Dr Rajitha K Nair
Life sketch of Dr CM Boger(1861-1935)
Dr: Cyrus Maxvell Boger was born as the son of Prof:Cyrus and Isabelle Maxwell Boger on 1861. He received his early education in the public school of Lebanon Pa and graduated from the Philadeiphia college of medicine. He later studied at Hahnemanns Homoeopathic college in Philadeipia and qualified himself as a homoeopath. He was as American homoeopath of German origin and was a contemporary of Dr:Kent.
Dr.Boger became widely known through a large number of learned contributions to the Homoeopathic literature. His authorship of several medical books, his repertory construction, translation of several medical books from notable German authors and his indefatigable labor in research made him universally recognised as an authour of considerable
Some important literary works of Dr.Boger are
- Transactions of the original Repertory of Antispsorics(systematic alphabetic repertory of homoeopathic materia medica)- 1899-1900.
- Boenninghauseis characteristics & Repertory – 1905.
- Synoptic key to Materia Medica – 1928.
- Times of remedies and Moonphases – 1906.
- General Analysis
- Studies in Philosophy and healing
- Additions to Kents Repertory
- Translation of TPB
- Card Repertory – Boger Boenninghausen slipe.
These works made him universally recognised as an authour of considerable eminence. Probably there has never been a more through student of Boenninghausen than later Dr: CM Boger. Perhaps the greatest piece of literature left by Dr: Boger is Boenning Hausen’s characterstic and Repertory based on the original Repertory of antipsoric remedies but brought up to date and more valuable by the addition of more rubrics remedies and also by the addition of synoptic Materia Medica as one section of the book.
Dr: Boger aged 74 passed away on 2nd sept 1935 after as illness lasting 2 weeks.
H/o and Evolution of Boger’s Repertory.
During the later part of 19th century , with the emergence of Kents repertory the applications of Boenninghausen Therapeutic pocket book was relegated to the back stage. Boger was an ardent follower of Boenning Hausen’s school of philosophy which in his view was much closer to Hahnemannian concept of disease understanding. Dr: Boger was a prolific writer on the use of repertories who was at ease with both Kents and Boenninghausen’s school of philosophy. The construction and informations based in Kent’s repertory also impressed him. So he embarked on the mission of achieving and integration of the information present in these two repertories.
While Dr: Boger was practicing in US he understood the difficulties faced by the practitioners of his days in finding out a similimum from the Materia Medica in the shortest possible time. Finding that the practitioners had to depend on the existing faulty translations of the Repertory of Antipsorics he took up the task of translating it in 1899. While doing this translation he was further convinced that BH’s basic principles plan and construction were sound and the book was comprehensible and practicable. He was also aware of the difficulties faced by practitioners while using Therapeutic pocket book as well as the criticisms leveled against its principles and methodology.
So he took up the work of rewriting Boenning Hausen’s Repertory by adding new chapters, new rubrics and new medicines. Thus he modified chapter of Therapeutic pocket book by adding modalities and concomitant at the end of each chapter. The outcome was a more useful work and was published by Boericke and Tafel in 1905. Even after the publication of the Ist edition Boger continued to work on the Repertory. But he could not survive to see the publication of the 2nd edition of his Repertory. Later the manuscripts were published posthumously with the assistance of his wife by Roy & company in 1937. This can be considered as the 1st Indian edition of Bogers Repertory.
2nd Indian edition was also brought forth by Roy & Company in 1952. 3rd Indian edition was published by B.Jain after 20 years in 1972. All the present edition are reprints of the 2nd edition published in 1937.
Full name of the book is Boenninghausen’s characteristics and Repertory. Characteristics includes the ‘characteristic symptom of Boenning Hausen translated by Boger for the first time. They are the same characteristic symptom as seen in other Materia Medicas. This materiamedica part deals with symptomatology of each remedy and permits ready reference to Materia Medica. Boger’s translations of original rubric from German to English has been stated to be more accurate than that of Allen.
Philosophical background of boger boenninghausen characteristics and repertory
Boenninghausens pioneering work was in great use during the second half of the 19th century because it was the only work of its kind available to the practitioners. With the publication of kents repertory it receded to the back stage. Consequently BH’s work as well as his principles were over looked. Boger creditably resuscitated Boenninghausen by refining and enriching the fundamentals and recasting the sturcture and methodology. Boger subscribed to the principle of totality of symptom which was originally given by Hahnemann.
His work Boenninghausen characteristic and repertory is based on the following fundamental concepts.
- Doctrine of complete symptom
- Doctrine of pathological generals
- Doctrine of causation and time
- Clinical rubrics
- Evaluation of remedies
- Fever totality
While taking the case history of all symptoms of the patient, it may not be complete in terms of sensations, locations, modalities and concomitants. BH noted these deficiencies in proving also where the provers falls to narrate all the symptom completely.A complete symptom to one which consists of sensation location & modalities. During case taking some symptoms may also be noticed in relation to time before during or after the main complaint. These may not be always having any direct pathological relation to the main complaint Boger got the idea of complete symptom from BH’s method of erecting totality but Boger improved the idea by relating sensations and modalities to specific parts. In Bogers Repertory complete symptoms are well arranged and it is seldom necessary to do grand generalisation regarding sensations and modalities.
Concomitants are also given greater importance. They typify the individual reactions and they corresponds to the strange rare and peculiar symptoms of Hahnemann. Common concomitants are unimportant unless they are present in an extraordinary degree.
The most important concomitants are
- Those which are rarely found combined with the main affection, hence also Infrequent under the same condition in proving.
- Those concomitants which belong to another sphere of action of main complaint.
- Those concomitants which belong the distinctive marks of some drugs even if they have never been noted in the proceeding relation before.
Doctrine of pathological generals.
In addition to complete symptom Boger also gave importance to general changes in tissues and parts of body. Pathological changes tells us the state of whole body and its changes in relation to the constitution. Pathological generals are expressions of the person which can be known by the study of changes at the tissue level. Some constitutions are prone to some pathological changes in some parts of the body. This common changes in different tissues show the behaviour of the whole constitutions which is important to understand the individual.
Pathological generals can be
Structural alterations in tissues organs and systems pertaining to man as a whole. A particular sensation or a local pathology becomes a physical general sensation or a pathological general when interpreted in the light of underlying constitutional state predictive of a generalised disturbance in human economy as. Psycho-physio-pathologic basis.
Eg: pain in heels /Tendo Achilles, uric add diathesis painful sensitive soles, gouty/rheumatic state or sensitive/hysterical/neurotic subject.
Miasmatic background interpretation.
- A solitary want or mole -sycotic
- Localised patch of eczema-psoric
- Fistula in Ano-syphillitic miasm
- Bone pains at night- syphillitic miasm.
Re-current Epistaxis-Heamorrhagic diathesis
Recurrent bolls,delayed healing of wounds and ulcers, easy suppuration-diabetic state.
Structural alterations common to 2 or more than two location.
Dicharge,Acidity,Excoriation, redness, cracks, Fissuses, Acridity can be can be taken in a still wider context as to include the mind -Acrid mind.
General Locations eg:Glands, skin-folds, flexures, Glands,bends, angles-mouth,corners,canthi, sphincters mucus membranes.
Discharges when common to 2 or more Locations-colour,odour&consistency.
Degenerative changes in many location Atrophy&emaciation.
Doctrine of Causations & Time
In Boger’s hierarchy of evaluating symptoms He gaves more importance to causation & general modalities. In his synoptic key he emphasises that while taking the case we should first try to elicit the evident cause and course of sickness and all which now to interfere with the patients comfort. So according to Boger causation and Time are more defenite and reliable in cases as well as in medicines.
Every chapter in his Repertory is followed by sub chapters on Time, Aggravation, Ameliorations and concomitants. Section on Aggravations contains many causative factors. According to him these causative factors are very useful for finding out the similimum in the shortest possible time. In the chapter choosing the remedy he is giving importance to miasmatic as well as exciting causes. The natural tendency to disease may be due to psora syphillis & sycosis. External cause excite disease principally by means of external impressions when there is a natural predisposition. In some cases it is easy to prescribe upon cause. Eg: sprains fever etc. Causations are very important because if the cause is removed the effect will go by itself.
Boger was the first person who appreciated the use of clinical conditions in grouping medicines. Several clinical conditions are mentioned in his Repertory which will help the physician in case of advanced tissue changes where we will not get a clear picture because of poor susceptibility. There rubric will help to arrive at a small group of medicine which can be further narrowed down with the help of modalities. These clinical rubrics can be used when the case is not having any other choice or if the case is lacking in characteristic expressions. This helps mainly in finding out a palliative drug which is suitable in helping to overcome the present crisis.
Evaluation of Remedies
Boger followed the same method used by BH. Medicines are graded into 5 rank by the use of different typography such as
- Ist Grade CAPITALS 5Marks
- 2nd Grade bold 4Marks
- 3rd Grade italics 3Marks
- 4th Grade Roman 2Marks
- 5th Grade (Roman) I Marks
Ist Grade remedies are proved reproved and clinically verified. In the 2nd Grade intensity is slightly lower than the first Grade. Italics / 3 marks remedies are proved & reproved but not clinically verified. Roman – clinically verified but not seen during proving. (Roman ) doubtful remedies which needs further study.
Apart form these we can find one more gradation Boger’s Repertory about which nothing is mentioned. It is indicated as (CAPITALS).
Eg: upper extremities – caries – (ASAF).
Is a unique contribution of Boger. This section can be considered as a self contained repertory within the large Repertory. Each stage of fever is completed by Time , Aggravation, Amelioration & concomitant. Fever chapter is almost complete.
Deals with relationship of 125 remedies. It can be used for studying the relationship of remedies at various levels as mind, parts, sensation and modalities.
Boger’s concept ot totality
In the chapter choosing the remedy he emphasised the importance of 7 points given by Boenninghausen. Repertory gives us a group of drugs with similar symptomatologies and from this group final differentiation can be made after considering the individualizing or peculiar symptoms. There individualizing features can be
Changes in personality and temperament (quis) -This should be noted especially when striking alterations occur. These may sometimes obscure the physical manifestations and these may be corresponding to only a few remedies. The expressions of the moral and mental activities affords the best for the choice of medicines in mental affections.
Nature and peculiarities of the disease (quid) -The nature of the disease and virtues of drugs should be thouroghly known before we can give aid in sickness. Knowledge of disease or diagnosis helps to exclude all medicines which donot correspond to the nature of the disease. Diagnosis will not help us much for the sure selection of the similar remedy.
Seat of disease(ubi) :Almost every drug acts definitely upon certain parts of the organism. Whole body io not equally affected even in local or general disease some drugs affect (RT) side some (Lt) side and some diagonally. So in order to cure it is essential to ascertain the seat of action. eg: The specific curative powers of sepia in fatal joint abscesses of fingers and toes to extraordinarily conclusive evidence upon thio point , for they differ from similar gatherings only in locations and remedies so suitable for abcess elsewhere remains ineffectual here. Here he says that if the diagnosis of our time were known to Hahnemann he would have localised remedies moreaccurately than simply saying right,left etc.
Concomitants (quibus auxillus) - While selecting the simillimum concomitants should be given much importance. Common or well known accompaniments are unimportant unless they are present in an extraordinary degree or appear in a singular manner. The most important concomitant symptoms are
- Those which are rarely found combined with the main affection hence also infrequent under the same condition in proving.
- Those concomitant which belong to another sphere of disease than that of the main one.Eg: cough > paasing flatus.
- Those symptoms which bear the distinctive marks of some drug even if they have never been noted in the proceeding
- relation before.
Important concomitants may sometimes out rank the symptoms of the main disease and may help in the selection of the simillimum. These symptoms may give individuality to the totality and are the same characteristic symptoms which Hahnemann called striking extraordinary and peculiar. When the concomitant and main complaint presents with the same modality it will become more important.
CAUSE(cur) – Disease causes can be either Internal or external. Internal diseases arise from internal disposition which is highly susceptible. These are due to uneradicated miasms of psora, syphillis and sycosis. When not due to these they are due to remenants and sequate of acute affections, due to drug disease poisoning etc or due to combination of drug disease with the other which is very difficult to treat and in which cases antipsoric remedies will be very effective. In many of the acute diseases rapid and durable cures can be effected by the administration of antipsortc remedies.In the treatment of many diseases the best selected remedy is often ineffectual unless preceded by a suitable antipsoric, antisyphillitic or antisycotic. While dealing with drug diseases drugs given should be properly ascertained and treated.
Drugs diseases are generally compound & will not show a clear picture hence the knowledge of contents of former prescription to necessary. In some cases it is very easy to find the cause and helps to find a similar remedy eg: burns, sprains etc-:
But if different cauaes can produce the same condition the choice may become difficult-Eg: Common cold – After sweating
- By exposuse of a part
- By drenching in rain
Dr. Boger to giving much important to the causative modalities.
So without knowing the cause, the correct homoeopathic remedy cannot be selected.
Modalities ACCORDING TO SITUATION & CIRCUMSTANCES.(quomodo) - Modalities are the modifiers of characteristics. All well proved drugs manifests common symptom of many drugs but their modalities may be differing. Modalities must be specialised eg: If motion generally aggravates we should note the different kinds of motion as whether they arise during commecement or are continued etc. General modalities and particular modalities are important. Cravings and aversions to various food materials furnishes important points in deciding the remedy. According to Dr: Boger when symptom are pointing to one particular remedy and if modalities don’t agree it will not be indicated and we will have to search for another remedy having same or similar modalities
TIME MODALITIES(quanto) – Time factors are equally important as aggravations and ameliorations. Here two important things to be noted are the periodical return of symptoms after a shorter or longer period of quiescence. In these types there may be some special or accidental causes such as menstural disturbances, seasonal or temperature influences etc.
Eg : Fever every 14 days
Convulsions during menses.
The hour of days when the disease is better or worse.
These are of much greater importance because we can find these features in many disease and we can find this in many proving so these are peculiar and are qualified.
Eg: time modalities of cough, diarrhoea etc. unless they are clear and decided (iike hell & lyco at 4-8pm ) or return at
exactly the same hour (Antc , Ign , Sab) they are unimportant.
It is easy to select the right remedy after a picture of disease complete in respect and fully meeting all requirements has been drawn up then to obtain the materials for such a picture and costruct it for one’s self.
Evaluation of symptoms:
Apart from the above mentioned 7 points Dr: Boger appreciated the use of time factors , causative modalities,
Pathological generals and tissue changes to understand the case.
Causative modality Mental & physical – fear, Excitement Physician should try to elicit the evident cause and course of sickness down to the latest symptom. To this add all things which now seems to interfere with the patients comfort.
Modalities or natural modifiers of the sickness should be then ellicited. The most vitally important of such influences are Time temperature, openair , posture, Being alone, Motion,sleep ,Eating and Drinking ,Touch,Pressure, Discharges etc.
Important point to be noted here are the presence of irritability, sadness fear placidity etc. Mind is given adequate importance and for selecting a drug it becomes imperative that the remedy selected is always in agreement with the mind. The interdependence of mental and physical states is so great that we can never afford to overtook it entirely. They classifies every other symptom often in a decisive way. [from: how shall I find the Remedy - Boger]
Estimate the patients own description of his sensation. Always ascertain whether any of the following primary sensations are present like Burning, Cramping , Cutting. Bursting , soreness , Throbbing and Thirst. Others may also be present but presence of any one of these may often overshadows them.
Entire objective Aspect or expression of the sickness This Includes facial expresion Demeanor, Nervous Excitability, Restlessness Facial expression, Torpor , colour & odour of secretions, sensibility and any abnormal colouring.
Parts affected or locations must be determined. This will be more helpful in reaching the diagnosis.
By going over the above rubrics in this manner the contour of the disease picture will be clearly outlined and will point clearly towards the similar remedy. The actual differntiating factor may belong to any these rubrics. From these it is very clear that Boger has given importance to causation modalities, concomitants , General sensations & Pathology and location to given last importance in the order of hierarchy.
Diagrammatical representation of evaluation
MODALITIES - Causative Modalities, Time, Temperature weather, open air, posture , motion, eating anddrinking, sleep. if alone, pressure, touch,discharges.
MIND - Irritability, sadness, fever, placidity
SENSATION - Burning, Cutting, Cramping, Bursting,Soreness, throbbing, Thirst
OBJECTIVE ASPECT Demeanor, Restlessness, Nervous Excitability, Facial Expression, Torpor, Secretions , Colour,Odour.
PART AFFECTED - Organ, Right, Left.
Plan and construction of BBCR
Having found certain difficulties in the day to day use of TPB Boger tried to modify the structure and content of the book by adding many medicine and rubrics drawn from his own experience and other sources. Thus the book has undergone a vast change but its basic principles have remained unchanged.
The book consists of.
Mataria Medica Part
Before these two sections book contains
A Foreword written by Dr:HA Roberts in 1938 He emphasises that the works of BH are the most comprehensive in logic , philosophy and applicability of the early writers perhaps with the single exception of works of Hahnemann. He stresses this point by noting that even though Hahnemann compiled a brief index to remedies and Jahr preceded BH’s publication of Rep of Antipsoric remedies it was BH who first evaluated remedies in relation to individual symptom and it was he who first introduced the Relationship of remedies to the individual case. BH evolved the doctrine of concomitants which he believed to be of peculiar and characteristic value.
Many criticism have been raised against BH’s TPB on the ground that there has been no differentiation between general & particular modalities. But in this like its predecessor The Repertory of Antipsorics modalities for each part is assembled at the end of the section of Repertory devoted to that part and a section for general modalities in arranged towards the end of the book.
This book to a valuable addition to the Homoeopathic literature in making available the combined observation and logic of Boenninghausen and the wide and wise observation gathered by Dr.Boger from long year of study & practice.
- Historical sketch of the of Boenninghausen
- Preface- 2 parts
- Introductory essay about source books
- Notes by Dr: Boger
- On the use of Repertories
- Choosing the Remedy
- Repetition of Dose
- Homoeopathic prognosis
- Index of contents
- Index of medicines in Materia medica part
- Index of chapters in Repertory part
The sections in repertory are given as 53 units but there is a total of 58 chapter because one chapter given as subchapter in index appear as main chapters in the body of the book.
After the Materia Medica and Repertory part towards the end of book there are three more indexes dealing with Word index to Boger BH Rep compiled by S.P Roy. Word index constitutes 101 pages.
Index to main sections/ chapters
Index to main chapters & subchapters
Word index arranged chapter wise. The index of the book is excellent and exhaustive which enables even a novice to locate the symptom more readily. In spite of all these the Repertory is lacking in an index of remedies represented in the repertory part.
Later an index was prepared by Dr. Tiwari where he gives the total no: of remedies represented in Repertory to 442. But originally this book contains 489 remedies.
Total No: of Pages – 1231 pages . which are arranged double coloums.
Arrangement of materia medica part
A total no: of 140 medicines are given in the materia medica part in alphabetical order. Each medicine the contents are arranged in Hahnemannian schema i.e from head to foot in each remedy Allied Remedies are given as the last section which list a group of remedies which are related in some way or other with the remedy. In some cases complimentary remedies are included separately.
After all remedies a brief note is given regarding the duration of Action of Remedies where he classifies all remedies into 5 groups as
- Shortest action
- Brief action
- Medium duration of action
- Long acting Remedies
- Very long & deep acting remedies
There are taken from the notes of Hering confirmed by Boenninghausen and it is said that the symptoms which appeared last in the proving are of great value.
In a section on important hints 12 observation given by Dr J.T Kent to arranged in a condensed form.
In the MM part remedies are graded into 2 i.e italics & ordinary Roman
It comes under the classification of LOGICAL UTILITARIAN TYPE. This Repertory is based on the logic of particulars to generals especially on pathological generals & complete symptom based on the doctrine of INDUCTIVE LOGIC.
Source book Materia Medica part
- BH’s characteristics translated by Boger for the first time.
- Whooping – cough – homoeopathic Treatment of whooping Cough in its Various forms published by Boenning hausen in 1860.
- Homoeopathic Domestic Physician in Brief Therapeutic Diagnosis-1853.
- Therapeutic Hints from the Aphorisms of Hippocrates.
- Symptom Text of Intemittent fever.
- Aided remedies are added at the end of remedy which are the results of long years of observation by BoenningHausen.
Dr: Boger was also impressed by the data presentation in Kents Repertory. He therefore attempted to arrange and improvise the information present in BH’s repertory as an organised and easily accessible manner. So he presented the data in such a way that a symptom could be repertorised as a unit in the relevant chapter Itself. This was a phenomenal shift from the facility of BH’s repertory where each element of the symptom had to be repertorised from different sections.
This improvement was accomplished by arranging the relevant sensation, there modifying factors (Agg&Amel) and accompanying symptoms (concomitants) under each locations. Thus the book has undergone a vast change but its basic principles have remain unchanged.
To make this arrangement more comprehensible he differentiated the heading in the 2nd chapter of TPB (parts of body and organs) into distinct headings or separate chapters. While doing this he arranged each location according to Hahnemann’s anatomical schema and are given as separate chapters. In this arrangement he followed the pattern adopted by BH for the construction of Rep of Antipsoric (ie each location followed by sub chapter on <,> and concomitants.) Boenninghausen divided his repertory into seven sections and that plan has been faithfully followed by Boger, In compiling his repertory. Hence the general section in BBCR is same as that of TPB.[But headings like mind & intellect, parts of body and organs etc are lacking in BBCR , instead they appear as separate units.Boger also improved the Repertory by expanding on the mental rubrics. This strategy facilitated its use even in cases where the mental symptoms predominate.
The overall outlook of the chapters in BBCR as compared to TPB are
Mind & Intellect in TPB-Mind, Sensorium, Vertigo Vertigo to given as a rubric in section intellect in TPB- Here separate chapter.
Parts of Body&Organs.
Boger differentiated the headings in this section of TPB in to separate chapter/distinct entitles and made each location a separate chapter as per Hahnemannian scheme. Thus he increased the no: of chapters in BBCR and made the work somewhat similar to Kent. This type of arrangement can be seen in Boenninghausens Repertory of Antipsorics. Here he completed each of these location sections with subchapters on sub locations, Time, Aggravation/Amelioration comomitants and cross reference. In this chapter he added many Rubrics and sub rubrics.
Sensations & complaints in general
Although sensations and complaints are given in all locations sections General sensation are given under a large section with 3 other sections like Glands ,Bones Skin & Exterior body. Arragement of this chapter is a little bit similar to that of TPB but for the last section skin of TPB title here is skin & exterior body.
Sleep & dreams
Boger divided this section in to many subchapters. In the Text, sleep and Dreams are given as separate chapters.
The most significant contribution that Dr:Boger made for the cause of Repertories was the organisation of data pertaining to the fever symptoms .This chapter was indeed a masterr stroke as no other Repertory is as elaborately designed as BBCR in the area of fever Totality- In the section related to fever each phase of fever is presented in a complete form with reference to the location affected ,by their sensation and complaints and their modifying and accompanying factors.
Conditions in general.
Many criticism had been raised against Boenning Hausen,s Therapeutic pocket book on the ground that there has been no differentiation between general & particular modalities. But Dr:Boger fairly met the criticism by arranging modalities for each part assembled at the end of the section to that part and general modalities in a large section towards the end of the book.
Here this section consists of 2 parts
- Conditions in general -Time
- Conditions of Aggravations & Ameliorations in General.
In both these sections Aggravations and Ameliorations are given within the same section. But in Boenning Hausen’s
Therapeutic pocket book the main heading was Alteration in the state of health with three sections
- Aggravations according to time
- Aggravation according to position & circumstance
- Amelioration according to situation & circumstances
- Allen removed there heeding and arranged it under 2 section Aggravation & Amoliorations
Similar arrangement as that in Therapeutic pocket book. Relationship of only 125 remedies are given [in TPB - 148] Relationship chapter contains rubrics like Mind, Location, Sensation, Glands Bones skin Blood , circulation and fever
Related Remedies & Antidotes. [in Therapeutic pocket book - other Remedies.] So the whole repertory can be classed as 58 units [53 units as given in index] Each of these units can be considered as separate chapter. Most of these chapters contains many subchapters except prostate gland & stomach. The no: of units are increased from 7 to 58 by mainly splitting the subsections in Parts of Body and Organs into different entities.
NAMES of all main sections are written in DARK CAPITALS. Thus we can see a total of 58 main section in this Repertory [In index 53 only]
Names of subchapters are written in ORDINARY CAPITAL.
Name of chapter is printed in the Top of each page.
If it is subsection name of main chapter will be written at Top left hand side of page & subchaptor’s name in Rt hand side. Thus we can identify whether that section is a main chapter or a subchapter.
Total No: of pages 1231 arranged in double coloumns.
Rubrics are printed in bold ordinary letters.
Sub rubrics are printed in italics [same in Rep of antipsorics]
Medicines are evaluated into 5 grades.
1. CAPITALS 5.Marks 1st Grade
2. Bold 4. Marks 2nd Grade
3. Italics 3. Marks 3rd Grade
4. Roman 2. Marks 4th Grade
5. (Roman) 1. Mark 5th Grade
This gradation is based on the frequency of appearance of symptom in provers.Thus 5 mark medicines are most important and one mark least important.
Rarely (CAPITAL) in brackets is given. Grading of this is not mentioned any where.
Ist grade remedies are proved , reproved and clinically verified.In 2nd grade intensity is slightly lower than Ist grade.
Italics/ 3 mark remedies are proved and reproved but not clinically verified. Roman – clinically verified but not seen during proving. (Roman ) doubtful remedies which require further study.
Boger’s Repertory is based on the concept of complete symptoms. The general arrangement of each chapter to the presentation of information under distinct headings, conditions, Time, Aggravation Amelioration and concomitants. Under each of these chapters rubrics are arranged in alphabetical order with certain exceptions.
The chapters or sections in Bogers Repertory can be classified in to two groups as
- General section – eg: Mind – Completed with sensation, modalities,Concomitants and cross referece.
- Regional Section
In each regional section we get 4 subsections
- Locations & sensation- Given together
- Modalities (Time, Aggravation & Ameloration)
- Cross references.
These subchapter are at certain times divided into further subchapters. The flow of sequence of the chapters in regional
section is in Hahnemann’s anatomical schema.
Sub location are arranged in a schematic order as
- Inner to outer – Head Internal , Head external, chest Inner – chest ext
- More important to less important.
In each of these chapters
- Condition refers to sensations & complaints
- Time refers to the time of aggravations
- Aggravations refers to circumstantial aggravating factors
- Amelioration refers to circumstantial relieving factors
- Concomitant refers to accompanying features
- Cross reference refers to the availability of similar meaning rubrics under that heading.
Arrangement of subchapters & rubrics
A distinct pattern is adopted for the arrangement of rubrics through out the repertory. There is a near similarity in the arrangement of rubrics pertaining to the localities chapter. All chapters dealing with complaints have similar arrangement. Modalities [Time,Aggravation, Amelioration] are arranged alphabetically.
Arrangement of Mind Chapter
In mind chapter the medicines in general which have a predominant action on the mental sphere are listed initially. it is followed by chapters on Time Agg, Amel, concomitant & cross reference. This chapter is a distinct development over Therapeutic pocket book . It has about 365 rubrics referable to conditions apart from modifying and concomitant factors.
Section on location & sensations
Locations and sensations are mixed in Bogers Repertory. So separate headings are not given for them. They are given within one section or are given together in Bogers Repertory. A definite order is maintained for their arrangement.
Usually location is further split into different subdivisions, sides and extension. In some chapters there subdivision are included as rubrics within the main section [eg: Upper Extremities - Shoulder, Elbow, LE- Thighs , Khees], But in some chapters these sub locations are given as subchapters to the main Location [eg: Eye - orbit, eyelids, eyelashes, canthi]
There rubrics on sub location are useful because it guoups medicines for the parts. These rubrics groups those prominent medicines which are capable of producing different types of symptom in relation to that organ or location. Clinically these medicines have affinity towards these organs. This grouping may not help us in the process of systematic repertorisation but it can be of much help to know the affinity towards parts, it suggest organ remedies which may be useful for finding out a drug for palliation when only a few prescribing symptom are available in the case.
- With in each chapter especially in case of central locations the medicines in general are listed initially [eg:Head,Chest]. In case of B/L location medicines predominantly indicated for each side of the given locations are given [ear - right. Left, Nose- Right Left]. This arrangement is lacking in some B/L locations. Eg: In eye chapter Ist rubric is eyeball.
- This is followed by different anatomical parts in that particular location eg: Head – Forehead, Temples occiput etc.
- In each of these location rubrics their sub locations extensions alternation and sides are given. Eg: p 251 – Head Int - Forehead – eyes of.
- While giving location as rubrics a letter will be given as abbreviation which given in the brackets. Eg:Head int-forehead (F).
There are important because each specific sensation is again attached to the subdivision of the main locations. This is useful from the point of repertorisation or it specifies the sensation to the part and contains only a group of medicine . Can be used only for reference purposes. That is why it is said that location and sensations are mixed in Boger Rep.
Begins after the and of location. In some chapters we can see a horizontal line demarcating locations and sensations or indicating end of location & beginning of sensation. In the section on sensation different sensation and pathological conditions are mentioned in relation to the part. Therefore it meets the usual objections raised against Boenninghausen’s Therapeutic pocket book.
Sensations are arranged in alphabetical order. Each sensation to a general rubric which to followed by a group of medicines. It is divided into subrubic under which parts are mentioned usually as abbreviation of locations. There is no general rubric for pain but it is mentioned as various types of pain leaching, burning, etc. Usually these sub rubrics are too specific and have less no: of medicines. These are less useful for repertorisation.
The rubrics for location and sensations are mixed and there are no separate heading for them but it is easy to understand because there is an order ie. after location sensation are arranged alphabetically. This is followed by chapters on time, Aggravation, Amelioration & concomitants and cross reference. When sub location are given as subchapters for a main location chapter these sub location chapter will be given before the chapter on time, Agg, Amel & concomitant.
- Scapular region
- Back proper
- Lumbar region
- Sacrum & coccyx
- Spinal column & vertebra
- After these chapters on Time, Aggravations, Ameliorations &
Rubrics in sensation can be
- Pathological Symptom
- Diagnostic/Clinical Rubrics
In some chapter Abbreviation for sub location are given in the beginning of the chapter.e.g Hypochondria-liver(L), Spleen(S)
Time refers to Time of Aggravations of complaints. Here medicines are grouped under the broad divisions of time like morning/ forenoon/ noon etc. This is useful because most of the patients mention the broad divisions of time rather than the specific hour of suffering. So clock timing are given only very rarely only in some chapters. These rubric contains only small groups of medicines. Fixed type of rubrics can be seen in all section of time. In some sections we get rubrics like alternation, periodicity etc. Rubrics are arranged form morning to next morning ie in clock wise direction.
Time section are appended to almost all chapters at the end of each chapter and a general time is given toward the end of all sections. Thus he made a differentiation between general & particular time modalities.
Time section is absent in Regional chapter like
- External Abdomen
- Inguinal & Public region
- Anus & rectum
- Prostate gland
- Urinary organs
- Sexual Impulse
- Larynx & Trachea
Subchapter – aggravations.
Modalities for each part are assembled at the end of each section devoted to that part and General modalities constitutes a large section arranged towards the last part of the book.
Aggravations refers to circumstantial aggravating factors. Thissection deals with
- Factors which increase the specific complaints of parts.
- Causative Modalities – A/F or factors which excite or bring on some complaints. Eg: Head Internal – sewing
- Concomitants – In some chapter concomitant are given in Aggravation chapter especially in those section which are not followed by a separate section on concomitants eg P. 291 – Head Int – Agg – urinary crisis – poly uria with -
- Aggravations are arranged in alphabetical order.
- In some chapters Agg & Amel are together under one head Aggravation and Amelioation.Eg: Sensorium, Stool
- In some chapters Agg & Amel are given together under the heading conditions. Eg: Anus & Rectun , Perineum, Urine
- (condn of urination), Urinary organs, Genitalia, Voice & Speech.
- Aggravation chapter is larger than Amelioration and is most useful for repertorisation particularly of A/c or short cases.
- This chapter is bigger than Amelioration section because patients and provers usually note down only the factors which increase their suffering. This chapter is most useful for Repertorisation particularly for acute cases or so called short cases.
Patients will not usually narrate the ameliorating factors which decreases the suffering. This section deals with circumstantial relieving or ameliorating factors. Amelioration factors are less commonly noticed by patient & provers so this subsection contain less no: of rubrics. This section is given less importance while doing Repertorisation. Ameliration factors are used for the purpose of individualising the patient.
Concomitants are the minor complaints seen associated with the major complaints but having no direct pathological relation to the main complaint. Boger collected concomitants from different sources namely proving, clinical experiments and verifications. Most of the concomitant section are well explained and are arranged an alphabetical order with many rubrics and subrubrics. In some main section comcomitant chapters contain only a small group of medicines without any rubric / symptom. Eg: Mind. These types of Rubrics are less useful for Repertorisation.
Chapter on fever to full of concomitant in relation to chill heat & sweat under different headings. Each stage of fever has
separate chapters on concomitant. Each concomitant section is further divided into subchapters beginning with mind & ending with deep & Dreams. All of these sub chapter contain many rubrics. Headings of these sub chapter on concomitants are written in small capitals. If a main chapter has no concomitant section some of the concomitants will be given under Aggravation chapters. Usually concomitant section are arranged after section on modalities.
Detailed concomitant section are given in chapters Iike
- Stool – concomitants before , during & after stool given separately
- Mictuartion – Before , At beginning of, during , At the close of, After micturition
- Sexual Impulse
Concomitants are important because these are the keynotes and characteristic symptoms of the patient. Although Boger gave much importance to concomitant, this section is induded only in 22 chapters.
Chapters where concomitants are absent
2. Head Internal
12. Water brash & Heartburn
16. External Abdomen
17. Inguinal & Pubic region
19. Anus & Rectum
22. Urinary organs
24. Larynx and Trachea
25. Voice & speech
26. Neck ft External throat
29. Upper Extremities
30. Lower Extremities
Subsection- cross reference
Cross reference refers to availability of similar meaning rubrics under that heading. This Is also an Important subsection which makes the repertory more useful. In cases with full of symptom or with scarcity of expressions we have to properly evaluate the symptom & have to find out the characterstic symptoms- To locate these characteristic symptoms in Repertory we have to adequately interpret and convert them into rubrics. This subsection helps us to do this and also helps to clear out confusion about similar rubrics.
However cross reference is not given at end of all chapters. In certain sections we can find cross reference sections appended even to subchapter like Aggravation, Amelioration or concomitants.
In these cross Reference section we will not get any medicine for Rubrics. For medicines we have to refer to the rubric refered to in the main section.
- Apart from these separate section on Cross Reference – comparisons are given under most of the rubrics in the main rubrics. Eg: P392. Face Burning – compare fever partial heat.
- In some cases the primary rubric in the main section will not contain any medicine but have an indication to refer another rubric. Eg: P 405 – Face – Cramp see spam. Here Face.
- Cramp contains no medicine. For getting medicine we have to refer face spasm.
Arrangement of rubrics & medicines
- lst Rubric in most of the sections is rubric in General. This rubric groups those prominent medicines which are capable of producing different types of symptom in relation to that organ.
- Main rubrics are printed in bold letter and sub rubrics in Italics,
- In Regional section, Abbreviation of Locations will be given.
For further specification of sensations in these locations These abbreviated letters will be given in brackets. For further modification of these location such as side right or left the letter capital L or R in italics will be given. Eg:P 261 – Head Internal – Drawing – T should be read as drawing pain in R,L (Rt) temple, Left Temple. Sometime side affinity will be specified for some medicines within a rubric and for this the letter small (I) or (r) will be given in brackets after the name of the remedy. Eg P- 260 – Head internal – Cutting T- Agn …Puls(r) senecio(l) Very rarely some causative factors or terms will be given after a medicine in bracket. This term will be applicable to the proceeding medicine only. Eg: P 317 eye strabisim A,… (<worm)….Z . Interpreted as cina has strabismus form worms,
The main chapters denoted by DARK CAPITALS In Boger’s Repertory are
8. Coryza (given under nose in index)
16. Water brash & Heartburn
18. Nausea & vomiting
20. Epigastrium (given under stomach in index)
23. External Abdomen (given under abdomen in index)
24. Inguinal & Pubic region
27. Anus & Rectum
29. Prostate Gland
31. Urinary Organs
33. Sexual Impulse
37. Larynx & Trachea
38. Voice & Speech
39. Neck & External Throat
42. Upper Extremities
43. Lower Extremities
44. Sensation and complaints in General
47- Skin & Exterior body
52. Circulation given under blood in index)
53. Heat and fever in general
55. Compound fever
56. Conditions in general-Time
57. Conditions of aggravations and ameliorations in general
If main chapter is a location for eg-eye- the subsections on sub locations are given immediately after the main location.
Only after these sub chapters on sub locations that these time aggravations and ameliorations for the general locations are arranged. Eg: P 309-EYES
Sections for special senses are given as sub chapters
Almost all the sections have many subchapters. These subchapters can be
- Cross reference to the main sections
- Sub locations
- Cross reference to each of these sublocations
Chapters without any sub chapters are stomach and prostate gland.
A distinct pattern is adopted for the arrangement of rubrics through out the repertory . there Is a near similarity in arrangement of rubrics pertaining to localities chapters. All chapters dealing with complaint have same arrangement. The modification factors are arranged alphabetically.
Arrangement of chapter on mind
In the mind section medicines which have a predominant action on the mental sphere are listed initially. The different conditions like time, aggravations, ameliorations, concomitant factors and finally cross reference follows this. This chapter is also a distinct development over Therapeutic pocket book. It has about 365 rubrics referable to conditions apart from modifying and concomitant factors. All the rubrics in relation to emotion and intellect are given under the chapter mind. However mental symptoms are also give under condition of Aggravations & Ameliorations in general. These rubrics don’t generally have sub rubrics or have smaller sub rubrics with less number of medicines.
Arrangement of chapters which are location In case of central locations, medicines in general are listed initially. In case of bilateral locations, the medicines predominantly indicated for each side of the given location are indicated initially. This is followed by the different anatomical parts of that location, listed along with medicines. This follows relevant sensation which are arranged in the alphabetical order. Time related aggravations, circumstantial aggravations, circumstantial amelioration, concomitant factors and finally cross reference follows this.
Arrangement when chapter is a sensation.
When the chapter is a sensation, complaint or condition eg: Errucation, the remedies in general are listed initially followed by time related aggravations, circumstantial aggravations, circumstantial amelioration, concomitant factors and finally cross references, follow them. The chapters of sensation in general, glands bones and skin and cumulatively followed by a short list of circumstantial aggravations and an insignificant data on Time related aggravations.
Arrangement of fever rubrics
There are by for the most elaborate of the chapters in the repertory. There are five chapters referable to this area as
- Pathological Types
- Compound fevers
Fever –pathological types. This chapter on fever has details regarding the pathological Types of fevers.
Chapter on chill has details regarding the different locations of chill sensation, sensation of coldness and the particular areas of feeling coldness. This chapter contains details regarding sensation of shivering. Time related aggravation, circumstantial aggravation & circumstantial amelioration follow this. The details of concomitants are arranged with reference to Hahnemanns anatomical schema.
Heat & fever in general
Chapter on Heat and Fever in general has details regarding localities of heat sensation. Time related aggravations, circumstantial aggravation and circumstantial amelioration follow this. Concomitants are arranged according to Hahnemann anatomical schema.
This chapter has details about areas of sweat. This is followed by Time Aggravations, Circumstantial aggravations, circumstantial ameliorations and concomitants. Here also concomitants are arranged in anatomical schema.
Chapter on compound fever has made distinction about paroxysm of fever starting with chill, with shivering, with heat and with sweat.
Arrangement of concordance chapter
The concordance chapter has 124 medicines in it. The arrangement of rubrics in there chapter is according to the pattern adapted in concordance chapter of Boenninghausens Therapeutic pocket book. Utility of this section is for finding out the possible second prescription.
Scope / adaptability of Boenning Hausen’s characteristics and repertory.
BBCR is an updated edition of Boenninghausens systemtic Alphabetic Repertory of Homoeopathic Medicines (Transation of original Repertory of Antipsorics published by Boenning Hausen in 1832). This work had corrected various anomalies that have been recognised in the original version. Bogers Repertory is the latest among the three well known repertories in use, the others being Kents Repertory and Therapeutic pocket book.
Thus the characteristics and Repertory has the following additional features.
The accessing of complete symptom as regards location, sensation, modality and concomitants is made to a large extend within each of the chapters. This is made by the inclusion of these elements from the other sections of the Repertory for reference as well as repertorisation of a case where particulars are dominating the picture, here the repertory can be utilized with advantage. Thus it is more useful in acute and short cases.
The no: of mental symptoms has increased due to the additions of rubrics from other sources which Boger evaluated for inclusion in to this Repertory by adjusting to the scale of gradation. This repertory starts with a large mind section which is quiet elaborate, of course it doesn’t compete with kents section on mind, there are many rubrics in this Repertory which are not mentioned in Kent. Eg: crankiness, duality sense of etc
There are a number of diagnostic and pathologically relevant rubrics which can serve to indicate the remedy in the absence of characteristic individualizing symptoms. we find many diagnostic clinical rubrics mentioned in each chapter with a group of medicines. These medicines have been used in the conditions mentioned and found to be useful in majority of cases. Thus they have been proved and verified. There are many controversies regarding the use of diagnostic rubrics but these cannot be neglected as they have a group of common symptoms which medicines also have produced in proving. But since there is similarity only at the level of common symptoms results can be of a lesser quality.
By using there clinical Rubric or diagnostic Rubrics it doesn’t mean that the dynamic level of the disease is forgotten. The clinical search light is used as an eliminator in the first to be followed by the dynamic level spot light to Illuminate with precision.
Fever chapter is very purposefully arranged, making this repertory indicated prominently in cases of fever. In fact this chapter is a hall mark of this Repertory. From practical point of view this chapter is of immense use. It has got many subdivisions also. Concomitants in relation to chill, heat and sweat under different headings are really valuable for bedside practice.
There is a prominent mention of constitutional types under the chapter sensation and complaints. This reduces the practitioners work and helps him to find the similimum by using it in the first place in the totality.
The original sections like parts of body and organs sensations and complaints etc are retained in their original format for a wider selection of rubrics.
The facility of cross reference is given at the end of each chapter which is of help in selecting similar rubrics or precise rubrics.
There are many pathological generals which are valuable for Repertorisation and selecting the similimum. Eg uric acid diathesis, Haemorrhagee tendency to , Inflammation suppruation etc.
All compliant of infants are compiled under a single large Rubric Infant affections of this is unique and very useful in pediatric practice.
Concomitant chapter follows modalities in most of the locations. In Therapeutic pocket book concomitants are not given seperately except in a few chapters. Boger made it more useful for practice by attaching concomitants to the
The chapters in Bogers Repertory can be classed as
Mentals - Mind, Sendorium – 2
Particulars – In Hahnemannian Anatomical Scheme -22.
11. Inguinal & pubic region
12. Anus & Rectum
14. Prostate gland
15. Urinary organs
17. Larynx & Trachea
18. Neck & External Throat
21. Upper Extremities
22. Lower Extremities
Physical Generals-8 chapters
5. Sexual Impulse
Local Pathologies – 6
2. Water brash & Heartburn
4. Nausea & Vomiting
Section Dealing with Discharges- 2
Sections dealing with physiological function – 2
2. Voice & Speech
1. Sensation & complaints in general
5. Conditions in general
6. Conditions of Aggravations & Ameliorations in general
Sections related to fever- 5
1. Fever – Pathological Types
3. Heat & fever in general