Dr Amruta Shinde
The word modality, we refer to circumstances and conditions that affect or modified a symptom, of which the conditions of aggravation and amelioration are the most important. Modalities are one of the important componentsof a complete symptom. This idea of complete symptom was introduced by Dr. Boenninghausen. We must consider everything that tends to increase or diminish the equilibrium.
Modality we mean the circumstances of occurrence, aggravation and amelioration of any reported symptom by the patient. Amongst the modalities, causative factors, predisposing factors as well as precipitating factors rank first and the aggravation come next, while the amelioration are consider last. Thus from the stand point of individualization, modality assume the highest importance.
Key words- modalities, bbcr, homoeopathy
Modality is the circumstances and condition that affect or modify a symptom.
AGGRAVATION-Aggravation means increase the condition due to any circumstances. It is denoted as using symbol “<” or abbreviation “agg”
AMELIORATION-Amelioration which gives relief or reduce the intensity of symptom .
Patient is better in condition or circumstances it denoted as using the symbol “>” or abbreviation “amel”
Importance of modalities – According to Dr. Hahnemann  Aphorism 18While considering totality of symptom with accompanying factors which modified or which changes to the patient’s equilibrium the factors which increases and decreases the condition in every individual case the modalities are the sole guide to the choice of remedy. The sum of all the modalities help to individualizing and also help to selection of remedy. Modalities guide to select remedy
Dr. Boger told about the modality, in the BogerBoennighausen’s Characteristics and Repertory.
Dr.Boger took the very gross work of rewriting Dr.Boenninghausen’sTherapeutic Pocket Book which is based on the original repertory of the AntipsoricRemedies.His valuable study and additions to the MateriaMedica and repertory part which was published by Dr. Boericke and Dr.Tafel in 1905 .
Dr. Boger rearrange the repertory part by giving modalities in each chapter and at the end there is separate chapter on modalities i.e., conditions of aggravations and ameliorations in this chapter Dr. Boger given the modalities in very detailed manner. While working on BogerBoenninghausen’s Characteristics and Repertory he follow the principle of totality of symptom which was followed by Dr. Hahnemann. Dr. Boger was fully in agree with the idea of what constitutes a complete symptom i.e., Location, Sensation, Modality and Concomittant.
The repertory is based on following fundamental concepts.
- Doctorine of complete symptom and concomitants.
- Doctorine of pathological general.
- Doctorine of causation and time.
- Clinical rubrics.
- Evaluation of remedies.
- Fever totality.
Dr.Bogers concept of totality.
- Change of personality and temperament.
- Peculiarities of disease.
- Seat of disease.
- The cause.
- Circumstancial Modalities.
- Time modalities.
Aggravation –This subsection contains factors which increases the complaints or excite some concomitant factors are also found in subsection,which are very useful in repertorization for acute.
Amelioration- This subsection contains factors which decreases the complaints or better. This section is smaller than the aggravation.
MATERIALS AND METHODS
Case definition: Cases presenting with various and characteristic Modalities in all age groups and both sexes was included in my study.
Clinical Study: 30 cases including Acute and Chronic cases of both sexes and different ages was studied. Case taking was done by using standard case taking performa as per Homoeopathic principles.BogerBoenninghausen’s Characteristics and Repertory was used.
Cases presenting with various and characteristic Modalities in all age groups and both sexes was included in my study.
- Cases not presenting with characteristic modalities.
- Patient who required emergency medical treatment.
- Systemic complication.
CRITERIA FOR ASSESMENT: –
This was done on the basis of following criteria –
- Good – more than 70-80% relief of symptoms
- Moderate – 40 – 70%relief of symptoms
- Poor – less than 40% relief of symptoms
The importance of Modalities from BBCR in reaching the Similimum of the case and how the totality of the case is rearranged as per the selected repertory is understood by this study. So in all patient, included in the study I have tried to understand the complete picture of the case & working out of case on the basis of modalities from BBCR. After reaching the group of similar remedies, selection
of similimum was done by referring the modalities from BBCR.
30 patients were studied, each case were workout and selection of similimum for the case was done taking into consideration of modalities .
Improvementin modalities was the prior focused in the follow up.
Out of total 30 cases, 6 showed Good improvement, while 20 cases showed moderate improvement & 4 case showed poor improvements.
Dietary advises, Counselling and required investigations was initiated in cases wherever necessary.
Homoeopathy is the system of medicine where the similimum is selected on the basis of Homoeopathic Philosophy, Homoeopathic MateriaMedica.
Prescription on the basis of modalities gives you best Similimum remedy. After conducting the study on 30 patients, from the evaluation of the results obtained after post treatment I have come to the conclusion that when the remedy is selected on the basis of modalities the outcome is good improvement and patient as well as physician can assess the effect of Homoeopathic remedy on specific disease condition by knowing the intensity of symptoms. This satisfies my purpose of selection of this topic.
During this entire process of study, I have found that while repertorization of each case I have chosen the rubrics of aggravation and amelioration and also taken into consideration the causative modalities.
- Dr. Samuel Hahnemann.Organon of medicine 6th edition-Published in-1833.
- Dr.Boger- Conditions of aggravation and amelioration -BogerBoennighausen’s Characteristics and Repertory.-Published in –Reprint edition-1993
- Dr. H. A. Robert –Drug Proving-The principle and art of cure by homoeopathy by-Published in 1936.
- Dr. Stuart Close- Symptomatology-The genius of homoeopathy lectures and essays on homoeopathy philosophy – Published in 1924
- Times of remedies and moon phases by Dr. C.M Boger.
- Repertory to the modalities by Dr. Samuel Worcester.
- An index of Aggravation and Amelioration by Edwin a. Netby and Thomas and George.
- Therapeutic pocket book by Dr.Boenninghausen.
- A Synoptic key of theMateriaMedica. by Dr. C.M Boger
- Homoeopathy explained by John Henry Clarke.
- A concise repertory of homoeopathic medicine by Dr. S.R Phatak.
- Essentials of Repertorization- by Dr.Shashi Kant Tiwari
- The Art of Case taking and Practical Repertorization in Homoeopathy- by Dr.Ramanlal P. Patel
- Evolution / unfolding of homeopathic repertories. By- Prof. Dr.NiranjanMohanty
M.D.(Hom.) Part 2 Homoeopathic Repertory.
B.V.D.U. Homoeopathic Medical College, Pune, India.