At 11:34 AM 10/24/2007 +0200, you wrote:
Below is info on BOLD in Repertory & also addresses proving symptoms
It is complicated and depends on a variety of things
Good info on minimum.com on this from Karen Allen
"So.... in answer to your question, grade represents either frequency of
symptom in proving, frequency of use in clinical practice, or intensity of
symptom in proving or clinical use. Which begs the question - if it can
mean these various things, how do I make use of it?
One of my personal objections to the use of grade is that it creates bias
and expectation. Students and others new to homeopathy are drawn in by the
bold type remedies, especially in the middle of the night with a crying
child on one's shoulder, as one thinks that the needed remedy must surely
be one of these in bold. The bod type grabs one's attention and the plain
type remedies tend to be neither seen nor noticed. This causes a problem
because any remedy in the rubric could be applicable. "
MUCH MORE EXCELLENT INFO BELOW on how BOLD is used in the REPERTORY
http://www.minimum.com/bb/viewtopic.php ... 1d97b06eaa
982dd
The meaning of the repertory gradings bold, italics etc
I am trying to understand the remedy gradings of bold, italics and plain
type in the repertory more clearly.
One understanding of bold is that the bold remedy is successfully
prescribed more often than the other remedies, for that symptom. With this
understanding, Sepia should be bold in the rubric craving sour foods
because craving for sour foods is often clinically verified with Sepia,
while Veratrum album should not be bold because craving sour foods is less
often clinically verified with Veratrum album.
But when you look at that rubric, you see Sepia is only italics and
Veratrum album is bold. Why? Because of the other understanding of the
meaning of boldness. To these other people, and apparently to the author of
this rubric, boldness does not mean how often a remedy is clinically
verified for a symptom, but rather boldness means how often the symptom is
verified within in that remedy, in comparison to all the other symptoms of
that remedy. In other words, when a symptom is a very marked feature of a
remedy, (as craving sour is of Veratrum album) then the remedy will appear
in bold in that rubric, even when there are relatively few clinical
confirmations of this symptom for that remedy. The low number of clinical
confirmations of craving sour in Veratrum album is because it is a much
lesser used remedy, but the frequency of craving sour in the overall
symptom picture quite high, hence Veratrum album's boldness in that rubric.
Which understanding of the meaning of boldness do you teach?
FROM Karen Allen
Heartspring Assoc, 5404 Meridian Ave N, Seattle, WA 98103
Hi GC,
Thanks for your question. Many people get confused about this so it is a
good thing to review. Unfortunately this is not a simple yes or no
question, so this response is fairly extensive. I hope it is not too much
information for your interest!
Let's begin with the basics about grade. In the original repertories that
were developed by various homeopaths, each practitioner how different ways
of showing their data. While the concept of a repertory as an index into
materia medica was consistent, the way it was implemented had much
variation. 'Repertory' did not hatch fully formed; it evolved, and the
concept of grade also has evolved. Let's go through a few proverbial
examples...
From Jahr's 'Therapeutic Guide', (circa 1850), Chapter on Toothache:
Indications according to the time of day:
Worse in the evening, Puls., Merc., Bell., Antim. cr., Nux v., Rhus t.,
Ignat., Bry.; in bed, in the evening, Merc., Antim. cr.; especially when
falling asleep, Ars.; worse at night, Merc, Cham, Puls, Bell., Calc., Rhus.
t., Staphys., Arsen., Sulph., Silic., Bry., Magnes. carb., Coff.; before
midnight, Bry., Bell., Cham.; after midnight, Merc., Staphys., Nux vom.;
early in the morning, in general, Nux v., Bell., Ignat., Carbo veg.;
especially when on the point of waking, Nux v., Bell., Carbo veg.
are capitalized. The symptoms and remedies are intermixed instead of
starting on separate lines as we see in newer repertories. Notice that the
abbreviations are the ones that Jahr chose, not the standard ones we have
today. There was no representation of grade at all. The italic font was
used to identify the remedies that are in with the symptom text
From Nash's 'Leaders in Therapeutics' which included a repertory in the
back of the book (circa 1899), the Chest section of the repertory included
in the back of the book:
Abscess, AXILLA: (1) Merc., Hep., Sil.; (2) calc., nit-ac., sul. LUNGS (1)
Hep., Sil., Calc.; (2) kali-c., sul. MAMMAE: (1) Phyt., Sil., Sul.; (2)
bell., bry., lach., merc., phos.; threatening in old cicatrices: (1)
Graph., Phyt.
example, notice that the symptoms are still intermixed with the remedies,
and the remedy abbreviations are different. The concept of grade is well
established, and it is represented here by the use of (1) and (2) as well
as the capitalization or lower case of the first letter in the remedy name.
Much of the data that was included in these small repertories that were
included in the back of materia medica and therapeutic texts were heavily
influenced by the clinical experience of the author, and it is reasonable
to assume that at this time, grade of (1) represented those remedies that
were used more frequently for the symptom indicated.
From Pierce's 'Cough Better and Worse', a repertory published a little
later in 1907:
morning on and after rising to breakfast.- Ailant., Arn., Bor., Carb. an.,
Carb v., Chel., China, Cina, Euphr., Fe., K. bi., Nat. s., Nux v. Osmium,
Phos., Puls., Rumex, Senega, Sil., Thuja.
and during the day.- Carb. an., Cocc. c., Euphr., K. bi., Sang. n., Thuja
to a system of numbers or use of capitalization. Pierce italicized those
remedies thought to be most useful. Notice that again, the remedy
abbreviations are different, reflecting Pierce's choices for them. Notice
that the symptoms are listed on separate lines now rather than intermixed.
(See Part 2)
Part 2 of response:
As you can imagine, it was difficult for the average homeopath to switch
easily from one reference to each other, and with much of the information
about grade swayed by the local experience of a practitioner/author (which
may not apply to other populations in other parts of the country), there
was no clear standard. Dr. Kent, upon persistent requests from many of his
colleagues, made an attempt in the late 1890s, with frequent updates and
improvements until his death in 1916, after which the work was carried on
by his wife, Dr. Clara Kent and others until 1957 when the last version of
it was published.
In Kent's repertory, he attempted to combine all of the information from
the various repertories, and create a standard organization, set of
abbreviations, and representation of grade. As in any repertory, much of
the information is from the original provings, and this is modified or
added to as clinical experience contributes additional understanding of the
remedy. Since the repertories Kent drew from included grading that was
based on a combination of provings and clinical experience, there is a
mixture in his repertory, and some of this has been carried forward into
later repertories.
Unfortunately, the grading of symptoms in homeopathy has not been
standardized, so it is not possible to identify exactly the correspondence
between the actual proving symptom and the grade for that remedy found in
any Repertory. Kent was quite specific about how he chose to apply grade in
the entries that he made to the repertory (though he accepted the grading
done by other colleagues in most cases.) There are several factors to
consider. Grade can be used to describe the intensity of a symptom. Or it
can be used to describe frequency of a symptom in the proving.
Pretend there is a proving for Pumpkin Pie (the Thanksgiving day variety).
One of the symptoms that comes out of this proving is a manic desire to
shop and spend money (explaining why the day after Thanksgiving is the
biggest shopping day of the year). Pretend that there were 30 people in the
proving and every one of them had some level of desire to shop, went out
and spent some amount of money the next day. Based on frequency this would
come up in the repertory as a bold font, highest grade entry for the remedy
because the symptom applies widely to the population affected. Now pretend
a different scenario: out of the 30 people in the proving, only 2 were
possessed with a shopping mania, but of them went out and spent every penny
they had and as much as they could borrow. In this case, the symptom is
clearly very intense for those who have it, but it only affected a few
people, so it would be in plan font, lowest grade.
One of the problems with matching grade to intensity of symptom is that
intensity is often related to perception. Unlike the event above where the
shopping/spending was clearly independently verifiable, lots of symptoms
like pain and discomfort care subjective. They relate to individual pain
threshold so the level of intensity is highly variable, reported vey
differently by different provers.
Kent felt that frequency was a much more reliable indicator. Frequency
shows how likely a remedy is to act across the population of a proving, and
can be conjectured to represent how likely a remedy is to act across the
larger population of a practitioner's ill clients. From this point of view,
grade actually represents the average of susceptibility a larger population
has to the effect of that remedy on that symptom. Kent (and several other
prominent homeopaths) actually believed that a remedy needed to earn it's
position in bold type, and that it was not until a proving had shown and
clinical experience had repeatedly verified a symptom, was it truly
entitled to be in the highest grade.
Part 2 of response:
As you can imagine, it was difficult for the average homeopath to switch
easily from one reference to each other, and with much of the information
about grade swayed by the local experience of a practitioner/author (which
may not apply to other populations in other parts of the country), there
was no clear standard. Dr. Kent, upon persistent requests from many of his
colleagues, made an attempt in the late 1890s, with frequent updates and
improvements until his death in 1916, after which the work was carried on
by his wife, Dr. Clara Kent and others until 1957 when the last version of
it was published.
In Kent's repertory, he attempted to combine all of the information from
the various repertories, and create a standard organization, set of
abbreviations, and representation of grade. As in any repertory, much of
the information is from the original provings, and this is modified or
added to as clinical experience contributes additional understanding of the
remedy. Since the repertories Kent drew from included grading that was
based on a combination of provings and clinical experience, there is a
mixture in his repertory, and some of this has been carried forward into
later repertories.
Unfortunately, the grading of symptoms in homeopathy has not been
standardized, so it is not possible to identify exactly the correspondence
between the actual proving symptom and the grade for that remedy found in
any Repertory. Kent was quite specific about how he chose to apply grade in
the entries that he made to the repertory (though he accepted the grading
done by other colleagues in most cases.) There are several factors to
consider. Grade can be used to describe the intensity of a symptom. Or it
can be used to describe frequency of a symptom in the proving.
Pretend there is a proving for Pumpkin Pie (the Thanksgiving day variety).
One of the symptoms that comes out of this proving is a manic desire to
shop and spend money (explaining why the day after Thanksgiving is the
biggest shopping day of the year). Pretend that there were 30 people in the
proving and every one of them had some level of desire to shop, went out
and spent some amount of money the next day. Based on frequency this would
come up in the repertory as a bold font, highest grade entry for the remedy
because the symptom applies widely to the population affected. Now pretend
a different scenario: out of the 30 people in the proving, only 2 were
possessed with a shopping mania, but of them went out and spent every penny
they had and as much as they could borrow. In this case, the symptom is
clearly very intense for those who have it, but it only affected a few
people, so it would be in plan font, lowest grade.
One of the problems with matching grade to intensity of symptom is that
intensity is often related to perception. Unlike the event above where the
shopping/spending was clearly independently verifiable, lots of symptoms
like pain and discomfort care subjective. They relate to individual pain
threshold so the level of intensity is highly variable, reported vey
differently by different provers.
Kent felt that frequency was a much more reliable indicator. Frequency
shows how likely a remedy is to act across the population of a proving, and
can be conjectured to represent how likely a remedy is to act across the
larger population of a practitioner's ill clients. From this point of view,
grade actually represents the average of susceptibility a larger population
has to the effect of that remedy on that symptom. Kent (and several other
prominent homeopaths) actually believed that a remedy needed to earn it's
position in bold type, and that it was not until a proving had shown and
clinical experience had repeatedly verified a symptom, was it truly
entitled to be in the highest grade.
Part 4 of response:
But the child on your shoulder is not an average, it is just one little
person with a fever, and any remedy in the rubric could apply. This is why
homeopathy is based on a remedy selection from a constellation of symptoms,
not just one. The larger pattern helps to identify the remedy.
In all honesty, I seldom use grade in my teaching or in my own practice. I
have not found it to be helpful, and I don't pay attention to it. When I
did a proving several years ago of Sus (pig's milk, semen, blood and
saliva), the additions I provided to Roger van Zandvoort for inclusion in
the Complete Repertory were all in plain type.
Just so you know, this is my opinion based on my understanding and clinical
experience. There may be other practitioners who have a different point of
view, and I encourage you to be open minded in collecting various opinions
on this and other homeopathic topics.
Best wishes in the New Year, and I hope this information was helpful for
you as you continue to study homeopathy!
Karen
----------------------------------------------------------------------
Sheri Nakken, former R.N., MA, Hahnemannian Homeopath
Well Within & Earth Mysteries & Sacred Site Tours (worldwide)
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