Perhaps one of the greatest piece of homoeopathic literature left by Dr Boger is the Boenninghausen’s Characteristics and Repertory. “The combined observations and logic of Boenninghausen and the wide and wise observations garnered by Dr Boger from long years of study and practice,” is the tribute that Dr H.A. Roberts paid to Boger. Boger indeed helped the profession by pulling all his experiences in the evolution of ‘Portrait of Disease’ (natural as well as artificial).
Dr C.M. Boger was a leading practitioner of United States in the early decades of the twentieth century. As a practical man he well understood the difficulties faced by the practitioners of his days in finding out a correct correspondence in the materia medica in the shortest possible time. The perceptive mind of this German physician soon discovered that, in spite of the availability of a plethora of literature and clinical experiences, the burning question was, how best those could be put to use. In his time, both the Boenninghausen and Kentian schools were popular. Boger made a study of both but accepted Boenninghausen’s way of working out of a case. Finding that the practitioners had to depend on existing faulty translations of Repertory of Antipsoric Remedies, he embarked upon the task of translating it in 1900. In the course of his translation work, he was further convinced that Boenninghausen’s basic principles, plan and construction were sound, and that the book was comprehensible, and hence practicable. Boger was also aware of the difficulties faced by the practitioners while using the Therapeutic Pocket Book as well as criticism leveled against its principles and methodology.
Boger also undertook the major work of rewriting Boenninghausen’s repertory. This he did by adding aggravations, ameliorations and concomitants in a detailed manner at the end of every chapter. The outcome was a more useful work enriched with many new chapters, new rubrics and medicines. The total number of medicines used in this repertory comes to 464. It was published by Boericke and Tafel in 1905. Even thereafter, Boger continued to work on the repertory; however, death snatched him away before he could give the final version. His manuscripts were published posthumously with the assistance of his wife, by Roy & Co., India in 1937.
This second edition proved very useful in successfully working out cases. It contains characteristics of medicines in the first part and repertory proper in the second. Hence, the title Boenninghausen’s Characteristics and Repertory. The work is an attempt to bridge Boenninghausen and Kent.
Dr Dario Spinedi who wrote a foreword to ‘Complete Repertory’ writes, ‘I discovered that Boger’s Boenninghausen’s Repertory is a real gold mine for all kinds of symptoms.’
Dr J.H. Clarke says,” Dr Boger’s large work, Boenninghausen’s Characteristics and Repertory, contains Boenninghausen’s Characteristic Materia Medica as well as the repertories of all his work combined into one. It is a most valuable compilation.”
Boenninghausen’s pioneering work was in great use during the second half of the nineteenth century, because it was the only work of it’s kind available to the practitioners. However, with the publication of Kent’s repertory in 1897, it receded to the back stage. Consequently, Boenninghausen’s work as well as his principles, were overlooked. Boger creditably resuscitated Boenninghausen by refining and enriching the fundamentals and recasting the structure and methodology.
Boger, while working on Boenninghausen’s repertory, subscribed to the principle of totality of symptoms, which was originally given by Hahnemann. He was fully in agreement with the idea of what constitutes a complete symptom, which is studied in relation to four factors, viz, location, sensation, modalities and concomitant.
Boger’s work Boenninghausen’s Characteristics and Repertory is based on the following fundamental concepts:
1. Doctrine of Complete Symptoms and Concomitants
Patient narrates the story and details the suffering during the clinical interview. All symptoms are not concrete and complete. A complete symptom is that which consists of location, sensation and modalities. During the interview, unreasonable attendants of main symptoms are also noticed in relation to the time (before, during or after), which are called concomitants. Boger borrowed the idea of a complete symptom from Boenninghausen’s method of erecting a totality, but he improved over it by relating sensation and modalities to specific parts, thereby he fairly and squarely met the criticism.
In the book, the complete symptoms are well arranged and it is seldom necessary to do grand generalization regarding sensation and modalities. Concomitants are given greater importance by Boger in relation to the parts.
2. Doctrine of Pathological Generals
Boger was not satisfied by merely following the principle of complete symptoms, but he went further to seek general changes in the tissues and parts of the body. Today, with our advanced knowledge of medicine, it is not difficult to understand the importance of pathological generals mentioned by him in the repertory.
Pathological generals tell the state of the whole body and it’s changes in relation to the constitution. They help us to concentrate on more concrete changes to select the simillimum. The chapter in the book ‘Sensations and Complaints in General’ is full of examples of pathological generals, which include discharges, structural alterations, constitutions, diathesis, etc (for a detail study, cf. section 6).
3. Doctrine of Causation and Time
Boger has given an adequate place and importance to causation and time of the expressions. Each chapter in the book is followed by time aggravation. The section on aggravation also contains many causative factors. From his point of view, causation and time factors are more definite and reliable in cases as well as in medicines. In his own practice, he has successfully employed these factors to find out a simillimum in the shortest possible time. His other works also substantiate the importance of these factors. In the chapter ‘Choosing the Remedy’ he gives importance to the miasmatic cause, as well as exciting cause.
From Boger’s Synoptic Key, a valuable gift to the homoeopathic world, it is obvious that his hierarchy in evaluating symptoms was somewhat different from Boenninghausen and Kent. He gives more importance to causation and general modalities (mental and physical) followed by general sensations (pathological generals and physical generals), which hold the key in the remedy as well as in the person. Thus, according to Boger, they need to be given an adequate place in repertorization.
4. Clinical Rubrics
Boger was not the first person, who appreciated the use of clinical conditions in grouping medicines and their use in selecting a remedy in absence of characteristic symptoms in the case. But he was the first one who appreciated and mentioned several clinical conditions, which he came across in day to day practice. Though they should be put to a limited use, they help the physician in cases of advanced pathology that is, gross tissue changes where he is left without a clear picture because of poor susceptibility. These rubrics are useful to arrive at a group of medicines, which can be further narrowed down, with the help of modalities and concomitants to select finally the most similar remedy.
5. Evaluation of Remedies
Boger followed the same innovation, which Boenninghausen introduced in the grading of remedies. He introduced the grading of symptoms into five ranks by the use of different typography such as:
| CAPITAL | 5 |
| Bold | 4 |
| Italics | 3 |
| Roman | 2 |
| (Roman) in parenthesis | (1), rarely used. |
The gradation is based on the frequency of the appearance of symptoms in the provers. Thus five mark medicines are most important and one mark least important.
Note: The original gradation of Boenninghausen was only four. He did not give importance to Roman parenthesis.
6. Fever Totality
This is the unique contribution of Boger. The arrangement of the chapter on Fever is self-explanatory. Each stage of fever is followed by time, aggravation, amelioration and concomitant. Thus, they help to repertorize any simple as well as complicated case of fever.
7. Concordances
By including a chapter on Concordance, Boger has made the philosophy clearer and practical, though it deals with relationship of medicines of only 125 remedies. Concordances should be worked on the same principle as is followed in Therapeutics Pocket Book (for a detailed study, cf. chapter-1, section 8).
Having found certain difficulties in the day to day use of Therapeutic Pocket Book, Boger tried to modify the structure and content of the book by adding many medicines and rubrics drawn from his own experiences and other sources. Thus, the book has undergone a vast change, but it’s principles have remained unchanged.
While compiling the repertory, Boger followed the basic plan and construction of Boenninghausen’s Repertory of Anti- psoric Medicines, which could overcome many difficulties faced in using Therapeutic Pocket Book.
Unlike Boenninghausen, he made several sections for different parts of the body and he added many rubrics and subrubrics. The chapter on Fever has been entirely changed in its arrangements as well as in its contents for easy reference. However, he used the same gradation as that of Boenninghausen
The repertory embraces the psoric and the antipsoric repertories, the sides of body, the repertory part of the intermittent fever and of whooping cough as well as a large number of paragraphs from the aphorisms of Hippocrates.
In order to understand the book, it is imperative to acquaint oneself with it’s plan, construction and arrangement.
Most of the sections in the book start with the rubric ‘In general.’ This rubric groups those prominent medicines, which are capable of producing different types of symptoms in relation to that organ/location. Clinically, these medicines have an affinity towards those particular organs. This grouping may not help us in the process of systematic repertorization, but it can be of much help to know the affinity towards the parts. It suggests organ remedies, which may be useful for finding out a drug for palliation, when only a few prescribing symptoms are available in the case.
Location rubrics are followed by further subdivisions of parts, with each part having rubrics like ‘side’ and ‘extending to.’ After the location, different sensations are arranged in an alphabetical order. Each sensation is a general rubric, which is followed by a group of medicines. It is divided into subrubrics under which, parts are mentioned (mostly abbreviations). Rubrics for the pain are further divided into various types of pain that is, aching, burning, etc. Usually these subrubrics are too specific and have a less number of medicines. Thus, these subrubrics are less useful in repertorization.
The rubrics for location and sensation are mixed and there are no separate headings given for them, but it is easy to understand because there is an order, that is, after location, sensations are arranged in an alphabetical order. This is followed by time, aggravation, amelioration, concomitant and cross- reference.
For example:
HEAD — INTERNAL
In general
PARTS — FOREHEAD
LOCATION
sub-divisions
Extending to
Eye region of – sides
Extending to
TEMPLE
Sides
Extending to
ETC.
(Separate chapters)
Abdomen — as if from
Aching — PARTS (subrubrics)
Forehead (F)
Temples (T)
Sides (S)
Vertex (V)
Occipital (O)
ETC.
TIME
AGGRAVATION
AMELIORATION
CONCOMITANTS— NOT GIVEN
CROSS-REFERENCE
1. Location and Sensation
Location and sensation are mixed in Boger’s repertory; so separate headings are not given for them. Usually the location is further split into different subdivisions, sides and extension. This subsection of location is useful because it groups medicines for the parts. In repertorization, if a rubric is selected for parts, these rubrics can be used.
In the repertory, sensation begins after the end of location. Usually a horizontal line indicates the end of location and beginning of sensation. Different sensations and pathological conditions are mentioned in relation to each part. Therefore it meets the usual objections raised against Boenninghausen’s grand generalization.
Each specific sensation is again attached to the sub- divisions of the main location. This is useful from the point of repertorization as it specifies the sensation and contains a group of medicines. Rubrics, which contain smaller group of medicines, can be used only for reference purpose.
2. Time
Here the medicines are grouped under broad divisions of time like, daytime, morning, forenoon, noon, etc. There are no specific hours mentioned, unlike the Kent’s repertory. This subsection of time is given at the end of each section. This sub- section specifies the aggravation of complaints at a particular time. In some chapters, specific hours are mentioned with a very small group of medicines. This is useful because most of the patients mention broad divisions of time rather than the exact hour of suffering.
3. Aggravation
This subsection contains factors, which increase the specific complaints of the part, and it also includes the factors, which excite or bring on the complaints.
Some of the concomitant factors are also found in this subsection especially in those sections which are not followed by a separate chapter on concomitants.
This subsection is larger than amelioration and most useful for repertorization, particularly for acute cases or so-called short cases.
4. Amelioration
It is found in practice that the patient finds it difficult to present ameliorating factors. Thus, this subsection contains lesser number of rubrics and is given lesser importance in repertorization. The ameliorating factor is used for the purpose of individualizing the case.
5. Concomitants
This is a major contribution of Boger to the homoeopathic system of medicine. He has worked hard to collect concomitants from different sources — namely provings, clinical experience and verifications which were not accessible to the profession earlier. This is a valuable addition for the purpose of repertorization.
Most of the concomitant subsections are well explained and arranged in an alphabetical order, but a few subsections have only a group of medicines (for instance, ‘Mind’ section), which are obviously less useful.
Chapter on fever is extremely rich in concomitants in relation to chill, heat and sweat under different subheadings. For this Boger is gratefully remembered. However, all chapters are not followed by this subsection.
6. Cross-reference
This is another significant subsection, which makes the repertory more useful and comprehensible. In our day to day practice, we get a maze of symptoms in some cases and in a few there is scarcity of expressions, but in both conditions we have to evaluate and come to the characteristic symptoms for a prescription. To locate these hard-earned characteristic symptoms in the repertory, we must adequately interpret and convert them into rubrics. This subsection helps us to do this and also to clear our confusion about similar rubrics. However, cross-reference is not given at the end of all chapters.
| Concomitants Enlisting Only a Group of Medicines | Concomitants Given in Detail | Modalities (Agg. and Amel.) Not Given | Only Aggravation is Given | Conditions Given for Modalities |
| Mind | Vertigo | Appetite | Watebrash & heartburn | Anus & rectum |
| Respiration | Coryza | Thirst | External abdomen | Perineum |
| Teeth | Prostate gland | Pubic region | Genitalia | |
| Nausea & vomiting | Menstruation | Larynx & trachea | Voice & speech | |
| Stomach | Sensation & complaints in general | Skin & exterior body | Urine | |
| Stool | Glands | Urinary organs | ||
| Urine | Bones | |||
| Sexual impulse | Sleep | |||
| Menstruation | Dreams | |||
| Cough | ||||
| Fever |
Pathological generals are the expressions of the person, which are known by a study of the changes at the tissue level. Certain types of constitutions are prone to certain pathological changes to different levels of system and organs. An individual may respond to constant unfavourable stimuli through pathological changes in different tissues, but a common propensity might still persist. This common change in different tissues shows the behaviour of the whole constitution, which is important to understand the individual. This requires knowledge of pathology, keen observation and careful study of the symptoms on the part of the physician to detect the pathological generals in a patient and use it for finding out a simillimum. Boger emphasized the importance of pathological generals both in his repertory and his book General Analysis. Both books can be used side by side for the purpose of repertorization.
A Few Pathological Generals in the Repertory
Different kinds of sensations or pains if noticed in many parts can be taken as ‘general.’ All the rubrics mentioned in ‘sensations and complaints in general’ are not pathological generals. Rubrics become pathological generals only if the case expresses likewise.
Boger’s General Analysis and Synoptic Key are also useful for the purpose of using pathological generals.
Advantage
If the case shows a pathological general, it can be repertorized by following Boger’s method. Thus, finding out the simillimum would be easier.
Caution
Alcoholism, intoxication – Mind
Awkwardness – Mind
Guilt, sense of – Mind
Hydrophobia – Mind
Hypochondriasis – Mind, Sensations and Complaints
Hysteria – Mind, Sensations and Complaints
Confused – Mind
Confusion – Sensorium
Muscles don’t respond to will– Mind
Phlegmatic – Mind
Unsociable, shy, aversion to society – Mind
Society agg. – Aggravation and Amelioration
Yielding disposition – Mind
Faintness – Sensorium, Sensations and Complaints
Hydrocephalus – Head, internal
Parotid glands – Ear, face
Sinuses – Nose
Sneezing – Coryza
Zygoma – Face
Glands – salivary – Mouth
Stomatitis – Mouth
Uvula – Mouth, Palate
Diphtheria – Throat
Globus hystericus – Throat
Aversions and desires – Appetite
Hiccough – Eructation, Hiccough
Cough ends in eructation – Eructation agg.
Acidity – Stomach, Heartburn, Eructation Pancreas, diaphragm
Spleen, gall bladder – Hypochondria
Ascites – Abdomen
Hernia, inguinal – Inguinal and Pubic Region
Hydrocele – Genitalia – Scrotum
Pregnancy, complaints during -Genitalia – Female Organs
Pregnancy – Aggravation and Amelioration
Prostatic fluid loss of, stool during – Sexual Impulse
Cheyne-Stokes respiration – Respiration
Croup – Larynx and Trachea
Asthma milleri (spasm of) – Larynx and Trachea
Bronchitis – Chest
Tuberculosis, pulmonary – Chest
Angina pectoris – Heart and region of
Goiter, heart – Heart and region of
Air, aversion to, open – Sensations and Complaints
Anemia – Fever, circulation
Asphyxia – Sensations and Complaints
Anxious feeling (internal anxiety) – Sensations and Complaints
Anxiety in limbs – anxious feeling – Sensations and Complaints
Asleep, sensation in limbs – Sensations and Complaints
Atrophy of different parts – Sensations and Complaints
Carried wants to be – Mind, Aggravation and Amelioration
Constitutions – Sensations and Complaints
Symptoms of joints – Sensations and Complaints
Haemophilia – Sensations and Complaints
Hard bed, sense of, feel that bed is hard – Sensations and Complaints
Heated, easily becomes (easily feels heated) – Sensations and Complaints
Hydrophobia, hypochondriasis, hysteria – Mind, Sensations and Complaints
Ill, sense of being – Mind, Sensations and Complaints
Increasing (pain slowly increasing to climax, coming down slowly etc) – Sensations and Complaints
Infants, affections of – Sensations and Complaints
Influenza – Sensations and Complaints
Lightness of limbs– Sensations and Complaints
Ophisthotonos – Sensations and Complaints
Paralysis agitans – Sensations and Complaints
Diphtheritic – Sensations and Complaints
Limbs – Sensations and Complaints
Rheumatic – Sensations and Complaints
Puberty, youth – Sensations and Complaints
Running like a mouse along limbs – Sensations and Complaints
Scurvy – Sensations and Complaints
Sensation, illusions of – Sensations and Complaints
Illusions – Mind
Sense, illusions of – Mind
Smaller, shrinking, sense of – Sensations and Complaints
Sequelae – Sensations and Complaints
Spasm – dentition (convulsion during dentition) – Sensations and Complaints
Uterine – Sensations and Complaints
Menstrual – Sensations and Complaints
Spots (complaints/sensation in spots) – Sensations and Complaints
Sudden (pain comes suddenly and goes suddenly) – Sensations and Complaints
Walk (difficulty in learning walking in children) – Sensations and Complaints
Well feeling (denies being sick) – Sensations and Complaints
Curvature (rachitis) – Bones
Fracture – slow union (slow union) – Bones
Necrosis (septic osteomyelitis) – Bones
Abscess, boils, carbuncle (difficult to heal) – Skin
Eruption – unhealthy – Skin
Unhealthy – Skin
Hair falling – Skin
Nails affected in general – Skin
Pathological types (fever types of) – Fever
Concomitants of chill, heat, sweat – Fever
Alone (desires solitude) – Aggravation and Amelioration
Company, aversion to- Mind
Company – Aggravation and Amelioration
Society – Aggravation and Amelioration
Children in, women, females, for, pregnancy, climacteric, dentition, during – Aggravation and Amelioration
Distant (complaint causes symptoms at distant parts) – Aggravation and Amelioration
Diverting the mind ameliorates – Aggravation and Amelioration
Driving or riding in a carriage, (symptoms caused by journey, travelling) – Aggravation and Amelioration aggravates Emotions, aggravates (different mental modalities) – Aggravation and Amelioration
Food and drinks (agg. & amel.) – Aggravation and Amelioration
Frost – Aggravation and Amelioration
Hang down (letting limbs) – Aggravation and Amelioration
Injury and shock – Aggravation and Amelioration
Loss of vital fluids – Aggravation and Amelioration
Lying on (postural modalities) – Aggravation and Amelioration
Lying on (symptoms appear on opposite side of lying on) – Aggravation and Amelioration
Side, pain goes to side at which he is not lying – Aggravation and Amelioration
Moon (modalities related to) – Aggravation and Amelioration
Music, intolerance of – Aggravation and Amelioration
Old age, senility – Aggravation and Amelioration
Shipboard on (seasickness) – Aggravation and Amelioration
Shock, nervous – Aggravation and Amelioration
Stomach, disordered – Aggravation and Amelioration
Stone cutters for – Aggravation and Amelioration
Suckling (nursing agg.) – Aggravation and Amelioration
Sun (agg. and amel.) – Aggravation and Amelioration
Suppressions – Aggravation and Amelioration
Talk of others – Aggravation and Amelioration
Thinking of his disease – Aggravation and Amelioration
Uric acid diathesis – Aggravation and Amelioration
Wet, getting drenched (getting wet in the rain, complaints from) – Aggravation and Amelioration
Boenninghausen’s Characteristics and Repertory has got it’s own advantages over other repertories. It is well explained, well arranged, follows a definite plan and construction and is based on a sound philosophy. Adequate acquaintance with the repertory is needed to put it to maximum use.
Boger has given greater importance to causation, time dimensions, modalities and generals (pathological, physical and mental). The repertory can be used by following the methods mentioned below which allow us to use it in different cases of different dimensions with individual pictures. Therefore, it is the case, which decides the method to be applied to select a simillimum, not the physician. It is a highly qualitative approach, and hence any kind of manipulation or twisting of data should be strictly avoided. Mental state should be used for final selection of the drug in all the methods given below. Selection of method is entirely based on the availability of data in a case.
1. Using Causative Modalities in the First Place
This method would be useful if the case has definite causative modalities and other expressions, which are arranged below according to the hierarchy.
CAUSATIVE MODALITIES (Ailments from):
Mental and physical, that is, fear, excitement, getting wet, etc.
OTHER MODALITIES:
AGGRAVATIONS – Mental, Physical
AMELIORATIONS – Mental, Physical
PHYSICAL GENERALS
CONCOMITANTS
LOCATION and SENSATIONS
(Example — Case–1)
2. Using Modalities in the First Place
Sometimes we find that a case is not presented with causative modalities, but it has other general as well as particular modalities. Such cases can be repertorized by using the following order:
MODALITIES – Mental, Physical
CONCOMITANTS
PHYSICAL GENERALS
LOCATIONS and SENSATIONS
3. Using Concomitants in the First Place
In some cases, if clear concomitants are available even without any modalities, such types of cases can be successfully repertorized with the help of this repertory by following the order given below.
CONCOMITANTS
MODALITIES
PHYSICAL GENERALS
LOCATIONS and SENSATIONS, ETC.
(Example – Case–2)
4. Using Pathological Generals
These are the changes in the tissues at different locations in a person, which follow a pattern; thus they show the expression of deviation in the constitution and it is very important in erecting a totality. The following order should be followed:
PATHOLOGICAL GENERALS
PHYSICAL GENERALS
CONCOMITANTS
MODALITIES
(Example – Case–3)
5. Using Diagnostic Rubrics
Boger has contributed many clinical conditions in the repertory and they can be used when the case does not have any other choice, or if the case lacks in characteristic expressions. This helps mainly in finding out a palliative drug, or a drug which is suitable in helping to overcome the present crisis. It should be arranged as follows:
CLINICAL RUBRIC
AGGRAVATIONS
AMELIORATIONS
WEAK CONCOMITANT
PHYSICAL GENERALS
(Example — Case–4)
6. Following Roberts’ (Boenninghausen’s Therapeutic Pocket Book) Method
LOCATIONS and SENSATIONS
MODALITIES
CONCOMITANTS
PHYSICAL GENERALS
Here sensations and modalities are first referred to the parts concerned. In case the particular sensation and modalities are absent, they can be referred to in the general chapter. If general modalities are represented well (that is, if the rubric contains more number of medicines), they should be used for the purpose of repertorization (Example – Case –5).
7. Fever Totality
In a fever case, if the stages (chill, heat, sweat) are distinct, the following order would be preferable; if some stage is not available in the case, only the next stage should be used for repertorization.
CHILL
Type/Partial chill/Coldness-partial/Shivering Time
Aggravation Amelioration Concomitant
HEAT
Type/Partial Time Aggravation Amelioration Concomitant
SWEAT
Type/Partial Time Aggravation Amelioration Concomitant
(Example – Case–6)
Pathological types of fever mentioned in the repertory can be used for reference and final selection of the drug, but more importance should be given to the repertorial result, which is obtained by following the above order. Sometimes these rubrics (pathological types) can be used by following the fifth method mentioned earlier.
Section on blood circulation (congestion, palpitation, heartbeat, and pulse) should be used if symptoms are prominent during any stage of fever.
8. Use of Concordance Chapter
This chapter deals with the relationship of remedies. The chapter can be used by following the same method, which is used in working on the Relationship of Medicines in Boenninghausen’s Therapeutic Pocket Book (see Part II, 1.3.4.7).
CASES WORKED OUT WITH BOENNINGHAUSEN’S CHARACTERISTICS AND REPERTORY
CASE–1
A lady, 50 years, unmarried, complaining of joint pains since 20 years, came for homoeopathic treatment. She had tried allopathic, ayurvedic and homoeopathic therapies (for one year) that gave slight relief for a short period, but the complaint remained.
It was diagnosed to be a case of rheumatoid arthritis with the following picture (in brief):
| Location | Sensation | Modalities | Accompaniments |
| Joints, small and big, since 20 years Slow onset | Pain and swelling of single joint. Pain as of a scorpion bite, burning, impo- ssible to put feet down to rest. Stiffness 3 . | After tension 3 < sour things 2 < cold things 2 < potatoes 2 < milk 2 >hot water bag 3 >gentle massage >gasting < morning 2 < damp 3 | Lump-like swelling here and there which disappeared on massaging |
When she is excited due to worries and tension, her complaints increase; it also caused difficulty in breathing and some throat trouble. History or tonsillectomy in childhood. She used to get frequent colds.
Patient as a Person
Physical Generals
| Thermal reaction: | Chilly |
| Appetite: | Good |
| Thirst (increased): | With dryness of mouth |
| Milk agg. 3 : | Acidity and joint pains |
| Craving: | Sweet 3 |
| Aversion: | Meat 2 , milk 3 |
| Sleep: | Good, but full of dreams |
Constipated since childhood, takes hot water in the morning, which helps her.
Constipation does not bother her.
Perspiration, in winter also; palm 3 , feet 3 , head at night.
Since a few years, palm and feet sweating reduced.
Menstrual Function
| Menarche: | At 16 years |
| Flow: | 3-4 days |
| Blood: | Dark red |
| During Menses | Painful, bleeds more if there is tension |
| Menopause: | At 41 years, flushes, bleeding increased, hypertension |
| Leucorrhoea: | Thick, brownish |
Mental Generals
She has undergone many hardships in life.
All complaints increase 3 by tension, anxiety, vexation, grief and sorrow.
She is sentimental 2 , affectionate 2 , nervous 3 , has fear of darkness, lizards, creeping animals.
Classification and Evaluation of Symptoms
Anger, vexation, tension, grief – Mental causative modalities
Cold wet feet, agg. – Physical causative modalities
Milk agg. joints and stomach – Physical general modalities
Sour agg. joints and stomach – Physical general modalities
Craving – sweets – Physical general
Aversion – meat – Physical general
Aversion – milk – Physical general
Perspiration–head, soles, palms – Physical general
Arthritic pain – Complaints in general
Stiffness – Complaints in general
Selection of Repertory
It is found that the case has strong causative modalities, general and particulars along with marked physical generals. This case demands Boger’s method of repertorization.
Selection of Rubrics
| Rubrics | Reason | Page No. |
| 1. Emotion | Strong mental causative modality | 1166 |
| 2. Wet feet | Physical causative modalities | 1152 |
| 3. Milk | Physical general modalities | 1121 |
| 4. Sour | Physical general modalities | 1122 |
| 5. Desire – sweet | Physical general | 477 |
| 6. Aversion–meat | Physical general | 474 |
| 7. Arthritic pain | Complaints in general | 882 |
| 8. Stiffness | Complaints in general | 925 |
| Repertorial Result | ||
| Bryonia | — | 24/6 |
| Calcarea carbonica | — | 27/8 |
| Ferrum metallicum | — | 16/5 |
| Lycopodium | — | 28/7 |
| Natrium muriaticum | — | 22/7 |
| Pulsatilla | — | 32/7 |
| Silicea | — | 25/6 |
| Sulphur | — | 29/7 |
Analysis of Repertorial Result and Prescription
We have got a list of close running remedies; with the help of patient’s other symptoms, which are not included in the repertorial totality, the above medicines can he differentiated:
Patient is chilly.
Patient sweats on head, palms and soles. Any tension leads to menstrual bleeding.
Patient is mostly constipated which does not bother her. Moderately built.
This type of differentiation is called the ‘potential differential field’ (PDF).
Finally with the help of this technique, Calcarea carbonica was selected.
CASE–2
An 18 year old girl who was suffering from migraine presented the following picture:
| Location | Sensation | Modalities | Accompaniments |
| Head, right sided |
She wants somebody nearby, likes a dark room, likes to close her eyes and lie down because of headache, but nothing gives her relief. This was the acute picture of the complaint.
Selection of Rubrics
| Rubrics | Reason | Page No. |
| Head internal | Location | 250 |
| Stomach, symptoms with | Strong concomitant | 290 |
| Evening | Modality | 280 |
| Air open > | Modality | 292 |
| Pressure external > | Modality | 294 |
Repertorial Result
| Bryonia | — | 14/4 |
| Cocculus indicus | — | 6/2 |
| Natricum carbonicum | — | 9/3 |
| Pulsatilla | — | 19/4 |
| Sulphur | — | 9/3 |
Analysis of Repertorial Result and Prescription
Two medicines, Bryonia and Pulsatilla run very closely. Pulsatilla was the final prescription because she wanted somebody nearby during the attacks and there was marked amelioration in open air.
CASE–3
A patient, 45 years, male, married, presented with the following medical report:
C/o: Difficulty in walking since 9 months.
Patient complains of swaying to either side, with tendency to fall, since 9 months. He also complains of difficulty in taking food to the mouth and slurring of speech. There is a persistent sticking sensation in the throat. No history of nasal regurgitation, headache, convulsions, ear discharge. Since last 2 months, he also notices a mild destabilization on turning the head. No history of headache, vomiting, trauma, fever or injections. All the symptoms are progressive in nature.
Non-diabetic, non-hypertensive.
Anaemia – Absent
Jaundice – Absent
Cyanosis – Absent
Oedema – Absent
Blood pressure – 130/80 mm of Hg
CNS:
Higher functions – Normal
Cranial nerves – Normal
Motor system – Normal
Jerks – Superficial and deep, normal with flexor Babinski’s bilaterally
All modalities of sensations – Normal Cortical sensation – Normal Cerebellar signs – Positive bilaterally
Investigations
Blood sugar
– Fasting: 102 mg%
– Postprandial: 143 mg%
Discussion
Presented with slowly progressive cerebellar disturbance. CT shows superior vermian and mild cerebellar hemispherical atrophy, consistent with the diagnosis of Holme’s cerebellar cortical atrophy.
It was also a case of transient blurring of vision on turning the head to the sides, for which Disprin had been started.
Final Diagnosis:
Cerebellar Degeneration (Holme’s).
On further enquiry, the following information was collected:
1. Difficulty in walking, swaying to either side
-Agg. on closing eyes 3 Agg. walking slowly 2 Amel. walking fast
2. Dizziness on turning neck
-Agg. sun 3
3. Extremities: Feels that circulation has stopped
-Agg: rest 3
-Agg. while rising 3 Amel. moving about 3
4. Joints: Neck, elbow, knee, ankle; pain with stiffness
=Amel. movement
5. X-ray cervical spine: Mild spondylotic changes are seen in the cervical vertebrae.
Some More Information About the Patient
| Build: | Well built |
| Appetite: | Decreased |
| Stools: | Regular |
| Thermal reaction: | Chilly patient |
| Helping: | Wounds, delayed healing (H/O) |
| Perspiration: | Head 3 , palms 2 , soles 2 |
| Graying of hair: | Started quite early (at the age of 30 years) |
| Sleep: | Disturbed 3 ; after 3:00 am (marked since many years), talks during sleep 2 |
Small pox during childhood; marks present on face, but no complication afterwards
After eating, feels terribly weak; must rest for at least ten minutes
Heat of sun aggravates his all complaints
Diagnosis
Cerebellar degeneration (Holme’s), cervical spondylosis.
Selection of Repertory
It is noticed in the case that a common pathology ‘degeneration’ is running throughout. Early graying of hair also goes in favour of premature senility. Here ‘degeneration’ can be taken as an important pathological general. The case falls in the domain of Boger’s method of repertorization.
‘Senility’ is the rubric for degeneration, which is found in the chapter ‘Aggravation and Amelioration.’
Selection of Rubrics
| Rubrics | Reason | Page No. |
| Senility | Pathological general | 1134 |
| Sun, agg. | General modality | 1144 |
| Eating after, agg. | General modality | 1114 |
| Sleep, disturbed | Physical general | 994 |
| after midnight | ||
| Talking, sleep | General | 990 |
| Sweating, head | Characteristic feature of | 1080 |
| person, concomitant |
| Repertorial Result Calcarea carbonica | – | 21/6 |
| Baryta carbonica | – | 17/3 |
| Bryonia | – | 21/6 |
| Lachesis | – | 21/5 |
| Sulphur | – | 20/5 |
| Conium maculatum | – | 12/3 |
Analysis of Repertorial Result and Prescription
Patient is chilly and there is marked sluggishness in the person’s activities since the beginning. So Calcarea carbonica was selected.
Case–4
A male, 56 years, who had been taking treatment for chronic pharyngitis, a known diabetic, presented with a complaint of vertigo which he developed suddenly in a long bus journey. On consultation, it was diagnosed as ‘benign paroxysmal vertigo.’ He was taking other medicines, but with partial relief only.
Symptoms
Feels that everything is rotating.
Sensation of pressure on the vertex, from inside out as if going to burst.
< night 2
< lying down 3
< lying down right side
> closing eyes 3
< if gets up suddenly
| Thirst: | Decreased |
| Appetite: | Not affected |
| Perspiration: | 2+ (not associated with vertigo) |
| Stools: | Motion regular |
On the night previous to the journey, he got up suddenly because of a sound and could not sleep thereafter. Feels he is becoming forgetful.
Selection of Repertory
In this case, only some modalities and concomitants are marked. This case can be repertorized with the help of Boger’s repertory using the fourth method, that is, using diagnostic rubrics.
Selection of Rubrics (Chapter Vertigo)
| Rubrics | Reason |
| Night < Lying down < Rising from bed | Modalities Modalities Modalities |
| Memory affected | Concomitant |
Repertorial Result
| Rhus toxicodendron | — | 15/4 |
| Phosphorus | — | 12/4 |
| Conium maculatum | — | 13/4 |
| Nux vomica | — | 10/4 |
Analysis of Repertorial Result and Prescription
Considering the pathology and sphere of action as well as the symptom, closing eyes, amel., from Kent (in Boger’s repertory it is not well represented) – Conium fits the case. Conium 30 – daily doses were given.
CASE–5
A female, 46 years, suffering from rheumatoid arthritis since fifteen years, presented with the following picture.
| Location | Sensation | Modalities |
| All joints (started with left ankle, knee, hip, neck, shoulders) | Pain and stiffness. Pain, swelling and heat with increasing and decreasing severity. | < first few movements 2 < winter 2 < morning 2 |
| Stiffness is more marked (in ankle joints). | > hot application 2 | |
| > continued walking 3 |
Patient as a Person
Physical Generals
| Thermal reaction: | Chilly |
| Perspiration: | + Forehead |
| Appetite: | Not so good, if slightly disturbed or depressed (patient’s language) |
| Cravings: | Sour 3 , coffee |
| Stool: | Frequently hard stool |
Menstrual Function
| Menarche: | 15 years |
| Regular cycle: | 21 days |
| Clots++ | |
| Before: | Mood alteration |
| During: | Pain lower abdomen |
Mental Generals
Irritable 3 – shouts Changing moods 2
Sentimental 3
Dreams – Talking to kids, praying She is a religious person
Selection of Repertory
In this case, location, sensation and modalities are prominent with marked physical generals. Mental state can be used for final differentiation. Hence, Boger’s repertory can be selected for repertorizing the case by using Roberts’s method.
Selection of Rubrics
| Rubrics | Reason | Page No. |
| Upper extremities: | ||
| Joints, in general | Location | 807 |
| Pain, in general | Sensation | 823 |
| Stiffness and heavyness | Sensation | 829 |
| Lower extremities: | ||
| Joints, in general | Location | 844 |
| Pain, in general | Sensation | 860 |
| Stiffness in ankle joint | Sensation | 866 |
| Uncovering agg. | Modality | 1148 |
| Craving sour | Physical general | 477 |
Repertorial Result
| Calcarea carbonica | – | 14/4 |
| Kalium carbonicum | – | 22/6 |
| Sepia | – | 28/8 |
| Silicea | – | 22/6 |
| Sulphur | – | 25/6 |
Analysis of Repertorial Result and Prescription
Kalium carbonicum, Sepia and Sulphur are running close in this list.
Patient is chilly and her mental symptoms decide the prescription in favor of Sepia.
Sepia 30 was prescribed.
Case–6
A 17 year old girl presented with 3-4 days of feeling feverish, having bodyache and tiredness, which was later diagnosed as be rheumatic fever. Record is presented below (in brief):
| Location | Sensation | Modalities | Accompaniments |
| General, 3-4 days | Fever 102° F | Headache, throbbing | |
| Chill | < morning | Swelling both legs since morning | |
| Feverish feeling | afternoon | Constipated since one week | |
| Hot feeling Bodyache 2 & tiredness 2 | < evening | Thirst + Fan, can tolerate no objection |
O/E – 102° F
Blood pressure – 120/80 mm of Hg
Bilateral, pitting, pedal oedema
R.S. – N.A.D.
C.V.S. – N.A.D.
Rx Bryonia 200/4 doses hourly was prescribed
22-10-90 No relevant change
23-10-90 (8:00 am) Thirst, leg swelling – same, heat +
Appetite +, aphthous lower lip
C.V.S., R.S.—N.A.D
Motion passed, but not satisfactory
Investigation report –
Microfilaria – Negative
Hb – 11.9 gm %
T.L.C. – 4600/ mm 3 N – 63%, L – 32%, E – 04%, M – 01%
E.S.R. – 20 mm/ hour
Urine – RBC (1–2), Pus cells – occasional, Epithelial cells – occasional
Last night there was slight feeling of coldness around midnight.
23-10-90 (3:15 pm) – Bryonia 200/4 doses hourly, continuous
With the heat – palm and soles are cold
Thirst + but less than before
Both legs swollen, knee joints painful Left elbow painful and swollen
Heat, joints +
Rx Bryonia 200/4 doses hourly continued
24-10-90
A.S.O. titre 600 I.U./ml of blood (diagnostic of rheumatic fever)
There are migratory joints affections
Thirst – Not marked, less than usual
No desire to uncover, always wants covering Urine – No complaints
Palms and soles are cold
Walking with difficulty, heavy legs
Following Rubrics are Selected:
| Rubrics | Page No. |
| Heat | 1059 |
| Time – evening | 1059 |
| Concomitants – thirstlessness | 1069 |
| Aversion to food | 1068 |
| Lower extremities heavy | 1073 |
| Hand cold | 1072 |
| Feet cold | 1073 |
| Uncovering, aversion to | 1075 |
Pulsatilla gets highest marks. It has migratory joints pain and covers the rubric ‘rheumatic fever’ under pathological types (4 marks).
Pulsatilla 30 /4 doses hourly was prescribed on 24-10-90 at 4:30 pm.
26-10-90
Joints >
Highest temperature – 100.8° F. at 10.00 a.m.
Lowest temperature – 99.0° F. at 2.00 p.m.
27-10-90
Temperature – Afebrile
All joint– Swelling>
Tenderness >
Heat >
Appetite – Good, motion passed.
Slowly the joints recovered and the patient felt better.
C.V.S. – N.A.D.
R.S. – N.A.D.
Patient was discharged on 29-10-1990.
Boger’s repertory is the latest among the three well known repertories in use, the other two being, Therapeutic Pocket Book and Kent’s repertory. Boger’s repertory has some special advantages over other repertories.
1. Complete Symptoms
Each location is followed by the particular sensations, modalities and concomitants, which were lacking in Therapeutic Pocket Book and Kent’s Repertory.
For reference as well as repertorization of a case where particulars are dominating the picture, this repertory can be utilized with advantage. Thus, it is more useful in acute and short cases.
2. Diagnostic Rubrics
We find many diagnostic clinical rubrics mentioned in each chapter with a group of medicines. These medicines have been used in the conditions mentioned and found to be useful in a majority of cases. Thus, they have been proved and verified.
There are controversies regarding the use of diagnostic rubrics, but diagnostic rubrics cannot be neglected as they have a group of common symptoms, which medicines also have produced in provings. But, since there is similarity only at the level of common symptoms, the result can be of a lesser quality.
3. Pathological Generals
This repertory contains many pathological generals, which are valuable for repertorization and selecting a simillimum. For example:
Haemorrhage, tendency to – Sensations and Complaints
Uric acid diathesis – Aggravation
Discharges – Sensations and Complaints
Suppuration – Sensations and Complaints
Inflammation – Sensations and Complaints
4. Rubric — Infant, Affections of
This is a big rubric with many subrubrics in the chapter ‘Sensation and Complaints in General’. This is unique and very useful in paediatric practice.
5. Constitution
Different types of constitutions with a group of medicines are available in the chapter, ‘Sensations and Complaints in General.’ This reduces the practitioner’s work and helps him to find the simillimum by using it in the first place in totality.
6. Separate Concomitants
This chapter follows modalities in most of the locations. In Therapeutic Pocket Book, concomitants are not given separately except in a few chapters. Boger made it more useful for practice by attaching concomitants to the parts.
7. Fever Chapter
This is a unique work of Boger. From a practical point of view, this chapter is of immense use. It has many sub-divisions also. Concomitants in relation to chill, heat and sweat under different headings are really valuable for bedside practice. This is one of the best repertories for fever cases.
8. Cross-reference
This subsection is given at the end of most of the chapters, which helps us to find an appropriate rubric.
9. Mind Section
This repertory begins with a large ‘Mind’ section, which is quite elaborate. Of course, it does not compete with Kent’s section on ‘mind’, but sometimes, one has to refer to it to find out some rubrics, which are not mentioned in Kent (for example, cf. section 11 of this chapter).
10. Menstruation Chapter
This is well arranged and followed by concomitants in the following order:
Before menses
At the start of menses During menses
After menses
All these were not available at one place before this repertory was published. Similarly chapters on stool, leucorrhoea, micturition, etc, are also found in the repertory.
A list of mental rubrics in Boenninghausen’s Characteristics and Repertory, not found in Kent’s repertory as main rubrics under ‘Mind’ section are given below:
Alcoholism Automatisms
Awkwardness (this rubric is found in Kent’s Repertory under Extremities)
Beautiful, things look
Beclouded, dim Beseeching
Beside, oneself being Blissful feeling (joy in Kent) Brainfag, exhaustion Carefree
Catalepsy (under Generalities in Kent)
Clear headed
Clothes himself improperly Cold, frigid
Collar, pulls at Communicative
Compassion, sympathy (sympathetic in Kent)
Comprehension, easy
Contradictory to speech, intentions are Crankiness
Death agony Deliberate Delicacy, feeling of
Disconsolate, unhappy Discordant Discourses, holds
Dizziness and instability of Duality, sense of Execrations
Ill-humour, crossness Imitation, mimicking Impressionable Insecurity
Murmuring, in sleep Overactive
Paranoia Passionate Patient Peevish Pensive
Persecuted, feels Perseverance Playful Presentiments Profanity Resignation Rivalry Satyriasis
Surly Taciturn
Tastes, everything Trance
Unamiable, unfriendly Untidy
Rubrics in ‘Boenninghausen’s Characteristics and Repertory’ by Boger – not to be found in Synthetic Repertory as main rubrics: In general:
Agitated (compare Excitement)
Alcoholism, intoxication, etc (compare Delirium tremens)
Aphasia
Assembled things, swarms, crowds, etc, hallucinations of
Awkwardness
Bad part, takes everything in; easily offended (compare Sensitiveness)
Bashful
Beautiful, things look
Beclouded, dim
Benumbed
Beseeching
Bewildered, strange, everything seems, as if in a dream errors of locality, disordered orientation
Bold exhaustion
Brain
Buffoonery
Calling
Calmness, composure, tranquility, etc
Carefree
Careless, heedless, etc
Clearheaded
Clothes himself improperly
Cold, frigid
Collar, pulls at
Compassion, sympathy (immoderate)
Corner, mops or broods in a
Crankiness
Dejection, despondency (compare Low spirits, Despair)
Deliberate Delicacy, feeling of
Depression (compare Sadness)
Disconsolate, unhappy
Discourses, holds
Dissatisfied, discontent, wants this then that
Distracted, preoccupied, unobservant, difficult concentration, can’t think
Dizziness and instability of (compare Variableness)
Dogmatic, opinionated, etc (compare Haughty)
Domineering, imperious (compare Importance)
Drunken, sense of
Duality, sense of
Excitable (compare Irritable)
Execrations
Expressions, difficult Failure, feels himself a
Faultfinding, reproachable, etc
Ferocity
Finery, fond of
Flings away, what he holds in his hand, inclination to (compare Desired things)
Fly out of her skin
Fretful
Future, confounds the future with the past
Gaiety, joyfulness (compare Liveliness)
Gentle, mild, tender
Gloomy (compare Melancholy)
Grasps at others Groaning, moaning
Guilt, sense of, (compare Remorse)
Hands, clapping
Headstrong, obstinate, defiant, stubborn
Held, wants to be
Homicidal, murder, etc.
Ill-humour, crossness (compare Peevish)
Illness, sense of sick feeling Illusions, delusions, visions, etc
Imaginations, fancies, fixed ideas (compare Illusions)
Importance, feels his (compare Domineering)
Indecision, hesitation
Insults, imagines
Intellect, impaired, mental exhaustion, weakness of, etc.
Insert, lack of
Intoxicated, as if
Knife, impulse to injure with (compare Homicidal)
Learning to speak, late in
Licks up, things
Lies, thinks her words are
Life, satiety of (compare Suicidal)
Lively, animated, vivacious (compare Gaiety)
Low spirited (compare Sadness, Dejection, Melancholy, etc)
Mistrust, suspicion, doubt
Mournfulness
Mouth, puts things into
Muscles, don’t respond to will
Nervous exhaustion
Nonsensical
Nose, grasps others
Open-hearted
Oppression
Pain, intolerant of
Paranoia
Peevishness, fretful (compare Ill)
Humour, anger
Pensive, deep in thought (compare Thought)
Perplexity
Persecuted, feels
Fantasies (compare Imaginations)
Phlegmatic
Photomania
Pinch, impulse to
Plays with fingers
Possessed, as if demonical mania, etc
Presence of mind wanting
Presentiments, premonitions, foreboding, etc
Profanity, cursing, etc
Projects, full of
Proud, arrogant, self-esteem, haughty, airs, etc
Punctilious
Pyromania
Relatives, ignores his
Relaxation, mental prostration
Repeats same thing
Repenting, bad conscience, etc
Repulses, help
Reveries, daydream, etc
Rich, fancies himself
Roaring
Salvation, doubt of
Scolds, to herself (compare Abusive)
Sense, absence of, anoia
Shouting
Sickness, simulates
Skeptical
Snarling, like a dog
Snatching
Solicitation
Solicitude
Solitude, love of (compare Company)
Spinning, imitates
Spiritless
Spirituality, lack of
Sprightliness (compare Lively)
Stamping
Stiff
Still
Stupidity (compare Comprehension)
Supplication
Surely, sullen, morose (compare Anger)
Swallows, faeces, etc
Taciturn, silent, mute, etc (compare Quietness)
Tedium, ennui
Tender mood
Thieves, delusion of
Tossing about
Unamiable, unfriendly, etc
Uneasiness
Unruly
Unsociable, shy, averse to society (compare Bashful, Reserve)
Variable, vacillating and alternating moods
Vexation, also affects
Vigor, feeling of
Volition, affected
Wailing
Whining, whimpering
Whispering
Word hunting
Though it is claimed that Boger’s work improved and updated Boenninghausen’s Therapeutic Pocket Book, many difficulties have been noticed while using Boger’s repertory. In practice, it could not replace the Therapeutic Pocket Book, which is still helping many practitioners because of it’s individuality in construction and contents. The following difficulties are particularly noteworthy: