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venkat

Introduction to the Therapeutic Pocket Book
by Dr. Herbert Alfred Roberts and Annie C. Wilson

BŒNNINGHAUSEN'S THERAPEUTIC POCKET BOOK
DR. T. F. ALLEN

PREFACE

Bœnninghausen's Therapeutic Pocket Book has been
used for more than a century by many masters of
homœopathic Practice. If it has fallen into
comparative disuse during the past few years it is
because few of the younger generation of homœopathic
physicians have had a knowledge of its philosophic
background and practical principles. It is not our
purpose to set forth the superiority of any one
general repertory ever another ; but it is our desire
to demonstrate the sound philosophy and practical
application of this work to such states as the
physician meets in everyday practice. It is as nearly
fool-proof as any repertory can be, once its
principles are assimilated. In the following pages the
statement is made that the book is not perfected ; it
has not grown to its full possibilities of usefulness
; but the principles upon which it is based are sound
and will allow further development and expansion
without endangering those basic principles or
distorting their balanced importance.

Let us utilize all the means at our disposal to
insure to each patient the simillimum, which is his
only hope of cure, and let us do so with the fullest
possible comprehension of natural laws, and the
application of those laws in practical form as they
appear in our homœopathic literature. Let us not
forget that every man who has labored constructively
for homœopathy has built upon some law or definite
guiding principle ; if we will utilize these works we
shall see the wisdom of the past flowering in the
healing of the present.

Derby, Conn.
August, 1935.
BŒNNINGHAUSEN (1785-1864)

Baron Clemens Maria Franz von Bœnninghausen was
born in the Netherlands on a family estate of his
father. The family traced its lineage through
Westphalian and Austrian ancestry, one ancestor having
been appointed as Field Marshal by Ferdinand II of
Austria in 1632. Since for centuries the family had
devoted themselves to military careers the family
fortunes were but moderate.

His early life was spent in the open, and he
entered rather late upon his education, but after once
starting, his progress was rapid. He graduated from
the Dutch university at Gröningen with the degree of
Doctor of Civil and Criminal Law, and thereafter for
several years he filled increasingly influential and
arduous positions at the court of Louis Napoleon, King
of Holland, remaining in the Dutch Civil Service until
the resignation of the king in 1810, when
Bœnninghausen too retired from the Dutch service. In
1812 he married and went to one of the family estates
in what later became western Prussia. He devoted much
thought to developing the state agriculturally, and
became greatly interested in agriculture and allied
sciences, particularly botany. Through his interest in
the development of agricultural resources he came in
touch with the most prominent agriculturists of
Germany, and he formed the first agricultural society
in the western part of Germany. At the reorganization
of the Prussian provinces of Rhineland and Westphalia
in 1816 he was offered the position of President of
the Provincial Court of justice for the Westphalia
district. As a part of these duties he was called upon
to act as the sole judicial President in the
evaluation of land in the two provinces, because of ;
his technical knowledge of agriculture and land
values. This work necessitated much traveling, and
later his appointment as one of the General
Commissioners kept him traveling throughout the
provinces almost constantly.

Bœnninghausen made diligent use of these
opportunities to study the flora of the provinces, and
he published a book covering the abundant flora in
these districts which called to him the attention of
some of the best botanists of Europe ; these botanists
came into even closer touch with him upon his
appointment, at about this time, as Director of the
Botanical Gardens at Münster. His agricultural and
botanical writings brought him the honor of diplomas
in many learned societies and two prominent botanists
of that day each named a genus of plants after him.

In 1827 he suffered a derangement of health,
which had hitherto been excellent. Two of the most
celebrated physicians obtainable declared this to be
purulent tuberculosis. His health continued to decline
until the spring of 1828, when all hope of his
recovery was given up. At this time he wrote a
farewell letter to his close botanical friend, A.
Weihe, M. D., who was the first homœopathic physician
in the province of Rhineland and Westphalia, though
Bœnninghausen was ignorant of the fact, their whole
correspondence having touched on botanical, not
medical, subjects. Weihe was deeply moved by the news
and answered Bœnninghausen's letter immediately,
requesting a detailed account of his symptoms and
expressing the hope that by means of the newly found
curative method he might be able to save a friend whom
he valued so highly. In response to the reply which
Bœnninghausen sent to this letter, Weihe sent some
Pulsatilla which Bœnninghausen took according to the
directions, following also the course of advice which
Weihe gave him regarding hygienic measures.
Bœnninghausen's recovery was gradual but constant, so
that by the end of the summer he was considered as
cured.

This event bred in Bœnninghausen a firm belief in
the results of homœopathic treatment, and he looked
well into the matter. He became thoroughly interested,
in the principles of the new method of healing, and
did his best to create an interest in homœopathy among
the physicians with whom he came in contact, as he
himself was one of the founders of the medical society
at Münster ; but they were deaf to his arguments, and
he himself set out to master the subject through such
books as he could procure. In his university days he
had had some medical lore, although he was not an
approved physician. Two of the most aged physicians
eventually became interested in the subject of
homœopathy through Bœnninghausen's cures of some of
their stubborn cases, and they remained faithful to
homœopathy during the remainder of their lives. By
this time Bœnninghausen's fame had spread to France,
Holland and America, and he had gained many converts
to the new doctrine of healing among physicians in
these lands, by correspondence and literary efforts.
During this time, not being an approved physician he
had practiced but little but devoted himself to
furthering the cause by his literary efforts, which
were extended in the effort of making the work of
practicing homœopathy easier. At this time, you will
remember, there was no short way to approach the study
of homœopathy. No repertories, save a brief one in
Latin by Samuel Hahnemann himself, had been published
as an index to point the way to the indicated
homœopathic remedy, and many hours must have been
devoted to the study of remedy after remedy before the
true picture was seen. Jahr did not publish his first
repertory until 1834, and in his fourth edition he
writes a preface in which he gives Bœnninghausen
credit for the system of evaluating the remedies which
he (Jahr) had only then begun to use ; this fourth
edition was published in 1851.

King Friedrich Wilhelm IV, under date of July 11,
1843, issued to Bœnninghausen a document empowering
him to practice medicine without any restraint.

From 1830 Bœnninghausen was in close touch with
Hahnemann, until the close of Hahnemann's life, and as
long as Bœnninghausen lived he kept in close touch
with all those practicing homœopathy. However, his
literary work was much hampered by the permission to
practice freely, and he did not publish his books as
frequently after that event, although he spent much,
time at that labor. It is interesting to note that his
earliest works found instant circulation among those
interested in the new doctrine, and almost every
practicing homœopath had Bœnninghausen's, works in his
library. Bœnninghausen's works in the order of their
appearance are listed here :

The Cure of Cholera and Its Preventatives (according
to Hahnemann's latest communication to the author).
1831.

Repertory of the Antipsoric Medicines, with a preface
by Hahnemann. 1932.

Summary View of the Chief Sphere of Operation of the
Antipsoric Remedies and of their Characteristic
Peculiarities, as an Appendix to their Repertory.
1833.

An Attempt at a Homœopathic Therapy of Intermittent
Fever. 1833.

Contributions to a Knowledge of the Peculiarities of
Homœopathic Remedies. 1833.

Homœopathic Diet and a Complete Image of a Disease.
(For the non-professional public.) 1833.

Homœopathy, a Manual for the Non-Medical Public. 1834.

Repertory of the Medicines which are not Antipsoric.
1935.

Attempt at Showing the Relative Kinship of Homœopathic
Medicines. 1836.

Therapeutic Manual for Homœopathic Physicians, for use
at the sickbed and in the study of the Materia Medica
Pura. 1846.

Brief Instructions for Non-Physicians as to the
Prevention and Cure of Cholera. 1849.

The Two Sides of the Human Body and -Relationships.
Homœopathic Studies. 1853.

The Hom. Domestic Physician in Brief Therapeutic
Diagnoses. An Attempt. 1853.

The Homœopathic Treatment of Whooping Cough in its
Various Forms. 1860.

The Aphorisms of Hippocrates, with Notes by a
Homœopath. 1863.

Attempt at a Homœopathic Therapy of Intermittent and
Other Fevers, especially for would be homœopaths.
Second augmented and revised edition. Part 1. The
Pyrexy. 1864.

After the proclamation empowering him to practice
medicine, Bœnninghausen founded the society for
homœopathic physicians in Westphalia, which flourished
for many years under the interest which was roused in
the homœopaths whom Bœnninghausen drew about him.

Bœnninghausen was a close friend of Adolph Lippe,
and also of Carroll Dunham. Both of these men
expressed their appreciation of the work Bœnninghausen
had accomplished, in Vol. 4 of the American
Homœopathic Review. Lippe mentions particularly the
repertorial work of Bœnninghausen and its accuracy,
and one wonders if it was not this which fired his
interest in repertorial work, which Lippe's son
brought forth in a completed form.

Lippe gives the year of Bœnninghausen's birth as
1777. It is not a matter for controversy, since
Bœnninghausen devoted all the time he had to the
promulgation of the work which he held so dear.

Of his seven sons the two eldest chose
homœopathic medicine as their profession, which was a
great joy to him. The elder of these sons practiced
for a time in the neighborhood of his boyhood home,
later going to Paris where he married the adopted
daughter of Hahnemann's widow. He lived with Madame
Hahnemann and her daughter, and had access to
Hahnemann's library and manuscripts.
REPERTORY USES

The intelligent use of a repertory implies that
we understand the scope of a repertory as well as the
purpose of a repertory. We may ask : What is a
repertory? To which the reply might be : A repertory
is an index of symptoms, arranged systematically. The
system of arrangement may be founded in turn upon
definite guiding principles ; or it may be
alphabetical or schematic.

Again we may ask: What is the Purpose of a
repertory? Our answer may be: A repertory has two
definite purposes: 1. To serve as a reference and
guide in looking up a particular symptom that may
indicate the simillimum, or that may make the
necessary distinction between two or more similar
remedies in any given case; 2. For careful study of
all the symptoms that may appear in a chronic case.

The repertory is not meant for use in those cases
where there are clear indications for the simillimum.
In those cases the additional symptoms that might be
secured from the patient, under pressure of
questioning, possibly would confuse a case that
already stands out clearly ; or if the repertory is
used here, it might be used in the manner of a quick
reference, to verify the leading indications for the
remedy, or if some slight doubt were felt, to
differentiate between those seemingly indicated. In
clearly cut cases, even if the repertorization
verified the picture, for the student of materia
medica this would have been a waste of time.

On the other hand, we must take into
consideration those physicians who have not gained a
thorough knowledge of the materia medica ; or to be
considered still more, those chronic cases where
several remedies emerge only in shadowy outlines from
a background that is a network of chronic symptoms
ever more intricately woven. There are many such cases
that come to the homœopathic physician, cases that
have suffered many things of many doctors ; cases with
mismanagement after mismanagement superimposed upon
circumstantial stress and that again upon hereditary
tendencies. These cases rarely show a clear picture of
a single indicated remedy, and very often show no
related group of remedies. Often it is impossible to
see any remedy-likeness in such a symptom group
without careful repertorization, but with that
analysis we may see not only the single indicated
remedy, but we may trace the probable sequence of
remedies that may be necessary to bring the case to
the desired cure, for it is possible to envision the
probable sequence of remedies, at times, just as we
can look back over a chronic history and see the
indications for various remedies at various periods in
the patient's past life.

The value of any repertory depends upon several
elements :

I. The art of the physician in taking the case.

II. A knowledge of the repertory one attempts to use:

(a) Its philosophic background
(b) Its construction
(c) Its limitations
(d) Its adaptability

III. Intelligent use of the resulting analysis.
THE ART OF THE PHYSICIAN IN TAKING THE CASE

This embraces the art of the physician in
securing the confidence of the patient and in drawing
out from him those subjective symptoms, of mind, body
and spirit, that are an integral part of the
difficulty for which he seeks help; it embraces also
the art of observation of those observable symptoms,
plus the general atmosphere radiated by the patient,
that go to make up the objective symptoms in their
widest sense. 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.

Bœnninghausen himself recognized that with the
best possible case taking the record is often left in
an incomplete or fragmentary state. 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. Most
frequently the conditions of aggravation and
amelioration of particular symptoms, or of the
patient's general condition, could not be stated
because of the patient's lack of observation. 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.

Bœnninghausen comprehended the difficulties
encountered by the physician in securing a complete
picture of the case, and his comparisons of his case
records and the records of provers convinced him that
the same lack of observation existed in the provers as
existed in patients.

Noting these deficiencies in the materia medica,
therefore, and realizing the importance of these
auxiliary modifying and concomitant symptoms of
disease, Bœnninghausen for many years diligently
observed and collected all such symptoms as they
appeared in the cases which came to him for treatment.
Every case was examined symptomatically with this
purpose always in view, viz., to make every symptom as
complete in itself as possible, covering the specific
points of locality, sensation, conditions of
aggravation and amelioration, and the concomitance or
co-existence of other symptoms under the same
circumstances.

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.

Bœnninghausen tells us in his Preface, page ix:

From one point of view the indicated conditions
of aggravation or amelioration have a far more
significant relation to the totality of the case and
to its single symptoms than is usually supposed ; they
are never confined exclusively to one or another
symptom, but, on the contrary, a correct choice of the
suitable remedy depends very often chiefly upon them.

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.

The Totality of the Symptoms and its
corresponding simillimum which the homœopathic
prescriber seeks are both based on the same idea. 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. Bœnninghausen so designed his Pocket Book
that it would enable the physician to bring the
symptoms together and complete one part by another.

The perceptible symptoms of disease are often
broken up and scattered through the different parts of
a patient's organism in much the same way that
symptoms are dispersed in the ordinary repertories.
The scattered parts must be found and brought together
in harmonious relation according to the typical form.

Bœnninghausen proceeds upon the Hahnemannian
theory that it is the patient who is sick -not his
head, nor his eye, nor his heart. 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 motion
of the legs, as in walking, increases the pain in the
eyes, Heat has been rendered by rubbing.
With this condition there was ravenous hunger which
always came on with the attacks.

His history divulged the fact that he had had for
years a discharge from the car, which had been stopped
eight years ago by an car specialist. Since then he
had suffered from these attacks, which were increasing
in frequency and violence.

Now let us see what a well rounded repertory
analysis can make of this case.

1. LOCATION:

Left side of face, page 59
Cheeks, page 57
Upper jaw, page 57

2. SENSATION:

Pulling Sensation, page 175

3. CONDITIONS OF AGGRAVATION AND AMELIORATION:

while sitting, > belching ; upon first rising in the morning ; there is
some discharge, white, watery and profuse at times.
Considerable sneezing rainy days,
rising from bed, page 317

The following remedies ranked : Sil. 27/113
lacked 28 (but it has > change of position) ; Sep.
27/109 lacked 6 ; Puls. 26/115 lacked 6 and 18 ; Phos.
26/110 lacked 18 and 28 ; Sulph. 26/109 lacked 6 and 7
; Nux vom. 26/103 lacked 7 and 28 ; Bry. 26/102 lacked
7 and 28 ; Ars. 26/97 lacked 3 and 6 ; Caust. 26/78
lacked 6 and 20.

At first glance this girl appeared to be a
Pulsatilla case, but a repertorization and closer
study demonstrated that Silica was the correct choice,
since it had the modalities that Puls. lacked. After
Sil. l M. there was a sharp but very brief aggravation
and steady and rapid improvement and but one very mild
return of the symptoms, that was quickly cleared by a
second powder of the same potency.

* * * * *

CASE V.

A young woman, 35 years of age, was brought in by
her family physician who felt he needed help on the
case. She was greatly depressed, cried a great deal,
and felt so unlike her cheerful self that she "felt
frightened at herself." She has a "mad desire to walk"
although she is averse to any work, mental or
physical. She "faces the day with dread" ; feels as if
alone in the world ; music, of which she has been very
fond, is now extremely distasteful. She admits there
is no reason why she should not be happy and content,
since she has pulled through some hard times and now
the road has been smoothed out. She has not slept for
several days. Previously, she would awaken from sleep
with a general quivering, especially in the pit of the
stomach. She feels "weak in the knees" and has an
"allgone" sensation which is better after 4 p. m. She
has developed an aversion to being with people,
especially crowds.

There is a great deal of headache, dull pain that
comes and goes across the forehead,
Hi Venkata,

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