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Use of repertory in clinical practice

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Title: Use of repertory in clinical practice


1
Use 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.

3
Repertory 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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A 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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Case 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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Cina
  • 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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Conium
  • 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

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  • 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.

16
More 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.
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  • I prescribed Muriatic acid which gave complete
    relief

18
Other 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.

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A case of renal colic
  • Chapter Kidneys
  • Rubric Pain, tearing.
  • Agonizing as from passing of calculus , in back
    and hips Arn.

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A case of Malaria
  • Chapter Fever
  • Rubric Changing , paroxysms
  • After homeopathic potencies Sep.

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A case of convulsion
  • Generalities CONVULSIONS (Convulsive movements)
    (Extremities Convulsion(motion convulsive)
    changing in character bell., ign., puls., Stram.

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A 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.

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A 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.

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A 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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Some more examples
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A 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.

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  • 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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Case 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

36
Kents 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.

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A 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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Use 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.

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  • 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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A 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.

43
Other 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.

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Selection of rubrics
  • I selected the following rubrics
  • Joints knee
  • Back dorsal region
  • Back lumbar region
  • Lumbar region rheumatic pains
  • Arthritic pains
  • Disease Ankylosing spondylitis

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  • 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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Remedy 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.

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Discussion
  • 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.

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Repertory 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.

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My 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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Severe 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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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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A case of AIDS
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  • 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.

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  • 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.

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Repertorisation
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Follow 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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An 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

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  • Infections AIDS Chest PHTHISIS pulmonalis
    sycotic
  • Cough Catarrhal

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  • 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

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  • 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.

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  • 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

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  • 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

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  • 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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13/8/08 CD 4 213 wt 57 phos LM1 20/8/08 reported
better RPt LM1 for 15 days
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10/9/08 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
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A 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.

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  • 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

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Repertorzation BBCR
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  • 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.

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Ch 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.

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Rubrics 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.

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Some 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.

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A 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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Phosphorus
  • 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.

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A 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

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Rubrics 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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Thuja
  • 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.

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  • Some surgical conditions for which we find
    excellent help from the repertory

89
Some surgical conditions
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Conclusion
  • 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.

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