Title: Use of repertory in clinical practice
1Use of repertory in clinical practice
- Dr D P Rastogi ,DMS (Hons) MBS Cal , M D Hom,
DF Hom London P Gr Glasgow
2- Repertory is a tool provided by Hahnemann him
self and requires a skill to use. - We need to develop this skill for better
selection of the remedy. - Repertory suggests and Materia Medica decides.
3Repertory as a bridge
- In fact repertory is Materia Medica on our tips
and is a bridge between the case and Materia
Medica. - Kents and Boger Boenninghausen repertories are
good enough to begin with. However computer soft
wares give us the option of using various
repertories for a single case.
4- Repertory use and familiarity with repertory
rubrics has helped me tremendously in practice. - A patient presented the picture of depression. On
asking the cause she narrated that she had given
some money to one of her close relative . But the
person refused it to return.
5- On the other hand he denied point blank that she
ever gave that money. - It is more the deception which is worrying her
she said. - I looked up the rubric Grief deception from and
was able to visualize the leading remedies out of
which I selected Ignatia which completely
relieved.
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7A case of Blepharospasm
- A patient presented blepharospasm of both eyes
which could not be helped with the best of
allopathic treatment. The patient also had
photophobia.The case was repertorized in Knerrs
repertory where Euphrasia was suggested as the
only remedy under Lids- spasms with photophobia.
The case was cured with Euphrasia.
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9Case of genital warts
- A lady accompanied one of my patient and
presented problem of genital warts. - There was no other symptom except itching.
- Her family physician has ruled out Hiv infection
by elisa test. - I could not discover any particular desire or
aversion for food nor could I find anything
characteristic in the mind to provide any
guidance for prescription.
10- I looked up Knerrs repertory and found the
solitary remedy Sabina mentioned under Genital
warts- itching. I prescribed Sabina 0/1 to be
taken 4 times a day for 15 days. - After 15 days the report came that most of the
warts have fallen.
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12Cina
- Treating cough in children is often
problematic as it is both annoying to the patient
as well as to the parents. - I have often found concomitants given in the
chapter of Boger-Boenninghausen repertory very
helpful in picking up the remedy. - For Cina the repeatedly verified concomitant has
been cough with disagreeable behavior.
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14Conium
- A very senior executive was recommended to see me
for his foot drop following some injury to the
back - A quick repertorization on the following rubrics
was done - Lower Extremities foot
- Lower Extremities drags the feet
- Back Lumbar region
15- Feet ,cant place them on ground
- On the basis of the above rubrics using BBCR
Conium appeared to be the remedy, covering all
rubrics which was given in 0/1 every 2 hours. On
the third day improvement was reported and more
medicine was asked for. At the end of 7 days it
was noticed that there was no more dragging of
the foot.
16More Examples
- I had a patient whose main complaint was vertigo,
it was worse lying on right side - I looked up the vertigo chapter and found the
following entry
Vertigo LYING side, on agg. stram. Vertigo
LYING side, on amel. merc. Vertigo LYING
side, on right agg. mur-ac. Vertigo LYING
side, on left, agg. alumn., iod., phos.
17- I prescribed Muriatic acid which gave complete
relief
18Other examples from Kents repertory a case of
osteosarcoma
- Chapter Extremities
- Rubric Tumors, shoulder,fattyAm-m
- Knee Ant-c
- hollow of Calc-f., phos., sil.
- Leg Tarent.
- Varicose Arn.
- Tibia, osteosarcoma Syph.
19A case of renal colic
- Chapter Kidneys
- Rubric Pain, tearing.
- Agonizing as from passing of calculus , in back
and hips Arn.
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21A case of Malaria
- Chapter Fever
- Rubric Changing , paroxysms
- After homeopathic potencies Sep.
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23A case of convulsion
- Generalities CONVULSIONS (Convulsive movements)
(Extremities Convulsion(motion convulsive)
changing in character bell., ign., puls., Stram.
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25A case of multiple ulcers
- Mind REMORSE (Thoughts tormenting) afternoon
am-c., carb-v. - Mind REMORSE (Thoughts tormenting) evening
puls. - Mind REMORSE (Thoughts tormenting) night
puls. - Mind REMORSE (Thoughts tormenting) repents
quickly croc., olnd. - Mind REMORSE (Thoughts tormenting) trifles,
about sil. - Mind REMORSE (Thoughts tormenting) waking, on
puls.
26A case of urticaria
- Mind DESPAIR religious (of salvation,
etc.)(Anxiety salvation, about)(Doubtful soul's
welfare)(Religious affections) arg-n., Ars.,
Aur., calc., camph., chel., hell., hura, ign.,
kali-p., Lach., Lil-t., lyc., med., mez., nat-m.,
plat., plb., podo., psor., puls., stram., sulph.,
thuj., Verat. - Mind DESPAIR social position of Verat.
- Mind DESPAIR trifles, over graph.
27A case of schizophrenia
- Mind SITS quite stiff cham., hyos., puls.,
sep., stram. - Mind SITS and breaks pins Bell.
- Mind SITS in one place for 3 or 4 days during
headache con. - Mind SITS meditates (Absorbed)(Meditation)
calc-s.
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29Some more examples
30A case of varicose ulcer
- Mr RN aged 46 yrs consulted me with a non healing
varicose ulcer in his right leg on 5.2 08.. He
had undergone surgery for this in 1995 and was ok
for 10 years. But it has developed again and not
responding to any treatment. The patient is a
mild diabetic. Desires tasty food and sweets.
31- I took the following rubrics and repertorized
from BBCR - Lower extremity leg
- Blood vessels, varicose and inflamed
- Blood vessels varicose, veins especially
- Desire for piquant, appetizing things
- Desire for sweets
- Urine saccharine
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35Case of headache
- When I was working in CGHS dispensary in Delhi I
got a patient who had chronic problem of
headache. I got the following particulars - Patient complained of pain in head.
- Worse at 4 am
- The case was solved by using Kents repertory
36Kents repertory
- Head Pain GENERAL midnight before (9) lach.,
am-m., anac., caust., chin., dulc. - Head Pain GENERAL midnight about (12)
kali-c., agar., all-s., arn., ars., elaps - Head Pain GENERAL midnight after (18) ars.,
sil., thuj., agar., bufo, carb-an. - Head Pain GENERAL midnight 1 a.m (1) pall.
- Head Pain GENERAL midnight 1 a.m.-10 a.m (2)
chin., elaps - Head Pain GENERAL midnight 2 a.m (2) cimic.,
sulph. - Head Pain GENERAL midnight 3 a.m (5) agar.,
bov., chin-s., nat-m., thuj. - Head Pain GENERAL midnight 4 a.m (3) chel.,
raph., stram. - Head Pain GENERAL midnight 5 a.m (2)
Kali-i., dios.
37A case of stammering
- This was a case of a school boy who came under my
treatment for stammering. - On detail case taking it became clear that he has
problems with uttering only certain words. - Kents repertory came to rescue and suggested
lachesis as the remedy. - This worked.
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39Use of Boericke repertory
- This was a terminal case of Cancer and was sent
home from the hospital - The relative of the patient who was known to me
from the Ministry of health came to borrow an
oxygen cylinder from the hospital. - She had great dyspnoe which was worse lying on rt
side.
40- I looked up Boerickes repertory and found only
one remedy mentioned under dyspnoe lying on right
side. - It was given in 30 potency 4 times a day.
- It gave great relief and she did not need the
oxygen cylinder ,which was returned after a week.
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42A case of Ankylosing arthritis
- Mr. PSK aged 24 yrs, a soft ware engineer
consulted me for treatment. - He was undergoing treatment at the best treatment
center in New Delhi without relief. - His knee joints and back , both dorsal and lumbar
regions were affected. - He was diagnosed to be suffering from Ankylosing
spondylitis.
43Other symptoms of the case
- He had a desire for salty things.
- Desired cold ,icy liquids.
- Had desire for juicy things.
- He had great aggravation at the change of
weather. - He revealed a tendency of procrastination.
44Selection of rubrics
- I selected the following rubrics
- Joints knee
- Back dorsal region
- Back lumbar region
- Lumbar region rheumatic pains
- Arthritic pains
- Disease Ankylosing spondylitis
45- Desire for salty things
- Desire for cold icy liquids
- Desire for juicy things
- Agg weather change of
- Mind Procrastinates
- I had to use Murphy repertory besides BBCR as
some rubrics were not found in BBCR.
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47Remedy selection
- Phos acid covered most of the rubrics including
modalities and the mental symptom
procrastination. - Therefore it was selected and administered in LM
1 - It was continued and brought quick overall relief
to the patient. - There was a need to go to LM 2 and 3 as the
treatment continued.
48Discussion
- The patient did not want to stop the allopathic
medication and therefore simultaneous use of
homeopathic medication continued. - The patient continues well and had no pains and
has no difficulty in ascending stairs. - His ESR westergren has come down to 10mm/1st
hour from 80mm/1st hour during 5 months of
treatment.
49Repertory use
- Is not limited to only chronic cases.
- We can use it for acute cases also and in cases
where there are only few symptoms to guide.
50My personal case
- Some weeks ago I developed acute pain in my right
inguinal region which was worse on walking. - I felt extreme difficulty in walking a small
distance like walking to the wash room. - However I felt that it was better after I walked
a little distance. - I would show how I worked out the remedy.
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52Severe pain in joint of second toe
- This was the case of my late wife.
- She woke me up from sleep complaining a very
severe tearing pain in the second toe. - I had no clue to the case.
- I decided to look up in Kent's repertory
- I reached extremities looking for tearing pain
and found the remedy.
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54 A case of sterility
- A young lady 27yrs presented with the problem of
not being able to conceive. - Detailed investigations of both partners did not
show any abnormality. - The lady mentioned that her menses have been
scanty even since puberty. - A concomitant was observed that she becomes very
sleepy at menses time.
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56A case of AIDS
57- This is a case of a young lady whose husband died
from AIDS. - This lady got the infection from him and was
suffering a lot. - She was on ART yet she was in a very bad shape.
CD 4 was 73 - She developed esophageal candidiasis endoscopy
confirmed and was unable to drink or eat.
58- She was helped to a very great extent.
- Within a week of homeopathic remedy her
candidiasis cleared and she was able to eat. - On follow up she showed improvement in her CD4
count which has become 188 - Her condition improved so much that she married
leaving behind her frustration and helplessness . - This is an advantage with homeopathic treatment
which provides real healing.
59Repertorisation
60Follow up
- As she continued to improve she gave additional
symptom that while sleeping some body tries to
choke her throat - Although she is aware of this but she cant move.
- This symptom was added to her case chart and
again repertorized.
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62An other case of AIDS
- A young gentleman working in Dubai got HIV
infection - He presented for treatment
- His CD 4 was 213
- All the rubrics taken are
63- Infections AIDS Chest PHTHISIS pulmonalis
sycotic - Cough Catarrhal
64- Cough CONCOMITANTS Hernia, pain in
- Expectoration Lemon-yellow
- Infections AIDS Generalities EMACIATION
Infections AIDS Rectum, DIARRHOEA - Mind Anger effects of
- Mind Fear disease, of
- Stomach Desire for warm food
65- Stomach Desire for condiments, piquant,
appetizing, things - Stomach Desire for salty things
- Stomach Desire for cold liquids
- Stomach Desire for cold icy liquids
- Mouth PROPER Odor from, bad breath, etc.
66- Generalities AGG Heated or overheated becoming
- Stomach Thirst Thirsty excessive
- Stomach Thirst Thirsty large, amount, for
- Mind Contradiction intolerant of
- Mind Consolation ameliorates
- Sleep Sleeplessness symptoms which cause
67- Sleep DREAMS dead, of the relatives ferr.,
fl-ac., mag-c., mag-s., rheum, sars. - Stomach Desire for sweats
- Stomach Aversion to fruit
- Stomach Aversion to vegetables
- Mouth TASTE Sweet
68- Perspiration PARTIAL SWEAT upper part of body
- Perspiration PARTIAL SWEAT Extremities Arm
- Perspiration PARTIAL SWEAT Extremities
Forearms - F Food CHICKEN, agg. desires ferr-i., graph.,
phos.
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7013/8/08 CD 4 213 wt 57 phos LM1 20/8/08 reported
better RPt LM1 for 15 days
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7210/9/08 rpt for 15 days 12/11/08 phos acid
0/1 19/11/08 Rpt 4 times daily 26/11/08 headache
is much less. Rpt 4 times daily. 03/12/
08 headache much better phos acid wt
65 10/12/08 CD 4 349 No headache
73A case of migraine
- Mrs AS complained of chronic migraine which made
her life hell. She was constantly taking pain
killers to get some relief. She gave long history
of suffering from this pain which always used to
be only on one side of the head and used to be
almost a daily occurrence. She was introspective
by nature and had a weeping tendency and the
weeping always came with anger. Her pain was made
worse by noise.
74- I made use of the following rubrics from her
history - Location of pain--Half of, one side
- lt by noise
- Mind introspective
- Weeping with anger
- migraine
75Repertorzation BBCR
76- The case was prescribed Chamomilla 0/1 to be
taken 4 times daily as it covered all rubrics. - This brought almost complete relief in the
occurrence of the pain and also brought overall
general improvement as soon as the medicine was
taken.
77Ch otorrhoea
- Miss S B 10yrs presented on 20/2/2001 with
complaint of ear discharge since 4 years. She
complained of itching in the meatus. The
discharge was offensive. Her mother described it
as putrid. There was no other symptom to guide
the selection of the remedy. No marked desires or
aversions for food. Nothing remarkable in the
temperament.
78Rubrics taken
79- Petroleum and Psorinum were the two remedies
which were suggested,As offensive and putrid
discharge was covered by Psorinum , it was
preferred and given in LM 1 4 times daily. - Follow-up visits were on 8/3, 23/3,27/4, 3/5 and
finally on 1/9/2001. The case showed improvement
right from the first follow-up and did not need
any other remedy and was cured.
80Some cases worked out with Knerr
- Knerr repertory is a very useful repertory as it
is based upon Hering Guiding Symptoms. - The symptoms are given in the language of the
patient. - If we find the exact rubric the chances of
sucesses are excellent.
81A case of Psoriasis
- Following rubrics were taken
- Skin Eruptionsscaly,psoriatic
- Stomachdesire for fruit
- Desire for condiments
- Desire forcoldliquids
- Desire for ice cream
- Desire forchocalate
- Desire for salty things
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83Phosphorus
- Phosphorus 0/1 was prescribed and improvement
started - Gradually it was raised in series up to 0/4 with
placebo given in alternate weeks and the case
progressed towards cure.
84A case of Disks syndrome and Vitiligo
- A lady 50 yrs of age presented with symptoms of
Disk syndrome and vitiligo. Following rubrics
were taken for reprtorisation - BackDisks ,syndrome
- Skin vitiligo
- Back Lumber regionPainful
85Rubrics contd
- Back Agg Motion
- Back Amel Rest, during
- Desire for salty things
- Desire for sour things
- Constipation chronic ,habitual
- Constipation feces , hard , from
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87Thuja
- Thuja came out very prominently.
- It was given in 0/1 4 times daily for a month.
- Improvement was reported in both back pain and
vitiligo spots around the mouth - The same medicine is being continued with
progressive improvement.
88- Some surgical conditions for which we find
excellent help from the repertory
89Some surgical conditions
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100Conclusion
- We can use Kents Repertory or any other
repertory of our choice in our daily practice
with great advantage irrespective of whether we
take the mental and physical generals or use the
short cut of selecting one prominent rubric. - It will always improve our results and knowledge
of Materia medica besides establishing evidence
based homeopathy.
101thanks