Abstract: Repertory is a tool to reach at the Simillimum. The process of Repertorization is essentially an elimination, which starts with a broad choice and slowly narrows down giving us an adequate small group of medicines, so that the final selection is made easier with the help of further reference to the each individual rubric and its counterpart in Materia Medica. The following case demonstrates the practical utility of Repertory for the selection of the Simillimum.
Homeopathic Case Record:
Mr. KDN a 30 year old male with an anxious look on the face and a fair complexion came for his complaints of breathlessness, cough and other symptoms. He was a known case of bronchial asthma.
Preliminaries
| Date: 25-12-06 | Name: Mr K DN | Age/Sex: 30 yrs/Male |
| Religion: Hindu | Education: Studied till 12th standard | Occupation: Service |
| Marital status: Married | Spouse: 25 yrs Occupation: House wife |
Children: A 2 year old son. |
| Father: 65 years old Occupation: Retired Military Man |
Mother: 55 years | Brothers: 2 Sisters: 2 |
| Diet: Non Vegetarian | Address: Mumbai | |
Chief Complaint
| Location | Sensation | Modalities | Accompaniments |
| Respiratory System Nose Since 3and a half to 4 years Frequency: 1/week Pace: Gradually increasing Duration: Few Hours |
Sneezing2+ Coryza3+ Congestion1+ Cough short bouts3+ with occasional white expectoration Dyspnoea2+ |
< Winter3+ < Dust2+ < Night2+ < Change of temp2+ (Hot to Cold) (Cold to Hot) ( |
Past History (P/H): Nothing significant Family History (F/H): Nothing significant
Treatment History: Inhaler- Asthaline occasionally.
Physical Generals- Patient as a Person
- Appearance: Lean built
- Perspiration: Normal
- Appetite: Normal
- Hunger: Aggravation
- Thirst: Normal
- Cravings: Pungent2+, Salt2 +
- Aversion: Sweets2+
- Stool: Normal
- Urine: Normal
- Sleep: Normal
- Dreams: Gets Frightfuldreams3+ regularly and wakes up frightened
- Sexual Function: Normal
- Skin: Wounds healing Normal
- Thermal State: Chilly
* The superscripts 3+, 2+, 1+ in the case denote intensity of the symptoms.
Life Space Investigation: Patient is basically from Nainital where he spent his childhood along with his four other siblings. He is the youngest among the siblings, and has two elder brothers and two elder sisters. His father is a retired army man who is a good natured but strict and disciplined person. His childhood days were good where he studied till 12th standard and then appeared for further studies in army but was not selected in the race and had to leave his desire to become a part of Indian army. Further studies were not possible as father was not capable of providing patient private education. His eldest brother had joined army while patient came to Boisar and started working in chemical company. He is sensitive to injustice done to others and helps that person to get justice. On few occasions he was scolded by his boss because of his unnecessary involvement in his coworkers matter. Inspite of reaction of boss patient helps to those who are in need of help. Patient is having anxiety while doing his work about proper completion of it. He is having good relationship with his coworkers. Patient is an anxious person by nature and gets disturbed sleep and persistent similar sort of anxiety about his health. Patient feels that the anxiety is felt at the chest area and it may start his respiratory complaints. Patient can’t watch, read or listen about cruelties or violence done to others. Because of his sensitivity he likes only watching comedy serials and movies. Patient was married 4 years back and stays with his family at Boisar. His wife is good by nature and there are no interpersonal relationship problems.
Examination Findings:
| On examination (O/E) General Appearance: Lean Temp: 98.8 0 F Pulse: 82/minute RR: 22/minute BP: 130/80 mm Hg Weight: 52 kg |
Systemic examination (S/E) CNS: NAD CVS: S1S2 Normal R/S: Wheeze2+ Bilaterally Decreased Air Entry P/A: Soft LS: Not Palpable * RR- Respiratory Rate, BP- Blood Pressure, CNS- Central Nervous System, CVS- Cardiovascular System, R/S- Respiratory System, P/A- Per Abdomen, L- Liver S-Spleen |
Case Processing
- Disease Diagnosis and Miasmatic Understanding:
Bronchial Asthma: – Disease Considerations
Precipitants: Winter3+, Dust2+, Night2+, Change of Temp2+
Symptoms: Cough in short bouts3+ with occasional white expectoration
Dyspnoea2+
On Examination: R/R- 22/min
R/S: Wheeze2+
Bilaterally Decreased Air Entry
Miasm:
Dominant Miasm: Sycosis- Pathology [1] Bronco spasms [2] Pathological Reversible Disease
Fundamental Miasm: Tubercular-Mind- Anxiety2+ Sensitivity, Hunger agg., Dreams2+
- Hahnemannian Classification of Disease: Chronic
- Susceptibility with Reasons: Moderate – Few characteristics available.
- Sensitivity: Moderate- Few qualified mental attributes
- Potency: 200 (Considering the nature of pathology, level of susceptibility and miasmatic understanding)
- Repetition: Infrequently
- Selection of Repertory: This case has qualified mental and physical generals hence Complete Repertorial approach has been selected.
- Repertorial Totality with Classification and Evaluation of Symptoms
| Rubrics | Classification and Evaluation of Symptoms |
| Mind, Anxiety Chest in Mind, Sensitive to cruelties, violence Mind, Injustice cannot support Mind, Dreams Frightful3+ Generalities, Chilly Generalities, Hunger: Aggravation Generalities, Cravings: Pungent2+ Generalities, Cravings: Salt2+ Generalities, Aversion: Sweets2+ Stomach, Appetite: Decreased |
Characteristic Mental General, Emotional, Dispositional Symptom Characteristic Mental General, Emotional, Dispositional Symptom Characteristic Mental General, Emotional, Dispositional Symptom Characteristic Mental General, Emotional, Subconscious, Dispositional Symptom Characteristic Physical General, Dispositional Symptom Characteristic Physical General, Dispositional Symptom Characteristic Physical General, Dispositional Symptom Characteristic Physical General, Dispositional Symptom Characteristic Physical General, Dispositional Symptom Characteristic Physical General, Dispositional Symptom Characteristic Physical General, Dispositional Symptom |
- Repertorial Sheet
- Repertorial Result
| Chilly | Totality and Symptoms Covered | Hot | Totality and Symptoms Covered |
| Phosphorous | 23/07 | Sulphur | 21/07 |
| Calcarea Carbonicum | 21/07 | ||
| Causticum | 18/07 | ||
| Nitric Acid | 16/07 |
- Final Selection of Constitutional Remedy: After Repertorization of this case we came to a group of remedies and we will consider the first five closely coming remedies viz. Phosphorous, Sulphur, Calcarea, Causticum and Nitric Acid. Thermal state of patient is chilly therefore Sulphur is not considered for final differentiation.
Phosphorous was the first drug of choice as it is covering the totality of symptoms apart from the sensitivity towards cruelties watched, heard off or seen by patient. Only two remedies cover this symptom Calcarea carbonicum and Hepar sulphuris calcareum. Therefore, synthetic prescription of Calcarea phosphoricum is selected as the final choice of remedy.
- First Prescription: Calcarea phosphoricum 200 single dose at bedtime
- Advice: Breathing Exercises, Avoid Exertion and Exposure to precipitating factors
Follow up
| Date | Follow Up | Interpretation | Action |
| 02/01/07 | Coryza >3+ Cough>1+ Expectoration same Dyspnoea > Didn’t take any allopathic treatment On Examination:- Vitals stable Respiratory System: R/R- 18/min Wheeze > Air Entry- Right side decreased Left side Improved |
1. Subjective distress minimized 2. Objective findings are supporting to subjective relief 3. Disease Activity > 4. No new symptoms |
Calc-p. 200 single dose at bed time Placebo 2 pills qds x 7 days |
| 10/01/07 | No Coryza Cough>2+ Expectoration >1+ Dyspnoea same as last follow up On Examination:- Vitals stable Respiratory System: R/R- 18/min Wheeze >2+ Air Entry- Right side Improved Left side Improved |
1. Subjective distress in terms of Dyspnoea same 2. Objective findings better than last follow up 3. Disease Activity > 4. No new symptoms |
Calc-p. 200 single dose at bed time Placebo 2 pills qds x 7 days |
| 19/01/07 | No Cough No Expectoration Dyspnoea occasional on exertion On Examination:- Vitals stable Respiratory System: R/R- 18/min No Wheeze Air Entry Bilaterally Equal |
1. No Subjective distress 2. Objective findings positive 3. Disease Activity >3+ 4. No new symptoms |
Placebo 2 pills qds x 7 days |
Since 19/01/07 the patient came only once or twice in a year during change of weather or before the onset of winter for a prophylactic measure to avoid subjective and objective distress, at that time Calc-p. 200 single dose and afterwards in multiple doses were repeated. In between acute exacerbations were managed with Kali-c., Ars-alb., Bry., as per the acute state to which patient responded very well. Considering the miasmatic load in between, the patient was administered Tuberculinum 1M infrequently. Patient is currently doing well with Homeopathic treatment and doesn’t need allopathic treatment for his acute or chronic complaints.
Bibliography:
- Tiwari, 2012, Essentials of Repertorization, 5th ed. New Delhi, B. Jain Publications.
- Boericke, W 1999, Pocket Manual of Homoeopathic Materia Medica, 9th ed. Calcutta, Modern Homoeopathic Publications.
About the Authors: Dr. Tejas Trivedi MD (HOM) ICR, Mumbai is an Assistant Professor, Department of Organon at Virar Homoeopathic Medical College and Hospital, Virar and he has been practicing Classical Homeopathy since last seven years at Mind and Body Wellness Centre, Mumbai.
Dr. Yogesh D. Niturkar, MD (Hom) ICR has been practicing Classical Homeopathy for last seven years at Mathura Homoeopathic Clinic, Latur and he is author of many homeopathic articles.
Source: The Homoeopathic Heritage, December, 2013
