Repertory Seminar
Repertory Seminar with Roger Van Zandvoort in Tiburon, California, May 2004. By Judy Schriebman, CCH, RSHom(NA), CHt. Judy practices homeopathy and hypnotherapy in San Rafael, CA. She is a graduate of the Hahnemann College of Homeopathy.
What’s the difference between Boger and Bönnninghausen? Kent and Künzli? Bay Area homeopaths were treated to an in-depth discussion on the difference between the philosophies and assumptions underlying the structures of the primary repertories in the second ever US seminar given by Roger van Zandvoort. Presented by Homeopathy West and held on a fabulously gorgeous weekend in Tiburon (north of San Francisco), the seminar was a thorough introduction to repertorial history, study and case analysis. Roger van Zandvoort is tall, articulate and inarguably the homeopathic world expert on repertories. Very personable, warm and approachable, he made sure that everyone understood the sometimes complex material before moving on.
Roger began with a historical tour, based on Douglas Hoff’s work, on the development of our many repertories. While all of us are familiar with the layout of Kent’s repertory, many homeopaths are unfamiliar with Bönninghausen’s great work and other important repertories of the past. This is unfortunate, as there is much valuable information contained within them. Roger’s life work is to bring this information to light so that it can be used. This is a painstaking process, involving combing through countless original repertories, double-checking every rubric listed for typographical errors in the remedies, getting old texts translated and adding the handwritten notes in the margins from some of the great practitioners of the past which were never incorporated into newer versions. Roger talked about each one of these repertories and their authors with the casual familiarity of one who knows them intimately well, bringing out each one’s strengths and weaknesses. These additions and corrections have been available to modern homeopaths in his “Complete” and “Millennium” Repertories. He is also working on the next leap forward, with his Repertorium Universale. More on that at the end!
So what is the difference? Basically, there are three “styles” of repertories: Kentian, which lists symptoms in ever-increasing specificity; Bönninghausen, which lists all symptoms as generals, and Boger, who refined Bönninghausen’s repertory to create smaller and therefore more specific and useful generals. Kent based his repertory primarily on exact symptoms experienced by the provers and certain clinical symptoms that were confirmed in practice. These were listed in very specific rubrics, some of which are famous but hardly ever met with in practice, such as Gels “Chest, cease, heart would, motion, if not in.” It also involves some very convoluted thinking on the part of the homeopath to even find it.
Bönninghausen, on the other hand, believed that remedies were applicable to a great many more situations than just those symptoms that arose in provings. A close associate of Hahnemann, he speculated that rather than having very specific, and ultimately very tiny rubrics that must match the situation at hand exactly, what if the clinical and proving symptoms could be broken down into their more general parts? Then by crossing the different parts of a complex symptom presented by a patient, one could arrive at a selection of remedies that would cover the symptom entirely. He also theorized that if a proving showed "right-sided shoulder pain," one could assume that the remedy had an affinity for both "right-sidedness" and "shoulders," and so the remedy would be added to both general rubrics. In our example above, the symptom for Gels could easily be seen to contain “Fear,” “Chest; cease, heart, would,” and “Motion amel,” which when crossed, gives us a nice selection of thirteen remedies to choose from, especially in a case where Gels is given and doesn’t work.
The “Fear” rubric, however, like many other big generals, contains every remedy that has any sort of Fear, which becomes too large to use successfully in many cases. Considered by many to be the finest homeopath of his time, Boger’s genius was to refine Bönninghausen’s approach and break down each one of these overly large generals into rubrics of a more useful size, which included separating out concomitants, amelioration and aggravation. Modern Brazilian homeopath J.A. Mirilli has also taken a refinement to Bönninghausen’s approach by combining many different tiny rubrics of the Mind which he then sorted into 250 central themes (such as “Blood,” “Ambition,” “Betrayal,” etc.) to make bigger, more complete rubrics. Mirilli also searched the original provings to get just the right shade of meaning, which often got lost when homeopaths first tried to fit the symptom to the established rubrics.
Bönninghausen’s way of thinking is particularly useful in cases where the exact symptom is given by the patient with crystal clarity and you rush to the repertory, only to find it non-existent. With Kent, you can’t use that symptom; with Bönnninghausen, you can. A complete symptom is built out of a phenomenon, a location and one or more modalities plus possibly a concomitant or a time. By working with complete symptoms, central to the case and crossing parts, we are more likely to fit our repertory to our patients, rather than the other way around. This way of thinking was borne out consistently in Bönninghausen’s practice and by other homeopaths of the time, including Kent, until he came out with his own repertory and denounced all other styles.
As an example, suppose someone came in terrified that their dog was going to catch fire in their absence. It ruins their life. But you know there’s no such rubric in Kent. Do you throw it out? No--you take the parts “Fear”, “Dog,” and “Fire” as pure themes, mix and match and Voila! (Well, not quite. I had to use the general “Animals” as the only “Dog” is in “Dogmatic.”) The other beauty of this approach is in the consistency of the remedies that appear. In our fictitious example, Lyss, Stram, Cupr, Hep, and Psor all cover the symptom. (You could also do your own search for every rubric having an affinity with Dog and combine them all together to form your own Bönninghausen/Mirrilli-style “Dog” rubric.)
The other difference between Kent and Bönninghausen was in the matter of grading remedies. From the introductions to the repertories, Roger has been able to discover the reasons behind the grading, which were not always followed, even by the authors of those rules. Kent used a 3 point system; Bönninghausen used 5. These grades were not based upon the intensity of the symptoms but upon the frequency seen in the proving and/or practice. Bönninghausen offers a bit more flexibility and precision with his wider range. For instance, Grade 1 is a proving symptom; Grade 2 is a proving symptom that showed up in 2 or more provers. With Kent’s system, the remedy could only be given Grade 1, conveying less information. Currently there is no agreed upon standard for how a remedy should be graded, which causes some confusion when adding in the new provings and when working between repertories.
What’s also missing, Roger claims, is the excellent clinical information contained
in the old American journals. And while there are many homeopaths practicing
all over the world, the information they’ve confirmed and collected is not compiled
in any one place. Our repertories, except for certain modern provings, have yet
to be updated from Kent’s time. To remedy that situation, Roger has developed
his latest work, the Repertorium Universalis. A combination of the best of all
repertories, with a consistent internal structure, he hopes to have this resource
online, accessible and appendable so that practitioners can add in remedies from
practice that have been found to cure symptoms. This repertory would also be
available to practitioners and students to check these additions. The question
of grading is also being dealt with by adapting Kent’s system of 3 grades but
with a bit of a twist:
Third degree should only be based on clinical confirmations, from 8 clinical
cases, from at least 3 different sources. Proving data are not necessary. (Especially
useful for tuberculosis, et al, which seldom shows up in a proving).
Second degree should be based only on clinical confirmations, but require fewer
sources, and can include pathogenetic or toxicological symptoms.
First degree should be documented cured symptoms, toxicological or pathogenetic
symptoms or symptoms from other sources (e.g. Chinese medicine, gemology, herbal,
aromatherapy, etc). Just because these sources are not homeopathic does not mean
they’re invalid, but they will need to be confirmed in homeopathic practice to
move up the grade.
He also hopes to include the number of times a certain remedy has been found to cure a certain symptom by a number of different sources so that remedies which clearly work (by having a higher number of confirmations) will stand out from those of lesser degrees.
A week after the seminar, our study group gave Bönninghausen’s style of repertorizing a spin and we were impressed with the way it pinpointed a group of remedies that really hit the mark. As Roger pointed out, it’s not the only way to get to the heart of a case, and sometimes the Kentian way will be better, but it’s a great “new” tool to help analyze the case when Kent just doesn’t seem to fit.