: 840-  Heart-Pulse and Circulation, Pericardium, effusion  ⁞ Sal. Ac.

π ( pie) symptoms observed in the sick only.

For Eg.:

  • Page No. 17 – Mind and disposition – absentminded: π Carb. ac.
  • Page No. 28 – Mind and disposition – Confusion: π Atrop. s.
  • Page No. 31 – Mind and disposition – Delirium, with convulsions: π Camph
  • Page no: 1036-Nerves- Trembling, of jaw: π Aur. mur.
  • Page no: 1037- Nerves- Twitching, π Atrop. s

t (toxicological extracts)

For Eg.:

  • Page No. 279 – Upper Face – face, blue – bluish, pale: t. Agar.
  • Page no: 1005, Chapter 35, Rest, Position, Motion, Position, lying down, motionless: t Ant.t
  • Page no: 840, Chapter 29, Heart, Pulse and Circulation, Palpitation, with vertigo; t Aethus.

Hand directs cross reference to related symptoms, diseases and conditions. 

There are given at the end of the rubric and sub-rubrics with remedies.  If no drugs are there means immediately after the rubric it can be seen.

For Eg.

  • Page no.: 17- Mind and disposition –Abandon, wild: Bell See Wildness
  • Page no.:  17 – Mind and disposition – Agony See anguish
  • Page no.:  47 – Mind and disposition – Flighty See Delirium
  • Page no.: 46 – Mind and disposition – Fear of misfortune: Calc, Clem, See happen 
  • Page no.:  375 – Throat, diphtheria:  See Fauces, Pharynx and Uvula exudates.

Different types of cross-references
i. With drugs e.g. page 17, Agitation
ii. Without drugs e.g. page 17, Agony Anguish
iii. Cross-reference is given in main heading itself. E.g.

     Page no: 616, erections penis.
     Page no: 616, Masturbation Seminal emissions.
iv. Cross-reference is given to different chapters also. E.g.
     Page no: 637, Mammae Chapter 24, i.e. in Pregnancy, Parturition, Lactation chapter.
     Page no: 1007, Sensation Chapter 43, i.e., Sensation in general chapter.
v. Cross-references are given at the end of sub rubrics. E.g.
     Page no: 17, Agitation Excitement, Restless.
vi. Cross reference given even in sub sub-rubrics also. E.g.
     Page no: 37, Delusion, vision, on closing eyes eyes closed.
     Page no: 37, Delusion, vision, of faces faces.
vii. Cross-reference is given in Index also. E.g.
     Page no: 1219, Achroma, Vitiligo

Construction of the Repertory

  • Hahnemann schema is followed which is same as that of Hering guiding Symptom of our Materia medica.
  • There are 48 chapters.
  • After the Chapter heading, the main rubrics/sub headings of each chapter are given for a thorough understanding about the construction of the repertory

Order of arrangement

The order of arrangement, followed in the compilation of this repertory is the one inaugurated by Hahnemann, developed, perfected and used by Hering throughout his entire materia medica work viz.: the anatomical or regional division into 48 chapters. Each chapter is alphabetically divided into sections and rubrics sufficient to allow full scope for analysis of the matter contained therein without destroying consistency as a whole. 

Construction inside the chapter

  • Each chapter is alphabetically divided into sections and rubrics sufficient to allow full scope for analysis of the matter contained therein without destroying consistency as a whole.
  • Author’s quoting from the preface – As in the Hering’s Guiding Symptoms, so in the repertory, original readings, the words of the prover and the clinician are preserved to the letter, it being thought preferable to retain the most delicate shades of meaning, occasionally even the different wordings of the same symptom, by taking refuge in an extra rubric or cross reference, sooner than amalgamate, fuse or commingle in vague generalization at the sacrifice of individuality.
  • There are 48 chapters, all arranged organ wise like Hahnemannian system till chapter – 34 and a rest chapter represents reaction of whole body. E.g. Mind, 2) Sensorium 3) Inner head 4) Outer head and so on. This organ wise classification follows an, ‘above downward’, ‘from inside outward’, ‘functional symptom first then organic conditions’ , ‘First the parts then the whole body’.
  • The page is divided into double column is deemed most convenient for the eye and is most advantageous to economy the space.
  • The section word is repeated down the columns till the end of that rubric.
  • Some areas the sub-rubrics connected to it are given in continuation like a paragraph.
  • Each chapter is divided into sections, which are given alphabetically, e.g. Chapter 4 – outer head has 9 sections, as – Dandruff, eruptions, fontanelles, forehead, hair, head, scalp, skull and tumor. On close observation one may see that the symptom under each rubric and sub rubrics also follow an alphabetical order. The sub rubrics are given in the same words as expressed by the provers or the patients. So, for the sake of alphabetical arrangement the expression of the provers and the patients are not mutilated. But the key words of the sub rubrics are given alphabetically. *
  • The words such as right and left, worse and better to avoid possible errors are printed out in full.

Arrangement of Rubric in each chapter

  • The ‘ rubric word ‘ or heading to each paragraph, (eg – Coryza Acrid 🙂 printed in somewhat bolder and blacker type and followed by a : (colon)  applies to each symptom in the paragraph, that is the black letter word is to be mentally repeated for every sentence rounded with a semicolon. It will be observed that the symptoms under each rubric follow in alphabetic order.
  • For e.g. in Pg. 22[11]

Anxiety, at night : Al. s. p., I Carbo a., I Lach. , I I Merc, Ver.; gonorrhoea, I Merc; in bed, Ang.; driving out of bed (ascites, mania), ll Ars.; emansio mensium, I Dig.; caused by undulating throbbings in chest, Ast. r.; with desire to escape, I I Merc; in bad effect of fright, I Merc; in heart disease, I Dig.; as from heat, I Puls.; with feeling of helplessness, II Lith.; after metrorrhagia, I I Sep.; after midnight, I I Ars.; with palpitation caused by pressure in stomach, I Sul.; with rheumatism, l Ars.; in typhoid, I Canth.; with frightful visions, I Camph.

  • The word appetite under the rubric Forgetful is specially given in bolder type. The alphabet “a” of appetite gives it the right of placement in the first place. The second, sub-rubric is associated with “business”. The letter ‘b’ of business naturally follows after ‘a’ of appetite. But under this sub-rubric, there are further extensions connected with forgetful in business, as then this type of forgetful is modified or associated with other conditions also (concomitants).
  • For example, the Forgetful rubrics appear as follows:

First of all, all the indications are given in an alphabetical order. I have marked the main circumstantial association by bolder types. For example, after ‘business, comes ‘dates; then ‘do; then ‘dreams, followed by ‘evening and ‘everything and so on

Forgetful, in business: Fl-ac.; crept into a corner and said he must sleep, could not sleep but still remains lying down, Jamb.; remembers all he had forgotten, during slumber, Selen.

Forgetful of dates: I con.; Fl-ac.

Forgetful, of what she is going to do: in post-partum haemorrhage, I Cann-s., II Carb-ac.; What he has just intended to do, I Card-m,; what she wants to do or has done, I Chel.; from one moment to next what she wishes to do, I Manc; what he has done a short time ago, I Calc-p.

Forgetful of everything except dream: (melancholy after mortification), I Ign.

Forgetful in evening: Fl-ac.; I Form.–Forgetful, of almost everything: Fl-ac. and so on.

  • Another example:-

ABSENTMINDED :

  • Absentminded, in albuminaria :
  • Absentminded, in apoplexy :
  • Absentminded, on awakening
  • Absentminded, irritation of brain :
  • Absentminded, after coffee :
  • Absentminded, when conversing :
  • Absentminded, goes to post a letter, brings home in her hands :
  • Absentminded, after nausea:
  • Absentminded, in ozaena:
  • Absentminded, supposes to be in two places at a time:
  • Absentminded, makes purchases and goes off without them :
  • Absentminded, standing in one place and never accomplishes what he undertakes :
  • Absentminded, starts when spoken to :
  • Absentminded, with senselessness and intoxicated condition
  • Absentminded, vanishing of thoughts :
  • Absentminded, with uneasiness :
  • Absentminded, in urticaria:
  • Absentminded, after wine :
  • Absentminded, in yellow fever :

Chapters
The main chapters are 46, but Knerr added the 47th chapter based on Hering’s Stages of life and constitution (Age, Complexion, Constitution, Habit, Occupation, Size, Temperament), which he had appended at the end of all remedies, after giving their pathogenesis, including clinical confirmations, under different headings. The last chapter, the 48th chapter, is on Drug Relationships. The chapters are as follows-

  1. MIND AND DISPOSITION
  2. SENSORIUM:  Confusion, dizziness, falling, giddiness, intoxication, lightness, reeling, staggering, swaying, vertigo
  3. INNER HEAD:  Apoplexy, brain, forehead, head, headache, occiput, parietal, temples, vertex
  4. OUTER HEAD:  Dandruff, eruption, fontanelles, forehead, hair, head, scalp, skull, tumors 
  5. EYES:  Accommodation, anterior chamber, aqueous humor, canthi, choroids, ciliary body, circumorbital, conjunctiva, cornea, eyes, illusions, iris, lachrymal apparatus, lachrymation, lashes, lens, lids, ophthalmia, optic nerve, orbit, photophobia, pupil, retina, sclerotica, sight, supraorbital, viterous.
  6. EARS:  Auditory nerve, ears, Eustachian tubes, hearing, illusions of hearing, membrane tympani, tympanic cavity
  7. NOSE:  Coryza, nose, smell
  8. UPPER FACE: Eruption, expression, face, face ache.
  9. LOWER FACE:  Chin, lips, lower jaw, outer mouth.
  10. TEETH AND GUMS:  Dentition, gums, teeth, toothache
  11. TASTE AND TONGUE:  Speech, taste, tongue
  12. INNER MOUTH:  Mouth, saliva
  13. THROAT:  Fauces, oesophagus, palate, pharynx, swallowing, throat, tonsils, uvula.
  14. APPETITE, THIRST, DESIRES, AVERSIONS
  15. EATING AND DRINKING
  16. HICCOUGH, BELCHING, NAUSEA AND VOMITING:  Eructation, gagging, hearburn, hiccough, nausea, retching, seasickness, vomiting, vomiturio, waterbrash
  17. SCORBICULUM AND STOMACH:  Epigastrium, Stomach
  18. HYPOCHONDRIA:  Diaphragm, hypochondria, liver, spleen
  19. ABDOMEN:  Abdomen, colic, flatulence, inguinal region, intestines, perineum, pubes.
  20. STOOL AND RECTUM:  Anus, cholera asiatica, cholera infantum, cholera morbus, constipation, diarrhoea, dysentery, flatus, hemorrhoids, rectum, stool, before stool, during stool, after stool, worms
  21. URINARY ORGANS:  Bladder, kidney, ureters, urethra, urination, before urination, during urination, after urination, urine
  22. MALE SEXUAL ORGANS:  Coition, erections, penis, genitals, glans, gonorhoea, masturbation, seminal emissions, sexual excess, sexual excitement, sexual power, spermatic cords, sycosis, syphilis, testicles
  23. FEMALE SEXUAL ORGANS:  Climacteric period, clitoris, coition, genitals (Labia, Mon veneris, Pudenda, vulva), leucorrhoea, mammae, menses, before menses, during menses, after menses, ovaries, sexual excess, sexual excitement, sterility, uterus , vagina
  24. PREGNANCY, PARTURITION, LACTATION:  Abortion, infants, lactation, lochia, mammae, nipples, parturition, placenta, post partum, pregnancy, puerperal
  25. VOICE AND LARYNX, TRACHEA AND BRONCHIA:  Air passages, bronchia, epiglottis, glottis, larynx, trachea, voice
  26. RESPIRATION: Asphyxia, asthma, breathing, dyspnea, expiration, inspiration, suffocation
  27. COUGH and EXPECTORATION:  Cough, before cough, during cough, after cough, whooping cough, expectoration.
  28. INNER CHEST and LUNGS:  Clavicles, inner chest, lungs, sternum
  29. HEART, PULSE AND CIRCULATION:  Blood, blood vessels, heart, palpitation, pericardium, pulse.
  30. OUTER CHEST:  Axilla, male nipples, outer chest
  31. NECK and BACK:  Back, coccyx, lumbar region (Loin, small of back), neck, sacrum, scapulae, spine, spinal cord.
  32. UPPER LIMBS:  Arms, elbows, fingers, hands, shoulder, wrists.
  33. LOWER LIMBS:  Ankles, feet, heels, hips, knees, legs, nates, tendoachillis, thighs, toes, walking
  34. LIMBS IN GENERAL:  Joints, limbs
  35. REST, POSITION, MOTION
  36. NERVES:  Activity (strength), catalepsy, chorea, convulsions, fainting, faintness, hysteria, lassitude (fatigue), malaise, sensations, starting, trembling, twitching, weakness.
  37. SLEEP:  Awaking, dreams, drowsiness, sleep, falling asleep, during sleep, after sleep, after sleep, sleeplessness, yawning.
  38. TIME:  Afternoon, evening, forenoon, morning, night, before midnight, after midnight.
  39. TEMPERATURE AND WEATHER:  Air, cold, dark, light, season, temperature, warmth, water, weather.
  40. FEVER:  Chill, chilliness, fever, heat, sweat, temperature
  41. ATTACKS, PERIODICITY
  42. LOCALITY AND DIRECTION
  43. SENSATION IN GENERAL
  44. TISSUES:  Adipose, bones, cancer, cartilages, decomposition, degeneration, emaciation, excretions, fibrous, fluids, gangrene, glands, granulomatous organs, periosteum, plague, stenosis, suppuration, swelling, tubercles, tumours, ulcers.
  45. TOUCH, PASSIVE MOTION, INJURIES
  46. SKIN
  47. STAGES OF LIFE AND CONSTITUTION:  Age, complexion, constitution, habit, occupation, size, temperament. 
  48. DRUG RELATIONSHIP:  Under each remedy the following heading are seen: Antidotes, Collateral, Compatible, Complementary, Inimical and Similar .

Index

DRUG RELATIONSHIP

  • Almost every drug has the relationship as following:
  • Antidotes: – To the effects of massive and molecular doses; chemical antidotes in poisoning; to the lasting or chronic effects super induced by the drug.
  • Collateral: – Side relations belonging to the same or allied botanical family or chemical group.
  • Compatible: – Drugs following well.
  • Complementary: – Supplying the part of another drug.
  • Inimical: – Drugs disagreeing, incompatible, do not follow well.
  • Similar: – Drugs suggested for comparison by reason of their similarity, usually compatible, unless too similar.

Adaptability

  1. If the totality of the case fits into the following order, Knerr’s repertory will be useful.
  2. Temperament and stages of life and constitution.
  3. Mind and disposition with described symptoms/concomitants.
  4. Physical generals (appetite, aversion, desires, perspiration, etc.).
  5. Complaints with special features. (Modalities, concomitants, directions, etc.)
  6. Tissue affinities, sensations, and modalities.
  7. Single symptoms can also be referred with its detail, which would help one to prescribe in an acute case or so-called short case.

Knerr repertory used as a source for other repertories

  • Mac Repertory
  • Homoeopathic Medical Repertory
  • Synthetic Repertory
  • Repertorium Homeopathicum Syntheticum
  • Kent’s Repertorium Generale
  • The Complete Repertory
  • Repertory Of Homoeopathic Materia Medica By Dr. J. T. Kent, M.D, Sixth American Edition, Patel. R. P
  • Hompath Classic 8.0 Version
  • Synthetic Repertory

Comparison between few rubrics of Kent’s repertory and Knerr’s repertory

  • If one studies Kent’s repertory under forgetfulness, there are comparatively much less number of sub-rubrics. Some authors even have criticised that Kent particularised very heavily in the section on Mind, he omitted giving greater details, and made more generalisations. In his first edition, he had kept more of particularised details in the section on mind.
  • Another area where it could be utilized is to gather the cross-references, and utilise them when revising and improving Kent’s repertory. For example, let us study the rubric Aversion’ in Kent (Mind)[pg9] and compare it with Aversion’ in Knerr’s book (Mind And Disposition)[pg25].
  • ‘Aversion to everything’-(Kent) Alumn., am-m. etc. But in ‘Aversion to all things’ (Knerr)-Bov. (in urticaria), is not there in Kent’s repertory and is again modified by ‘as soon as he sits idle’ Calc..
  • The following are not there at all in Kent’s Repertory. For example–
  • ‘Aversion amusement, to’-Ign.
  • ‘Aversion domestic duties, to’-Citrus.
  • ‘Aversion children, calls them too little (induration of os tincae); to her’-Plat.
  • ‘Aversion sex; in women to opposite’- Raph.
  • ‘Aversion women; to’- Puls. [Indirectly mentioned as ‘- religious to the opposite sex : Puls’ is given in KENT]
  • In this context of aversions, Knerr gives a cross reference to rubrics like ‘Company’; ‘Dissatisfied’ and ‘Hate’. In his rubric on ‘Hate’, he has given ‘Hates women-Puls’.
  • Apparently, ‘aversion to women’ may extend even to ‘Hate’, and he has, thus, given them at two different place
  • In Knerr’s repertory, there is a mental rubric ‘Depressed’ (dejected, despondent) and another ‘Sad’ (Dejected, Downcast, Low-spirited).
  • But, Kent in his repertory, has combined these two into ‘sadness’.
  • Knerr has given a very short rubric in ‘discouraged’, but Kent has given a fairly large rubric in his book.

These differences have come about, because each author interpreted these expressions slightly, differently, or laid different emphasis.

  • Knerr, however, has, at times, done too much of hair-splitting details also. For example, he has separated fear symptoms into three areas—(a) Apprehension (b) Anxiety (c) Fear, whereas Kent has referred to see Anxiety, Fear etc. in respect of Apprehension. It is very difficult to differentiate the different shades or meanings of very closely related rubrics.
  • Apprehension’ denotes a mixture of anxiety and fear put together. Even ‘Anxiety’ has an element of fear, and fear certainly has a component of anxiety. For classification and tabulations, we have to make certain compromises. These difficulties are more compounded, especially, when symptoms and expressions collected from provers, is likely to be not very accurate or expressive, and may be misjudged. This is why, while repertorising, we are advised to see also closely related rubrics or cross references.
  • In the section HYPOCHONDRIA, Knerr has taken Diaphragm, Hypochondria, Liver and spleen, although Kent has taken them under Abdomen in general. Knerr has, however, taken up general sensations and other organs under abdomen which follows in chapter on Hypochondria. For example: the items taken here are colic, flatulence, inguinal region, intestines, perineum, and pubis. This division was followed in strict adherence to ‘Hering’s Guiding Symptoms’. None of them included ‘Gallbladder’ has a separate entity or locational organ, but took it only as a part of liver. Hence, indirect mentions were made. For example, there is no direct reference anywhere as ‘inflammation-gall bladder’. Knerr has given under ‘Liver, Gall ducts: Cattarrh’ and ‘Liver, gall stones (biliary calculi)’. Kent has given under pain ‘Liver-colic, gall stones’.
  • Kent did not keep Jaundice in relation to liver etc. but, kept it under ‘Skin’. But, Knerr kept it under ‘liver, Jaundice’. Like the instances cited, there are many such examples, where something useful could be included in the Kent’s repertory from this great work of Knerr. There are remedies here and there, which should have found place in Kent, although, Kent borrowed a very large part of his material in his repertory from Hering’s Guiding Symptoms. His degree of valuation of remedies have been based almost entirely on Hering’s works.
  • Knerr’s chapters on OUTER HEAD, which has been kept as a separate chapter from chapter on INNER HEAD. (Kent has included both ‘INNER HEAD’ and ‘OUTER HEAD’ in the same section under HEAD). Here, the rubrics about ‘HAIR’ are given in more detail and more extensively than in Kent’s repertory, although, Kentian rubrics have naturally large number of remedies because of later editions. With the increased problems of hair-loss today, we are being approached by patients in large numbers. We should pay more attention to remedies, which have a bearing on hair-loss etc.

Comparative study of the rubric ‘absent-minded’ in various repertory

BY

  • C. LIPPE
  • W. D. GENTRY
  • C. B. KNERR
  • J.T. KENT

LIPPE

GENTRY

KNERR

KENT

RUBRIC NOT PRESENT

Absentminded- A.  Al-cep., Apis., Can-ind., Caust., Coni., Ind., Kali-brom., Kali-c., Natr-m., Nux-m., Nux-v., Phos-ac., Sil.

  A. and inattentive.  Oleand.

  A.; forgetful. Anac., Graph., Lach., Nux-m.

  A.; forgetful; dull and listless; cannot concentrate mind or thought. Anac.

A.; thinks is in two places at same time. Lyc.

  Forgetful, a. Kali-c., Stann.,

  Melancholy, with sadness, a. and sometimes sense of disgrace. Sulph.

  Very a. Ind.

  Very forgetful, a. Anac., Apis., Naja., Nux-m., Phos-ac.

ABSENTMINDED: Act. sp., IIAgnus, Amm. c, Ang.,        IIArn., IIApis, Arum, t., IBell., Bov., Calad., ICann. i., πCarb. ac, Carb. s., ICaust., ICham., IIChel, IICic, IColch., Daph., IIElaps, IGraph., Ictod., Ilgn., IKali br., IKali c, Lyss., IIMerc, INatr.m., lOleand., IINux m., IPlat, IPlumb., IPhos., Polyp., Puls., IRhus, ISep.

Absent-minded, in albuminuria: ICoccus. Absent-minded, in apoplexy : IBar. c.

Absent-minded, on awakening : does not know where he is or what to answer, INux. m.

Absent-minded, irritation of brain : ICup. ac.

Absent-minded, after coffee: in afternoon, ICepa.

Absent-minded, when conversing: Cinch, bol.

Absent-minded, goes to post a letter, brings it home in her hands : ILac. c.

Absent-minded, after nausea: in afternoon, Calc.

Absent-minded, in ozaena : lAur. met.

Absent-minded, supposes to be in two places at a time : II Lyc.

Absent-minded, makes purchases and goes off without them : ILac. c.

Absent-minded, standing in one place and never accomplishes what he undertakes : INux m.

Absent-minded, starts when spoken to : Carbol. ac.

Absent-minded, with senselessness and intoxicated condition : INux m.

Absent-minded, vanishing of thoughts : Zinc.

Absent-minded, with uneasiness : Magn. c. Absent-minded, in urticaria : IBov.

Absent-minded, after wine :in afternoon, ICepa.

Absent-minded, in yellow fever : ISul.

HANDDullness, Forgetful, Memory weak.

ABSENT-MINDED (See Forgetful) : Acon., act-sp., aesc., agar., agn., all-c., alum., am-c., am-m., anac., ang., Apis., arg-m., arn., ars., arum-t., asar., aur., bar-c., bell., bov., bufo., calad., calc-s., calc., Cann-i., cann-s., caps., carb-ac., carb-s., carl., Caust., cench., Cham., chel., chin., cic., clem., cocc., coff., colch., coloc., con., croc., crot-h., cupr., cycl., daph., dirc., dulc., elaps., graph., guai., ham., Hell., hep., hura., hyos., ign., jug-c., kali-br., kali-c., kali-p., kali-s., kreos., lac-c., Lach., led., lyc., lyss., mag-c., manc., mang., merc., Mez., mosch., naja., nat-c., Nat-m., nat-p., nit-ac., Nux-m., nux-v., olnd., onos., op., petr., ph-ac., phos., Plat., plb., Puls., rhod., rhus-t., rhus-v., ruta., sars., Sep., sil., spong., stann., stram., sul-ac., sulph., tarent., thuj., Verat., verb., viol-o., viol-t., zinc.

morning : Guai., nat-c., ph-ac., phos.

11 a.m. to 4 p.m. : Kali-n.

noon : Mosch.

menses, during : Calc.

periodical attacks of, short lasting : Fl-ac., nux-m.

reading, while : Agn., lach., nux-m., ph-ac.

starts when spoken to : Carb-ac.

writing, while : Mag-c.

Conclusion

  • Thus, we can see that the rubric absent-minded is absent in the Repertory of the more characteristics symptoms of materia medica by C. lippe, whereas it is present in BTPB as the rubric Absence of mind in mind section of the chapter Mind and Intellect.
  • Absent-minded rubric is present in The Concordance repertory of the more characteristic symptoms of materia medica by W. D. Gentry, also in A repertory of  Hering’s Guiding Symptoms of our Materia Medica by C. B. Knerr , and again in the Repertory of Homoeopathic Materia Medica by J. T. Kent.
  • Although it is present in various repertory but the concept and understanding of the rubric varies from author to author.
  • This can be emphasised by looking at the sub-rubrics.
  • In Gentry and Knerr, both of which are puritan repertory, the symptoms of the provers as presented are found.
  • Dr. Kent has included a no. of medicines under the rubric in general but we find lesser no. of subrubrics. This may be because although such symptoms were found during drug proving, they were not confirmed and clinically verified.

MERITS

  • The repertory without much modifying the prover’s language – Hence included under Concordance repertory.
  • This is the most reliable repertory even today with vast information.
  • Separate section is for stages of life – under Ages, sub-rubrics like – Boys, Children, girls, men, old people, puberty, women, young people and youths.
  • Under constitution 26 types of constitution are mentioned like-anemic, asthmatic, carbo-nitrogenoid, gouty etc.
  • Under Temperaments, 7 types are given like – bilious, choleric, mild, melancholic, phlegmatic, sanguine.
  • Under occupation, lots of rubrics are given like – actors, bookworms, businessmen, miners, etc.
  • Many pathological rubrics are given throughout the book showing the affinity of the remedy towards that disease.
  • A complete index of localities and terms are given at the end of this book.
  • In drug relationship chapter large no. of remedies relationship is mentioned with gradation.
  • Drug index is mentioned with abbreviations.
  • Cross references are mentioned wherever necessary in order to differentiate the similar rubrics while working out a case.
  • There are four grading of symptoms, which helps us to understand the relative importance of drugs in the concerned symptom.
  • Additional chapters are given in this book, which are not found in any other book.   For eg: Chapters – Pregnancy, parturition, lactation. Heart, pulse and circulation. Limbs in general. Rest, position, motion. Nerves. Time. Temperature and weather. Attacks, periodicity. Locality and direction. Tissues. Touch, passive motion, injuries. Stages of life and constitution.

  • Certain general information is given as rubric
    Page no: 408, Eating and Drinking, Drinking, tea, Is injurious to the young but beneficial to the old, because it increases nitrogenous bodies by diminishing tissue waste.
  • Certain prophylactics are given as rubric
    Chapter: Stool and Rectum, Cholera, A prophylactic, suggested by Hering, consisting of a pinch of powdered milk of sulphur (Lac sulphur), sprinkled into stockings and worn in contact with the soles of feet, has proved a successful preventive in several epidemics of Asiatic cholera. Aegidi recommends as a preventive one dose every evening for a week, of Chin. m. 0.001-0.006 and ozonized water.
  • Longest rubrics: Page no: 1161, Skin, Eruption, psoriasis, inveterate, in a man at 45, addicted to immoderate use of brandy, eight years ago was cured of amaurosis by electricity, and six months later cutaneous disease commenced, sickly appearance, vascular but thin, complexion dark, had gonorrhoea, chancre and buboes, and was drunk at first consultation, eruption first appeared on elbows, then knees and calves, at the diseased points skin first became thickened, then fissures appeared and finally white shiny hard adherent scales which were continually reproduced, occasionally rheumatic pains, I Mang

LIMITATIONS

  • As the sub-rubrics are given continuously with a double column arrangement in page looks clumsy and so very difficult to find the sub and sub sub-rubrics.
  • Most of the sub-rubrics have one or two remedies, which will not be useful for repertorization.
  • Finer rubrics and sub rubrics very difficult to distinguish each other especially in Sensorium chapter.
  • Same rubric is repeated or found with similar meaning, but seen with different drugs.
  • Nosodes are not represented well.
  • Not easily comprehensible for the beginners.

Utility Of Knerr’s Repertory

  • This repertory is mostly used for the purpose of reference in clinical practice and not for systematic repertorization. It helps us to refer to symptoms without much variation in the language of provers.
  • This repertory has no distinct philosophy in its construction and does not follow any principle, for forming a repertorial totality during the process of repertorization.
  • It helps to confirm and reassure our choice of selection of remedy based on totality of symptoms when a peculiar symptom is reported by the patient and both match after reference of this repertory.

BIBLIOGRAPHY

  1. Calvin B. Knerr; Repertory Of Hering’s Guiding Symptoms Of Our Materia Medica.
  2. Tiwary, Shashi Kant; Essentials of Repertorisation, 5th edition, B. Jain Publishers Pvt. Ltd., 25th impression: 2014.
  3. Kent J. T.; Repertory of the Homoeopathic Materia Medica. 6th American edition. B. Jain. Publishers (P) Ltd. 2009, New Delhi
  4. William D. Gentry; The Concordance Repertory Of The More Characteristic Symptoms Of The Materia Medica; A. L. Chatterton & Co. 1892; 78 Maiden Lane.
  5. Constantine Lippe; Repertory To The More Characteristic Symptoms Of The Materia Medica; B. Jain publishers (P) Ltd. 2007, New Delhi.
  6. Internet- world wide web.

Dr. Sana Shahid
P.G.T., Department Of Case Taking And Repertory,
Mahesh Bhattacharyya Homoeopathic Medical College And Hospital.

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