TERMINOLOGY AND CROSS -REPERTORIZATION.

Various terminologies of Repertory and Cross Repertorization

1. DR.N.HINDUJA TERMINOLOGIES AND CROSS -REPERTORIZATION DEPARTMENT OF REPERTORY AND CASETAKING DR.G.SRIDHAR PROFFESSOR ,GUIDE PG PART -1 MNR HOMOEOPATHIC MEDICAL COLLEGE

2. RUBRIC GENERAL RUBRICS PARTICULAR RUBRICS SUBRUBRICS SIMILAR RUBRICS CROSSREFERENCE GRADATION ELIMINATION GENERALIZATION PARTICULARIZATION TERMINOLOGIES

3. RUBRIC RUBRICA LATIN HEADING, A GUIDING RULE RUBRICS ARE THE CONVERTED FORM OF SYMPTOMS INTO REPERTORIAL LANGUAGE IN WHICH A LONG SENTENCE IS EXPRESSED BY A FEW WORDS, WITH PROPER ARRANGEMENT ACCORDING TO THE CONCERNED REPERTORY.

4. conversion to rubrics should be done without compromising the meaning of a symptom. For that, we can split the symptom as much as possible to convert each part into a rubric or sub rubric, but in whichever way it is read, should convey the exact meaning as that of the original symptom.

5. Rubrics are classified into General rubric /main rubric /super rubric Sub rubric Sub sub rubric /sub-sub sub rubric

6. Main rubric These are the main headings or main rubrics given under different chap-ters, which are mentioned as side headings and usually it contains larger number of medicines. Dr. Kent states that while repertorizing, first work out the general rubric followed by particular rubric to avoid missing a simillimum.

7. Sub rubric: main rubric and they modify or qualify the main rubric and mostly it contains less number of medicines than the main rubric, with few exceptions. The sub rubrics always differentiate the remedies with particular components such as a location, sensation, modalities, concomitant, extension, on-set, and pathology.

8. sub sub rubric/Sub - sub - sub rubric: These are the subdivisions of sub rubrics, which gives further explanations to narrow down to specific remedies by differentiating the remedies in the main rubric. Subdivisions of sub - sub rubrics are called as sub - sub - sub rubrics and so on.

9. Source - Sources of Rubrics are different Homoeopathic Materia Medica. Construction of rubric - It is the process of making the rubrics from várious symptoms of Materia Medica. While conversion of symptoms into rubrics following rules are adapted - Convert the rubric with language of repertory used. Convert the language of the case to that of the repertory without mutilating its original meaning.

10. EXAMPLE - 1) Symptom - Throbbing pain in head relieved by hard pressure. Rubric - pains, sub rubric- pulsating, pressure amel. - Head section. (K.R.) 2) Symptom - Patient has fear of death when alone. Rubric - fear, sub rubric - death, sub-sub rubric alone when, Mind section. (Kent R.) Rubrics are usually written or printed in special lettering. Arrangements of rubrics - Rubrics are arranged alphabetically under each and every section in different repertories. Example - Skin section - Adherent, Anesthesia, Bedsore,Biting, Callous, Cancer.

11. Sub rubrics are further characterization, classification or Modification of rubrics on the basis of certain conditions. i.e., Side (Laterality), Time, Modalities, Extensions, Sensations, Locations, Adaptability, alternates with, causation, sensation as if, various types, unexpected deviation etc.

12. EXAMPLES OF SUB RUBRICS - FROM KENT'S REPERTORY EYE SECTION. Following sub rubrics modifies rubric pain : a) Side- Right side, left side. b) Time- Daytime, morning, forenoon. Noon, afternoon, evening, night, midnight, followed by clockwise timings. c) Modalities- Which are arranged alphabetically starting from, air cold Agg. To yawning. d) Extension- E.g. eye, pain, extending to frontal sinus. - Spig. e) Sensation- E.g. eye, pain, aching, biting, boring, cutting, drawing etc. f) Location- B.g. under conjunctiva, back behind lids, canthi in, eyelids, eye brows etc. g) Adaptability- E.g. pain in eye while reading. - Nat. Mur

13. TYPES OF RUBRICS: Similar rubrics Particular rubrics Pathological rubrics Clinical rubrics Diagnostic rubrics Eliminating rubric

14. Similar rubrics: These are rubrics that resemble each other or correspond in meaning. The physician should select the right choice after comparison of both, while converting symptoms into rubrics. For example in Kent's repertory: MIND - SPEECH and MIND - TALK MIND - THINKING and MIND - THOUGHTS

15. Particular rubrics: Rubrics related to a part or organ are called as particular rubrics. FOR EXAMPLE IN BBCR: EYES - CONJUNCTIVA HYPOCHONDRIA - SPLEEN

16. PATHOLOGICAL RUBRICS: Rubrics that represent any pathological changes of conditions are called pathological rubrics. FOR EXAMPLE IN BBCR: SENSATIONS AND COMPLAINTS IN GENERAL - ATROPHY SENSATIONS AND COMPLAINTS IN GENERAL - SUPPURATION CLINICAL

17. CLINICAL RUBRICS : rubrics related to clinical conditions are known as clinical rubrics. FOR EXAMPLE IN BOERICKE'S REPERTORY: NOSE - INTERNAL NOSE - BLEEDING EPISTAXIS) FEMALE SEXUAL SYSTEM - HAEMORRHAGE (METRORRHAGIA) NERVOUS SYSTEM - SCIATICA

18. DIAGNOSTIC RUBRICS: The name of the diagnosed disease itself is the rubric and only represents the remedies that are frequently used for treatment of the disease. FOR EXAMPLE IN BOERICKE'S REPERTORY: GENERALITIES - ADDISON'S DISEASE NERVOUS SYSTEM - INFLAMMATION (MENINGITIS) THROAT - DIPHTHERIA

19. ELIMINATING RUBRICS: It is the rubric that is selected for elimination process of repertorization. The most prominent symptom of the patient should be considered for choosing eliminating rubric, as all the other remedies which do not cover the eliminating rubric are all eliminated

20. LETS SEE HOW THESE RUBRICS ARE ARRANGED IN KENTS REPERTORY

21. Rubric (in alphabetical order) Laterality (1.e. left or right) Time Modalities, conditions, modifiers Extensions (any symptom that goes from here to there) Locations Laterality Time Modalities, conditions, modifiers Extensions Sensation Laterality Time Modalities, conditions, modifiers Extensions Locations Laterality Time Modalities, conditions, modifiers Extensions THESE ARE SUB-SUB-RUBRICS THESE ARE SUB-RUBRICS BACK IN SUB-RUBRICS AGAIN NOW IN SUB-SUB-RUBRICS AGAIN THESE ARE SUB-SUB-SUB-RUBRICS

22. CROSS REFERENCE The word cross-reference means a reference to another text or a part of a text, typically given in order to elaborate on a point. In repertory, it is meant as a guiding link to refer similar rubrics and their remedies either to compare or to make one understand the rubric used in the repertory instead of the word we are searching for.

23. TWO TYPES OF CROSS REFERENCE CONFIRMATORY CROSS-REFERENCE: 01 02 COMPARATIVE CROSS-REFERENCE:

24. 1. Confirmatory Cross-Reference: A cross-reference given in brackets, along with the main rubric, without any medicines against it. This type of cross-references helps us to locate the appropriate rubric. For example in Kent's repertory: Mind - Abandoned. (See Forsaken) Medicines are indicated only under the rubric 'Forsaken', so these medicines should be considered for Abandoned also. Here, the words 'Aban-doned' and 'Forsaken' are used as synonyms.

25. Comparative Cross-Reference: In the second type also, the main rubric will be given along with a cross-reference in brackets, where the cross-reference may have some sort of similarity with the main rubric. While locating such rubric and the rubric given as cross-reference, both represent almost different group of medi-cines, listed against them separately. This type of cross-reference is provided for comparison of the rubrics as well as their remedies. For example in Kent's repertory: Mind - Anger (Irritability and Quarrelsome) It means that the rubric Anger and its remedies can be compared with that of 'Irritability' and 'Quarrelsome. Other than this, some of the repertories provide notification to locate the cross-reference, whether it is present as a sub rubric under the main rubric itself or found somewhere else as a main rubric or sub rubric, by altering the case of the cross-reference (upper case or lower case). some other repertories also give symbols to denote cross-references. Some examples for cross-references from different repertories: In BBCR, cross-references are mentioned along with the rubrics as see' for cross-references without medicines and as 'compare' for those with remedies. Cross-references are also given at the end of the chapters as a subsection. In Synthesis repertory, cross-references with remedies are mentioned with a '4' symbol and (See)' denotes cross-references without rem-edies. In Murphy's repertory, cross-references are mentioned as 'see' given in brackets. In Knerr's repertory, cross-references are denoted by a hand signal (°.

26. GRADATION OF REMEDIES - Gradation of remedies means quantitative value of remedies in provers as well as in patient. The principle of gradation of remedies depends upon appearance of that symptom in the remedy during proving, reproving and clinical verification. The credit of evaluating or grading of remedies goes to Dr. Boenninghausen, which he has used in his first repertory 'Repertory of antipsoric remedies'. He used the five variations in type that indicated the individual evaluation of each remedy to the given symptom or rubrics. In different repertories remedies are graded in different ways:-

27. GENERALIZATION Whenever a Sensation or a Modality is experienced in more than two Locations, it can safely be generalized. Thus, if burning is felt in the Vertex, Eyes, Soles, Rectum it may be considered as a general characteristic of the remedy and, therefore, a General symptom. Further, if this burning is relieved in all these Locations by cold applications, then ‘Cold Applications>’ will be considered as a General Modality of the remedy in question. Boenninghausen, following Hahnemann very closely, held that the patient is ill as a whole and not in his parts. He considered that what is true of the Part must be true of the Whole. Boenninghausen’s keen logical mind, therefore, generalized all Sensations and Modalities and grouped them together, irrespective of their original Locations. For this sweeping generalization, he has been severely criticized by Hering and Kent. They emphasized the fact that in many remedies, the Modalities in the General Sphere did not agree with the Modalities in the Particular Sphere. But, a closer consideration indicates that these instances could as well be considered exceptions rather than the rule.

28. PARTICULARIZATION Symptoms pertaining to a Part are of importance in acute complaints when they dominate the scene. The general constitutional symptoms usually recede under the circumstances so that they are perceived, if at all, in a hazy manner. Thus, the acute prescription, of necessity, will be based on these Particulars. In rare instances, however, this does not obtain and the general constitutional symptoms continue to remain in the forefront. This indicates that the onslaught of the acute explosion has shaken the very foundations and that the Life Force is on the verge of extinction unless helped in time by the deep-acting constitutional remedy. The responsibility of a Homoeopathic physician is very great under the circumstances and he should lose no time in administering the indicated remedy in proper potency and repeat it as often as is required. But, usually, these symptoms come to the fore after the acute illness has been tackled by a remedy based only on the Particulars. By contrast, in the management of a chronic case, the Particulars give way to the Generals which are all-important. It is said, therefore, that a strong General will over-rule any number of Particulars; and, a strong Particular will assert itself over a weak General. It should be appreciated that the Generals help the delineation of the outline whereas the Particulars furnish the details which differentiate the remedies in a well-defined group determined by the Generals. At times, a peculiar strong Particular may point to a small group of remedies and thus help a quick prescription. In this case, that Particular acts as a key-note. However, when utilising a Particular in this manner, the prescriber has to ensure that the other important features of the case are also covered by the remedy so pointed out. The Particulars are important as they provide the base for the evolution of the Generals as suggested by Boenninghausen.

29. Repertory is the medium for conducting the exercise of Repertorisation,thus repertory act as a medium for Repertorisation. We may use one Repertory or more than one for this exercise. Thus depending on the number of repertories used the medium of Repertorisation may be classified as Unitary medium Multiple medium Comparative Integrated

30. Unitary medium In this only one Repertory is used for the whole case The Repertory is selected on the basis of operating schools of philosophy All the symptoms which are to be Repertorised are found in that Repertory The unitary medium affords the easiest passages all the rubrics are found under one roof. ONE ONLY

31. Multiple medium / cross repertorisation Here more than one Repertory is used for the given case. The term cross repertorisation is used when more than one Repertory is consulted either to help in the selection of the similimum or to confirm the result obtained from the use of one Repertory.

32. Purpose 1. To highlights the oneness of all the Repetories with regards to their objective i.e. to find the similimum 2. To select well represented rubrics from any of the Repertories. Further divided in to Comparative medium Integrated medium

33. Comparative medium Here the same set of symptoms are repertorised in different repertories. Quite often an academic exercise, to understand & appreciate the relative value of different repertories for the given case. Useful when the operating schools of philosophy cannot be determined The medicines which are leading in the repertorial result may not tally between different repertories. More time consuming process

34. Integrated medium When all the required rubrics are not found in a single repertory When there is no clarity as regards to the operating schools of philosophy in the case. When the operating schools of philosophy is vague or more than one schools of philosophy is indicated then the dominant schools of philosophy has to be determined. This is determined on the basis of the nature of the symptoms found in the case. The repertory thus selected is called the Base repertory and the other repertories are called Accessory repertories. The multiplicity of repertories may belongs to the same schools of philosophy or to different schools. In a case when all the repertories belongs to the same schools of philosophy ,the repertory which affords the major share of rubric is called as the Primary repertory ,and the repertories which contribute for lesser number of rubrics are called Secondary repertories

35. if some symptom has to be accessed from a repertory not belongs to the same schools of philosophy as the primary repertory such repertory is called as Accessory repertory Eg . Synthesis for Generals Kent for particulars While using the integrated medium, it has to be remembered that the grading of medicines in different repertories is not the same. So we have to consider the scale of grading of the primary or the Base repertory as the bench mark and convert the grades of medicines in the Secondary or accessory repertories. Eg, If Kent’s repertory is used as Base repertory & TPB & Boerick as accessory repertories, then The 1st grade of TPB scores 3 instead of regular 5 The 2nd grade ” 2 ” 4 The 3rd & 4th ” 1 ” 3 and The 1st grade of Boerick 3 ” 2 The 2nd ” 2 ” 1

36. Cross - repertorization is used when more than one repertory is consulted ,either to help in selection of the similimum or to confirm the result obtained from the use of one repertory . cases with wide dimension helps in preparing a totality from any angle-kent, Boenninghause and Boger. Any case,which has various rubrics that are not found in one repertory needs reference of more than one repertory.

37. METHODS OF CROSS REPERTORIZATION USING ONE TOTALITY REARRANGING THE TOTALITY INTEGRATED APPROACH

38. USING ONE TOTALITY A case is selected for repertorization through a repertory, and accordingly a totality is erected. The same totality can be used for referring other repertories.

39. REARRANGING THE TOTALITY In this method, the totality is rearranged according to the philosophy of different repertories. Thus, after taking the case, the evaluated symptoms are arranged logically which can be restructured according to different repertories.

40. INTEGRATED APPROACH Under this method, one totality is erected in the first instance for repertorization. Then rubrics should be referred to in all repertories and a note made regarding the availability of the rubrics. The next step is to find those repertories where these rubrics are represented well. This is the most important approach, which helps to derive the maximum benefit from all existing repertories. Well represented rubrics, selected from various repertories, are used for repertorization. This approach leaves minimum error in repertorization, especially in respect of omission of Drugs

41. REFERENCES PRINCIPLES AND PRACTISE OF HOMOEOPATHY-M L DHAWALE ART OF CASETAKING-R.P.PATEL ESSENTIALS OF REPERTORIZATION-S.K.TIWARI INTRODUCTION TO REPERTORIZATION-MUNIR AHMED