“The best repertory anyone can have is in his own memory.”
John H. Clarke | The Prescriber
Repertory = index, list, catalogue. This method embraces a variety of techniques whereby a repertory is employed to determine a small group of remedies, from which the most similar one to the case may be chosen.
Repertories were introduced into homeopathy because the expanding materia medica became, even in Hahnemann’s lifetime, too voluminous to allow quick and easy reference. A repertory provides an efficient means of accessing the materia medica, without having to read and compare endless lists of symptoms. The purpose of repertorisation, however, is not to replace materia medica study. Rather it is designed to provide a bridge between the case being worked on and the remedy pictures in the materia medica. A successful repertorisation takes the prescriber to those few remedies bearing close similarity to the case, which may then be studied and compared in the materia medica to determine the final choice. Some practitioners are highly skilled in the use of a repertory and are able, by selecting the rubrics very carefully, to narrow the choice down to one remedy using the repertory alone.
The most important thing to keep in mind is that a repertory should be considered as a complement to, not a replacement for the materia medica. Those practitioners I have met who are repertory technicians of the highest order are first and foremost, without exception, masters of the materia medica.
Repertories in Use
Kent’s Repertory has dominated the scene for the best part of this century. Kent is said to have laboured for over sixteen years to produce it, and many homeopaths still rank it as one of the standard works of reference. It is, however, seriously outdated now in its original form, so thankfully there have been numerous attempts to update, revise and replace it.
The Synthetic Repertory of Barthel and Klunker is basically an updated version of Kent’s Repertory, with additional material from a wide variety of sources. This repertory is produced in three volumes, but unfortunately contains no particular symptoms whatsoever. Other modern repertories following the same format as Kent but with much additional material have been produced by Eizayaga and Kunzli. Yet another modern repertory based on Kent’s which has gained a strong following amongst classical homeopaths, is the Synthesis Repertory of Ed. F. Schroyens. Containing around 200,000 additions to Kent’s original version and based on the RADAR computer repertory programme, this is probably the best Kentian-style repertory currently available in book form. Another Kentian repertory, which is not for the faint-hearted, is the Complete Repertory of R. Van-Zandvoort, based upon the MacRepertory computer programme.
Robin Murphy’s Homeopathic Medical Repertory is, for me, the most user-friendly and versatile repertory currently available. It was first published in 1993 and was quickly sold out and replaced by a considerably revised second edition. The format has been a source of some controversy, as Murphy took the radical step of replacing the Kentian schema with a completely alphabetical layout. Whilst it takes a bit of getting used to for those raised on Kent, it is, in my experience, much quicker and easier to access once you are familiar with it. Those who have never been exposed to a Kentian-style repertory should, in my opinion, save themselves a huge amount of unnecessary labour and simply start off with this one.
Another criticism levelled at Murphy is that his repertory lacks the references scattered throughout repertories such as Kunzli’s, which enable the user to trace the source of remedy and rubric additions. Personally I find these references superfluous, and Kent himself never saw the need to include them. To me, a repertory will always be a dynamic, imperfect and incomplete reference work, and I feel that any homeopath’s clinical experience is as valid as anybody else’s. There is a kind of elitism within homeopathy these days which suggests that certain ‘masters’ are to be trusted, and clinical experiences coming from any other source must be treated with suspicion – a delusion of superiority if ever there was one!
Although there are more comprehensive repertories available now, Murphy’s has several key features that make it a favourite amongst thousands of users worldwide. Apart from the alphabetical format, it also contains a large number of clinical rubrics and modern-day terms such as Raynaud’s Disease, Allergic Reactions, Multiple Sclerosis, Endometriosis, Chemotherapy agg., etc. Murphy’s repertory also has some wonderful new chapters which gather together a mountain of information scattered throughout the homeopathic literature. These include Environment, Food, Blood, Children, Diseases, Toxicity and Emergencies.
Phatak’s Concise Repertory is still one of my favourite homeopathic books, and is especially useful when using the physical generals approach. I find Phatak’s Repertory to be a wonderful time-saver in practice provided it is used appropriately. If there are mental or particular symptoms to be repertorised, Murphy is usually a better choice. To save time, I will often select a single general rubric from Phatak to start an elimination repertorisation (see below), and then use rubrics from Murphy for the remainder.
Boenninghausen’s Characteristics and Repertory is one of the earliest repertories, but was completely revised and updated by Boger in the early part of this century. It is a major work, but is probably doomed to stay on the back shelves of most homeopathic libraries these days.
Clarke’s Clinical Repertory was produced as a companion volume to his Dictionary of Materia Medica and The Prescriber, with which it is cross-referenced to some extent. It actually contains four repertories in one, as it includes sections on causations, temperaments and relationships of remedies as well as the clinical index. Its main advantage is that it tends to emphasise the minor remedies, whereas virtually every other repertory tends to emphasise the polychrests. However, this is offset by the fact that Clarke chose to use different remedy abbreviations to every other author, which renders it somewhat confusing to use.
There are literally dozens of ‘lesser’ repertories available, most of which focus on a particular disease state or bring together data from many sources on a similar theme, such as causation, dreams, time aggravations etc. One such repertory I have found helpful is the Homeopathic Aide-Memoire written by Peter Coats. This is essentially a pocket-sized repertory for acute prescribing, but contains other gems of clinical information as well.
When to Repertorise
Repertorisation can be used to support almost any prescribing technique, but it is probably most effectively used when symptom-similarity is the primary basis for the prescription, the reason being that the repertories we have available are chiefly composed of symptom-lists. It is generally less appropriate when using a miasmatic or organopathic approach. Some repertories, such as Clarke’s and Murphy’s are more clinically orientated and are therefore useful in supporting a therapeutics approach.
There are three main ways in which a repertory may be used in practice:
1) Spot Checking
This means simply flicking through the repertory to find a key rubric in the case and noting which remedies feature. Many practitioners do this during the case-taking as a means of checking out a particular line of enquiry, eliminating or confirming a remedy or group of remedies in mind.
A twelve year-old boy was brought into our clinic displaying behavioural problems and various digestive disturbances. Lycopodium seemed well-indicated for him but had failed to make much impression, so we questioned him further. Asked about fears, he reflected a little, then responded without any shadow of doubt that he had a fear of being paralyzed! Not knowing if such a symptom even existed in the materia medica, I went straight to Kent’s Repertory where the symptom was found in the Mind section with just five remedies listed. The only remedy in italics was Anacardium, which was found to cover the rest of the case well and was given with marked improvement. This case demonstrates the value of a spot-check and illustrates how rapid a repertorisation can be, provided the characteristic symptoms are chosen at the outset.
2) Elimination Repertorisation
This is a more thorough technique but is designed to prevent the prescriber having to write out lengthy lists of remedies, most of which need not be considered. The method involves choosing a key symptom from the case about which it can be said that the remedy the patient needs has to be in the corresponding rubric. That primary rubric is then taken as a starting point, and only the remedies listed in it are repertorised any further. There are several instances in which this is an appropriate strategy:
i) When there is a clear cut, direct aetiology in the case (see Aetiologies). For example, if someone dates all of their presenting complaints back to a severe fright, ‘ailments from fright’ may be taken as the primary rubric. It is very unlikely that a remedy outside of that group will be needed. It is worth noting that in the Synthetic Repertory, all of the Ã¦tiological rubrics which are scattered throughout the mind section of Kent’s Repertory have been brought together under the single heading ‘Ailments from’.