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Sunday, January 10, 2010

STEPS TO REPERTORISATION:

Posted by Anonymous
INTRODUCTION
Repertorisation is not only a mechanical process of counting rubrics &totality marks obtained by a medicine;it also includes the logical steps to reach the proper repertory& finally differentiating the remedies with the help of materia medica

Art of repertorisation is based on the art of proper elicitation of symptoms with the fullest possible expression of each of them, then their proper evaluation, categorizing and classification.only if we know steps involved in repertorisation, we will be able to do in precise manner and will be able to follow in a proper way to get a good result.

STEPS TO REPERTORISATION
It starts from case taking and ends by finding out the similimum. The following steps are indispensable in order to arrive at the terminal stage of remedy section.
1.Case selection
2.Case taking/ case receiving
3. Case recording
4. Defining the problem
5. Analysis of symptoms
6. Evaluation of symptoms
7. Totality of symptoms
8. Selection of repertory
9. Repertorial totality
10.Selection of rubrics
11. Repertorial technique
12. Repertorial result
13. Repertorial analysis
14. Miasmatic assesment
15. Susceptibility assesment
16. Plan of treatment
17. Remedy selection
18. Potency selection and application

CASE SELECTION
• Absolutely surgical cases, poisoning
• Cases not within domain of homoeopathy
• Aphorism 67


CASE TAKING
• Stepping stone for repertorization
• A WELL TAKEN CASE IS HALF CURED
• Ahporism 83-104
• Artistic part is the most important part

CASE RECORDING
• For effective repertorization, precise recording is necessary
• It is done simultaneosly while interrgating
• Patients story is recorded in a standard case recording format
• Aphorism 104
• Without burdening the memory we can quickly restore the picture at any future
• Hahnemann, Boenninghausen, Hering, Kent, Lutze had their own case records

DEFINING THE PROBLEM
• The record guides him to undersytand the person & his disease
• It means to define the individual who is facing a problem
• Includes diagnosis of disease, predisposition, disposition, diathesis.
• Precisely doing this, a physician would be able to go ahead further in the right direction

ANALYSIS OF CASE/SYMPTOMS
• Means separation of things
• Categorization & classification of a given case according to the scope & limitations of homoeopathy
• Which classification of disease it falls? Whether curable or incurable? With remedy?
• Symptoms resolved as
a)location with radiation b)sensation with intensity/character c)modalities d)concomitants

• Aphorism 153 mental
• common general physical
• Hahnemann uncommon PQRS particular location sensation modalities

basic
• Garth Boericke mental & physical determinative general modalities absolute symptoms cause type location character concomitant modalities

mental
general physical

PQRS
• Kent particular particular with modalities common
• Boger - modalities- causative, time, temp, sleep, position, etc mind sensation objective symptoms parts afected


• Boenninghausen – quis – change of personalty & temperament quid – pecularities of disease Ubi – seat of disease qubus auxilus – concomitant Cur – cause Quomodo – modalities Quando – time
• For particulars – location, sensation, modalities, concomitant

• In this part physician shiuld be able to grasp the whole picture in relation to the patient & his parts.
• Should be able to spot the strange rare peculiar & striking symptoms
• It is governed by various principles, hence variation cannot be denied
• Different stalwarts have different approaches
• Proper analysis needs a keen & analtyical mind
• Should be able to analyze every symptom in depth & arrange it logically
• All these require great patience & time

EVALUATION OF SYMPTOMS
• Implies the principle of grading or ranking the different symptoms in order of priority which are to be matched with drug symptoms
• After analysis physician has to determine the value of each symptoms
• Elizabeth Wright –the evaluation of symptoms is perhaps the most important part of the homoeopathic technique & for a beginner one of the most difficult
• But it becomes easy & automatic if one adheres strict to the principles & philosophy of homoeopathic practice

• The basic principle is symptoms are ranked according to their intensity
• Purpose is to form a comprehensive portrait of the disease so that a similar portrait can be found in materia medica
• One important general can over rule several particulars
• Particulars become important if qualified with modalities

• In Kentian method – mentals then physicals & particulars the least
• Boger – pathological generals & objective symptoms are more important
• An intense particular will be rated higher tha poor generals
• Based on analysis evaluation is done

TOTALITY OF SYMPTOMS/SYNTHESIS OF CASE
• Synthesis means making whole out of parts
• Case synthesis is defined as the process of rearranging the information obtained from case taking to form a comprehensive & conceptual image
• The presence of common symptoms & excess of particulars do not help to make a distinctive image
• Generals give a strong individuality to the image
• Aphorism 5 together with 95 & 103 shows that the totality of symptoms includes all the relevant data elicited from not only the past history but also from family history to know its fundamental cause
• Aphorism 6,7,70,153,154
• Aphorism 18- totality of symptoms observed in each case of disease can be the only indication to guide us in selection of remedy
• By this individualization we can eliminate the general symptoms common to similar pathological conditions

• Boger – pathological generals
causation concomitant modalities physical generals mentals for diferentiation

Kent – emotions intelluct general modalities physical generals characteristic particulars

• Boenninghausen – location sensation modalities concomitants physical generals mentals for differentiation

• Based on evaluation totality is framed

SELECTION OF REPERTORY
• After the totality is erected the following points are considered: 1)generals: mental/physical 2)particulars:location,sensation,modalities,concomitants 3)pathological generals
• Full of generals – kent rep
• Pathological generals – boger rep
• More particulars – therapeutic pocket book, boger also can be used
• Synthetic rep – for more generals & pathological generals but no particulars
• Generals – synthesis, complete, homoeopathic medical rep
• Recent repertories are used for all kind of cases

REPERTORIAL TOTALITY
• After selecting the repertory the next step is to rearrange the totality according to the repertory selected
• Also called as repertorial syndrome as it consists of signs & symptoms

SELECTION OF RUBRICS
• To convert symptom into rubrics require well acquaintance with the repertory
• The symptom found in the patient may not be in the same form
• So one must know the construction, arrangement, philosophical background, scope & limitation of each repertory
• Process of searching the required rubrics from particular sections & locate the same in the repertory

• Rubric should be arranged I hierrachy, reason & page number
• Final outcome written as: symptoms rubrics reason page no 1 x1 y1 z1 2 x2 y2 z2 3 x3 y3 z3

REPETORIAL TECHNIQUE
• Plain paper, chart, thumb finger, card & computer
• Particular to general, general to particular, classical method(characteristic symptom), eliminating ,combined
• Case is referred to repertory worked out

REPERTORIAL RESULT
• A group of close running medicines are noted according to symptoms covered & marks obtained
• Eg. Lyco 8 rubrics & 16 marks written as 16/8
• A few medicines which are nearer to first is also noted
• With the few drugs, safely & confidently enter into materia medica

REPERTORIAL ANALYSIS
• The remedy that gets the highest mark is not necessarily the final remedy
• Results should be finally verified in the court of materia medica
• Marks are important but these do not constitute the final verdict
• Picture of patient to be compared with the drug & differentiated with the help of materia medica
• The field differentiating the drug is called potential differential field(PDF)

• Conceptual image – repertorial totality =PDF

• Grading of drugs is given based on intensity of the symptom in that drug
• So intensity of symptom is necessary

Rubric grade no of rubric marks A B C D I 1 3 1 2 3 2 3 1 2 3 II 3 1 2 3 2 4 1 2 3 2 III 5 2 3 1 1 6 2 3 1 1

• MIASMATIC ASSESMENT

• SUSCEPTIBILITY ASSESSMENT

• PLAN OF TREATMENT
Acute, chronic, intercurent
• REMEDY SELECTION

• POTENCY SELECTION & APPLICATION

CONCLUSION
• Unless we follow the final judgment it is fruitless
• Repertory serves the purpose as the dictionary of the language of disease, being the index
• For bridging this literature(mat med) the grammar is organon
• Very few uses repertory
• Even in institutions provides little scope for it in curriculum & syllabus

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