The Significance of Clinical Repertories in Modern Homeopathy

Abstract

Homeopathic practitioners created clinical repertories out of practical necessity. These repertories represent a vast amount of work and are a valuable resource for homeopathic knowledge. While numerous repertories have stood the test of time, only a select few gain widespread popularity and remain readily accessible to physicians. Among these valuable resources, clinical repertories truly stand out. This article aims to encourage the study and utilization of these clinical repertories. Regional or clinical repertories organize symptoms or conditions with their corresponding remedies. They are invaluable for choosing remedies based on clinical symptoms, pathological similarities, causative factors, modalities, and concomitant symptoms. These repertories serve as a quick reference for selecting medicines and are often organized by specific organs or body systems, making it easier to locate remedies for conditions related to areas like Bell’s Diarrhea, Berridge’s Eye, or Minton’s Uterus. Moreover, clinical repertories prove especially useful in cases where the patient’s characteristic symptoms are obscured by their clinical condition. When a doctor primarily notes common, prominent symptoms along with some modalities and concomitants, clinical repertories are crucial for finding the most similar remedy.

Keywords: 

Clinical / Regional repertory, construction, scope and limitation, repertorization, similimum, 

Introduction

In medicine, physicians must understand people not just as individuals but also as part of a larger group, both when they’re healthy and when they’re ill. They need to combine tangible observations with abstract scientific principles. This means their approach to study should be based on phenomenology, learning through what they perceive with their senses.

Our observations, naturally, are always clinical. And when it comes to homeopathy, a unique way of using medicine, diagnosing isn’t simply slapping a label on a disease. Instead, for a homeopath, diagnosis is about understanding how a patient reacts to a specific drug, all with the goal of helping them find their way back to a healthy, vital balance.

These repertories are essentially guides that list clinical symptoms or conditions along with their corresponding groups of medicines. They make it easier to pick a remedy by focusing on things like pathological similarities, the cause of the illness, specific modalities which means what makes symptoms better or worse and concomitants means accompanying symptoms^.[3]

While they’re not typically used for full-scale repertorization, these repertories become incredibly useful when a patient’s clinical condition hides their unique characteristics. In these situations, when a doctor mostly seesprominent, common symptoms with just a few modalities and concomitants, these clinical repertories are vital for choosing the most similar remedy^.[2]

Even though homeopathy stresses treating each person uniquely based on their distinct symptoms, clinical repertories which guides that group medicines by specific diseases or conditions, still appeared in practice very early on, even during Hahnemann’s time.

Despite many homeopathic leaders discouraging the idea of grouping remedies by disease names, this approach led to the creation of these clinical repertories. A key modern supporter of this method was the late Dr. J. Crompton Burnett. He was crucial in bringing to light the significant healing power contained within the older, largely forgotten works of homeopathic masters. Using nosological correspondence that means matching remedies to disease classifications – is one way to find a similar, if not the most similar, remedy for a patient^.[6]

When a case clearly presents with strong, characteristic symptoms pointing to a specific remedy, the official diagnosis of the disease becomes less important here are instances where a clinical repertory would not be the appropriate tool. Instead, the ultimate guide should be the Materia Medica, which details the full picture of each remedy.

Generally, we deal with two kinds of symptoms. First, there are subjective symptoms—what the patient feels and describes. Since everyone’s ability to express these feelings varies, especially with hysterical patients or young children, the physician needs to interpret them carefully. Then there are objective symptoms, which the physician can observe directly with or without tools. These symptoms might not always pinpoint a specific disease or pathology, but they’re crucial for choosing the right prescription. Symptoms that are pathognomonic help us narrow down to a class of remedies, ruling out others that might seem similar on the surface.

Large general repertories like Kent’s or Synthesis are often too bulky for doctors to carry around, and they don’t include Materia Medica. This is why books combining both Materia Medica and a repertory, such as BBCR, Boger’s Synoptic Key, or W. Boericke’s Materia Medica with O.E. Boericke’s Repertory, are so useful. In fact, O. E. Boericke’s repertory is considered a key general clinical repertory.

A clinical repertory essentially acts as an index of remedies for various consistent symptom patterns that can be given a disease name. These can be categorized in a few ways:

• General clinical repertories, like Boericke’s and Clark’s repertories, cover a broad range of conditions.
• Disease-oriented clinical repertories focus on specific illnesses, such as “The Therapeutics of Intermittent Fever,” “Repertory of Leucorrhoea,” or “Bell’s Diarrhoea.”
• Organ-based clinical repertories specialize in conditions related to particular organs, for example, “Minton’s Uterine Therapeutics” or “Berridge Repertory of Diseases of Eye.”

Many smaller clinical repertories were published in old homeopathic journals. Unfortunately, their limited availability today has contributed to their disuse and, in turn, hindered the progress of homeopathy.

The Concept of Clinical Repertories

Clinical repertories are specialized guides that list specific symptoms or conditions alongside the remedies that address them. While they’re not typically used for a full-scale repertorization process, they become incredibly helpful when a patient’s obvious clinical issues overshadow their unique, individual symptoms. In these situations, a doctor can use them to find a remedy based on the prominent common symptoms or conditions, combined with any modalities and concomitants. It’s interesting to note that even though homeopathy strongly emphasizes prescribing based on a person’s individual characteristics, clinical repertories still emerged in practice right from Hahnemann’s era^{. [6]}

Even though many prominent figures in homeopathy disapproved of grouping medicines by disease names, this approach still led to the creation of several clinical repertories. Even Master Hahnemann himself disliked this practice, calling it “treating the names of the diseases with names of therapeutic actions^{. [2]}However, Dr. J Compton Burnett was a keen supporter of this approach.. He believed that homeopaths “need any and every way of finding the right remedy,” whether it’s a simple match, a symptomatic match, or even a pathological match, asserting that this still aligns with the understanding of homeopathy as “an expansive, evolving science.” Dr. Burnett’s writings, like his works on “Diseases of the Liver” and “Organ Diseases of Women,” show his preference for specific medicines for certain clinical conditions. For instance, he frequently used Chelidonium majus for jaundice, liver enlargement, and liver tumors, and remedies like Hypericum, Arnica, Bellis perennis, Kali chloricum, cuprum aceticum, and Cedron for traumatic uterine conditions.

Although Dr. Burnett advocated for this practice, he did not create a dedicated repertory for it. The distinction of creating the first truly useful clinical repertory goes to Dr. J. H. Clarke. In the introduction to his clinical repertory, Clarke wrote that “Specific remedies become associated with particular diseases, and all patients diagnosed with a given disease should be prescribed one of the remedies attributed to it. ^[4]

Clarke’s Clinical Repertory was built upon his extensive Dictionary of Materia Medica. Although it was popular in its time, O. E. Boericke’s repertory eventually surpassed it in popularity. This was likely due to Boericke’s more practical and useful arrangement of rubrics by different anatomical sections. Currently, many other valuable regional clinical repertories are available to help practitioners identify similar remedies^{. [5]}

Even though homeopathy emphasizes individualized treatment based on unique symptoms, clinical repertories emerged early on, even during Hahnemann’s time. These repertories, which group medicines by disease names—a practice many homeopathic leaders discouraged—still became a part of the system.

The late Dr. J. Crompton Burnett was a significant contemporary advocate for this particular approach in homeopathy. He believed in using “any and every way of finding the right remedy,” from simple symptom matching to a deeper pathological similimum, arguing that this still aligns with homeopathy’s nature as an “expansive, progressive science.” Burnett’s work brought forgotten therapeutic insights from earlier masters back into use.

Hahnemann himself strongly disapproved of treating diseases by name, calling it “treating the names of the diseases with names of therapeutic actions.” Yet, as J.H. Clarke put it, this clinical avenue allows that “Certain diseases come to have certain remedies assigned to them.”

Early examples of useful regional clinical repertories include Bell’s Diarrhoea (1869) and Berridge’s Eye (1873). While Burnett championed the concept, J.H. Clarke is credited with compiling the first useful general clinical repertory.

One example of such a resource is THE PRESCRIBER, which offers direct treatment guidance rather than focusing on broad generalities or tiny details, making it practical for any case. ^[1]

Today, two prominent “general clinical repertories” are J.H. Clarke’s A Clinical Repertory and Boericke’s Materia Medica Repertory.

Despite Master Hahnemann’s criticism of treating “disease entities” as a personalized event (Organon of Medicine, 5th ed., §235), the importance of clinical repertories in homeopathy can’t be overlooked. While compiling a science from isolated observations is challenging, these repertories serve as a preliminary method for narrowing down potential remedies for a diseased condition with a known name.

Clinical Repertories Based On Parts:-

Repertory of psychic remedies with Materia medica by Jean-Pierre Gallavardin

Complete repertory to the homeopathic Materia medica on the disease of the eyes by Berridge. 

Uterine therapeutics by Henry Minton 

Skin diseases by M. F. Douglas 

Homeopathy: Therapeutics of the respiratory system by M. W. Van Denburg: 

Ophthalmic diseases and therapeutics by Edwin. S. Munson

Repertory of the urinary organs and prostate gland including condylomata by A. R. Morgan: 

Clinical Repertories Based On Conditions:- 

• The rheumatic remedies by Herbert A. Roberts 

• The homeopathic therapeutics of diarrhea, dysentery, cholera morbus, cholera infantum, and all other loose evacuations of the bowels by James. B. Bell 
• The homeopathic therapeutics of hemorrhoids by William Jefferson guernsey 
• The therapeutics of fevers by H. C. Allen
•  Lee & Clark’s cough & expectoration a reportorial index of their symptoms
• Borland’s pneumonia by Douglas M. Borland:- 

•  A Repertory of gonorrhoea with the concomitant symptoms of the genitals and urinary organs by Samuel A. Kimbal
• Repertory of migraine and other headache concomitants by Dr. Siju P. V

Utility of Clinical repertory

• Clinical repertories list symptoms or conditions alongside corresponding groups of homeopathic medicines. 
• They aid in remedy selection by focusing on pathological similarities, causation, modalities (factors that modify symptoms), and concomitants (accompanying symptoms). 
• While not typically used for full repertorization, they are valuable when clinical conditions obscure characteristic patient symptoms, helping physicians identify modalities and concomitants for selecting the most similar remedy (similimum). 
• These repertories are also useful for studying homeopathic therapeutics and Materia Medica. 
• They are particularly helpful for repertorization. 
• Cases lacking prominent mental or physical general symptoms but rich in common ones.

• Cases with a clear clinical diagnosis.
• Short cases with limited symptoms.

• They serve as quick reference tools for bedside use. 
• Clinical repertories include unique rubrics (symptom categories) not found in other general repertories, making them good companions for studying such rubrics. 
• They assist in finding the most appropriate palliative medicine for incurable cases. 
• Regional repertories (a specific type of clinical repertory) help identify the similimum for particular clinical conditions.

Scope and limitations of clinical repertories

Scope

Clinical repertories, while often underutilized, offer significant benefits when their purpose and limitations are understood. Their scope includes:

• Supporting Homeopathic Study: They are valuable tools for learning about both homeopathic therapeutics and Materia Medica.
• Aiding Specific Case Types: Clinical repertories are particularly helpful for repertorization.
  • Cases where patients lack prominent mental or physical general symptoms but present with many common symptoms.
  • Cases that have a clear clinical diagnosis.
  • Short cases with only a few symptoms.
• Quick Bedside Reference: They serve as fast reference guides when a physician needs clarity or to narrow down potential remedies for a specific disease, especially when a nosological label is present.
• Unique Rubric Exploration: These repertories contain rubrics (symptom categories) that aren’t found in general repertories, making them excellent companions for studying such unique symptom presentations.

• Palliative Care in Incurable Cases: They assist in identifying the most suitable palliative medicines for patients with incurable conditions.
• Targeted Remedy Selection: Regional repertories, a subset of clinical repertories, are useful for pinpointing the most similar medicine for a specific clinical condition.
• Acute Case Management: They are highly effective in acute cases, where patients often report only particular symptoms due to their suffering.

Limitations-

Clinical repertories have a limited scope because they are built upon clinical observations and disease classifications. This means they are primarily useful for specific types of cases and are best utilized as reference tools.

Despite their value, clinical repertories should never be the primary tool in homeopathic practice. Therefore, practitioners must exercise careful judgment when using them to analyze a case.

Conclusion

Even though Dr. Hahnemann, the founder of homeopathy, critiqued treating “disease entities” as a patient’s experience is highly individual (as outlined in Organon of Medicine, §235, 5th ed.), the importance of clinical repertories can’t be overlooked. While homeopathy isn’t just a collection of individual observations, clinical repertories offer a fundamental way to narrow down potential remedies for conditions with a specific medical diagnosis. As Clarke states, they provide “the most elementary method” for finding the homeopathic remedy that best matches the patient’s symptoms.

Reference:

1. J. H. Clarke. The Prescriber. Third edition. B. Jain Publishers (P) Ltd.2006; New Delhi.
2. http://www.academia.edu/7440649/IMPORTANCE_OF_CLINICAL_REPERTORIES_WITH_AN_OVERVIEW_OF_BOERICKE_REPERTORY
3. Tiwari SK. Essential of repertorization. 5^th Ed.  New Delhi: B Jain Publishers (P) Ltd; 2012.
4. Clarke J.H. Clinical repertory to the dictionary of materia Medica: Together with Repertories of Causation, Temperaments, Clinical Relationships, and Natural Relationships. United Kingdom: Homoeopathic Publishing Company; 1904. 
5. Boericke W. Boericke’s new manual of homoeopathic materia medica with repertory. 37th Ed. New Delhi. B. Jain Publishers (P) Ltd; 2016. 
6. Siju PV. A reference to repertories for homoeopathic students. Reprint ed. B. Jain Publishers (P) Ltd. 2007; New Delhi.

Shweta Patel ¹, Srabani Pal², Nitish Kanaujiya³, Bhagyalaxmi Jadhav⁴

¹ Professor, HOD, Department of Homoeopathic Pharmacy, Sumandeep Homoeopathic Medical College & Hospital, Piparia, Vadodara, Gujarat.

² Professor, HOD, Department of Human Anatomy, Sumandeep Homoeopathic Medical College & Hospital, Piparia, Vadodara, Gujarat.

³ Assistant Professor, Department of Human Anatomy, Sumandeep Homoeopathic Medical College & Hospital, Piparia, Vadodara, Gujarat.

⁴ Professor, HOD, Department of Community Medicine, Sumandeep Homoeopathic Medical College & Hospital, Piparia, Vadodara, Gujarat.