Book review by Dr Sunila
SIR JOHN WEIR, (1879-1971)
Born in Paisley Renfrewshire, Scotland, Dr Weir was to become Physician Royal to King George V , King Edward VIII , King George VI , Queen Elizabeth II, and King Haakon VII of Norway.
Weir received his medical education first at Glasgow University and then in Chicago under the tutelage of Dr James Tyler Kent of Hering Medical College along with Drs Harold Fergie Woods and Douglas Borland.
Weir returned to the London Homeopathic Hospital as Consultant Physician in 1910, and was appointed the Compton-Burnett Medical College as Professor of Materia Medica in 1911. He rose to become President of the Faculty of Homeopathy in 1923.
Weir reputedly first learned of homeopathy through his contact with Dr Robert Gibson Miller (1862-1919) head of the Glasgow Homeopathic Hospital. It was Dr Gibson Miller who advised Sir John Weir to go to the USA.
Weir spoke on homeopathy before the Royal Society of Medicine in 1932, and was knighted by King George V that same year. The renovatedManchester Homoeopathic Institute and Dispensary was opened in Oxford Street by Sir John Weir in May 1939. Weir said in an “address:homeopathic remedies do not act directly on disease; they merely stimulate the vital reactions of the patient, and this causes him to cure himself.” Having advanced through all levels of the Royal Victorian Order he was, as a rare distinction, awarded the Royal Victorian Chain in 1947,possibly as a mark of the medical care he gave to the ailing King George VI.
- Homeopathy and its Importance in Treatment of Chronic Disease, (1915)
- The Trend of Modern Medicine, (1922)
- The Science and Art of Homeopathy, Brit Homeo Journal (1925)
- The Present Day Attitude of the Medical Profession towards Homeopathy, Brit Homoeo Journal.
- Homeopathy: a System of Therapeutics (1928)
- Homeopathy: an Explanation of its Principles (1932)
- British Homeopathy during the Last 100 Years, Brit Homoeo Journal.
- Samuel Hahnemann and his Influence on Medical Thought.
- Hahnemann on Homeopathic Philosophy (1935)
- Sir John Weir, Dr Margaret Tyler Obituary, Brit. Homoeo. Journal.
Dr. Margaret lucy tyler (1857-1943)
Margaret Tyler was a key figure in British homeopathy at the beginning of the twentieth century. Her love and dedication to homeopathy is evidenced by the fact that she worked in the London Homeopathic Hospital for over forty years. With money she inherited from her father she set up the Sir Henry James Tyler Scholarship Fund which sent several physicians, including D. Borland, and John Weir, to study with Kent between the years of 1908 to 1913. Kent was her protégé, although she never studied with him.
- Her book Homeopathic Drug Pictures is the fruit of a lifetime of experience; it is a magnum opus that was written in just under ten years. All her books bear testimony to her vast and insightful knowledge.
- Pointers to the common remedies.
- Dr. Margeret Tyler introduced the eliminating method of Repertorisation etc.
- A Review of “Kent’s Repertory” presented before Kent.
Indian books & periodicals syndicate
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“Repertorising” by DR. Margaret Tyler & Dr. John Weir is also included in Repertory of the Homoeopathic Materia Medica by J. T. Kent.
“Repertorising” by DR. Margaret Tyler & Dr. John Weir is an invaluable gift to homoeopathic world. This book is mainly dealing with thegrading of symptoms; which is very important in Repertorisation & in finding a similimum.
This book also deals with the importance of eliminating symptoms. Symptoms which help to eliminate some unimportant medicine to facilitate the selection of the similimum are called eliminative symptoms. These symptoms are best to start with in Repertorising a case.
This book also incorporated Dr. Gibson Miller’s Hot & Cold remedies (extracted from Dr. Kent’s works) & some cases to show the method of working.
Every individual will work the Repertory in accordance with his ability, in accordance with his tendencies, in accordance with his mentality, & his work done with it will show his personality. Success in Repertorising depends on ability to deal with symptoms; & this has to be taught, it is not innate.
The first essential to use the Repertory is to know the whole case. If lacking the totality, even though we know perfectly well the symptoms & where to find them, we will be in confusion. Without the knowledge of what you seek, without all important grading of symptoms, life is too short for using the Repertory as your habitual guide in prescribing.
Symptoms are of two orders:
- Those general to the patient as a whole (Kent’s generals).
- Those particular, to some part of him (Kent’s particulars).
GRADING OF SYMPTOMS
MENTAL SYMPTOMS: Among the generals, symptoms of the first grade are, if well marked, the mental symptoms. These take thehighest rank & strongly indicated mental symptoms will always rule out any number of poorly marked symptoms of lesser grade. The mental symptoms always provide that they are very definite & well marked, are the most important symptoms of the case.
But even the mental symptoms are graded. Of highest importance are those which relate to the WILL with love & hates, suspicions & fears. Of econd grade are thoe that affect the UNDERSTANDING, with delusions & delirium. Of lowest grade are those relating to MEMORY.
REACTIONS, as a whole TO BODILY ENVIRONMENT: to times & seasons, to heat & cold, to damp & dry, to storm & tempest, to position, pressure, motion, jar, touch etc. But they have got to be in capitals or italics in the patient as well as in Repertory, to take this rank; or to safely used, some of them, as eliminating symptoms.
CRAVINGS & AVERSIONS (3rd grade general symptoms): They must not be mere likes & dislikes, but longings & loathing.
MENSTRUAL STATE in women, i.e., general aggravation of symptoms before, during & after menses.
PARTICULARS: Consider them last for these symptoms are really of minor importance. For example, in a great railway system, replacing of rolling stock & repair of few yards of permanent way are less vital to the company than the brain quality of its general manager. Make the executive of the company efficient, & it will deal in the best way with details.
Go for the patient as a live entity, revealed by his generals & mental symptoms in chief; deal with him according to the law of similars & he will do the rest. The whole is greater than the parts. Never juggle with particulars at the expense of the life of the whole.
But in their position of secondary importance you must go into particulars if only to confirm your choice of drug.
Among the particulars the first grade symptom will always be anything peculiar, or unusual or unexpected or unaccountable.
A general symptom is the one that refers to the patient as a whole, and of which he can say “I” instead of “MY”. Where the patient says “MY” instead of “I” it is particular.
The Generals & Particulars may not be quiet different, but they be flatly contradictory in the same patient. For example, Arsenicum is worse from cold but the headache of Arsenicum is better from cold; Lycopodium is a warm remedy in main, yet its stomach symptoms are ameliorated by hot food & drinks. Even though this is a particular symptom, it is a peculiar symptom strongly diagnostic of one drug.
COMMON SYMPTOMS: A symptom may be common to all cases of a certain disease, & therefore of no great use in picking out the individual remedy for a particular case of that disease; or it may be common to a very great number of drugs & so very little use in Repertorising.
Eliminating symptoms are symptoms which help to eliminate some unimportant medicines to facilitate the selection of the similimum. If we get a marked eliminating symptom to begin with, we have only to carry down comparatively small number of drugs & it is easier & quicker to get the remedy. You will generally find that one drug stands out more & more pre-eminently- it may not be in all rubrics, but it has got to be in all the important ones, i.e., those best marked in the patient & of highest grade. Without the aid of eliminating symptom some half a dozen drugs will come out pretty near one another when you count up at the end & that your traveaux d’ Hercule will leave you unconvinced & still in doubt.
Before opening the Repertory, we must eliminate all the symptoms dependent on gross lesions, & thus in some measure reduce the risk. Be sure that symptoms taken are peculiar to, & characteristic of, the patient himself- not merely secondary to disease. But it is good to diagnose a case because we cannot eliminate symptoms dependent on a disease which we haven’t diagnosed.
Techniques of repertorisation
- Old method ( using plain paper sheet )
- Modern Method ( using repertorial sheet )
Whether we use old or new method, two basic logical processes are involved. They are:-
a) Total addition process, and
b) Eliminating process.
Elimination Method (Artistic Method)
Dr. Margeret Tyler introduced this method. In this method the symptoms are arranged in a hierarchy in accordance to the schools of philosophy of the selected repertory.
Eliminating symptoms are those symptoms which throw of all the medicines that are not needed for the patient and bring only those medicines which are required for the patient.
The eliminating symptom is very important in the exercise of repertorisation because it dictates & determines the medicines that compete for the mantle of the similimum. It acts as safe shortcut to the prescription in the hands of the experienced physician.
- Single step elimination
- Cascading elimination
SINGLE STEP ELIMINATION
The elimination of the medicine is done only once, at the beginning of the exercise.
The most prominently characteristic symptom is selected as the eliminating symptom. The medicines indicated for this are noted down. For the next rubric / symptom, only these medicines which are common to the eliminating symptom are considered.
Medicines outside the eliminating symptom _ whatever be its grade is not considered for repertorisation.
In this method elimination is carried out through the whole process.
Each symptom became the eliminating symptom for the next symptom.
Extreme caution & care should be taken in structuring the hierarchy of symptoms.
The symptoms have to be arranged in the descending order of importance.
The medicines in the first symptom / rubrics are noted down, for the second symptom only the medicines covers the first symptom are considered. On working out the third symptom only the medicines those are indicated against the second symptom are selected. So first symptom is the eliminating to second symptom, second symptom is eliminating for third symptom and so on. Thus each symptom is the eliminating symptom for the next symptom.
A few cautions may be borne in mind, namely,
- If evaluation of symptom is not strictly practiced, eliminating process would prove disastrous.
- Hierarchy of symptoms should be adequately accurate.
- However important the rubrics may be, do not take it for the use of eliminating process if it has only one or a few medicines.
- Preferably generals should be used for the purpose.
If the above cautions are followed properly, eliminating process will be the most suitable working method for the purpose of Repertorisation. It is time saving, less confusing and easy to practice.
Dr. Gibson Miller’ Hot & Cold Remedies
Remedies predominantly aggravated by cold
ARS, BAR-C, CAL-C, CALC-PH, CAPS, CAUST, CHINA, DULC, FERR, GRAPH, HEP, HYPER, KALI-ARS, KALI-CARB, MAGN-CARB, MAGN-PHOS, MOSCH, NITRIC-AC, NUX VOM, PHOS, PSOR, PYROGEN, RAN-B, RHUS, RUMEX, SABAD, SEPIA, SIL, SPIG, STRONT. (3+)
Remedies predominantly aggravated by heat
APIS, ARG-NIT, FLOUR-AC, IOD, KALI-IOD, KALI-SUL, NAT-MUR, NAT-SUL, PLAT, PULS, SABINA, SECALE. (3+)
Remedies sensitive to both extremes of temperature
MERC (MERC in chronic troubles aggravation by cold; in acute, aggravation by heat), Ip.
Ant-cr: aggravation by both heat & cold; aggravation by overheating & radiated heat, though many symptoms are ameliorated by heat.
They described 6 cases to show the method of working.
- Miss R. G. (20). (Outpatient, Hospital.) Feb. 15th, 1912.
- Pain, back, when she catches cold.
- Head: burning pain on vertex. > On closing eyes.
- She feels sick with headache daily < at menstrual period.
- Cough on and off for 4 years; really never free from cough. No pain. No sputum. She gets worse from heat.
- Faintish in warm room.
- Depressed from consolation. Irritable with noises.
Method of working
- < Heat (used as eliminating symptom to cut out cold remedies from list.
- < Consolation (Kent, p. 16): Nat-m, Lil-t, Plat, Thuj.
- Noises; irritable (p. 59): Nat-m, Iod.
- Faint in warm room (p. 1361): Puls, Lach, Lil-t, Lyc.
- Faint in crowd (p.1359): Nat-m, Sul.
- Headache >closing eyes (p.137): Bry, Sul, Iod, Nat-m, Plat
- Burning pain on vertex (p. 177): Bry, Lach, Nat-m, Sul, Nat-s.
- Burning pain on vertex. < At menstrual period (p. 177): Lach, Nat-m, Sul.
- Bryonia: 24
- Lach: 36
- Lyc: 22
- Nat-m: 611
- Sul: 48
Prescription: Nat-mur. 30, 4 doses 6 hourly.
March 14th, 1912: She became very much better. She hardly had a headache. No burning vertex. Not the least faintish. Pain in back has gone. No cough. No medicine.
There are cases, where you cannot get any mental or other general symptoms. In such cases, Times of day if very definite help. These are important generals, & very useful in helping to determine the drug. Some drugs have their very hour on the face of the clock: and others have a very marked periodicity. Eg: Evening: Lyc.
Worse from damp & worse from dry weather are deep-seated & very important; if strongly marked in the patient, they may be used as eliminating symptoms.
Last & least important of all, comes the name of the patient’s malady. So long the patient is improving, never meddle till he begins to slip back; that is the 1st moment to repeat or to reconsider the case.