The repertory. What is a repertory? History of repertory development. Differences in approach. The structure of the repertories. Complete Repertory. Where the changes have been made to create the Repertorium Universale. Details of the new structure. Where to find rubrics. Number of remedies and rubrics. Case examples. Demonstrating the logic of the Repertorium Universale. Over the past three decades much work has been carried out integrating and improving older and existing repertories, but the templates used to make these improvements are still largely based on the one created by James Tyler Kent over a century ago.
This is because the complete symptom of the patient, whatever it might be, can be built up from its component parts by the use of partial symptom rubrics, each of which is generally characteristic of the remedies it contains. The Kentian-structured repertory ie.
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In the Repertorium Universale nearly 1. It includes all the features of the Complete Repertory. The grades of remedies — an indication of their reliability in the context of each symptom — have been re-classified and further clarified.
The abbreviations of the remedy names have been corrected and synonyms reconciled. Most importantly, the re-structuring of the layout of rubrics makes it possible to use different repertorisation methods in a single search strategy.
This makes the Repertorium Universale a much more flexible tool for evaluating how closely a patient's symptoms match a given remedy's therapeutic profile in the materia medica. The following in-depth guide explains exactly how, where and why the Repertorium Universale differs from its predecessors, and what benefits it offers which have been unavailable in any one single repertory until now. He offered a prize for the best essay which succinctly defined disease symptoms according to their characteristic value to provide a basic standard for use in practice.
A two-year period was allowed for responses. After more than three years of resounding silence, he answered the question himself 1. Paradoxically, the better a repertory becomes, the more its essential limitations need to be underlined. Although it may seem to be stating the obvious, the repertory is an index. The back pages of the materia medica. There are different ways to index material, some intrinsically better than others, some a matter of personal preference.
Some indexes are more accurate than others. The homeopathic repertory from Latin repertorium, an inventory emerged as a concept around when Hahnemann started cataloguing all the symptoms gathered from the growing number of provings he was by then conducting. His alphabetical list of symptoms Symptomenlexikon grew to 4 volumes but was never published. The best way to structure and organise the indexing of the materia medica occupied many minds at the time, and debate about the advantages and disadvantages of each schema continued throughout that year period and for many years after.
The debate crystallised around a single critical issue — that of how to index a symptom without losing the features which made it characteristic of the remedy. Opinion diverged on this. Some notably Hering favoured preserving each symptom in its entirety and proposed an index biased towards exclusivity. Such an index results in a large number of very specific rubrics from Latin ruber, red: a heading or title containing relatively few remedies. It has great precision because the symptom is recorded exactly as the prover experienced it, narrowing down the choice of possible remedies very effectively.
But this makes it somewhat inflexible, not to mention an unwieldy size. So these dimensions, once established as being characteristic of the remedy, could legitimately be separated from their precise context and indexed in their own right. Such an index is biased towards inclusivity. It results in a smaller number of less specific partial rubrics containing relatively large numbers of remedies.
Complete symptoms can be constructed from the sum of their parts to match the case in hand, with the final differentiation being made between the remedies which appear in all or the majority of the rubrics. Many more repertories followed from a variety of authors, many of which were published as small specialist volumes devoted to a particular part of the body or a particular condition. Others reflected different approaches to finding the remedy. Two major repertory projects have since evolved. Synthesis has continued to develop along Kentian lines, informed to a large extent by the Hering viewpoint.
The majority of repertories use anatomical divisions Location as their primary system of classification, with the addition of various specialised sections Mind, Vertigo, Cough, Fever, Perspiration, etc and a General section for symptoms affecting the entire organism. Each symptom is then qualified by modifications arranged in blocks — Sides, Times, Modalities including Concomitants and Causations , Extensions, Locations and Phenomena. The hierarchy then extends to deeper levels by continually applying the block structure to the two final modifications Location and Phenomena , so they in turn have their own modifications, eg.
Head, Pain; forehead; evening, or Head, Pain; burning; evening, and so on to eg. Head; Pain; burning; forehead; evening; bed, in. Further subrubrics under the initial four modifications simply add greater precision, eg. Head; Pain; evening; 8 to 9pm. While this method preserves the complete symptom somewhere within the hierarchy, it leads to an enormous number of very similar rubrics in various different locations, often containing very different remedies.
There are some inconsistencies in the application of the structure resulting from the need to preserve symptoms in their entirety. Modifications unrelated to the block subject can sometimes be found, eg. His repertories are divided into anatomical sections, under which he lists Locations, Sides, Times, Concomitants, Aggravations, Ameliorations, Alternations and Sensations Phenomena all at the same level.
Subrubrics generally add greater precision within the focus of the main rubric, eg. Head; Forehead; eyes; behind, or Head; Time; evening; 9 pm to 1 am, though Sensations may be qualified further by Locations and vice versa. Generalisation is not automatic — subrubrics may contain more remedies than the main rubric, eg. If the exact complete symptom cannot be found, it can be built up from the sum of its parts, eg. Head; Time; evening, plus Head; burning and heat; forehead, plus Generalities; Aggravation; Lying; bed, in.
Further refinements were made in the Millennium edition, removing inconsistencies where a secondary rubric in Kent meant the opposite to the main one eg. Mind; Jesting, and Mind; Jesting; averse to , while still adhering to the basic Kentian skeleton. It also makes the structure of the repertory entirely consistent throughout. This single basic change removes the limitations the Kentian hierarchy places on the structure of the repertory as a whole, while still preserving the Kentian part of the repertory in its entirety, and the Kentian approach in the repeating block structure.
They form the first level of the hierarchy in each section. Remedies only qualify for addition to these rubrics if the symptom quality is clearly characteristic of the remedy. Some exceptions to the updating process need mentioning. The first is Concomitant — remedies which feature mental alterations as a concomitant of physical symptoms. There is a similar Concomitant rubric in the Generalities section. A further three sections have been introduced to the primary classification Heart and Circulation, Blood, and Clinical and the two Phenomena sections which were listed in their own right in editions of the Complete Repertory — Head Pain and Extremity Pain — have been reincorporated into the Head and Extremities sections.
Cross-references between rubrics have been thoroughly revised and increased, with the new repertory featuring more than double the number included in the last edition of the Complete Repertory. The Repertorium Universale contains nearly 1. Repertory gradings provide an additional source of information about the characteristic nature of remedy symptoms, but are frequently misunderstood.
This is incorrect. Repertory gradings, regardless of specific criteria which vary from repertory to repertory, have always indicated frequency: the number of times a particular symptom has been recorded for any one remedy. Gradings are consequently a confidence rating — an indication of reliability, or characteristic quality, or simply the fact that the remedy is a polychrest and has more documented clinical confirmation.
This has no direct relationship to intensity. Complete Repertory 4. Found in provings, or sourced directly from clinical experience, toxicology, or herbal use. He then completely over-rides that differentiation by stipulating that clinical confirmation is required for the second degree, consequently relegating all proving symptoms to the first degree, regardless of their significance, until such time as they receive clinical confirmation. In this first edition of the Repertorium Universale there are very few remedies in the redefined second degree.
Those included are mostly from recent provings. These will be restored to the second degree as a comprehensive revision of the data sources for first grade remedies takes place. This allows the advantages of the exclusive perspective specificity, precision to be freely combined with the advantages of the inclusive perspective combinability, completeness and both views to be used interchangeably as and when appropriate. It also means that the disadvantages of each perspective can be minimised — too great a degree of exclusivity and lack of differentiation.
The inclusive approach does have one significant conceptual advantage over the exclusive one. Its flexibility allows for the creation of a virtually infinite variety of complete symptoms, more than can ever be represented in any Kentian-style repertory. Not that Phase 2 trials are, but they strive for this impossibility. This inherent inaccuracy is a result of the many diverse susceptibilities of the provers, and the various occurrences of daily life.
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If we consider that adding an extra prover to any proving may produce a whole range of additional symptoms, while leaving out a particular prover will lose these symptoms, it becomes clear that it is impossible to have a perfect proving. The only way to resolve this would be to prove on every different type of person, but this would produce an impossible amount of information. While the totality of symptoms is sufficient as a basis for a homoeopathic prescription, the collected symptoms can always be expanded by a further proving, providing a fuller totality.
It is often difficult to know if the prover had bad milk in their tea, or if they developed a stomach ache due to the remedy. If we eliminate the symptom we may lose important information. Historically there has been an ongoing discussion in homoeopathy regarding inclusion or non-inclusion of ambiguous symptoms. Modern research methods would use statistical significance, i. But this is in opposition to homoeopathy, which pays special attention to unique and individual experience.
If we rely on statistically significant numbers of provers to confirm a symptom, we will lose all strange, rare and characteristic symptoms, resulting in a flat proving of common symptoms. This is often the case with over-zealous editing of a proving. The result is an unusable proving. Most modern provings are double-blind, that is, both the supervisors and provers are prevented from knowing what remedy is being proved. However, classical provings were not blinded at all, yet they have produced very reliable results over a long period of time.
Double-blind tests are supposed to compensate for bias in the observer and faith in the patient, but have never been verified in either of these factors. Although in previous writings I originally suggested double-blind provings, my experience has shown that it is not an essential factor in producing high-quality provings. I have also suggested in my prior writings the use of placebo, a unmedicated pill, which was not historically used in provings. Theoretically the placebo serves to distinguish the effects of the remedy from the effects of the proving process. According to this idea, we should eliminate symptoms similar to the placebo symptoms from the proving.
However it has been the repeated experience of many modern provers that those taking placebo also produce symptoms typical of the proving. This may sound strange in conventional terms, but it is consistent with the idea of a proving being a collective infection similar to an epidemic.
Our traditional proving process has served us well without the use of placebo. What follows is a brief outline of the actual proving process. Creating a full proving that aims to give the world a comprehensive new remedy picture requires time, enthusiasm, commitment and perseverance. In my experience the most important factors towards producing a thorough and useful proving are as follows:. Be organized. Use a class that has studied together for a while. Ask homoeopaths to be your provers. They usually make the best provers.
They know what they are looking for. Avoid random provers from scattered locations. Ensure careful and close supervision. Believe what the prover tells you; however strange, it may prove significant. Clinical experience will confirm or deny the symptom. Edit material carefully and extensively. Be tenacious. Many homoeopaths begin provings with much good will, but fail to complete them.
One should understand that while the proving itself takes two to three months, editing and collating a proving is a painstaking and lengthy undertaking. Consequently, only a small percent of provings begun are published, though this has improved with internet publications For a list of modern provings and publications see www. The master prover principal investigator is responsible for the proving, including the safety of provers, the accuracy of supervisors, the diligence of editing and final publication.
This job may be shared with a co-coordinator. The master prover oversees all the supervisors and provers, ensuring that everything is functioning properly and safely. She should keep track of the dates each individual proving begins, which preferably should be around the same time so as to keep management simple , and also of which provers are experiencing symptoms, how many doses each took etc.
The most demanding role of the master prover is the third stage of extraction, collation and editing of symptoms into the materia medica format. Good supervision is the key to a high quality proving. Often symptoms are produced, but due to poor supervision they go unnoticed. It is important to remember that Hahnemann tells us, 'Every real medicine…. Organon Paragraph Consequently supervisors should have some homoeopathic experience. This is a good learning opportunity for students nearing graduation. Each supervisor should have no more than two provers, as there is quite some effort involved.
The prover's case should be taken by the supervisor prior to the proving. This is essential in order to create a baseline to compare symptoms from before and after the proving. This contact may be by phone but not by email, as this would lose the dynamic personal contact, which is vital. Daily interrogation is important as provers often do not notice their symptoms or realise that they are experiencing a proving.
It is often difficult to distinguish the delicate proving symptoms from daily events and life fluctuations. Furthermore the prover becomes the proving, and cannot perceive that she is changing. She imagines that she is acting in a perfectly normal manner even when her behaviour is radically different from usual.
The supervisor's role is extremely important in providing a stable point of reference that does not change with the prover. The supervisor should question the prover carefully, bringing out the full nature of the symptoms and deciding if symptoms are relevant. She will be well-acquainted with the prover's case so that she can compare what is new, old, cured and altered in the person. When the prover possesses adaptability or flexibility, she can react to the proving and later return to her natural state. Likewise provings on people taking drugs of any kind are not recommended since the drugs may be imposing their own medicinal symptoms on the individual, as well as being a greater health risk.
I believe that children, pregnant women and animals should not prove remedies. The choice of proving remedy is personal. Any substance, natural or artificial, may be used, as long as the same source is used in conjunction with this proving forever after. The master prover may choose a substance according to medical potential, personal interest, toxicological or chemical properties, fields of investigation, omens or dreams.
If the proving is to be triple-blind, a third party will choose the substance and the master prover will not be informed. It is essential to record and verify the exact details of the original substance, such as species, gender, time when gathered, location, quantity by volume or weight, percentage and volume of alcohol, age and part of specimen, etc.
In the case of a nosode or sarcode precise details regarding the donor should be recorded. For plants one should investigate the herbal and botanical literature to discover the most potent part of the plant and the best time of gathering. It is preferable that the plant is collected from its natural environment. All substances should be as pure and free from pollution as possible. The exact mode of pharmaceutical preparation should be recorded.
Reactions to a proving depend mainly on the relationship between the susceptibility of the prover and the nature of the remedy proved. Other factors are potency, sensitivity, dose, repetition and timing. As the proved remedy has a random relationship to the prover, there are many possible reactions. These can be broadly divided into three main categories; homoeopathic, antipathic and dissimilar allopathic. It is the variety of the different effects on a large number of provers that creates a full and meaningful totality. In my experience the best group size for a proving is provers.
Since no one can be completely healthy, in any proving there is a statistical possibility that some provers will receive a similar remedy. If a prover with the Plumbum disease takes Plumbum, she will be cured. In fact most provings I have conducted have produced a few cures. A typical reaction is that of aggravation first, followed by amelioration or cure.
From this it is apparent that a simillimum cannot create a proving, just a curing. Conversely a remedy which produces a proving can never cure. When there is a simillimum, the cured symptoms are added to the proving as such. It is essential that the exact nature of the symptom prior to the cure be recorded.
In the case of the antipathic remedy opposite action the reaction will be amelioration first, followed by aggravation. In a clinical setting this would be an unfortunate result, often indicating organic pathology. However, as the prover is relatively healthy, she should be able to return to her former state once the remedy effect is over. The characteristics of a dissimilar reaction are symptoms that the prover never experienced before, i. These are the most significant and reliable symptoms of a proving. While a mild dissimilarity will produce the best proving, a greater dissimilarity will produce fewer symptoms.
To achieve results and generate proving symptoms the remedy will need to be repeated more frequently, and the effects will usually be of a local and common nature. Every constitution will bring out a different aspect of the remedy. One will bring out the throat, one will bring out the feet and one will bring out the mind. The more varied the susceptibilities, the more varied the symptoms. The symptoms that are produced by a dissimilar relationship in a proving result from the overlap of the constitutional symptoms and the remedy symptoms.
The symptoms of a Calcarea carbonica person proving Neon will represent the Neon aspect of Calcarea carbonica. Other than the susceptibility of the prover to the remedy, the main factor dictating the quality of reaction is sensitivity. This will range from extreme sensitivity to total lack of reaction. There are two types of sensitive provers, those who are sensitive to the particular remedy and those sensitive in general.
The latter can be divided into pathologically sensitive provers, who are extremely useful provers but often difficult patients to cure, and healthy provers who are very aware. According to Hahnemann Par footnote , this capacity of self-awareness is one of the gifts of provings, and a gateway to wisdom and self- knowledge, which will surely benefit practice. Often the most important proving symptoms are brought about by one or two of the most sensitive provers, the others serving to fill out the bulk of common symptoms.
Though conventional research methodology may discount these occurances as statistically insignificant, homoeopathy considers them to be highly characteristic and extremely valuable. During the proving particular attention should be paid to random external factors that may affect the prover, giving rise to false symptoms. These include infections, epidemics, colds, exposure to noxious influences and poisons including various forms of pollution.
In addition, external physical injuries or external emotional factors such as grief, shock, fright, etc. In all cases of strong external forces, or stronger dissimilar disease, it is prudent to eliminate the resulting symptoms, or even to terminate the particular proving. However one should keep an eye open for external events which reoccur in many provers, and are actually a response to the proving. This is a matter of the finest discrimination.
There are many diverse opinions concerning dose in provings. A study of the dose and potencies used in the history of provings reveals complete inconsistency.here
A systematic alphabetic repertory of homoeopathic remedies
Provings have been done with any potency from the mother tincture to the 50M, and with any dose ranging from single to daily repetition over a long period of time. The remedy is to be repeated until first symptoms appear and then stopped. The reasoning is that some people, who have greater susceptibility or sensitivity, show symptoms easily, while others, who have an allopathic relationship to the remedy or less sensitivity, need to be pushed.
This caution will generally produce a clearer proving and safe-guard the prover. Supervisors should keep close contact with their prover on the first day and help them to decide if symptoms have appeared. The formula I follow is a maximum of six doses over 2 days. If any symptom occurs, no further doses should be taken. If nothing has happened after two days, then no more doses are to be taken. Proving symptoms are often very mild, like a delicate cobweb over one's normal consciousness.
The single dose produces a purer experiment and often a more intense proving. In homoeopathy, less is more. As regarding potency, there was a time in Hahnemann's life when he sought to standardise the 30C potency for provings, but this idea was never taken up. I would recommend using two mid-range protencies such as 12C and 30C. After completing a proving in the lower potencies, a sensitive individual can repeat the proving with a single dose of higher potency. This will produce finer and more characteristic symptoms. The master prover decides on protocol, remedy, prover numbers, remedy codes and starting date.
The master prover allocates supervisors to provers.
Remedy is obtained and potentised. Orientation meeting is assembled. Provers sign informed-consent forms. Remedy and notebooks distributed. Provers keep notes weeks before commencing proving. This is an important baseline, but any longer will induce prover fatigue. Proving begins.
Prover notifies supervisor; supervisor notifies master prover. Prover begins taking remedy, a maximum of six doses over two days.
As soon as symptoms arise, no more doses are taken. Prover and supervisor are in daily contact, each keeps a full notebook. Supervisor and master prover remain in contact. As symptoms abate, contact frequency between supervisor and prover lessens to every 2, 3 and then 7 days. Once no symptoms have occurred for three to four weeks, the proving is finished. Notebooks are returned to master prover. Recording Proving Symptoms The prover keeps careful notes regarding all symptoms, modalities, times and concomitants, using their natural language. They ask for comments and observations from friends and family.
Each symptom is written on a new line, leaving space for remarks. Each day a new page is started, marking the day and date clearly. The time should only be included within the symptom text if it is definitely significant. Accidents and coincidences should be noted.
Group meeting The group meeting is an essential part of the proving. It is a demanding but wonderful experience. It should be held weeks after the proving. Each prover tells of their experience in detail, and supervisors comment on this. During this meeting the totality of all provers experiences are woven together into a cohesive whole.
Discovering the numerous ways in which a single entity expresses itself through many provers, diverse and at the same time unified, is an amazing and mind-expanding experience.
Complete Repertory to Homoeopathic Materia Medica by Berridge
The remedy picture is midwifed into the world, and we see its face and features for the first time. It is only an infant at this stage, and will require years of nursing and clinical use to mature. These symptoms can be extremely important, but supervisors and the master prover must exercise great care and discrimination when adding them.
They may of course be results of suggestibility, but my experience has shown that this is by no means always the case. It is useful to video the group meetings providing provers give their consent. After 6 months the provers should be contacted to check if anything else of significance has occurred. In this stage the prover's and supervisor's accounts are amalgamated into a single cohesive document.
It is helpful if they work with a third homoeopath or the master prover, who can help vet the symptoms. The final product should include valid symptoms only, and omit all superfluous, highly doubtful or irrelevant information. During this stage it is essential to be precise, censorious, forgiving and sensitive simultaneously. It may be helpful to remember that many symptoms from Hahnemann's provings that seemed dubious at the time were later clinically confirmed. Filtering symptoms for a proving is a delicate and difficult task, which should be undertaken with the utmost care.
Symptoms should be discarded whenever there is grave doubt. However, one should be careful not to be over-cautious and reject potentially useful symptoms. In mild doubt it is better to leave the symptom in, so that it can be confirmed or denied with clinical experience. An annotation as to the nature of the doubt would be useful. It is also interesting to note that many of our famous keynotes, now considered leading symptoms, originated from a single occurrence in one prover- for example, the isolation of Camphor and the enlarged sensation of Platina.
The following guidelines should aid in the process of selecting valid symptoms. They are to be used together as a whole, rather than individually:. How recent depends on the particular symptoms and case. We should discard any symptom that may have appeared naturally or spontaneously during the proving. For instance if a prover was suffering from migrains over the last few months, any similar migraine during the proving should be discarded.
For this reason old symptoms should be marked OS with time of last appearance.