Book review by Dr.Jubin BHMS,MD(Hom)
Medical Officer, Department of Homoeopathy, Govt. of Kerala
Clinical repertories :
They are those repertories which contain clinical symptoms or conditions and corresponding group of medicines. They facilitate the selection of a remedy on the basis of pathological similarity, causation, modalities and concomitants. They are not commonly used for the purpose of repertorisation. However these repertories can be used for cases where clinical conditions mask the characteristics of the patient. In such cases the physician finds the prominent common symptoms with a few modalities and concomitants. These cases need the help of clinical repertories for selecting the simillimum.
Origin Of The Concept Of Clinical Repertories :
In spite of emphasis on individualization and prescription based on characteristic expressions, the emergence of clinical repertories could not be prevented in homoeopathic practice as early as Hahnemann times. The grouping of medicines according to the name of diseases, though discouraged by many stalwarts gave birth to clinical repertories. The greatest modern exponent of this practice is the late Dr. J. Crompton Burnett, who has brought once more to light the vast therapeutic treasures which had been forgotten in the works of our great masters. The use of nosological correspondence is one method by means of which a similar, if not the most similar, remedy may be discovered.
All ways of finding indications are open to practitioners and the clinical avenue is one of them. J.H.Clarke has described it like this “ Certain diseases come to have certain remedies assigned to them and all patients who are found to be suffering from any given disease must be dosed with one of the remedies credited to it”. Master Hahnemann was certainly not happy with such kind of practice, he described it as , “Treating the names of the diseases with names of therapeutic actions”. Such a kind of practice was much favoured by Dr. J. Crompton Burnett. He expresses it as “ The fact is, we need any and every way of finding the right remedy, the simple simile, the simple symptomatic simillimum and the furthest reach of all—the pathological simillimum, and I maintain that we are still within the lines of Homoeopathy that is an expansive, progressive science”.
As early as in 1869 Bell’s diarrhoea and 1873 Berridge’s Eye, two very useful clinical regional repertories were published. Though the concept of such practice was conceived by Burnett he could not compile a separate repertory for that purpose and hence the credit of authoring the first clinical repertory goes to J.H.Clarke.
There are many clinical repertories available these days, but two of them are well known as General Clinical Repertories. They are A Clinical Repertory by J.H.Clarke and Materia Medica with Repertory by O.E.Boericke. There are many useful regional repertories which help the practitioners to find the similar remedy.
Scope and Limitation
Though they have not been put to their fullest utility, these are very useful too, the scope and limitations are properly understood and implemented in practice.
- Clinical repertories can be used in the study of Homoeopathic therapeutics as well as Materia Medica.
- They help to repertories the following types of cases
- Cases lacking in mental generals and physical generals but rich in common symptoms.
- Cases with clinical diagnosis.
- Short cases with very a few symptoms.
- They are used as quick reference books at the bedside.
- Clinical repertories contain some rubrics, which are not found in other general repertories, so they can become a good companion in the study of such rubrics.
- Clinical repertories help us to find the most appropriate palliative medicine in incurable cases.
- Regional repertories help in finding out the simillimum in a specific clinical condition.
Clinical repertories are based on nosological terms and clinical symptoms, which are the result of clinical observations hence their use is limited to particular type of cases. They are mainly used for reference work.
CLINICAL REPERTORY BY OSCAR.EUGENE.BOERICKE M.D
It is the most widely used beside clinical repertory which has been attached to Homoeopathic Materia Medica by William Boericke. M.D. Since both names are similar it creates confusion among users. Though the authors are different the repertory compilation is mainly based on the Materia Medica by William Boericke, the different editions of which are published as follows
3rd edition : 1906, published by Boericke and Runyan.
5th edition : 1912, published by Boericke and Tafel.
6th edition : 1916, published by Boercike and Runyan.
8th edition : 1922, published by Boericke and Runyan.
9th edition : 1927, published by B.Jain Publishers.
Clinical repertory was completely remodeled and brought up to date by embodying much of the available material. It was published in 1927.
Plan and Construction
It has the following chapters. The divisions of the sections is in the old Hahnenmannian schema.
- Urinary system
- Male Sexual system
- Female sexual system
- Circulatory System
- Locomotor system
- Respiratory system
- Nervous system
- Modalities : Aggravation and Amelioration.
A few prefatory remarks, pertaining to the practical and expeditious use of the reportorial contents, may assist in clarifying a certain inevitable obscurity of plan.
Headings and sub-headings and specific conditions of symptoms composed under the latter are arranged in alphabetical order.
Arrangement of rubrics :
The rubrics are arranged in alphabetical order, each rubric when extensive in scope is presented in the following order,
Eg: Headache :
Cause, Type, Location, Character of pain, Concomitants, Modalities- Aggravations and Ameliorations.
In each chapter the rubrics are arranged in alphabetical style. For example in Eye chapter we have the following rubrics : BROWS, CANTHI, CATARACT, CHAMBER, CHOROIDS, CILIARY MUSCLE, CILIARY NEURALGIA
Rubrics in each chapter are in BOLD CAPITAL.
Subrubrics in roman bold at first indentation and are arranged alphabetically.
Cross references are given after the remedies for the particular rubric or subrubric. In Kent’s Repertory they are given immediately after the rubric eg : Chapter Eyes
Rubric : Conjunctiva.
Subrubric : Inflammation, gonorrhoea, sympathetic form :
Remedies – See Purulent.
After Rubrics and Subrubrics, clinical condition or synonyms are given in parenthesis. Chapter : Eyes
Rubric : Conjunctiva
Subrubric : Inflammation (conjunctivitis)
- For one-sided diseases.
- To prescribe on the basis of nosological diagnosis.
- When definite cause is known.
- To prescribe on the basis of pathological generals.
- For the prescription of toxicological effects.
- For the prescription of a prophylactic remedy.
- For prescription based on suppressed effects.
- For acute cases.
Important features :
- The repertory has a total number of 1409 medicines. The index provides a list of 1414 medicines but certain medicines appear twice due to their dual names. Eg : Actea racemosa and Cimicifuga.
- Technical or clinical terms are often as rubrics and also bracketed thus assuming as subsidary place which is in strict accord with the Homoeopathic requirement to prescribe for the symptoms of each specific case and not for mere name of disease.
- The remedies are arranged in alphabetical order and the italics indicate the more frequently verified clinical remedy.
- Because of 2 types of typography used to indicate the intensity of remedies, it is more practical for reference work and repertorization.
- Index to repertory facilitates the search of a needed rubric to a great extent.
- Rubrics related to “Prophlactics” are given in Genralities under heading “Prophylactic”
- Rubric related to toxic effects of drugs are given in Genralities under the rubric Complaints – abuse of
- Many clinical rubrics are in this repertory – Bubonic plague, Addison’s disease.
- Affections of that part of location are given under that part. The chapter which represents a organ or system follows that pattern, the rubric will be that part, and subrubrics are the conditions relatecd to it for easy reference. Eg : Eyes – Choroid – Inflammation, Suppuration, Congestion.