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 A Critical Study on BOENNINGHAUSEN’S THERAPEUTIC POCKET BOOK
Dr.P.Sumesh.P   BHMS,MD(Hom)
Medical Officer, Dept. of Homoeopathy, Govt. of Kerala
 


Name of the book: BOENNINGHAUSEN’S THERAPEUTIC POCKET  BOOK
Author : Dr.Timothy Field Allen
Introduction : Dr.H.A.Roberts & Dr. Annie C Wilson
Publisher : B.Jain Publishers Pvt.Ltd , New Delhi
Printer : J.J. Offset Printers. New Delhi
Year of Publishing: 1935
Reprint Edition : 1994
First Edition : 1846
Price : Rs 75 /-
Total pages : 503

Contents:
Part I
Preface
Life History of Boenninghausen

Introduction
*Repertory Uses
*The art of physician in taking the case
*The philosophic Background
*Construction of the Repertory
* Introduction to different Chapters
-Mind and intellect
-Parts of the Body and Organs
-Sensations and complaints
-Sleep and Dreams
-Fever
-Alterations of State of Health
-Relationships of Remedies

*Limitations of Repertory
*Use of the Analysis
*Preface to the New American Edition
*Boenninghausen’s Original Preface

Part II
Repertory Proper
Index

Part. I

Preface by Dr. T.F. Allen
In the preface Dr. T.F. Allen says that his aim is to demonstrate the sound philosophy and practical application of this work to such state as the physician meets in everyday practice. He admits that the book is not perfect but the principles upon which it is based are sound and will allow further expansion without distorting the basic principles.

Life History of Boenninghausen

He was born in Netherlands. There is a controversy about the birth year of Boenninghausen, according to Lippe it is 1777. But in the beginning of the chapter the year given is 1785.
H.A. Roberts and Annie .C. Wilson gives a brief sketch of Boenninghausen’s life and they show how a lawyer turned to an expert Homoeopath. It was Dr. Weihe who influenced Boenninghausen by rescuing him from the purulent tuberculosis with the help of Pulsatilla.
Authors give works of Boenninghausen in their order of appearance. They are:

1. The cure of cholera and its preventives 1831
2. Repertory of Antipsoric Medicines 1832
3. Summary View of the Chief Sphere of Operation of the Antipsoric Remedies and of their characteristic Peculiarities, as an appendix to their Repertory 1833
4. An attempt at a Homoeopahtic Therapy of Intermittent fever 1833
5. Contributions to a Knowledge of the Peculiarities of Homoeopahtic Remedies1833
6. Homoeopahtic Diet and a Complete Image of a Disease 1833
7. Homoeopathy a Manual for the Non- Medical Public1834
8. Repertory of Medicines which are not Antipsoric 1835
9. Attempt at showing the Relative Kinship of Homoeopahtic Medicines 1836
10. Therapeutic manual for Homoeopahtic Physicians, for use at the sick bed and in the study of the Materia Medica Pura 1846
11. Brief Instructions for Non- Physicians as to the Prevention and Cure of Cholera 1849
12. The two sides of Human body and Relationships. Homoeopahtic studies 1853
13. The Homoeopahtic domestic Physician in Brief Therapeutic Diagnosis. An attempt 1853
14. The Homoeopahtic treatment of Whooping Cough in its Various Forms 1860
15. The Aphorisms of Hippocrates with Notes by a Homoeopath 1863
16. Attempt at a Homoeopathic Therapy of Intermittent and Other Fevers, especially for would- be Homoeopaths 1864

USES OF REPERTORY
Definition:
Repertory is an index of symptoms arranged systematically. The system of arrangement may be founded upon certain definite guiding principles, or it may be alphabetical or schematic.
Uses:
1. To serve as a reference or a guide in looking up a particular symptom that may indicate the similimum or that may make necessary distinction between two or more similar remedies in a given case.
2. For careful study of all the symptoms that may appear in a c/c case.
A repertory is not meant for those cases in which there is clear indication for the similimum.

The Value of Repertory
Depends upon several elements: -
1. The art of physician in taking the case.
2. Knowledge of the Repertory one attempt to use; as regards -a) Its philosophic background
b) Its construction
c) Its limitations
d) Its adaptability
3. Intelligent use of the resulting analysis.

THE ART OF PHYSICIAN IN TAKING THE CASE
Boenninghausen observed that, even with best possible case taking the case record is often left incomplete, one of the elements of symptom -ie., Location, sensation, modality or concomitant may be missing. He collected all such symptoms as they appeared in the cases; which came to him for treatment. Every case was examined symptomatically with the purpose to make every symptom as complete in itself as possible. Later he learned that, symptoms which existed in an incomplete state in some part could be completed by observing the conditions of other parts of the case.
This is called the doctrine of Analogy. He also discovered that, condition of aggravation or amelioration are not confined to a particular symptom, but they are like the red thread in the cordage of the British Navy, are applicable to all symptoms of the case. So he raised them (i.e. Particulars) to the level of Generals - It is called the doctrine of grand generalisation. It is the patient who is sick, not his head, nor his eyes nor his heart. Every symptom that refers to a part may be predicated of the whole man.The symptoms of disease are offen broken up and scattered through different parts of a patient. These scattered parts must be found and brought together in harmonious relation according to a typical form. This complete picture of the disease will give the totality.

Boenninghausen has designed his pocket book in such a way that, it would enable the physician to bring the symptoms together and complete one part by another.

PRIMARY SYMPTOMS
Symptoms which seemed to have a direct bearing on the complaint.
SECONDARY SYMPTOMS
They belong to the class of concomitants.
TYPICAL SYMPTOM
Common symptom or disease symptoms
ATYPICAL SYMPTOMS
Symptoms, which belong to the individual. They are theconcomitants of disease symptoms.

PHILOSOPHIC BACKGROUND
It was with the encouragement of Hahnemann, that Boenninghausen developed his first repertory:- Repertory of Antipsorics (1832). In 1835 he
published Repertory of medicines which are not Antipsoric, in 1836 Attempt at showing the relative kinship of Homeopathic medicines and in
1846 he published, Therapeutic manual for Homoeopahtic physicians.

BTP is a combination of all these four books. The original book was written in German, it was first translated by one most eminent
Homoeopathic physician. This translation was not practical. Later Alien made an edition; which suffered from faulty translation. Lastly in 1935 this Book was edited by Dr. H.A. Robert and Annie C. Wilson. Boenninghausen emphasized more on completing the symptom with all their components; i.e.

LOCATION
Which includes parts, organs, tissues, systems as well as directions and extensions.

SENSATION
Kind of pain, suffering and complaints, and also functional or organic changes characterising the morbid process. MODALITY

This includes conditions of aggravation or ameliorations. Factors which cause, excite, increase or decrease or modify a symptom are
included in the modality.

CONCOMITANT
Symptoms appear and disappear with the main complaints; but they does not have any pathological relationship with the main complaints.

BTP is based upon the following fundamental concepts:-
1. Doctrine of analogy and doctrine of grand generalisation
2. Doctrine of concomitant
3. Evaluation of Remedies
4. Concordances

DOCTRINE OF ANALOGY/DOCTRINE OF GRAND GENERALIZATION
To make a symptom complete, the local modalities and sensations pertaining to one part should be applicable to other parts; in case modalities and sensations are not experienced by the patient or unnoticed by the Physician. Thus he raised local symptoms to a general level which could be used for the whole person. This principle is called doctrine ofAnalogy/doctrine of Grand Generalisation, He considered sickness as expression of the whole man, and not of the part. Sickness is expressed through different parts of the person. Thus all those modalities which are noticed in one part, but missing in any other part should be taken as an expression of the whole person.

DOCTRINE OF CONCOMITANT
Boenninghausen, identified in each case a group of symptoms along with the main complaint; such symptoms were generally overlooked by the patient, and un noticed by the physician. He emphasized that, in all cases such a group of symptoms does exist, and they are missed, because of inadequate observation. They appear to be unrelated to the main complaint; but are quite crucial in individualizing the case as well as the remedy.

EVALUATION OF REMEDIES
Boenninghausen was the first to grade the remedies. He noticed that there is difference in the frequency and intensity in the appearance of symptoms in provers. He graded the remedies into 5 grades - or marks.
He used different typography to represent these different grades of remedies.

CAPITAL to represent
1st Grade (5 marks)
Proved (Recorded)
Reproved (confirmed)
Clinically verified.

Bold to represent
2nd Grade (4 marks) Proved (less than the1st grade)
Reproved
(Confirmed) occasionally
Verified.

Italics to reprent
IIIrd Grade (3 marks)
Now and then a prover brings out symptom,
Not confirmed.
But verified
Clinically verified.

Roman to represent
IVth Grade ( 2 marks)
Only clinically verified

(Roman) in paren- thesis represents
Vth Grade
One mark
Not confirmed
Not verified
doubtful remedies.
But proved.

CONCORDANCES
He discusses the relationship of remedies; under headings - mind,locality, sensation, glands, bones skin, sleep and dreams, blood, circulation, fever, aggravation, other remedies, antidotes and inimical. Other remedies covers all the symptoms, which do not full into such regulars groups

PLAN AND CONSTRUCTION
The whole book can be divided into 3 components of a symptom - Location, sensation, and modalities. However concomitants are found scattered. Plan of Alien's modified edition:-

I Mind and Intellect
II PARTS OF THE BODY
III. Sensations and Complaints

1. Sensations — In general
2. Sensations — Glands
3. Sensations — Bones
4. Sensations — Skin

IV Sleep and Dreams
V Fever
VI. Modalities
VII Relationship of remedies.

Introduction to different Chapters
Part II
Mind and Intellect:
Mind Chapter contains 18 rubrics and Intellect Chapter contains 17 rubrics. In order to clarify the use of the book he simplified the number of rubrics as far as possible. Boenninghausen based his work on the concept of the whole man, placing the balance of the emphasis on the value of concomitants and the modalities. It was not his intention to reflect the whole man through his mental reactions, as they may be difficult to get. Eventhough this chapter contains only 35 rubrics the aggravation chapters include 17 rubrics related to emotional excitement or state.
The first rubric “ Disposition generally affected” include medicines which affect the mind in general.
The rubric “ Amativeness” which means inclined towards love and
“ Mistrust” are not seen in kent’s repertory.

Word meaning of some rubrics
Avarice = greedy, miserly
Boldness = daring, “Courageous” in Kent’s repertory. But there is no medicine.
Fretfulness = peevishness, to irritated. Though this rubric is seen in Kent’s repertory it contains no medicine.
Gentleness = Mildness , no medicine is given under “ Gentleness” in Kent’s repertory
Haughtiness = Pride
Activity = excitement
Befogged = confusion. The rubric “ Befogged ”is not found in Kent’s repertory.
Comprehension difficult = Dullness
Ecstasy = exhilaration
Imaginations = fantastic illusions

Misplaced rubrics
• Unconsciousness - this should have been given under sensations chapter.
• Vertigo – there is no separate chapter. Since it is a sensation it should have bee given under “ sensation” chapter.
Though he has given emphasis to the Concomitants in case taking, the concomitants of mental symptoms are given under a single rubric “ Drugs which have concomitants of Mental Symptoms.”

Part 2
Parts of the body and organs
This section of the book follows in general the anatomical schema used by Hahnemann. T.F. Allen added many of the rubrics in the eye section. He also used an idea of combining Boenninghausen’s Repertory of the Sides of the Body with the original Pocket Book. This section on the parts of the body runs from page 24 to page 142, beginning with Chapter Internal Head and ending with Lower Extremities.

1. Internal Head:
The chapter begins with rubric- “ In general”.
Next different portions of head are given as rubrics- as
• Forehead
• Temples
• Sides of head
• Vertex
• Occiput
The chapter ends with the rubric - One sided in general
There is no definite order of arrangement of the rubrics.
2. External Head:

Rubrics
• Hair
• Scalp
• Skull
• Beard
• Margins of hair
Are given in the chapter “ External Head”
Misplaced rubrics
a) Motion of Head
b) General sensations in External Head
c) Behind the Ears

The first two rubrics should have been given in the chapter “sensations” and the third one in the “ear” chapter.
The chapter “External Head” ends in the page number 29, in which the Chapter “ Internal Head” again begins. This contains only two rubrics – “Left side and Right side.” The Chapter “External Head” is seen again with same rubrics in the page 30 where the second Chapter on “Internal Head” ends.

3. Eyes:
It contains rubrics like
• Aqueous humor
• Eye balls
• Choroid
• Conjunctiva
• Cornea
• Lachrymal apparatus
• Lens (Cataract)
• Optic nerve
• Retina
• White of eye (sclerotic)
• Brows
• Canthi
• Lids
• Orbits
• Sides- left and right

Misplaced rubrics:
• Adhesions in pupils
• Pupils Dilated
• Pupils Immovable
• Lachrymation
• Squinting
• Staring
They should have been given under the Chapter “ Sensations”
4. Vision:
Here Boenninghausen is deviated from his original Philosophy. “ Vision” which is a Sensation is given as a separate chapter among the parts of the body.
All the rubrics in this chapter and the Chapter as such can be considered as Misplaced.
Main rubrics in this Chapter include:
• Blindness
• Flickering
• Double
• Half vision
• Muscae Volitantes
• Dim
• Far-sighted
• Paralysis of Optic Nerve
• Photophobia
• Short –sighted

5. Ears:
This includes rubrics like;
• External
• Internal
• Middle ear ( confounded with Internal)
• Eustachian Tube
• Lobules

Misplaced rubrics:
a) Parotid Glands- this might have been given under the Chapter Face
b) Discharges from Ears -
c) Ear-wax-
The last two rubrics might have been given under the Chapter Sensations according to the Philosophy of Boenninghausen.
6. Hearing :
It include rubrics like:
• Acute
• Hardness
• Loss of Hearing ( from Paralysis of Auditory Nerve)
• Stopped Feeling ; etc
The Chapter along with its rubrics are out of place in the “Parts of the Body”. They should have been given under the “Sensations”.

7. Nose:
• External
• Internal
• Bones
• Root
• Septum
• Wings , etc are the main rubrics concerning the nose. But this Chapter contains many rubrics concerned with the sensations and complaints. They are
• Nose bleed
• Nasal catarrh
• Stopped Coryza
• Nasal Discharges
• Sneezing
• Ineffectual efforts to sneeze

The Chapter ends with Concomitants that are condensed into a single rubric – “Accompanying Symptoms of Nasal Discharges” and sides of nose “ Left side and Right side”

8.Smell:
This include rubrics
• Sensitive
• Weak or Lost
• Illusions of Smell in General
The Chapter along with its rubrics should have been in Sensation Chapter.

9. Face:
The objective symptom that may be observed in the face is given first. Followed by locations of sensations.
The important rubrics include:
• Color – Bluish – Around Eyes
• Color- pale
• Circumscribed Redness of Cheeks
• Comedones
• Drawn
• Emaciation
• Expression Altered
• Eyes protruding
• Eyes- Sunken
• Freckles
• Open mouth
• Wrinkles – On forehead

The typography of Locations of sensations are given as a separate Chapter this may create confusion among the users.
This include
• Forehead
• Temples
• Malar bones
• Cheek
• Upper Jaw
• Lower jaw
• Articulation of Jaws
• Lips
• Corners of lips
* Chin
And finally the Sides- Left and Right

10. Teeth:
It begins with “Toothache in General”
Followed by different types of tooth namely,
• Incisors
• Eye teeth = Canine teeth
• Molars
• Gums ( in Kent gums are given under Mouth Chapter )

Misplaced rubrics:
Hollow teeth = Caries of teeth
Teeth- Grinding

11. Mouth:
Misplaced rubrics include ( it should have been included under Sensations)
• Odor from Mouth
• Breath cold
• Breath hot
• Saliva diminished
• Saliva increased
• Tongue coated
The other rubrics include
• Mouth in General
• Tongue
• Hard palate
• Soft palate

12. Throat:
It include only the internal throat
Tonsils are given under throat

13. Mouth and fauces:
The Chapter on Mouth which ends on the page 64 again start on the page 65 as – Mouth and fauces in which the Sides ; Left and Right are given.

14. Hunger and Thirst:
This chapter should not have been given under the Heading of Parts of the Body. This might have been given as a separate Chapter or along with the Sensations.

The important rubrics include
• Loss of appetite
• Hunger
• Thirst
• Aversion and
• Desires

15. Taste:
This include rubrics like
• Altered in General
• Acid
• Bitter
• Metallic
• Nauseous
• Salty
• Sweetish
• Lost
Taste being a special sensation; it along with its rubrics should be given in the Sensation Chapter.

16. Eructation’s:
• Belching
• Hiccough
• Uprisings
• Waterbrash
Etc are given in this Chapter. The chapter as well as its rubrics is misplaced.

17. Nausea and Vomiting:
This include
• Nausea in General
• Qualmishness
• Retching
• Loathing
• Vomiting and nature of vomiting

18. Internal Abdomen:
• Stomach
• Diaphragm
• Hypochondria
• Liver
• Spleen
• Epigastrium
• Umbilical region
• Loins
• Groins ( including Coecum, coecal region, ilio- coecal region, iliac region and Pourpart’s Ligament )
• Inguinal Rings
• sides

Are given in Internal Abdomen.
In this the Loins are again given in the Extremities on Page 135
Hernia is the only one Misplaced rubric.

19. External Abdomen:
Pit of stomach
Mons Veneris
Inguinal glands
Are given under External Abdomen

20. Abdomen :
The sides of Abdomen are mentioned in this separate Chapter which appears on the page number 81.
21 and 22 . Hypochondria and Abdominal rings
These two chapters are mentioned as different chapters in the pages 82 and 83 respectively only to mention Left and Right sides.
23. Flatulence:
Flatulence in General
Borborygmi
Incarceration of Flatus
Are given in this Misplaced Chapter

24. Stool:
This chapter contains the following misplaced rubrics
• Diarrhoea
• Constipation
• Worms
• Round worms
• Tape worms
• Thread worms
• Tenesmus
• Anus
• Haemorrhoids
• Rectum
• Perineum

This chapter also includes certain concomitant symptoms like

Troubles before stool
During stool
After stool

25. Urinary Organs:
Kidney
Bladder
Urethra
Are given in this chapter
Prostate is given in this chapter which is a misplaced rubric

26. Urine:
Glycosuria can be taken for Diabetes Mellitus
Sediment in general can be used for urinary calculi

27. Micturition:
Tenesmus of bladder
Dysuria
Involuntary
Retention of urine etc are some important misplaced rubrics

Some concomitant rubrics are also given
Troubles before Micturition
-During Micturition
-After Micturition

28. Sexual Organs:
The chapter starts with the rubric Sexual Organs in General , followed by Male Organs in General. It is followed by different parts of the Male genitalia –, Testicles Penis, Glans, Forskin, Scrotum and spermatic cord. The chapter also include rubrics for female Organs in General. Vagina, Uterus, Ovaries are given as separate rubrics.
Misplaced rubrics in this Chapter include:
Labor- like Pains
Labor Pains Cease
After Pains
Desire Too Weak
-Too strong
Discharge of prostatic Fluid
Emissions
Erections
Impotency
Weak Sexual Power
The chapter ends with rubrics referring to the sides
Left and Right sides.

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