It is now a decade since the publication of our The Bönninghausen Repertory (TBR), and this second edition is the result of our continued application of this repertorial method with constant reference to our primary sources for clarification of rubric terms, by which process we gain an understanding of Bönninghausen’s Therapeutisches Taschenbuch (TT) and how it represents our primary, pure, pharmacography for the purposes of homœopathic diagnosis.
In order to provide a contextual prelude for a more detailed introduction to this work, we offer the following historical overview which will reward its study with the necessary perspective of the origins and scope of TT, and of its most faithful English language successor, this second edition TBR. A more detailed account of repertorial lineage will be found in our Homœopathic Diagnosis… (DHD).
Development of Repertory
Hahnemann’s induction of a general similars principle governing the clinical effectiveness of medicines marked the birth of Homœopathy as a deliberate approach to medical therapy, and further established the need for a new, pure materia medica to methodically record substance effects upon the healthy organism (provings). He soon realised this increasing volume of provings data required a way of referencing individual symptoms, and the first alphabetic symptom index was appended to his Fragmenta…(1805), and he also compiled two further indices with which he was not satisfied, and which therefore remained unpublished.
There followed a number of works, most notably by Hartlaub, Schweikert, Weber, and Rückert, each listing a single remedy alongside a single symptom, more or less as it appeared in the provings records, re-arranged for easier reference. But these works were bulky (e.g., Hartlaub’s comprised over 6,700 pages), and whilst useful for study, too cumbersome in the clinical setting. It is important to note that none of these indices constituted what we now recognise as repertory.
2. Bönninghausen & The First Repertory
“… which fact caused me, even at the beginning of my study of this excellent and invaluable treatment, to think of expedients which would make the choice of suitable remedies easier and more certain, by this means bringing the symptoms of each one more clearly into view;”
Bönninghausen was trained in Law and Botany, skilled in brevity and taxonomy, and thus well placed for the task of symptom indexing. Remarkably, the first fruits of his effort appeared very soon after his recovery, in 1829, with the title Alphabetical table for ready reference to homœopathic medicines, and this was followed by a rapid succession of works, through which, we observe, Bönninghausen developed and shaped his work into what was termed Repertory.
The first such work was his Systematic Alphabetic Repertory of Antipsoric Remedies (SRA, 1832), wherein, for the first time, Bönninghausen had identified the consistent elements of each symptom and rendered them in rubric form, arranged systematically and alphabetically, and incorporated a consistent 4-tier remedy grading system to indicate the frequency of clinical usefulness. SRA quickly went into a second edition (1833), and two years later Bönninghausen published a similar work on the ‘non-antipsoric’ remedies (SRN, 1835). These two works together form a single repertorial model to which we now refer jointly as The First Repertory (TFR), and upon which our modern repertories are based.
3. TFR Successors
In 1834, Georg H.G. Jahr published his Handbuch (JH1), modelled on SRA, but lacking the consistency, accuracy, and succinctness of Bönninghausen’s work. The second edition of Jahr’s Handbuch (JH2, 1835) was later translated into English, under the editorship of C.Hering, and published in 1838 as the first English language Repertory. This work found its way via C.Lippe, to E.J.Lee, and onto J.T.Kent, being wholly incorporated into his Repertory whose structure was consistent with that of its predecessors. Thus, it may be seen that even Kent’s Repertory, wholly in structure and largely in content, derives from the ‘systematicalphabetic’ model of TFR. But Kent’s itself is full of significant errors, not surprising given his inability to examine the original (German language) sources, and these errors are multiplied further by its emulates, which later works have especially served to dilute any accurate information already present, and thereby reduce the consistency and certainty in our prescribing.
4. Bönninghausen’s Therapeutisches Taschenbuch
Bönninghausen soon recognised ‘defects’ inherent in the design structure of TFR, and began his focus on a new, improved method of repertory, and with Hahnemann’s full approval, his Therapeutisches Taschenbuch was published, simultaneously in German (TT), French (MT), and English (TPi), in 1846.
Bönninghausen’s TT became the most widely used and highly acclaimed repertory, undergoing a number of English (and other) editions before being translated afresh, revived as it were, for The Bönninghausen Repertory (TBR). The following diagram outlines the basic lineage of repertory initiated by Bönninghausen.
Therapeutisches Taschenbuch (Therapeutic Pocketbook)
Bönninghausen’s foresight and desire for transparency saw him list the provings source for each of the medicines contained in his TFR, thereby allowing comparison of each entry against its source proving. So when it came to constructing TT from its immediate precursor TFR, Bönninghausen did not again consult the provings (already represented within TFR), he only needed to convert the information contained in TFR for placement within the new structure of TT. This is doubtless one reason why he gives no sources for the medicines in his TT, but the other reason, more importantly, is that the entries it contains cannot all be found as is within the provings – they are rather representations of provings, a distillation, Bönninghausen’s understanding of each medicine’s characteristics, completed by analogy, and further validated and weighted according to his extensive experience. Indeed, at that time, Bönninghausen maintained one of the busiest practices in all Europe, and we can therefore rightly understand why Stuart Close offered the following summation:
“The experience of nearly a century has verified the truth of Bönninghausen’s idea and enabled us, in the use of his masterpiece, The Therapeutic Pocketbook, to overcome to a great extent the imperfections and limitations of our materia medica.”
Bönninghausen’s TT is an entirely new structural model which, more than any other, demands a secure grasp of Hahnemann’s observations and teachings, and although we provide the following brief overview, the reader will do well to study our companion volume DHD wherein we detail this topic.
1. Abstraction & Recombination – the basis of homœopathic diagnosis and of TT
Homœopathic diagnosis is determined upon the characteristics of a case (i.e., the consistencies), which, either alone, or, what is most often the case, in their combination, sufficiently distinguish both the disease, and its homœopathic remedy. Furthermore, the characteristics of a specific disease (medicinal or otherwise) may be abstracted from their individual sufferer and recombined into a stand-alone, distinct disease entity, for the comparison and diagnosis of future cases, and this is precisely the practice in all medical diagnostics.
This same process of abstraction & recombination of characteristics is used to complete symptoms by analogy, where the qualifying characteristics of one symptom may be used to define another symptom of the same type, as well as those of a different type and location, and it is for this reason that the 65,000 or so symptoms in Hahnemann’s own pharmacographies (RA/CK) are, mostly, fragments of original symptom descriptions which have been abstracted (separated) and re-arranged, according to his familiar head-to-foot-schema – not only for easy reference, but more importantly, to allow for their ready re-combination into a case-specific variety, which application is clearly evident in the published case analyses from Hahnemann himself.
This process, thoroughly understood by Bönninghausen, formed the basis of his TT design and construction:
“…it was at first my intention to retain the form and arrangement of my original Repertory…at the same time I intended to compress it into one volume, to define every part of it with greater accuracy and to complete it as much as possible from analogy as well as from experience. Having, however, finished about half of the Manuscript, it had, contrary to my expectation, grown to such a size, that I the more willingly relinquished my plan, as I saw, that most likely the same object might be attained in a more simple and even more satisfactory manner, if, by showing the peculiarities and characteristics of the remedies according to their different relations, I opened a path hitherto untrodden into the extensive field of combination.”
Bönninghausen thus abandoned the structure of his TFR, wherein each body system or region listed its attached qualifying characteristics (symptom descriptions & modalities), abstracting these characteristics to a single ‘Sensations & Complaints in General’ chapter, from where they could be retrieved, and readily recombined into a case-specific variety (even if never before seen [in that combination] in the provings), thereby providing both a flexibility and scope unmatched in any other repertorial work by “…opening a path hitherto untrodden into the extensive field of combination”. Bönninghausen writes:
“The increase of this medicinal power in proportion with the increased dynamisation is, however, so striking that it must force itself on every attentive observer. It manifests itself most frequently and most strikingly in symptoms which have not before been noticed in the provings, but with reference to their location and to their sensation have some analogy with what is already known. On this is mainly founded the arrangement of our “Therapeutical Manual” [TT], and its use for fourteen years has perfectly confirmed what has just been said.”
This unique TT structure thus facilitates the re-combination of characteristics to a new case-specific variety, whilst still allowing the accurate reconstruction of the original proving symptoms, without loss of meaning, as may be seen with the following few examples using this TBR:
1. Alum.1043 “Unbearable itching of the whole body, especially on getting warm, and in bed; he has to scratch until he bleeds and after scratching the skin is painful. [Htb]”
This above symptom is well represented within TBR in the following rubrics:
Itching (pruritis), in general  +
Skin, Blood, drawing, after scratching  + Skin, Painful, after scratching  +
aggr. Warm (& warmth) in general, from  + aggr. Lying, bed, in (prolonged) 
Alumina is one of six remedies coming through in all these rubrics, and whilst a prescription could not be made on this symptom alone, it is nevertheless able to be reconstructed through a summation of its TBR representative rubrics. Let us now look at the leucorrhœa of Alumina (708-717), which may be stated in summation (completed by analogy) as follows:
Frequent acrid leucorrhœa: like bloody water; of yellow or transparent mucus, stiffening the underwear; with burning and itching in the genitalia and especially the rectum [perineum?], which parts, are inflamed and excoriated, making walking difficult; relieved by washing in cold water.
This composite symptom is well represented by the following TBR rubrics:
leucorrhœa, acrid  + bloody  + yellow  + itching  + Slimy  +
amel. Water (& washing)  + aggr. Walking, during 
Alumina again comes through this repertorisation (with only two other remedies), demonstrating the reconstruction of an original symptom is quite straightforward.
2. Stramonium63 “The skin on the forehead is wrinkled, the look staring, the whole face distorted and horrible (aft. 3h). [Frz]”
This single symptom can be reconstructed by combining the following rubrics:
Face, distortion  + Furrows, forehead, on the  + Eyes, staring 
Stramonium heads the list of remedies in this repertorisation, confirming that by re-combining the previously abstracted characteristics listed within this repertory, we can accurately reconstruct the original symptom record.
3. Stann.333 “When she attempted to sing, she must leave off every instant and breathe deeply on account of exhaustion and extreme emptiness in the chest, and she immediately became hoarse – a couple of weak cough impulses removed the hoarseness, but only momentarily. [Gss]”
This descriptive symptom may be reconstructed using the following rubrics:
Internal Chest  + Emptiness, sensation of  + Weakness  +
Voice, hoarseness  + aggr. Singing 
Stannum heads the list of remedies covering this combination.
The TT repertorial model is both unique and unmatched for accuracy, flexibility, and speed in forming a case-specific homœopathic diagnosis. Yet, whilst Hahnemann himself praised this work, others criticised it. Constantine Hering was perhaps the main antagonist, writing strongly against this ‘separation of characteristics’, which he described as a ‘great mistake’ But it is now clear from our own success using TBR, that Hering’s most erroneous view stemmed from his own bias and misconception, since he neither comprehended the genius behind its construction and its foundation in Hahnemann’s own teachings, nor did he ever put it to the test. But whilst there were others equally guilty of the same preconceptions without attempting an objective trial of TT, those who did trial its use fully realised its value, as can be seen from the following comments:
“I submit that of all plans which have ever been adopted, that of Bönninghausen is the best. It consists essentially of considering all symptoms to consist of three elements, namely, locality, sensation and condition [of amelioration and aggravation]. In my daily work I am constantly in want of knowledge of a condition of aggravation or amelioration, I find it in a moment, and as my eye glances over the list of drugs, one or two impress me and I refer to the Materia Medica for confirmation; or, I turn to a locality or sensation, or endeavor to combine all three, and study a drug or drugs found under every heading. … The chief discussion hinges … on the possibility of taking the three elements … and … re-grouping a symptomatology to correspond to that of the patient. Such a method is simple, compact, and has, I am bound to say, stood the test of large experience. I have worn out four bindings to Bönninghausen’s pocket book, purchased in 1861, and have always found it convenient and reliable; I could not work without it…”
“… In the manner I have described, he has investigated this matter and embodied the results in his Repertory Taschenbuch. Again, every proving consists of a great collection of symptoms, very many of which are common to the whole Materia Medica. In the great mass of these, the characteristic symptoms, the real gems of the proving, are overwhelmed and well nigh lost. To discover and bring these up to view is the practitioners’ and students’ great difficulty, bemoaned for thirty years past in every periodical. Yet Bönninghausen is almost the only one who has ever applied himself to the task of collecting and collating these characteristics. His little work on this subject although not recent, is still of great value to the student. It is a misfortune for our American students that our translators selected the elementary works of Jahr in preference to Bönninghausen.”
“The repertory which is the most indispensable to the thorough study of a difficult case still remains Bönninghausen’s Pocket Book. It has not been superseded nor do I think it ever will be, although a new edition is now sorely needed …”
“…between four or five hundred cases [of croup] without a loss is certainly a remarkably good record, and this was given to me by Bönninghausen himself in April 1858, as the result of his then experience with his method.”
Our own continued study and practical experience using this method of repertory over the past 15 years agrees with these comments. What more need be provided in support of an objective and conscientious trial of this work?
2. Remedy Grading
Given the difficulties associated with provings, and the consequent inaccuracies buried within many of our records, there is a need to somehow indicate the degree of certainty or reliability of these observations. Hahnemann was the first to realise this:
“A complete collection of such observations, with remarks on the degree of reliance to be placed on their reporters, would, if I mistake not, be the foundation stone of a materia medica, the sacred book of its revelation.” 
“The more obvious and striking symptoms must be recorded in the list, those that are of a dubious character should be marked with the sign of dubiety, until they have frequently been confirmed.” 
“A symptom, which has been printed in Capitals, I have observed more often, and the one printed in small letters more rarely. The ones put in brackets I published under reservation since they have been observed yet by myself only once, i.e., in a case not quite clear and doubtful. Here and there I added the brackets when I did not see the true being of a person, or if a person was of slow comprehension or he/she committed errors in dietary intake.” 
Bönninghausen well understood Hahnemann’s intention to indicate a degree of certainty, and further realised that the only way to assess the reliability of proving symptoms was by their clinical verification, and he was first to include a system of remedy grading within repertory, weighting each remedy according to clinical verification, even in his earliest repertorial prototypes. In his Preface to SRA (1832), Bönninghausen writes:
“Moreover, it has been my endeavour to constantly indicate symptoms that have been verified in practice, and I have sought to make this perspicuous by the use of a differentiating type;…”
Bönninghausen goes on to say that the first two grades (1-2) indicate the frequency of primary symptoms in the provings, whilst the highest two grades (3-4) further indicate the frequency of clinical verification. Bönninghausen enclosed the ‘dubious’ entries within parentheses as a mark of their uncertainty. But uncertain of what? we may ask – either the symptom was, or it was not produced by that remedy in provings, and thus the uncertainty to which Bönninghausen refers is not with respect to its actual appearance in the proving, but rather, to whether it is a consistency (characteristic) for that remedy. This 4-tier grading system (1,2,3,4) of Bönninghausen was thus most carefully constructed and consistently applied, every such grade within TT, indicating a characteristic of that remedy.
Bönninghausen sought to collect only the consistent components (characteristics) of a remedy proving, purposefully excluding everything ‘superfluous’ (i.e., which could not contribute towards the homœopathic diagnosis), and indicating any uncertainties for future verification. In summary, this process may be described as follows (we exclude the bracketed ‘uncertain’ entries):
- Medicines were initially listed at the ‘entry-level’ (grade 1), except those repeatedly displaying that characteristic (in their primary effect) within the provings which were placed in grade 2.
- Bönninghausen’s own increases of remedy grade were made in a stepwise (quantal) manner, in proportion to the number of clinical verifications.
Regarding the specific clinical criteria for deciding the increase of remedy-grade, Bönninghausen only gives the following hint:
“It is evident, that the limits of these classes, to increase the number of which seemed neither agreeable to the purpose, nor easily to be accomplished, could not be fixed with anything like mathematical certainty: nay, I could not even intimate the greater or lesser inclination to the preceding or the following order and only thus much could I attain, that the mistake remained something less than half a degree. Without being presuming enough to maintain, that everywhere within the stated limits I have hit the mark, I may be allowed to say, that no assiduity, no care, no circumspection has been wanting on my part, to avoid errors as much as possible.”
Bönninghausen spared no effort in applying the remedy gradings both methodically and consistently throughout his work, which, at a glance, afforded a readily visible confirmation of the provings. But as pointed out earlier, this information was initially placed within TFR, then transferred and adapted to the structure of TT, without the need to review the original sources; only the remedy grades were increased, wherever necessary, to reflect the further experience of Bönninghausen, or decreased, to accommodate a consolidation of multiple listings into one.
But we have discovered another significant benefit from this grading consistency being carried into TT whose structure incorporates the abstraction of characteristics, and whose use allows their case-specific re-combination. Identical combinations of characteristics successfully applied to a number of cases, would, according to the above guidelines, result in a stepwise grade increase, from ( )→1, 1→2, 2→3, or 3→4. Naturally, this would require a grade increase be made simultaneously, in all the rubrics used within that combination, and with more such cases, the grade would again increase, and so on. We have come to realise, in this way, that the consistency of grades across a group of rubrics in TT suggests a similar combination was used (repeatedly) by Bönninghausen himself, adding a further degree of security in our selection. Of course, the remedy must first of all have all the rubrics carefully chosen for that case, but those which also show consistency in (even low) grade, must be given due consideration.
3. Remedy Concordances
This most helpful chapter on the remedy relationships is as simple to use as it is brilliant in its concept and utility, but Bönninghausen left no particular instruction detailing its use, it has therefore been largely misunderstood and ignored, a fact evidenced by, among others, A.H. Okie’s ignorant omission of these concordances in his 1847 English language edition Pocketbook (TPO).
Bönninghausen’s first published work on the remedy relationships appeared in 1836, with the title Versuch über die Verwandschaften der homöopathischen Arzneien… [BVE] (Relationships of Remedies), and this was followed by his Concordances (chapter VII) within TT (1846), wherein we read (Foreword):
“I may therefore hope, that nobody will consider this section as useless and superfluous, now, that it has been improved and cleared as much as possible from errors. To me, who for the last fifteen years have considered the Materia Medica Pura the head point of Homœopathy and made it my principal study, these Concordances have been of the most decided importance, as they not only led me to understand the Genius of the medicines, but also to secure the choice of the different remedies and to fix their order, particularly in chronic diseases.”
Bönninghausen’s last and most refined work on remedy relationships was his Die Körperseiten und Verwandtschaften, 1853 [BKV] (The Sides of the Body and Remedy Relationships), about which he writes:
“…contains the result of the examination to which I have subjected, for a number of years past, my former labours in reference to the same subject, and which has convinced me that an excessive number of remedies rendered their proper application in disease so much more difficult.”
Bönninghausen did not leave sufficient directions for applying his concordances, but in his introductory comments to BVE (1836), he offers the following reasoning on this topic:
“If we have selected a remedy for the patient which best corresponds homœopathically to the group of symptoms (it consequently is related to the drug first taken), we will find as a rule that it has not only recently produced drug symptoms but it has also extinguished curatively all the complaints within its sphere of action. This experience appears to be the principal explanation of what doubtless has been observed by every attentive, homœopathic physician, viz., that some remedies act far more curatively when they have been preceded by certain other (related) medicines… The importance of a knowledge of the relationship of the remedies early occurred to me, and caused me to institute comparisons, particularly in the last two years; and in my numerous cases to constantly direct my attention thereto. An excellent opportunity to increase my knowledge of this subject was afforded me in arranging my repertories, and a still better one in writing the Summary of the Main Spheres-of-Action of Remedies, and this I have always kept in my mind. In this way, although difficult, I reached many unexpected results, which I further confirmed by experience.”
Bönninghausen had realised that a remedy prescribed homœopathically for a particular disease, having effected a change in the totality of symptoms, ‘paves the way’ for the next most (homœopathically) indicated remedy, which, in its turn, works better as a result of the changes effected by the first. Remedies were thus seen, in various conditions of disease, to relate (sequentially) to each other, to follow well and to complete the action of the former, and these relationships, based on the similarity of provings-to-disease symptoms, and further refined via clinical confirmation, were painstakingly recorded by Bönninghausen, from very early in his career.
In the use of these concordances, we must remember that whenever the usefulness of a remedy in a particular case has ended, we must review the collection of remaining distinguishing symptoms, including any new ones which may have since appeared, and to prescribe the next most indicated remedy. But a reexamination of the entire collection of these symptoms from the very beginning, including those now present (both persisting and new), is easily accomplished by the use of these concordances, which already list remedies related through their similarity of symptoms, and further graded according to Bönninghausen’s clinical experience. So when a case is at this point requiring a change of prescription, we need only consider the characteristics which remain unaccounted for, or which have now become so troublesome as to demand our particular focus of treatment, and at the same time consult the list of remedies given as relating to the previous correctly prescribed remedy, which therefore already cover, by virtue of their similarity, the first symptoms of the case. This procedure provides an accurate and speedy review of the entire collection of significant symptoms at any given moment, following a previous correct prescription.
But it must be emphasised that these concordances reflect the experience of Bönninghausen which may not always concur with our own cases of a different time and country. Therefore, the concordances must be used in conjunction with, not in place of, a proper and careful consideration of the case before us, with reference each time, as far as is possible, to the provings themselves.
An overview on the use of this repertory has been given in our Deuterologue, and a more detailed account, including the use of the concordances chapter, in our Homœopathic Diagnosis (DHD).
4. 125 Remedies – limitation?
The relatively small number of medicines represented within TT has too often been used as an excuse to dismiss its true value. But whilst more would have been welcomed, the fact remains that this repertory completely and accurately represents 125 medicines more than any other. But let us also not dismiss the number as being unusabley low, especially considering Hahnemann’s own words:
“Of medicines whose action has been accurately ascertained I possess now almost thirty, and of such as are pretty well known, about the same number, without reckoning those with which I am not entirely unacquainted.” 
“Our medical treasury is already large, very large, and we need not hanker after new remedies. I can see this from the second edition of Chronic Diseases…it will contain twice as much as the first.”