Now, the first repertory to be printed in this new millennium is In my library, I have one translated by Okie in , one translated by Hempel in , one translated and edited by T. Allen in , a reprint of the same in containing a long article about how to use the book by H. Roberts, and an Indian edition of the same from about

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Intelligent use of the resulting analysis. This combination of the subjective and objective symptoms comprises what we term the case. Still further, the art of the physician in taking the case must so record it that we may glean from this record those elements that may be translated intelligently into the rubrics of the repertory, or that may be left aside for later comparison with the materia medica after the bulk of the symptoms has been translated into, and used as, rubrics in the repertory analysis.

However, we often find that it is impossible to secure from the patient a clear-cut picture of his difficulties, in spite of the best art the physician may exercise. In some instances the localities or parts affected are not clearly stated. In others the sensation or affection is not indicated or described in an intelligible manner. Perhaps the patient could not state what relations the symptoms had to each other as to time, place and circumstances, if there were alternating symptom groups.

In these modifications of symptoms, such as conditions of aggravation and amelioration, lie the keys that unlock similitude of remedies to the individual case ; and in quite as great a degree do we find the interrelationship of symptoms of value. Every case was examined symptomatically with this purpose always in view, viz.

He soon learned that symptoms which existed in an incomplete state in some part of a given case could be reliably completed by analogy, by observing the conditions of other parts of the case. If, for instance, it was not possible by questioning a patient to decide what aggravated or ameliorated a particular symptom of the case, the patient would readily express a condition of amelioration of some other symptom.

It did not take long to discover that conditions of aggravation or amelioration art not confined to this or that particular symptom ; but that, like the red thread in the cordage of the British Navy, they apply to all the symptoms of the case. In reality, then, they are the general characteristics. By observing them and applying this principle he was enabled to complete many symptoms from clinical observation; and experience has borne out the truth and reliability of his method.

In examining a case, he gets what appears to the novice to be a heterogeneous lot of symptoms, or fragments of symptoms. Possibly there may not appear to be one complete symptom in the record.

He will find a clearly expressed sensation in some part, but no condition of aggravation or amelioration. In another part, a clearly expressed condition of aggravation or amelioration, but an indefinite sensation; or perhaps the patient will simply give a condition of aggravation or amelioration which he refers simply to himself in general.

He says, "I feel worse" under such and such conditions. In reality the patient is not expressing many symptoms, but only parts of a very few complete symptoms, which the examiner must bring together and complete. The scattered parts must be found and brought together in harmonious relation according to the typical form.

Every symptom that refers to a part may be predicated of the whole man. If there is a stitching pain felt in the eye it belongs to the man, and stitching pain is noted as a characteristic of his complaint in general. If he has at the same time chilliness on moving, and nausea with retching, these are noted as concomitant symptoms, parts which go to make up the whole of the grand or typical symptom called the totality.

Really, the totality is simply the complete picture of the disease. The totality is to the disease what the man, the ego, is to his organism. It is that which gives individuality and personality. Just as each particular symptom is made up of locality, sensation, and conditions of aggravation and amelioration, so the totality is made up of general characteristics of the particular Symptoms PLUS the condition that cannot be referred to a part under the same general divisions of locality, sensations and conditions.

The plan is fundamental, and probably final, because it is founded upon the principles of logic, and has been verified by the experience of a century. The Symptoms of the materia medica, like the symptoms appearing in sickness, may be reduced to certain fundamental forms, corresponding to the genera and species of biological science, or the generals and particulars of logic. These are the elements of symptomatology. In like manner, each particular symptom, primary or secondary, may be reduced to its elements of location, sensation and condition.

These primary and secondary symptoms were not related to time so much as to their relation to the case ; in other words, those symptoms which seemed to have a direct bearing on the complaint, and the other group of almost equal importance, the concomitant symptoms.

Symptoms appear in constantly varying combinations, in proving and in sickness. The form which symptoms may take in any given case is governed by the peculiarities of the individual. In the grouping of symptoms, therefore, the personal equation rules in every individual case.

All cases of rheumatism, for instance, will present certain symptoms in common -the diagnostic symptoms; but besides these common symptoms each case will present what Hahnemann calls uncommon, peculiar, characteristic symptoms, symptoms which represent the individual factor in the case, symptoms which differentiate it from the other cases of its class.

These symptoms vary in every case. It is for these peculiar symptoms that the similar remedy must be found, rather than for those general symptoms which appear commonly in almost every case. This free, one might be tempted to say lawless, grouping of symptoms has always. It has led to the arbitrary grouping of symptoms and the erection of so-called typical forms to which names have been assigned, as if they were real entities.

Moreover, such artificial forms or entities have been made the object of treatment, and the search for specifics goes on without ceasing.

Very naturally such a search is futile, and the treatment is a failure, for the simple reason that the typical forms as they appear in the textbook are never found in practice, since they lack in the textbook those uncommon, peculiar, characteristic symptoms which give individuality to each case met in practice.

It is to be remembered, however, that these symptoms are not chosen at random ; they must all bear a definite relationship to each other in the matter of time and circumstance even though they have a seeming irregularity in grouping.

By a wider application of the principle he gathers all the affected localities, all the sensations and all the conditions, each in its proper place, and thus erects the totality, which at the same time reveals both the remedy and the disease. The system is unique and extremely logical ; like fitting together many pieces of a puzzle we find every symptom or part of a symptom, however seemingly irrelevant or illogical, fitting smoothly into its place. The totality is related equally to the remedy and to the disease.

The symptoms of the remedy must correspond perfectly to the symptoms of the disease. They are counterparts ; they may even be considered as identical as to origin and nature in the last analysis. Under certain conditions, viz. For the sake of the conventions of general medicine we distinguish between them, since common usage and diagnosis have given us names for certain symptom groups ; but as students of the Low of Similars we recognize the value of the totality in our consideration of the patient, and we recognize equally of how little value the diagnosis is as an aid to a comprehension of the symptom totality.

It is the business of the physician accurately to observe, faithfully record, and scientifically classify the phenomena of disease for the purpose of discovering and applying the curative remedy. This is equally incumbent upon him, whether he is engaged in the conduct of a proving where a disease is artificially engendered, the study of an epidemic, studies in the natural history of a single disease, or in the treatment of an individual patient.

Precisely the same principles should govern in all these departments. The typical form of any disease is discovered only by observing many patients and collating their symptoms in such a manner as to bring out its personality, just as the sphere of action of the remedy is discovered by assembling under one schema all the symptoms of many provers.

Not all the symptoms that a remedy is capable of producing can be elicited from any one prover. Several, or many, provers of both sexes are required to bring out the entire range of symptoms of any drug. The symptoms of the many provers, by the Hahnemannian method, are all collated, classified, and arranged under a based on the anatomical divisions of the body.

The resulting typical form, which we call the totality, is an abstract form or image, comprising all that can be known of the artificial disease, so arranged as to have an individuality of its own. In a similar way the discovery of an epidemic remedy in any epidemic disease depends upon the study of many cases for the purpose of observing and collating all the symptoms that form its totality.

An epidemic might be considered as a gigantic, involuntary proving of some noxious element, germ or miasm, affecting a large number of persons at the same time under certain peculiar conditions. To find the antidote to the poison that is making the people sick, or in other words, the epidemic remedy, many patients must be observed, their symptoms recorded and the remedy that corresponds to the totality found by the Hahnemannian method of comparison.

When we come to deal with the sick individual we find that just as not all the symptoms of a disease as classified in the textbooks can be found in any given case of that disease, so all the symptoms of a remedy as observed in the provings cannot be found in any one case. Each typical group or totality, whether arising clinically or in a patient, contains many lesser, but none the less characteristic, groups of symptoms. The symptoms as first elicited from the patient or prover may be, and usually are, scattered, fragmentary, often apparently unrelated.

It is the business of the therapeutic artist to piece these fragments together in a definite and symmetrical form ; to give them their true form and individuality ; to erect the totality, which at the same time indicates both the disease and the remedy. This he must do according to some preconceived plan and form. He must have a framework or skeleton upon which and around which to build his symptom structure, if it is to have coherency or consistency.

He must be able to see through the confused and scattered symptoms and fragments of the symptoms the outline, at least, of the remedy ; and he must find means also to fill up the vacancies, supplying the missing links, and combine these fragments so as to make one harmonious whole.

When all the symptoms of a case have been gathered, and the totality has been found, we have all that can be known of the disease. It exists then in a form to which other different general names have been applied, as the symptom Picture, the case, the individuality of the case, and so on.

Confusion always arises when the attempt is made to make the true totality conform to the terms and classifications of theoretical pathology. There is no necessity for making such an attempt. The totality eliminates all the theoretical elements and speculations of traditional medicine and deals only with the actually manifest facts.

These facts it assembles, not according to some arbitrary or imaginary form, but according to a natural order. The same principles of classification that govern the botanist or zoologist in their classification of plant and animal life should govern the physician in his classification of the phenomena of disease.

It is often the bridge of knowledge between the physician and the chronic patient ; it is across the structure of the repertory that the physician may reach and treat the patient suffering from any obscure disease condition, but particularly the obscure chronic condition, and by means of which the physician may return again and again, if necessary, to a consideration of the case and its progress.

To one who has not studied the general repertory carefully its possibilities are lost in the mists of half-knowledge. By this time the records of symptoms developed through provings had reached bulky proportions, yet the only method of referring to the records of proven symptoms was the tedious perusal of page after page of materia medica. Hahnemann, who had watched carefully all the provings and who had proved many remedies under his own personal observation, had in all probability the least trouble in identifying the symptoms of any individual remedy ; yet the letters from patients who visited him during his later years record the fact that he often searched through pages of manuscript before administering a remedy.

Further evidence that identifying symptoms had become a stupendous task, even to Hahnemann, is the fact that he himself compiled a short repertory of some of the leading symptoms ; this was printed in Latin. Later he developed the repertory idea still further, but these later repertories are still in manuscript form, never having been published. Richard Haehl speaks of these in his Life of Hahnemann. This contained a preface by Hahnemann himself, and was undoubtedly one of the very earliest published repertories.

He proceeded on the hypothesis that this totality was not only the sum total of the symptoms, but was in itself one grand symptom the symptom of the patient ; and that whether the individual parts of the symptom were considered or the grand symptom-the totality itself-three factors must be present: 1. Locality : the part, organs or tissues involved in the disease process.

Sensation : the kind of pain, sensation, functional or organic change characterizing the morbid process. Conditions of Aggravation or Amelioration of the symptoms : the circumstances causing, exciting, increasing, or otherwise affording modification or relief of the suffering. These appear in every chronic case, and often to a marked degree. These are always leading symptoms, and these may be defined as those symptoms for which there is clear pathological foundation; or the symptoms that are most prominent and clearly recognizable ; or the symptoms which first attract the attention of the patient or physician ; or which cause the most suffering ; or which indicate definitely the seat and nature of the morbid process ; which form the "warp of the fabric," as it has been expressed.

In the leading symptoms alone, however, there is nothing particularly characteristic from the standpoint of the prescriber. For instance, we have remedies which produce cerebral congestion ; thirty-six which produce inflamed liver ; ninety-six produce inflamed lungs ; fifty-four produce inflamed ovaries ; the same number produce inflammation of the uterus.

Any one of these may become a leading symptom, yet the inflammation of any organ is not a fact of any great value in leading the prescriber to the simillimum.

In any of these conditions we have a location, if we properly diagnose the case, but unless we can qualify the location by the sensations and conditions of aggravation and amelioration. It was because of this that Hahnemann insisted on the necessity for considering the totality of the case. This was the concomitant symptom, and has led to the statement that his repertory is founded on the doctrine of concomitants. We should say ; the doctrine of the totality of the case, which must include the concomitants.

The word concomitant means existing or occurring together; attendant; the noun means attendant circumstance. We have spoken of the peculiar usefulness of the repertory analysis in obscure chronic cases with many symptom groups, where no single symptom group stands forth with sufficient clarity to warrant a prescription.



Director of New York Botanical Gardens. Sign Up For Newsletter. Or call us at: This book was written originally in German. Want to know more about the Therapeutic Pocketbook from Synergy Homeopathic? Ran his homoeopathic practice in Brooklyn, New York.


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