Introduction

The homeopath forms a conceptual image of the disease by collecting data from the patient, patient's relatives and from his own observations. The totality of a case is the basis for repertorization and serves the purpose to find out the most similar medicine of the Materia Medica. The success of repertorization depends on the ability to deal with symptoms and on the balance of the information collected and translated into rubrics.

Based on a different conception of the Totality of Symptoms there are different repertorization method. The four major influences in the art of repertorization are Hahnemann, Kent, Boenninghausen and Boger. Each of them emphasizes different aspects to form the totality of a case, yet they all have their origin in the Organon. "It is possible to obtain the needed correspondence in a great variety of ways and degrees, and one practitioner will find it in one way and another in another".[1] It is important for a homeopath to be familiar with these subtle differences so that he may apply them depending upon the prescribing data elicited from the patient. Each case is to evaluate as a whole in order to see which of these repertorization methods is best suited to the case in hand.

A thorough understanding of the plan and construction of the different repertories is indispensable for the application of the appropriate repertorization method.

The Totality of Symptoms

The foundation for ALL these methods is the TOTALITY of symptoms, which in homeopathic practice is the true diagnosis of the disease, and at the same time the diagnosis of the remedy. Totality is the qualitative sum total of all the symptoms presented by the patient.

Hahnemann defined the Totality of Symptoms as the outwardly reflected picture of the inner essence of the disease and the sole means whereby the disease can make known what remedy it requires. Symptoms are the outward and visible signs of the inward disturbance of the vital force and when these symptoms are removed the disease ceases to exist.

§ 147 Organon [emphasis added]

Strange, Rare, Peculiar and Characteristic Symptoms

There is much carbon, but few diamonds. To distill the essence out of all symptoms Hahnemann's criterion were the more striking, exceptional, uncommon, unusual, and characteristic signs and symptoms. He states:

§ 153 Organon

This has been found to be applicable to any component of the totality, irrespective of whether it is location, sensation, modality, or concomitant, or the symptoms of mind and disposition or even the symptoms of the parts of the body (particulars). The peculiar, unusual and striking symptoms represent that which is curable in each case of sickness and are the foundation of the homeopathic prescription.

Hence it is for the totality of the characteristic and peculiar symptoms that the similar remedy must be found, rather than for those symptoms which appear commonly in almost every case and remedy. They are peculiar to a few drugs and to a few patients suffering from similar diseases, reveal the individuality and are guides in the differentiation of remedies.

Hahnemann categorized the symptoms broadly into common and uncommon symptoms. Common symptoms are pathognomonic and found in many disease manifestations and remedies. They have some diagnostic but least prescribing value as they do not show how the patient reacts to the particular "morbific agent". They are useless as they do not serve to distinguish, and you need to distinguish, to pick out the remedy. So with all common symptoms, whether general or particular, they will not help you. Never start on these, they are absolutely useless unless you can get something that qualifies and distinguishes, that is peculiar to this patient.

Uncommon symptoms however are peculiar or particular to a patient or a remedy. They cannot be explained by physiology, pathology and anatomy. The stranger the symptom is the more valuable it becomes because it makes the patient unique. They are graded by their uniqueness and rarity accordingly. "The truly characteristic symptoms of the patient exist exclusively outside of the pathological groups of symptoms of the discerned disease; nay more, they are symptoms which never necessarily belong to the disease or any form of it, but which appear as absolutely accidental"[2].

The key to the enigma is the GRADING OF SYMPTOMS, hence the first step is to understand that which is common to all diseases, and that which truly individualizes the patient.

The Importance of the MIND

Hahnemann clearly stated that:

§ 211 Organon

He advises us in § 213 Organon that "one will never be able to cure according to nature - that is, homeopathically - if we do not, in every case of disease, even in such as are acute, observe, along with the other symptoms, those relating to the changes in the state of the mind and disposition, and if we do not select, for the patient’s relief, from among the medicines a disease-force which, in addition to the similarity of its other symptoms to those of the disease, is also capable of producing a similar state of the disposition and mind". Moreover, Hahnemann points out that the emotional and mental state is always altered, both in emotional and mental diseases as well as so-called physical diseases. The altered mental and emotional state is closely related to our active miasmatic state.

Hence the psychic condition of the patient should be written down among the totality of symptoms as one of the most important, if one desires to have a faithful picture of the disease from which to make a successful homeopathic cure. But, the mental symptoms do not exist in isolation but are part of the totality of symptoms. Mental symptoms can be more common to all human beings or truly characteristic, strange, rare and peculiar.

Hahnemann's followers, namely Kent, Boenninghausen and Boger, all placed emphasis on the totality of symptoms, the prime importance of peculiar, uncommon and striking symptoms as well as the symptoms of the Mind. A case may be workable by any of the methods, but the arrangement of the repertorial syndrome will be different due to their different approach in the evaluation of symptoms. Kent emphasizes Mentals, Boenninghausen points out the Modalities and Concomitants. Generals (physical, pathological, mental) Boger tells us.

"The art of repertorization lies in reconciling and getting the benefit of one or more of these viewpoints, depending upon the nature of the case before us, and the characteristic symptomatology we have been able to observe and elicit.... It is the unanimous opinion of leaders, however, that the symptoms of the disease that may be of diagnostic and prognostic value, which are common to the disease as such, have to be scrupulously kept out of consideration in our search for the curative remedy. Their positive value lies only in the fact that, when separated, the remaining symptoms are those which are characteristic of the individual sufferer"[3].

Process of Repertorization

1)     Proper case taking including clinical, homeopathic and miasmatic analysis: taking the case fully and correctly is of crucial importance, as the choice of the remedy will entirely depend on how effectively the case has been taken.

2)     Recording of the case.

3)     Defining the problem: What has to be cured (see § 3 Organon).

4)     Classification and evaluation of symptoms according to Boenninghausen's, Kent's or Boger's type, i.e. grading or ranking of different symptoms in order of their value in order to completely frame the totality and match them with the drug symptoms to find the simillimum.

5)     Selection of the repertory: the final choice of the repertory depends upon the gained symptom picture.

6)     Conversion of symptoms into rubrics and sub-rubrics.

7)     Repertorization (permutation and combination of rubrics) and preparation of the repertorization form.

8)     Analysis of repertorial results and final selection of the remedy: higher matched and graded medicines are analyzed. Repertorization is a means to an end, never an end itself. The mechanical use of repertories and accumulation of remedies which run through all or most of the rubrics only approximates the choice and is greatly overshadowed by the relative standing of the individual symptoms. Emerging remedies have to be studied in the materia medica for differentiation and the final selection of the remedy.

The simillimum is not necessarily the remedy securing the numerically highest number of marks. The number of rubrics covered is more important than the number of marks. If one finds an unusual remedy coming through for even one or two important symptoms, the physician should check it up in the materia medica if that could be the indicated remedy. Not having fully proved or represented in the repertory, it may not come through as the indicated remedy in repertorization. Kent also teaches us that we do not shall expect a remedy that has the generals must have all the little symptoms.

Different approaches - same remedy ?

It is always the whole patient who is sick, and as there is only one remedy most similar to the case all three methods should come to the same indicated remedy in a given case. However, the symptom picture of the patient is seldom complete and forces us to chose the best approach depending upon the presenting symptom picture.

	Boenninghausen	Boger	Kent
	Boenninghausen's Therapeutic Pocket Book (BTPB)	Boenninghausen's Characteristics and Repertory (BBCR)	Kent's Repertory of Homeopathic Materia Medica
The philosophical background is based on the following concepts All methods have their origin in the Organon and prescription is based on the Totality of Symptoms.	Doctrine of Complete Symptoms, Doctrine of Analogy, Doctrine of Concomitants and Modalities, Evaluation of Remedies, Concordances, Principle of Grand Generalization, i.e. each symptom (sensation and modality) present in one part is predicated to be a symptom of the whole.	Doctrine of Complete Symptoms, Doctrine of Concomitants and Modalities, Pathological Generals, Causation and Time, Clinical Rubrics, Evaluation of Remedies, Fever Totality, Concordances, Principle of Generalization (if sensations or modalities are present in more than three parts).	From Generals to Particulars, with highest emphasis on the Mental Generals and strange, rare and peculiar symptoms. Particular symptoms are used for further differentiation and the final selection of the remedy. They must be qualified. The place of Generalization and Concomitants is very limited in Kent's view of the totality.
Arrangement of symptoms The evaluation of symptoms is a must in all methods, and depends upon their value. All methods  emphasize the prime importance of characteristic, unusual, uncommon, strange, rare and peculiar symptoms as well as symptoms of the Mind.	Location Sensation Modalities Concomitants Mentals are used for differentiation and the final selection of the remedy.	The arrangement depends on the availability of data and their peculiarity: Causative modalities, Other modalities (agg. and amel.), Concomitants, Physical generals, Locations and Sensations, Pathological Generals, Clinical rubrics Mentals are used for differentiation and the final selection of the remedy. Fever totality: chill, heat, sweat as to Type/partial, Time, Aggravation, Amelioration, Concomitant.	Strange, rare and peculiar symptoms Mental Generals Physical Generals Characteristic Particulars Symptoms have to be graded according to their value.
Adaptability	For Cases representing: Complete symptoms,  prominent concomitants, marked sensations and modalities, when generals are lacking or strongly marked mentals are not available, cases having suffering in few parts but no modalities for all the suffering parts or scattered modalities, one-sided diseases with paucity of symptoms (if the totality of the state can be filled out), useful to get related remedies by working on the chapter on Concordances	Cases rich in particulars with marked modalities and concomitants, pathological generals, clinical symptoms, one-sided diseases (if the totality of the state can be filled out), objective symptoms and pathological symptoms (with absence of characteristic symptoms), cases without many mental symptoms, fever cases, useful to get related remedies by working on the chapter on Concordances	Cases having generals and characteristic particulars, when mental symptoms  or physical general symptoms are marked, useful in treating mental or emotional disorders, In cases with lacking Mentals, the Physical Generals and Characteristic Particulars will make the totality. If Generals are lacking, Characteristic Particulars should be used for repertorization, or, Boenninghausen's or Boger's repertorization methods.