Review Article on Utility of Clinical Repertory in Acute Diseases

Abstract–

During practice and while proving Dr. Hahnemann found difficulty in recording symptoms in a systemic manner hence he tried to form -Index of symptoms and remedies.⁽¹⁾ Hence Dr. Hahnemann was the first person to form a repertory. In the meantime during day to day practice cases came with few totality, partial one sided disease or with some clinical condition, Dr. J. H. Clark described it as certain diseases come to have certain remedies assigned to them and patients who are found to be suffering from any given disease must be dosed with one of remedies credited to it. ⁽¹⁾ So for the same purpose clinical and regional repertories were formed. These repertories are based on clinical conditions and verified remedies for those symptoms with various grades. Knowledge and detailed ideas of these repertories will be helpful in clinical practice. Dr. J. H. Clark and Dr. Boericke had done enormous work on it. ⁽²⁾ 

Key word:  Acute Prescribing, Acute Cases, Acute Totality, Clinical Repertory,

Introduction:-

In our clinical practice we need to come across both chronic as well as acute diseases & some might be of very acute nature, which need immediate attention. We know well that the credibility of a homeopathic doctor depends upon his ability to manage acute diseases well. Because here our prescription must be the accurate one, otherwise it can lead to a failure or may spoil the case to such a worse state & indeed the patient may leave us in time.

Dr. Hahnemann classified diseases on the basis of their nature into acute & chronic diseases. ⁽³⁾

Acute diseases are rapid morbid processes of the abnormally deranged vital force, which have a tendency to finish their course, more or less quickly, but always in a moderate time.

They lead either to recovery or death. They are produced by an exciting cause or acute miasm

They are further classified into:

1) Individual diseases   

2) Sporadic diseases

3) Epidemic diseases

Individual and sporadic diseases are.Caused by unfavorable conditions & meteoric or telluric influences respectively. ⁽³⁾

Epidemic diseases attack many persons with very similar sufferings from the same cause & generally become infectious, when they prevail among thickly congregated masses of human beings.

According to § 99, in acute diseases all the phenomena and the deviation from the state of health that has been recently lost are still in the memory of the patient and relatives. The physician certainly requires knowing everything, but has much less to inquire into. Presenting complaints are very prominent and impress our sense quickly. So it requires only few questioning because almost everything is self-evident. As they require immediate medical intervention, so one should not waste time in collecting details of constitutional state & should confine to the presentation of disease.⁽³⁾

All our stalwarts of field suggests, to limit our inquiry only to the recent deviations from health & not to mix up acute & chronic symptoms together. In all, exciting causes, modalities and other characteristic in relation to physical generals help in forming totality in acute diseases. Also we can consider objective symptoms, pathological type, location etc. as an eliminating symptom.

Dr. Boericke writes, often in the course of acute diseases, and in children, where no characteristic symptoms can be obtained, a pathological correspondence may be the only resource, but it is otherwise in the treatment of most chronic disease.⁽⁴⁾

It’s the habit of many of us to prescribe one or two prominent or keynote symptoms in acute diseases. But it’s more effective if we could consider a good acute totality & repertorisation done on it to prescribe effectively. “Pocket Manual of Homoeopathic Repertory” by Dr. Oscar E.Boericke is classed under the group of General Clinical Repertory covering whole symptomatology. ⁽¹⁾This repertory is based on clinical findings and clinical verification’s, and major source of which is Dr. William Boericke’s -Pocket Manual of Homoeopathic Materia Medica. The Materia Medica by William Boericke was published in 1901. The repertory was added to the 3rd edition in 1906. ⁽²⁾ As it is a Clinical Repertory it does not have any philosophical background. It was first published in companion with the 3rd edition of Dr. William Boericke’s Pocket Manual of Homeopathic Materia Medica.

In 1927 Dr. William Boericke formed -A Pocket Manual of Homoeopathic Materia Medica and Repertory. The repertory part of this book is formed by Dr. Oscar. E. Boericke. ⁽⁴⁾This Repertory contains many number of clinical rubrics in each section, simultaneously book contains Materia Medica part with Remedy Relationship for Totality

O. E. Boericke says the study of the repertory alone will give the indicated remedy. But throughout this work are found numerous suggestions for remedies based on clinical observations and deductions from partial proving, all of which may prove most valuable^.(4)

Arrangement of rubrics in boericke repertory is alphabetical which can greatly help physicians in finding indicated remedies very easily. ⁽⁴⁾

The repertory has two types of typography, so it is more practical for reference work and repertorisation.⁽⁴⁾ 

The repertory has a total number of 1409 remedies. Index provides a list of 1414 remedies but 5 remedies appear twice because of their dual names. For example – cimicifuga and actea racimosa 

Dr. J.H .Clarke published a general clinical repertory based on ‘Dictionary of materia medica’ in 1904. ⁽⁵⁾

This repertory is very useful in acute disease as it contains repertory of causation, repertory of temperaments, dispositions, constitution and states, repertory of clinical relationship, repertory of natural relationship.⁽⁵⁾ The special feature of this repertory is that it contains two type of typography so physician can find indicated remedy very easily. This repertory contains 1063 remedies but 52 abbreviations have appeared twice hence the actual number of remedies used in this repertory is 1011⁽⁵⁾.   

Dr. S.R. Phatak published a clinical repertory named ‘A concise repertory of homoeopathic medicines’. The first edition was published in 1963.⁽⁶⁾ The second edition was published in 1977. The third edition was published as ‘revised and enlarged edition’ in 2000.⁽⁶⁾ This is a concise repertory, which aims to reduce burden of prescriber by bringing the required information at one place in a different form. ⁽⁶⁾There is an alphabetical arrangement of rubrics present in this repertory. This is a very useful repertory for acute cases as it contains nosological rubrics. It contains 1971 main rubrics and 393 remedies. ⁽⁶⁾

Dr. J Crompton Burnett who has brought one more light to the vast therapeutic treasures which had been allowed to lie forgotten in the works of the great masters⁽⁶⁾. The use of nosological correspondences is one method by which a similar, if not the most similar remedy may be discovered. ⁽⁶⁾ 

Dr. J. Crompton burnett view on clinical repertories: – The fact is , we need any and every way of finding the right remedy , the simple simile, the simple symptomatic similimum and the furthest reach of all –the pathological similimum and I maintain that we are still within the lines of homoeopathy that is, an expensive, progressive science.⁽⁶⁾ 

Regional clinical repertories are very useful for management of particular disease very effectively, especially acute disease in short period of time. ⁽⁶⁾ 

1. The homeopathic therapeutic of diarrhea by: – James B. Bell: – very useful for management of diarrhea.
2. Complete repertory to the homoeopathic materia medica on disease of eyes :- Berridge

This repertory is very useful for management of acute disease of eyes ⁽⁶⁾.

3. Uterine therapeutics :- Henry minton

This repertory is very useful for acute disease of the uterus, active bleeding from the uterus. 

4. The therapeutics of fevers :- H.C.Allen 

This repertory is very useful for management of all kind of fever.⁽⁶⁾ 

5. Repertory of  the symptoms of intermittent fever :- William A. allen 

This repertory can play a wonderful role for the management of Malaria. 

6. Skin diseases :- M.F.douglas 

This repertory is very useful for management of acute skin such as acute eczema, urticaria, scabies and herpes. 

7. The rheumatic remedies :- Herbert A. Roberts 

This repertory is very useful for management of acute rheumatism, acute sprain.⁽⁶⁾ 

8. Homoeopathic therapeutics of the respiratory system :-  M.W. can denburg

This repertory is very useful for management of acute disease of respiratory tract such as acute sinusitis, acute bronchitis, pneumonia.⁽⁶⁾ 

Advantages of Using Clinical Repertories

1. Quick reference for pathological cases :-

Clinical repertories are   structured to provide direct access to remedies associated with specific medical   conditions   (e.g.,bronchitis, eczema, arthritis).⁽¹⁾

This stream lines the selection process, particularly in high-volume clinical settings.

2. Enhances accuracy in acute prescribing

In emergencies or acute presentations, a clinical repertory helps thepractitioner focus on immediate symptoms and find remedies that have shown clinical efficacy for similar presentations. ⁽²⁾

3. Bridges allopathic diagnosis with homoeopathic practice

Clinical repertories act as a bridge between conventiona ldiagnostic language and homoeopathic remedy selection, making homoeopathy more accessible to practitioners strained in both systems.⁽²⁾

4. Ideal for beginners and integrated practice

For students and new practitioners, clinical repertories provide a foundation for learning remedy relationships within diagnostic frameworks. This is really helpful in integrated clinics, where patients often present with diagnosed conditions seeking complementary care. ⁽²⁾

    5) Methodology of using clinical repertories

Diagnosis First: Begin with a clear, allopathic or clinical diagnosis. This forms the basis of rubrics selection.

Rubric Identification:   Search the repertory for the condition (e.g.,Psoriasis,Migraine,Cystitis) and select the rubric that most closely matches the patient’s condition.⁽¹⁾

Differentiation through material medica: After obtaining a list of indicated remedies, refer to materia medica to individualize and differentiate based on constitutional and modalities. ⁽¹⁾

Cross-Referencing: When possible, verify remedies using a general repertory or through software tools to ensure remedy correspondence. ⁽²⁾

Conclusion:-Clinical repertories are very useful for management of acute disease. Clinical repertories are time saving in emergency, acute conditions where there is no delay is permit-able.

Source:- 

1) Khanaj V.R. Reperire, Repertory Simplified, Restructured, Revised & Added Fifth Edition, Indian Books & Periodicals Publishers, New Delhi, Fifth Edition, 2010.

2) Tiwari S. K.:- Essential of Repertorization, 

B. Jain Publishers Pvt.Limited, New Delhi, Fourth Edition, Reprint 2008.

3) Hahnemann CFS: Organon Of Medicine (5th edition). B Jain Pvt. Ltd New Delhi

4) Boericke William Pocket Manual of Homoeopathic Materia Medica &

Repertory, 9th Edition, Year 1927, IBPP, New Delhi.

5) Clarke John Henry :- A clinical repertory to the dictionary of material medica : together with repertories of causation , temperaments, clinical relationships, natural relationships; Homoeopathic publishing company 1904. 

6) A brief study of regional repertory: – https: //www. Slidshare.net 

ABOUT AUTHOR:-

DR. KRISHNABEN GOPAL KHATRI 

PG SCHLOAR MATERIA MEDICA PART:-2 

EMAIL ID: – [email protected]

BARODA HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL VADODARA, GUJARAT