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Boger’s Concept of Totality- A Brief Case

Boger’s Concept of Totality- A Brief Case

Here is a brief case of headache, demonstrating the practical utility of Boger’s philosophy of totality.

The Logic of Dr. Boger:

The venerable Dr. Boger, in his article “Some Thoughts on Prescribing” instructs a physician to give importance to symptoms in the following order:

A new practitioner would find it helpful in following this logic. The prime reason is that in the process of case taking, a young practitioner usually finds it more comfortable to elicit the modalities and the sensations relating to the particular complaints compared to the alterations in the physical generals. Further, the changes in the mental generals are still more difficult symptoms to elicit, observe and interpret accurately without prejudice.

Why this order of priority to symptoms?

Our material medica is a compilation of symptoms noted from the healthy human drug provings. In this process, among the various symptoms, the sensations and modalities related to the particular symptoms were observed and described by the provers with much precision and accuracy. Hence, the characteristic modalities and the sensations are the most reliable symptoms of highest degree.

Further, it is not unusual that the locations mentioned under a remedy are most frequently a result of a clinical cure and are not noted while proving the drug. For example, the physician is prone to limit his choice of remedies if he considers the rubric ‘skin-spots-whitish’, which would mislead him to select a remedy from a mere handful of drugs. It is to be remembered that the remedies under this rubric have not produced the particular symptom during drug proving. Rather, they are considered as a result of their more frequent need in those particular clinical cases.

Caution must be exercised in valuation of the symptoms and in forming the characteristic totality of the case in hand. The ideal dictum in framing the logical totality is to take the location, sensation, modalities and concomitants together without distinction, as well as the mentals, if strong and well-marked. However, the modalities are the most decisive modifiers of the characteristics, according to Dr. Boenninghausen.

Case history:

Generals:

Mental Generals:

Case Evaluation:

After failure from some single-symptom prescriptions that included Lachesis, Kali bi and Nux vomica, I did a more systematic analysis. Following the logic described above, the following list of rubrics was prepared [BBCR, 47th impression 2018, by B. Jain publishers]:

S.noRubricsPage noType of symptom
1.Head, internal, agg., sleep, disturbed, by289[Modality]
2.Head, internal, agg, awaking on282[Modality]
3.Head, internal, time, forenoon280[Modality]
4.Appetite, desire for, cold liquids, water, etc.476[General]
5.Appetite, aversion to, milk474[General]
6.Head, internal, half of, one, right253[Location]
7.Stool, insufficient588[General]
8.Mind, presentiments, premonitions, forebodings, etc.213[Mental]
9.Mind, anger, crossness, etc.192[Mental]

 

The next step that would largely minimize the valuable time of the physician is to follow the repertorisation by elimination method. Accordingly, symptom-1 was taken as the eliminating rubric considering its prominence in this case.

From the subsequent groups, those remedies covering the eliminating rubric are listed along with their marks. Also, a remedy is discarded if it is not under the eliminating rubric, whatever its totality mark is.

The symptoms 8 and 9 are considered for confirmation of the remedy. It is to be noted that some symptoms date back much prior to the main complaint. They serve as the clues for further understanding the constitution and the underlying miasms in the case.

Prescription and follow up: 

A single dose of Cinchona off. in the 200th potency was prescribed with complete relief and no recurrence for about 40 days now.

Conclusion:

The aim of this brief article is to elaborate the practical utility of Boger Boenninghausen’s Characteristics and Repertory by mentioning the most essential logical ideas behind it. By ardently following this logical guidance I am convinced that success in homeopathy is accessible not only to the masterminds but to any sincere working physician.

“The proficiency of the physician’s daily work, rather than the flash of genius which makes an occasional brilliant cure, is the final measure of the successful practitioner.”

-Dr. C.M. Boger

 Bibliography:

The following works were referred to: