Use of repertory in clinical practice

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Use of repertory in clinical practice

• Dr D P Rastogi ,DMS (Hons) MBS Cal , M D Hom,
  DF Hom London P Gr Glasgow

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• 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.

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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.

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• 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.

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• 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.

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• 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.

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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

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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

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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.

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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
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• 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

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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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thanks