Newer remedies, requesting article- will taylor
Posted: Thu May 13, 2004 11:00 am
Dear Ellen,
here is the article by Will taylor.
Regards
Venkat
Analysis with Boenninghausen
by Will Taylor
In starting out with some reflections on the use of
Boenninghausen's Repertory, I am actually coming in at
a rather late stage of the process of analyzing a case
- the choice of a repertorial method, the selection of
rubrics and the "running" of a repertorial analysis
depend on careful case-taking and organization and
assessment of the case. But sometimes it helps to see
"where we're going" to in order to understand what we
need to do first - so with that spirit in mind, I
thought it would be advantageous to jump in at the
repertorizing stage and proceed in both directions.
I use several repertories in my work - most often I
refer to Roger van Zandvoort's Complete Repertory (on
computer in MacRepertory), but I also am quite fond of
Knzli's 'Kent's
Repertorium Generale' (paper), Kent (paper &
computer), the Boger-Boenninghausen repertory (which I
use on computer), Roberts' Sensations 'As If', Ward's
Unabridged Dictionary of
Sensations 'As If', Boericke's Repertory, and
occasionally Knerr's Repertory of Hering's Guiding
Symptoms. Although sometimes I hunt these
interchangeably to find "just the right rubric," more
often I find myself choosing one or the other to
optimize a particular strategy in analyzing a case.
I am currently infatuated with Boenninghausen's
repertory, not at all for universal use, but because
it offers an approach that feels complementary to the
Kentian method in which I was
trained, which may be more applicable to a subset of
the cases I see. These are those cases that center on
the characteristic symptoms of physical pathology or
"local" disease. This approach also lends itself well
to working with acute illness, and may be a very nice
way to approach homeopathic home-care of minor acute
illnesses in a classical fashion.
The structure of Boenninghausen's Repertory has its
logic in a particular approach to case
analysis.
Boenninghausen started with the observation that *any
complete symptom* contains 4 elements - these being
(1) location, (2) sensation, (3) modalities
(aggravation, amelioration, causation), and (4)
concomitant symptoms (simultaneously occurring
symptoms that do not necessarily follow obviously from
the symptom in question). To define thetotality of the
disharmony in the person presenting to us, we do best
if we can base our understanding on the four legs of
these four "parts" of a complete symptom.
Constantine Hering used the following visual scheme to
illustrate these four dimensions of a complete
symptom, and he gives it to us in his introduction to
'The Guiding Symptoms':
- -
- Sensations -
- -
- -
Localities - - Modalities
- Causation
Tissues - - Conditions
- -
- -
- Concomitants -
- -
It was Boenninghausen's observation, however, that in
the provings recorded in Hahnemann's Materia Medica
Pura (the original source record of provings of the
remedies of his day), the recorded symptoms were often
"incomplete", that is, the recorded symptoms of any
one prover may be lacking modalities, or
well-described sensations, etc.
For example, in Materia Medica Pura, pp. 515-517, the
abdominal pains of Colocynthis are described in
provers. One prover describes "Colic"; another
describes "along with some distention colic-like pain
in the abdomen and discharge of flatus;" another "a
sore cutting pain, which commenced when walking and
increased in violence at every step"; another "cutting
pains in the abdomen"; another "cutting in the
hypogastrium, at last so violent that he must walk in
a bent-forward attitude ... with dread of the work he
had to do"; another "alleviation of the violent
belly-ache by smoking tobacco"; another "acute pains,
as if severely clawed in the abdomen - a grasping in
the bowels, on account of these pains he can neither
lie quiet nor sit, and can only walk bent double."
Now each of these provers presents an incomplete
symptom, but taken together, we have location
(hypogastrium), sensation (sore, cutting, grasping,
severely clawed, colic-like), modalities (bent-forward, >tobacco), and concomitants
(distention, flatus, restlessness).
Boenninghausen also observed that, in provers, these
"parts" of a complete symptom were sometimes assorted
differently. For example in one prover, the
mental/emotional concomitant of
restlessness would be seen during headache; in
another, the amelioration by tobacco would be seen
with the irritability; in another, the grasping,
colic-like sensation would be felt in the bladder in
what looked like a cystitis.
Similarly to these provers, in patients presenting
with illness, symptoms are often stated incompletely,
or modalities may not be clearly expressed.
Based on his extensive experience with clinical work
and with provings, Boenninghausen concluded that this
problem of "incompleteness" of individual symptoms in
both provings and
clinical cases could be solved by "analogy." That is,
that symptoms in one part of the case or proving which
existed in an incomplete state could be reliably
completed by analogy, by applying the strong &
reliable conditions of other parts of the case. For
example, when we look at the pains (whatever kinds of
pains) of a Colocynthis state, we see some consistency
in their being
almost always cramping, grasping and colicky, better
from pressure, and most often ameliorated by bending
double and by heat, and we usually see restlessness as
a mental/emotional
concomitant symptom with the pain. So perhaps we see
someone with a headache that is grasping in character,
better by squeezing the head with the hands and
accompanied with restlessness. Even though we might
not find this exact symptom in a Colocynthis prover,
we can consider Colocynthis as a possible remedy, by
analogy of the sensation, modality and
concomitant of their headache with those seen in pain
in other locations of Colocynthis provers.
So (in this example) the strong, reliable &
characteristic "parts" of the abdominal pain symptom -
the sensations, modalities, and concomitants - can be
considered as general symptoms of the whole person,
rather than just as peculiarities of that specific
symptom, and can be applied in their various
combinations to other localities and tissues as well.
To deal in the Repertory with this issue of
"incompleteness" of symptoms, and to be able to apply
his notion of symptom completion by analogy, both in
the provings on which we are basing our identifying of
a simillimum, and in the clinical case we have before
us, Boenninghausen divided up symptoms into their
"parts" in his repertory. Rather than looking up
"abdominal pain better bending double," you will have
to look up "abdominal pain" and "better bending
double" to assemble your symptom.
Boenninghausen has been sadly misinterpreted as
de-emphasizing the importance of mental/emotional
symptoms, largely because of the difference in the way
he and Kent recommended working with them in
repertorization. The mental/emotional symptoms did not
take to being "broken up" as elegantly as the physical
symptoms did. So in his repertory he emphasized only
more general states, to be used in the later stages of
repertorial analysis when they were marked as strongly
in the case as in the repertory listing, and suggested
confirming mental/emotional symptoms of the patient
directly with the words of provers as a late step in
case analysis after repertorization provided a list of
remedies to consider. This is not because
Boenninghausen assigned a lower value to
mental/emotional symptoms in the totality, but rather
because he felt that the mind was a complex entity not
as easily understood as the physical symptoms in this
manner of breaking down symptoms into their "parts."
A Sample Case
For example., consider the totality of a child with an
asthma attack with spasmodic wheezing (3) and coughing
at 11 p.m. (3), worse if the winter window is open
(3), when he has to sit up (2) in bed to breath & is
restless (3) with anxiety and fear (3), & fearful of
being left alone (3), wanting both parents right on
the bed (3) with him. We can quickly recognize the
totality here, as you might pick a friend out of a
crowd, & *probably* give Ars alb successfully based on
gestalt." But in order to represent this "gestalt" in
a way that we can find it in a repertory to confirm
our selection or consider other possibilities, we need
to break it down into "pieces." I've
purposely chosen what looks like a very simple case so
that we can concentrate on the logic of what we are
doing here.
The first breakdown of the totality seems obvious: (1)
the physical asthma attack (with its specifics &
modalities); and (2 ) the mental/emotional state of
restless fear & anxiety & fear of being alone. We owe
the ease of making this first "division" of the
gestalt to the cultural heritage of Rene Descartes &
his infamous mind/body dichotomy - it really is not
that obvious a dichotomy to the patient!
So now we have our symptom of "central interest"
(asthma) and a mental/emotional concomitant symptom
(anxious/restless fear, fear of being alone, wanting
company). Boenninghausen stated
that the concomitant was to the totality, what the
modality is to the symptom. Having the modality in a
"part" of the person "distinct from" the location of
the "main symptom" gives it
even greater value (e.g., a "cough from tickling in
the larynx" concomitant, although helpful, is not
likely to be as helpful as this one).
We can represent this mental/emotional concomitant in
repertorial rubrics in two ways: (1) by simply stating
that there is a mental/emotional concomitant of the
symptom of central interest Mind; CONCOMITANTS); and
(2) by specifically stating the dimensions of this
symptom:
Mind; Fear; anxious, restless; Mind; Fear; alone, of
being + Mind; Company; desires. (I will combine these
last two rubrics into one because they are each rather
small and each carries an
aspect of the symptom). I also considered using Mind;
Fear; anxious, restless; and Mind;
AMEL.; company, as the mental/emotional concomitant
rubrics for this case, and as I type this up, feel in
retrospect that that would have been a better choice
for describing the state of this patient. Or one could
combine the three rubrics: Mind; Fear; alone, of
being; + Mind; Company;
desires; + Mind; AMEL.; company; to be even more
inclusive, where we cannot really determine which
single one applies best.
Next, we can "break down" the physical symptom of
asthma. There is spasmodic asthma, and cough (these
embody both "location" and "sensation" to some
degree), so Respiration; Asthma;
spasmodic and Cough; GENERAL. However as cough is a
common symptom of the patient's condition, and without
any real particular characteristics of the cough (e.g.
like "from tickling in the larynx"), it is not likely
to be very useful to us in repertorization. Then there
are the modalities - which Boenninghausen elevated to
general symptoms, of the whole person. So:
Generalities; AGG; Air; cold in
Generalities; TIME; Before Midnight
Generalities; AMEL.; Sitting
Now a lot of homeopaths (Constantine Hering notably
among them) criticized Boenninghausen for taking the
modalities away from their local symptoms. One of
their arguments was, that sometimes the modalities of
the part differ from the modalities of the whole. For
example Arsenicum is generally worse cold and better
heat, but its headaches are worse heat and better
cold. So Boger, in revising Boenninghausen's
repertory, created modalities sections within each
location section. So we can also find:
Respiration; AGG.; Air; cold
Respiration; TIME; Midnight; before
Respiration; AMEL.; Sitting, when; upright
In using these "modalities of the parts," give
priority to the "modalities of the whole;" but *add*
any remedies in the rubric for the "modality of the
part" that may be missing in the "modality of the
whole." That is, in your repertorization, be sure to
use all the remedies in the rubric:
Generalities; AGG; Air; cold in; but note that the
remedies Actea spicata and Lobelia are not listed
here, even though they are listed in Respiration;
AGG.; Air; cold. So add them to the
general rubric Generalities; AGG; Air; cold in for the
purposes of this case.
So the rubrics I would select from
Boger-Boenninghausen's Repertory for this case would
be:
Respiration; Asthma; spasmodic
Generalities; AGG; Air; cold in
- combine with: Respiration; AGG.; Air; cold
Generalities; TIME; Before Midnight
- combine with: Respiration; TIME; Midnight; before
Generalities; AMEL.; Sitting
- combine with: Respiration; AMEL.; Sitting, when;
upright
Mind; CONCOMITANTS
Mind; Fear; anxious, restless
Mind; Fear; alone, of being
- combine with Mind; Company; desires
Notice that I have selected the seven rubrics above to
represent as best I can the four "legs" of the "grand
symptom of the patient": Locality/Tissue, Sensations,
Modalities, and Concomitants.
Repertorization gives us (Grade x no. of rubrics /
Number of rubrics matched):
Ars (19/7 of 7); Nux-v (18/6); Phos (18/6); Bry
(16/6); Cham (12/6); Kali-c (13/6); Caust (12/6);
Verat (11/6).
Now we cannot just give Ars by the weight of its
score, even though it seems obvious & it is tempting
by now to get it done with. The repertorization is a
*pointer* to the simillimum, not its determinant.
Reflect on/read about the leading remedy and the
"runners-up." Go to the materia medica (here is where
a good keynote/confirmatory symptom materia medica
like Morrison or Phatak or Vermeulen's Synoptic
Materia Medica comes in most handy) and confirm the
remedy, perhaps even by asking a few more questions or
making a few more observations.
Now it may be very interesting to weight the
repertorization in various ways. This is not part of
Boenninghausen's method per se, but can add robustness
to any system of repertorial case
analysis.
Perhaps we can look more intently at strange, rare &
peculiar symptoms. Weighting for SRP symptoms
(something that computer repertorization makes easy -
I use MacRepertory) suggests
that we look with special interest at Ars, Lyc, Stram,
Nat-c, Kali-br and Caust (this is due largely to their
presences in the small rubrics, fear of being alone
and/or desires company). But since this
symptom really does not seem so unusually strange,
rare and peculiar in the context of the case, I would
not put a great deal of weight on it.
Similarly, weighting for Keynotes suggests that we
should look at: Bry (due to its prominence in the
rubrics Before MN & > sitting); Ars; Lyc (before MN,
desires company); Stram (fear alone); and Colch (sitting).
We can also emphasize small remedies. These are, by
definition, poorly represented in our literature, so
maybe the remedy we need is hiding in our
repertorization because it just hasn't
made it into (e.g.) the "asthma" rubric, as a
deficiency of inadequate proving & clinical
experience. One way would be to arbitrarily eliminate
the larger polychrests from consideration(not because
we do not like polychrests, but because we would like
to see what might come through if the remedy does not
happen to be one). So we can eliminate perhaps the 20
most familiar remedies and see what is left. Another
thing we could do (via computer) is to multiply the
score each remedy receives by a measure of the
"rarity" of each remedy in the repertory (i.e., the
likelihood of its being missed in a rubric in which it
might actually belong), what MacRepertory calls a
"small remedies" weighting. This tells us we should
add the following "small remedies" to our
consideration:
Mosch (11/5); Samb (6/4); Calad (6/3); Nux-m (11/5);
Ran-s (6/3); Coff (6/4).
This can also more or less be done without the
computer - look down your repertorization checklist to
find remedies that do well enough in the most
characteristic symptoms, but do not
seem very familiar.
And now that we have made more work for ourselves, we
can reflect on what we know and/or go read about all
of these possibilities too (adding to our original
list Stram, Nat-c, Kali-br, Colch,
Mosch, Samb, Calad, Nux-m, Ran-s, Coff).
I will skip a number of these here, but one of these
remedies - Moschus - does look particularly
interesting.
Now the only rubrics that Moschus does not match are
the anxious restless fear and the fear of being
alone/desire for company, but Morrison's Desktop Guide
offers: "The patient is anxious, fears his condition
and feels he could die ... Michael Carlston of Santa
Rosa, California presented two cases of asthma cured
by Moschus. The characteristics were sudden, severe,
even life-threatening asthmatic crisis, especially
coming during cold or after bathing and both cases
were associated with anxiety ...".
Morrison has 1-1/2 pages on Moschus - he talks about
spasms of smooth muscle as characteristic of the
physical complaints, describes "anxiety; feels he will
die," "hysterical asthma," "sudden, severe asthma"
(compare Cuprum). He does not mention it in his "Small
Remedies" seminars notes (rats! - I really love his
descriptions in those). Vermeulen's Synoptic Materia
Medica discusses mostly faces of the remedy that would
not pertain to the case we are seeing. Vermeulen's
Concordant Materia Medica has 2-1/2 pages of fine
print with good description of mental/emotional and
respiratory symptoms that do not really shed any more
light. Clarke has three and a half pages that again do
not shed further light on our patient. These
references suggest some mental/emotional symptoms for
Moschus that I do not see in my patient, but we know
that
you cannot rule out a remedy on this basis. Doing a
computer search of the Complete Repertory, Moschus
comes up in 1946 rubrics (so it is about as well-known
as Selenium & Strontium
carbonicum - not among the best-known 100 remedies,
but somewhere near the bottom of the best-known 200).
In the Complete Repertory, we find lots of anxiety &
fear & restlessness rubrics for Moschus, including a
boldface MIND; RESTLESSNESS, nervousness; asthma,
with; as an addition from Knerr. Now Knerr's repertory
is based on the materia medica of Hering's' Guiding
Symptoms, so we can go there (vol. 7, pp. 489-498) for
some source material. Hering lists, among much else,
very strongly marked "Asthma in hysteric individuals
and in children".
I decided that I had learned a lot but could not be
convincingly dissuaded from Ars. The family did not
have Moschus or Caladium or Sambucus or Kali bromatum
in their kit at home anyway.
The child above did *not* respond to Ars (30C in
divided doses in water), but came through the episode
all right on his albuterol nebulizer treatments. His
next episode responded very nicely to Moschus 30C in
divided doses every five minutes in water. Elimination
Rubrics
There are two contexts in which the issue of
elimination rubrics (confining repertorial analysis to
the remedies contained in one or more rubrics) comes
up:
(1) to make repertorization by hand a (somewhat!)
manageable task;
(2) when one really feels that consideration should be
limited to the remedies contained in one or a
combination of a small group of rubrics.
I have rarely had serious recourse to #2. It takes a
great deal of faith to believe that any rubric is
"complete." Reference to Knzli's Repertory may be
helpful. I would be more comfortable using
one of his "red-dot" rubrics eliminatively, as these
are rubrics that he felt were reliably complete.
Sometimes I "play around" with this option, though - I
will have a repertorization that is rather
non-discriminative. Usually that is because I took a
lousy case or did not organize it well for
analysis, but sometimes I just find myself stuck with
that.
So maybe, for example, the patient really avoided
revealing any mental/emotional symptoms, and that
avoidance *is* the mental/emotional stuff of the case,
so I combine into a single rubric:
MIND; HIDE, desire to
MIND; SECRETIVE
MIND; FEAR; observed, of her condition being
I do not know which of those describes her best, but I
feel pretty sure that her remedy ought to be in at
least one of those. I mean, I am about to give up on
this case anyway, and go home feeling discouraged to
consider changing professions and being a trout
fishing guide or something.
Anyway, this gives me a decent-sized eliminative
rubric of 34 remedies (using the 'Complete'). Then I
repertorize, confining my analysis to the remedies in
that combined rubric (for those with MacRep, drag
those 3 rubrics into the + side of the Elimination
box, and select "By Elimination" from the Analysis
menu). If repertorizing by hand, take a highlighting
pen & highlight the entire row of the eliminating
rubric. And lo and behold! Bar-c comes up nice and
strong out of the other rubrics chosen for the case.
Now this is not a case I would call my mom about or
send off for publication, but it is enough of a lead
that I can go back to the videotape and at least feel
some
sense of direction - and then go fishing.
With respect to #1, my understanding is that after
David Warkentin did a hundred or so manual
repertorizations of Bill Gray's cases, he ran out &
bought a Macintosh and learned how to program. Not to
be flip though, the "inexpensive" computer
repertorization options of any reliable quality still
are $500 plus hardware, so unless you are earning a
living at this (in which case that is really cheap),
you will be working by hand and will find times where
you need to do elimination or go crazy.
One thing that will obviously help, is to really do
your pre-repertory case analysis thoroughly, so you
are focused and can choose a minimum of high-quality,
nicely-sized rubrics. Even with the computer, I rarely
if ever work with more than 10 rubrics on a case, and
four to eight is more typical.
The eliminative rubric(s) should, obviously, represent
highly characteristic symptoms of central importance
to the case. Think about it a lot. Is this one of the
most important features that distinguishes the
*disharmony of this organism* from the rest of living
nature?
*Never* rely on a location or a pathological condition
(e.g., asthma, psoriasis, wart, uterine fibroid) as an
eliminative rubric. Almost by their definition, these
rubrics are incomplete. In provings, remedies are not
pushed to the point of creating pathological
conditions. Recall James Tyler Kent (somewhere in the
introduction to his repertory) stating that in
treating knee pain, he has only rarely used one of the
remedies listed in the knee pain rubric in his own
repertory.
Characteristic modalities, sensations, and
strongly-marked mental/emotional or general symptoms
(especially if these are concomitants of central
physical symptoms) - generally speaking, in that order
- are the best choices for eliminative rubrics. If you
use a modality or a sensation, be sure to combine the
general and the local rubrics that apply (e.g.,
Generalities; AGG; Air; cold in; + Respiration; AGG.;
Air; cold).
Make sure the eliminative rubric is of reasonable size
- e.g., the rubric Mind; Fear; alone, of being, if
used eliminatively on the asthma case I discussed
above, would have eliminated the
effective remedy. It is too small - only 4 remedies -
so most certainly is incomplete. If this is the
eliminative symptom you are going for, pick a more
encompassing rubric, like Fear, or Anxiety, or
Restlessness, or Mind; Concomitants, and add in any
missing remedies that might be found in a smaller
subrubric (e.g., Mind; Fear + Mind; Fear; alone, of
being + Mind; fear; anxious, restless). Now these are
admittedly a little big to be exceptional eliminative
rubrics - about 100 remedies each - but it still eases
your task by eliminating from consideration about 326
of the remedies in Boenninghausen's Repertory.
Ideally, you would like to find a characteristic
rubric with perhaps 20 or 30 remedies that describes a
well-marked, central & characteristic symptom of the
patient to use eliminatively, because that is small
enough to keep you focused, but large
enough that it is likely to be reasonably complete.
Knzli's repertory can be useful here - his
"red-point" rubrics are ones he considered
differentiative and reliably complete, and this could
confirm your trust in using them for elimination.
If I were to use an elimination rubric for the asthma
case above, probably the best choice would be to go
for the characteristic modalities (Sitting) using one of these or some
combination of them, or using an encompassing rubric
for the mental/emotional
concomitant such as Mind; Restlessness.
We will now look at some short cases that illustrate
Boenninghausen's approach further, and go on to look
at other aspects & approaches to case analysis over
time.
I would like to pick up again on the asthma case
mentioned above.
Recall this was a kid with an asthma attack with
spasmodic wheezing (3) and coughing at 11 p.m. (3),
worse if the winter window is open (3), where he has
to sit up (2) in bed to breath & is restless (3) with
anxiety & fear (3), & fearful of being left alone (3),
wanting both parents right on the bed (3) with him.
The rubrics I selected from Boger-Boenninghausen's
Repertory were:
Respiration; Asthma; spasmodic
Generalities; AGG; Air; cold in
- combine with: Respiration; AGG.; Air; cold
Generalities; TIME; Before Midnight
- combine with: Respiration; TIME; Midnight; before
Generalities; AMEL.; Sitting
- combine with: Respiration; AMEL.; Sitting, when;
upright
Mind; CONCOMITANTS
Mind; Fear; anxious, restless
Mind; Fear; alone, of being
- combine with Mind; Company; desires
And although Ars-alb seemed the obvious remedy by
gestalt recognition and repertorization, a
small-remedies weighting suggested considering
Moschus, which proved to be the effective
simillimum for the acute asthma attacks.
At this point, the child had responded to Moschus
nicely in a second acute attack, and the family has
since been giving Moschus with early coughing or
wheezing symptoms or when the peak flow readings
(obtained twice daily) drop below 80%, repeating 30C
in water every hour until peak flow shows a consistent
rise. And this has reduced his asthmatic symptoms to a
minimal level, with some minor episodes but no crisis
episodes now for over two months, and he has not been
using any allopathic medication at all. This is a
really big improvement for this child. The family is
now recruited to homeopathy, even the father is
interested (fathers are usually the last).
But the child is needing Moschus at least once weekly
to manage low peak flows or minor symptoms, and there
is no progressive amelioration of this chronic
condition. Do we need to continue with Moschus in this
manner, or give it in higher potency or in greater
consistency (e.g. 30C or LM1 daily), or look to a
different remedy to deal with the asthma at its root?
When I look at the child as a whole, outside of his
acute attacks of asthma, I do not see the picture of
Moschus. I will give some of his case below, but
suffice it here that with careful case-taking I feel
very pleased with Moschus as an acute remedy for his
acute asthmatic episodes,but feel that we need to look
further for a simillimumfortheroot of the disharmony
underlying his chronic asthma.
The Second Remedy
Boenninghausen gives us some wonderful help here with
his Concordances (appended to his Repertory), in
finding the remedy that will follow well after
successful response to a first remedy.
We need to ask ourselves, what remains of the case
after treatment with Moschus?
There are several things. What we are looking for
here, is what remains of the case we have already
taken after Moschus has acted. It happens that the
child continues to be generally fearful (1) &
frightened easily(2), wanting (2) & responding (2) to
reassurance, although not as acutely as in his asthma
crises. So there is a persistence of the "acute-like"
mental/emotional symptoms after Moschus. He does
continue to have episodic - although minor - coughing
and wheezing, so
there is some persistence of the aspects of locality
and sensation. His episodic asthmatic symptoms are
most often related to cold air exposure, and he tends
to get minor headaches in cold air as well, so there
is persistence of this aggravation not only with the
target symptom of asthma but also "on a grand scale".
Under Boenninghausen's Concordances for Moschus (p.
1201 in the Repertory), we can look up the
concordances for (1) Mind, (2) Locality, (3)
Sensations, and (4) Aggravation, and use these 3
rubrics as we would use any other rubrics in a
repertorization. Doing this gives us:
Nux-v (12/4 of 4), Acon (11/4), Phos (10/4), Bell
(9/4), Con (6/4), Ph-ac (5/4).
So there is a strong possibility (though not a
certainty) that we will find the remedy to follow
Moschus for this patient in one of these six remedies.
Isn't this just incredible??!
I hope you can see that Boenninghausen's approach
affords a logical and systematic way of
analysing and prescribing for even the most complex
and difficult cases.
--- Ellen Madono wrote: >
Hi Venkata,
________________________________________________________________________
Yahoo! India Matrimony: Find your partner online. http://yahoo.shaadi.com/india-matrimony/
here is the article by Will taylor.
Regards
Venkat
Analysis with Boenninghausen
by Will Taylor
In starting out with some reflections on the use of
Boenninghausen's Repertory, I am actually coming in at
a rather late stage of the process of analyzing a case
- the choice of a repertorial method, the selection of
rubrics and the "running" of a repertorial analysis
depend on careful case-taking and organization and
assessment of the case. But sometimes it helps to see
"where we're going" to in order to understand what we
need to do first - so with that spirit in mind, I
thought it would be advantageous to jump in at the
repertorizing stage and proceed in both directions.
I use several repertories in my work - most often I
refer to Roger van Zandvoort's Complete Repertory (on
computer in MacRepertory), but I also am quite fond of
Knzli's 'Kent's
Repertorium Generale' (paper), Kent (paper &
computer), the Boger-Boenninghausen repertory (which I
use on computer), Roberts' Sensations 'As If', Ward's
Unabridged Dictionary of
Sensations 'As If', Boericke's Repertory, and
occasionally Knerr's Repertory of Hering's Guiding
Symptoms. Although sometimes I hunt these
interchangeably to find "just the right rubric," more
often I find myself choosing one or the other to
optimize a particular strategy in analyzing a case.
I am currently infatuated with Boenninghausen's
repertory, not at all for universal use, but because
it offers an approach that feels complementary to the
Kentian method in which I was
trained, which may be more applicable to a subset of
the cases I see. These are those cases that center on
the characteristic symptoms of physical pathology or
"local" disease. This approach also lends itself well
to working with acute illness, and may be a very nice
way to approach homeopathic home-care of minor acute
illnesses in a classical fashion.
The structure of Boenninghausen's Repertory has its
logic in a particular approach to case
analysis.
Boenninghausen started with the observation that *any
complete symptom* contains 4 elements - these being
(1) location, (2) sensation, (3) modalities
(aggravation, amelioration, causation), and (4)
concomitant symptoms (simultaneously occurring
symptoms that do not necessarily follow obviously from
the symptom in question). To define thetotality of the
disharmony in the person presenting to us, we do best
if we can base our understanding on the four legs of
these four "parts" of a complete symptom.
Constantine Hering used the following visual scheme to
illustrate these four dimensions of a complete
symptom, and he gives it to us in his introduction to
'The Guiding Symptoms':
- -
- Sensations -
- -
- -
Localities - - Modalities
- Causation
Tissues - - Conditions
- -
- -
- Concomitants -
- -
It was Boenninghausen's observation, however, that in
the provings recorded in Hahnemann's Materia Medica
Pura (the original source record of provings of the
remedies of his day), the recorded symptoms were often
"incomplete", that is, the recorded symptoms of any
one prover may be lacking modalities, or
well-described sensations, etc.
For example, in Materia Medica Pura, pp. 515-517, the
abdominal pains of Colocynthis are described in
provers. One prover describes "Colic"; another
describes "along with some distention colic-like pain
in the abdomen and discharge of flatus;" another "a
sore cutting pain, which commenced when walking and
increased in violence at every step"; another "cutting
pains in the abdomen"; another "cutting in the
hypogastrium, at last so violent that he must walk in
a bent-forward attitude ... with dread of the work he
had to do"; another "alleviation of the violent
belly-ache by smoking tobacco"; another "acute pains,
as if severely clawed in the abdomen - a grasping in
the bowels, on account of these pains he can neither
lie quiet nor sit, and can only walk bent double."
Now each of these provers presents an incomplete
symptom, but taken together, we have location
(hypogastrium), sensation (sore, cutting, grasping,
severely clawed, colic-like), modalities (bent-forward, >tobacco), and concomitants
(distention, flatus, restlessness).
Boenninghausen also observed that, in provers, these
"parts" of a complete symptom were sometimes assorted
differently. For example in one prover, the
mental/emotional concomitant of
restlessness would be seen during headache; in
another, the amelioration by tobacco would be seen
with the irritability; in another, the grasping,
colic-like sensation would be felt in the bladder in
what looked like a cystitis.
Similarly to these provers, in patients presenting
with illness, symptoms are often stated incompletely,
or modalities may not be clearly expressed.
Based on his extensive experience with clinical work
and with provings, Boenninghausen concluded that this
problem of "incompleteness" of individual symptoms in
both provings and
clinical cases could be solved by "analogy." That is,
that symptoms in one part of the case or proving which
existed in an incomplete state could be reliably
completed by analogy, by applying the strong &
reliable conditions of other parts of the case. For
example, when we look at the pains (whatever kinds of
pains) of a Colocynthis state, we see some consistency
in their being
almost always cramping, grasping and colicky, better
from pressure, and most often ameliorated by bending
double and by heat, and we usually see restlessness as
a mental/emotional
concomitant symptom with the pain. So perhaps we see
someone with a headache that is grasping in character,
better by squeezing the head with the hands and
accompanied with restlessness. Even though we might
not find this exact symptom in a Colocynthis prover,
we can consider Colocynthis as a possible remedy, by
analogy of the sensation, modality and
concomitant of their headache with those seen in pain
in other locations of Colocynthis provers.
So (in this example) the strong, reliable &
characteristic "parts" of the abdominal pain symptom -
the sensations, modalities, and concomitants - can be
considered as general symptoms of the whole person,
rather than just as peculiarities of that specific
symptom, and can be applied in their various
combinations to other localities and tissues as well.
To deal in the Repertory with this issue of
"incompleteness" of symptoms, and to be able to apply
his notion of symptom completion by analogy, both in
the provings on which we are basing our identifying of
a simillimum, and in the clinical case we have before
us, Boenninghausen divided up symptoms into their
"parts" in his repertory. Rather than looking up
"abdominal pain better bending double," you will have
to look up "abdominal pain" and "better bending
double" to assemble your symptom.
Boenninghausen has been sadly misinterpreted as
de-emphasizing the importance of mental/emotional
symptoms, largely because of the difference in the way
he and Kent recommended working with them in
repertorization. The mental/emotional symptoms did not
take to being "broken up" as elegantly as the physical
symptoms did. So in his repertory he emphasized only
more general states, to be used in the later stages of
repertorial analysis when they were marked as strongly
in the case as in the repertory listing, and suggested
confirming mental/emotional symptoms of the patient
directly with the words of provers as a late step in
case analysis after repertorization provided a list of
remedies to consider. This is not because
Boenninghausen assigned a lower value to
mental/emotional symptoms in the totality, but rather
because he felt that the mind was a complex entity not
as easily understood as the physical symptoms in this
manner of breaking down symptoms into their "parts."
A Sample Case
For example., consider the totality of a child with an
asthma attack with spasmodic wheezing (3) and coughing
at 11 p.m. (3), worse if the winter window is open
(3), when he has to sit up (2) in bed to breath & is
restless (3) with anxiety and fear (3), & fearful of
being left alone (3), wanting both parents right on
the bed (3) with him. We can quickly recognize the
totality here, as you might pick a friend out of a
crowd, & *probably* give Ars alb successfully based on
gestalt." But in order to represent this "gestalt" in
a way that we can find it in a repertory to confirm
our selection or consider other possibilities, we need
to break it down into "pieces." I've
purposely chosen what looks like a very simple case so
that we can concentrate on the logic of what we are
doing here.
The first breakdown of the totality seems obvious: (1)
the physical asthma attack (with its specifics &
modalities); and (2 ) the mental/emotional state of
restless fear & anxiety & fear of being alone. We owe
the ease of making this first "division" of the
gestalt to the cultural heritage of Rene Descartes &
his infamous mind/body dichotomy - it really is not
that obvious a dichotomy to the patient!
So now we have our symptom of "central interest"
(asthma) and a mental/emotional concomitant symptom
(anxious/restless fear, fear of being alone, wanting
company). Boenninghausen stated
that the concomitant was to the totality, what the
modality is to the symptom. Having the modality in a
"part" of the person "distinct from" the location of
the "main symptom" gives it
even greater value (e.g., a "cough from tickling in
the larynx" concomitant, although helpful, is not
likely to be as helpful as this one).
We can represent this mental/emotional concomitant in
repertorial rubrics in two ways: (1) by simply stating
that there is a mental/emotional concomitant of the
symptom of central interest Mind; CONCOMITANTS); and
(2) by specifically stating the dimensions of this
symptom:
Mind; Fear; anxious, restless; Mind; Fear; alone, of
being + Mind; Company; desires. (I will combine these
last two rubrics into one because they are each rather
small and each carries an
aspect of the symptom). I also considered using Mind;
Fear; anxious, restless; and Mind;
AMEL.; company, as the mental/emotional concomitant
rubrics for this case, and as I type this up, feel in
retrospect that that would have been a better choice
for describing the state of this patient. Or one could
combine the three rubrics: Mind; Fear; alone, of
being; + Mind; Company;
desires; + Mind; AMEL.; company; to be even more
inclusive, where we cannot really determine which
single one applies best.
Next, we can "break down" the physical symptom of
asthma. There is spasmodic asthma, and cough (these
embody both "location" and "sensation" to some
degree), so Respiration; Asthma;
spasmodic and Cough; GENERAL. However as cough is a
common symptom of the patient's condition, and without
any real particular characteristics of the cough (e.g.
like "from tickling in the larynx"), it is not likely
to be very useful to us in repertorization. Then there
are the modalities - which Boenninghausen elevated to
general symptoms, of the whole person. So:
Generalities; AGG; Air; cold in
Generalities; TIME; Before Midnight
Generalities; AMEL.; Sitting
Now a lot of homeopaths (Constantine Hering notably
among them) criticized Boenninghausen for taking the
modalities away from their local symptoms. One of
their arguments was, that sometimes the modalities of
the part differ from the modalities of the whole. For
example Arsenicum is generally worse cold and better
heat, but its headaches are worse heat and better
cold. So Boger, in revising Boenninghausen's
repertory, created modalities sections within each
location section. So we can also find:
Respiration; AGG.; Air; cold
Respiration; TIME; Midnight; before
Respiration; AMEL.; Sitting, when; upright
In using these "modalities of the parts," give
priority to the "modalities of the whole;" but *add*
any remedies in the rubric for the "modality of the
part" that may be missing in the "modality of the
whole." That is, in your repertorization, be sure to
use all the remedies in the rubric:
Generalities; AGG; Air; cold in; but note that the
remedies Actea spicata and Lobelia are not listed
here, even though they are listed in Respiration;
AGG.; Air; cold. So add them to the
general rubric Generalities; AGG; Air; cold in for the
purposes of this case.
So the rubrics I would select from
Boger-Boenninghausen's Repertory for this case would
be:
Respiration; Asthma; spasmodic
Generalities; AGG; Air; cold in
- combine with: Respiration; AGG.; Air; cold
Generalities; TIME; Before Midnight
- combine with: Respiration; TIME; Midnight; before
Generalities; AMEL.; Sitting
- combine with: Respiration; AMEL.; Sitting, when;
upright
Mind; CONCOMITANTS
Mind; Fear; anxious, restless
Mind; Fear; alone, of being
- combine with Mind; Company; desires
Notice that I have selected the seven rubrics above to
represent as best I can the four "legs" of the "grand
symptom of the patient": Locality/Tissue, Sensations,
Modalities, and Concomitants.
Repertorization gives us (Grade x no. of rubrics /
Number of rubrics matched):
Ars (19/7 of 7); Nux-v (18/6); Phos (18/6); Bry
(16/6); Cham (12/6); Kali-c (13/6); Caust (12/6);
Verat (11/6).
Now we cannot just give Ars by the weight of its
score, even though it seems obvious & it is tempting
by now to get it done with. The repertorization is a
*pointer* to the simillimum, not its determinant.
Reflect on/read about the leading remedy and the
"runners-up." Go to the materia medica (here is where
a good keynote/confirmatory symptom materia medica
like Morrison or Phatak or Vermeulen's Synoptic
Materia Medica comes in most handy) and confirm the
remedy, perhaps even by asking a few more questions or
making a few more observations.
Now it may be very interesting to weight the
repertorization in various ways. This is not part of
Boenninghausen's method per se, but can add robustness
to any system of repertorial case
analysis.
Perhaps we can look more intently at strange, rare &
peculiar symptoms. Weighting for SRP symptoms
(something that computer repertorization makes easy -
I use MacRepertory) suggests
that we look with special interest at Ars, Lyc, Stram,
Nat-c, Kali-br and Caust (this is due largely to their
presences in the small rubrics, fear of being alone
and/or desires company). But since this
symptom really does not seem so unusually strange,
rare and peculiar in the context of the case, I would
not put a great deal of weight on it.
Similarly, weighting for Keynotes suggests that we
should look at: Bry (due to its prominence in the
rubrics Before MN & > sitting); Ars; Lyc (before MN,
desires company); Stram (fear alone); and Colch (sitting).
We can also emphasize small remedies. These are, by
definition, poorly represented in our literature, so
maybe the remedy we need is hiding in our
repertorization because it just hasn't
made it into (e.g.) the "asthma" rubric, as a
deficiency of inadequate proving & clinical
experience. One way would be to arbitrarily eliminate
the larger polychrests from consideration(not because
we do not like polychrests, but because we would like
to see what might come through if the remedy does not
happen to be one). So we can eliminate perhaps the 20
most familiar remedies and see what is left. Another
thing we could do (via computer) is to multiply the
score each remedy receives by a measure of the
"rarity" of each remedy in the repertory (i.e., the
likelihood of its being missed in a rubric in which it
might actually belong), what MacRepertory calls a
"small remedies" weighting. This tells us we should
add the following "small remedies" to our
consideration:
Mosch (11/5); Samb (6/4); Calad (6/3); Nux-m (11/5);
Ran-s (6/3); Coff (6/4).
This can also more or less be done without the
computer - look down your repertorization checklist to
find remedies that do well enough in the most
characteristic symptoms, but do not
seem very familiar.
And now that we have made more work for ourselves, we
can reflect on what we know and/or go read about all
of these possibilities too (adding to our original
list Stram, Nat-c, Kali-br, Colch,
Mosch, Samb, Calad, Nux-m, Ran-s, Coff).
I will skip a number of these here, but one of these
remedies - Moschus - does look particularly
interesting.
Now the only rubrics that Moschus does not match are
the anxious restless fear and the fear of being
alone/desire for company, but Morrison's Desktop Guide
offers: "The patient is anxious, fears his condition
and feels he could die ... Michael Carlston of Santa
Rosa, California presented two cases of asthma cured
by Moschus. The characteristics were sudden, severe,
even life-threatening asthmatic crisis, especially
coming during cold or after bathing and both cases
were associated with anxiety ...".
Morrison has 1-1/2 pages on Moschus - he talks about
spasms of smooth muscle as characteristic of the
physical complaints, describes "anxiety; feels he will
die," "hysterical asthma," "sudden, severe asthma"
(compare Cuprum). He does not mention it in his "Small
Remedies" seminars notes (rats! - I really love his
descriptions in those). Vermeulen's Synoptic Materia
Medica discusses mostly faces of the remedy that would
not pertain to the case we are seeing. Vermeulen's
Concordant Materia Medica has 2-1/2 pages of fine
print with good description of mental/emotional and
respiratory symptoms that do not really shed any more
light. Clarke has three and a half pages that again do
not shed further light on our patient. These
references suggest some mental/emotional symptoms for
Moschus that I do not see in my patient, but we know
that
you cannot rule out a remedy on this basis. Doing a
computer search of the Complete Repertory, Moschus
comes up in 1946 rubrics (so it is about as well-known
as Selenium & Strontium
carbonicum - not among the best-known 100 remedies,
but somewhere near the bottom of the best-known 200).
In the Complete Repertory, we find lots of anxiety &
fear & restlessness rubrics for Moschus, including a
boldface MIND; RESTLESSNESS, nervousness; asthma,
with; as an addition from Knerr. Now Knerr's repertory
is based on the materia medica of Hering's' Guiding
Symptoms, so we can go there (vol. 7, pp. 489-498) for
some source material. Hering lists, among much else,
very strongly marked "Asthma in hysteric individuals
and in children".
I decided that I had learned a lot but could not be
convincingly dissuaded from Ars. The family did not
have Moschus or Caladium or Sambucus or Kali bromatum
in their kit at home anyway.
The child above did *not* respond to Ars (30C in
divided doses in water), but came through the episode
all right on his albuterol nebulizer treatments. His
next episode responded very nicely to Moschus 30C in
divided doses every five minutes in water. Elimination
Rubrics
There are two contexts in which the issue of
elimination rubrics (confining repertorial analysis to
the remedies contained in one or more rubrics) comes
up:
(1) to make repertorization by hand a (somewhat!)
manageable task;
(2) when one really feels that consideration should be
limited to the remedies contained in one or a
combination of a small group of rubrics.
I have rarely had serious recourse to #2. It takes a
great deal of faith to believe that any rubric is
"complete." Reference to Knzli's Repertory may be
helpful. I would be more comfortable using
one of his "red-dot" rubrics eliminatively, as these
are rubrics that he felt were reliably complete.
Sometimes I "play around" with this option, though - I
will have a repertorization that is rather
non-discriminative. Usually that is because I took a
lousy case or did not organize it well for
analysis, but sometimes I just find myself stuck with
that.
So maybe, for example, the patient really avoided
revealing any mental/emotional symptoms, and that
avoidance *is* the mental/emotional stuff of the case,
so I combine into a single rubric:
MIND; HIDE, desire to
MIND; SECRETIVE
MIND; FEAR; observed, of her condition being
I do not know which of those describes her best, but I
feel pretty sure that her remedy ought to be in at
least one of those. I mean, I am about to give up on
this case anyway, and go home feeling discouraged to
consider changing professions and being a trout
fishing guide or something.
Anyway, this gives me a decent-sized eliminative
rubric of 34 remedies (using the 'Complete'). Then I
repertorize, confining my analysis to the remedies in
that combined rubric (for those with MacRep, drag
those 3 rubrics into the + side of the Elimination
box, and select "By Elimination" from the Analysis
menu). If repertorizing by hand, take a highlighting
pen & highlight the entire row of the eliminating
rubric. And lo and behold! Bar-c comes up nice and
strong out of the other rubrics chosen for the case.
Now this is not a case I would call my mom about or
send off for publication, but it is enough of a lead
that I can go back to the videotape and at least feel
some
sense of direction - and then go fishing.
With respect to #1, my understanding is that after
David Warkentin did a hundred or so manual
repertorizations of Bill Gray's cases, he ran out &
bought a Macintosh and learned how to program. Not to
be flip though, the "inexpensive" computer
repertorization options of any reliable quality still
are $500 plus hardware, so unless you are earning a
living at this (in which case that is really cheap),
you will be working by hand and will find times where
you need to do elimination or go crazy.
One thing that will obviously help, is to really do
your pre-repertory case analysis thoroughly, so you
are focused and can choose a minimum of high-quality,
nicely-sized rubrics. Even with the computer, I rarely
if ever work with more than 10 rubrics on a case, and
four to eight is more typical.
The eliminative rubric(s) should, obviously, represent
highly characteristic symptoms of central importance
to the case. Think about it a lot. Is this one of the
most important features that distinguishes the
*disharmony of this organism* from the rest of living
nature?
*Never* rely on a location or a pathological condition
(e.g., asthma, psoriasis, wart, uterine fibroid) as an
eliminative rubric. Almost by their definition, these
rubrics are incomplete. In provings, remedies are not
pushed to the point of creating pathological
conditions. Recall James Tyler Kent (somewhere in the
introduction to his repertory) stating that in
treating knee pain, he has only rarely used one of the
remedies listed in the knee pain rubric in his own
repertory.
Characteristic modalities, sensations, and
strongly-marked mental/emotional or general symptoms
(especially if these are concomitants of central
physical symptoms) - generally speaking, in that order
- are the best choices for eliminative rubrics. If you
use a modality or a sensation, be sure to combine the
general and the local rubrics that apply (e.g.,
Generalities; AGG; Air; cold in; + Respiration; AGG.;
Air; cold).
Make sure the eliminative rubric is of reasonable size
- e.g., the rubric Mind; Fear; alone, of being, if
used eliminatively on the asthma case I discussed
above, would have eliminated the
effective remedy. It is too small - only 4 remedies -
so most certainly is incomplete. If this is the
eliminative symptom you are going for, pick a more
encompassing rubric, like Fear, or Anxiety, or
Restlessness, or Mind; Concomitants, and add in any
missing remedies that might be found in a smaller
subrubric (e.g., Mind; Fear + Mind; Fear; alone, of
being + Mind; fear; anxious, restless). Now these are
admittedly a little big to be exceptional eliminative
rubrics - about 100 remedies each - but it still eases
your task by eliminating from consideration about 326
of the remedies in Boenninghausen's Repertory.
Ideally, you would like to find a characteristic
rubric with perhaps 20 or 30 remedies that describes a
well-marked, central & characteristic symptom of the
patient to use eliminatively, because that is small
enough to keep you focused, but large
enough that it is likely to be reasonably complete.
Knzli's repertory can be useful here - his
"red-point" rubrics are ones he considered
differentiative and reliably complete, and this could
confirm your trust in using them for elimination.
If I were to use an elimination rubric for the asthma
case above, probably the best choice would be to go
for the characteristic modalities (Sitting) using one of these or some
combination of them, or using an encompassing rubric
for the mental/emotional
concomitant such as Mind; Restlessness.
We will now look at some short cases that illustrate
Boenninghausen's approach further, and go on to look
at other aspects & approaches to case analysis over
time.
I would like to pick up again on the asthma case
mentioned above.
Recall this was a kid with an asthma attack with
spasmodic wheezing (3) and coughing at 11 p.m. (3),
worse if the winter window is open (3), where he has
to sit up (2) in bed to breath & is restless (3) with
anxiety & fear (3), & fearful of being left alone (3),
wanting both parents right on the bed (3) with him.
The rubrics I selected from Boger-Boenninghausen's
Repertory were:
Respiration; Asthma; spasmodic
Generalities; AGG; Air; cold in
- combine with: Respiration; AGG.; Air; cold
Generalities; TIME; Before Midnight
- combine with: Respiration; TIME; Midnight; before
Generalities; AMEL.; Sitting
- combine with: Respiration; AMEL.; Sitting, when;
upright
Mind; CONCOMITANTS
Mind; Fear; anxious, restless
Mind; Fear; alone, of being
- combine with Mind; Company; desires
And although Ars-alb seemed the obvious remedy by
gestalt recognition and repertorization, a
small-remedies weighting suggested considering
Moschus, which proved to be the effective
simillimum for the acute asthma attacks.
At this point, the child had responded to Moschus
nicely in a second acute attack, and the family has
since been giving Moschus with early coughing or
wheezing symptoms or when the peak flow readings
(obtained twice daily) drop below 80%, repeating 30C
in water every hour until peak flow shows a consistent
rise. And this has reduced his asthmatic symptoms to a
minimal level, with some minor episodes but no crisis
episodes now for over two months, and he has not been
using any allopathic medication at all. This is a
really big improvement for this child. The family is
now recruited to homeopathy, even the father is
interested (fathers are usually the last).
But the child is needing Moschus at least once weekly
to manage low peak flows or minor symptoms, and there
is no progressive amelioration of this chronic
condition. Do we need to continue with Moschus in this
manner, or give it in higher potency or in greater
consistency (e.g. 30C or LM1 daily), or look to a
different remedy to deal with the asthma at its root?
When I look at the child as a whole, outside of his
acute attacks of asthma, I do not see the picture of
Moschus. I will give some of his case below, but
suffice it here that with careful case-taking I feel
very pleased with Moschus as an acute remedy for his
acute asthmatic episodes,but feel that we need to look
further for a simillimumfortheroot of the disharmony
underlying his chronic asthma.
The Second Remedy
Boenninghausen gives us some wonderful help here with
his Concordances (appended to his Repertory), in
finding the remedy that will follow well after
successful response to a first remedy.
We need to ask ourselves, what remains of the case
after treatment with Moschus?
There are several things. What we are looking for
here, is what remains of the case we have already
taken after Moschus has acted. It happens that the
child continues to be generally fearful (1) &
frightened easily(2), wanting (2) & responding (2) to
reassurance, although not as acutely as in his asthma
crises. So there is a persistence of the "acute-like"
mental/emotional symptoms after Moschus. He does
continue to have episodic - although minor - coughing
and wheezing, so
there is some persistence of the aspects of locality
and sensation. His episodic asthmatic symptoms are
most often related to cold air exposure, and he tends
to get minor headaches in cold air as well, so there
is persistence of this aggravation not only with the
target symptom of asthma but also "on a grand scale".
Under Boenninghausen's Concordances for Moschus (p.
1201 in the Repertory), we can look up the
concordances for (1) Mind, (2) Locality, (3)
Sensations, and (4) Aggravation, and use these 3
rubrics as we would use any other rubrics in a
repertorization. Doing this gives us:
Nux-v (12/4 of 4), Acon (11/4), Phos (10/4), Bell
(9/4), Con (6/4), Ph-ac (5/4).
So there is a strong possibility (though not a
certainty) that we will find the remedy to follow
Moschus for this patient in one of these six remedies.
Isn't this just incredible??!
I hope you can see that Boenninghausen's approach
affords a logical and systematic way of
analysing and prescribing for even the most complex
and difficult cases.
--- Ellen Madono wrote: >
Hi Venkata,
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