Critical Study of Repertorium Universale

INTRODUCTION : C. von Bönninghausen’s repertories, especially his Therapeutic Pocket Book have been used for more than 165 years by many masters of homeopathic practice. They have fallen into comparative disuse during the past 120 years because J.T. Kent and also C. Hering wrote strongly against them occasionally. Kent did so for economic reasons just to promote his own repertory and thus few homeopaths have knowledge of C. von Bönninghausen’s philosophic background and practical principles of repertorization. The purpose is not to set forth the superiority of any one general repertory over another; but it is our desire to demonstrate the sound philosophy and practical application of C. von Bönninghausen’s work to such states as the homeopath meets in everyday practice. Once its principles are assimilated and used and many times in combination with the more Kentian way of repertorizing.

A failure to grasp the concept and philosophical basis of what Hahnemann and Bönninghausen were seeking to achieve in the Therapeutic Pocketbook has most likely been the principal underlying reason for its falling into disuse. Some practitioners have mistaken their own lack of understanding for a failure in the work itself, and have gone on to compound the error by teaching this to others.  

Over the past three decades much work has been carried out integrating and improving older and existing repertories, but the templates used to make these improvements are  still largely based on the one created by Kent over a century ago. This has its limitations as the full potential of other methods of repertorisation, particularly Boenninghausen’s can’t be fully utilized in any single Repertory.

In 2002-3, the project took a new direction and a new structural arrangement of the repertory, the Repertorium Universale , was introduced. In this repertory, Kent’s basic structure gave way to one which successfully married Kent’s approach with that of the older sources. This allowed much fuller use to be made of methods such as Bönninghausen’s and gave homeopaths far greater flexibility and versatility in the way they could approach the repertorisation of a case. The repertory allowed complete symptoms to be reliably constructed from the sum of their parts, rather than relying on finding an existing record of the exact, or closest possible symptom.

Boenninghausen technique has considerably greater flexibility and potential for solving cases that a repertory based only on complete recorded symptoms. This is because the complete symptom of the patient, whatever it might be, can be built from its components parts by the use of partial symptom rubrics, each of which is generally characteristic of remedy it contains. This is enormously useful in cases where very distinctive and characteristic symptoms can’t be including in the repertorisation because it simply isn’t in the repertory.

The Repertorium Universale differs from purely Kentian repertories. It still contains all the Kentian repertory information in its familiar form, but the alterations to its basic structure make it a far more flexible tool than one constrained to Kent’s schema. The repertory is designed to work equally well with any number of different repertorisation strategies. Boenninghausen’s approach can be used as easily as Kent’s, and it’s ideally suited to the newer family/group-based thematic analytical techniques. This introduction and guide explains exactly how, where and why the Repertorium Universale differs from its predecessors and what benefits it offers which have been unavailable in any one single repertory until now.

PLAN AND CONSTRUCTION:-

Most of Bönninghausen’s published work is included in the comprehensive modern computerised "super-repertories" - the Complete Repertory and  Synthesis.  But their predominantly Kentian structure has made it difficult to use Bönninghausen’s approach in conjunction with them. The problem of updating the more general rubrics with newer remedies (which aren’t admitted directly to a rubric as a result of their provings) has been partially addressed in composite main rubrics (a feature of the Complete but not Synthesis), but this falls a long way short of a systematic updating of the entire repertory from the perspective of the "Bönninghausen Method."

This is the deficiency which Roger van Zandvoort is seeking to remedy in the Repertorium Universalis. What he has done with the structure of the repertory is essentially to turn the Kentian schema inside out. In Kent’s schema, each major phenomenon is listed alphabetically within its appropriate main section with sub-rubrics qualifying sides, times, alternations, modifications (modalities, causations and concomitants), extensions and locations. Van Zandvoort has taken these qualifying dimensions and generalised them to section level as the first level of the hierarchy, followed by the phenomena according to the more familiar Kentian layout, so that the first level in each section now appears as blocks of qualifying dimensions, viz:

Alternating symptoms

1. Sides
2. Times
3. Modifications
4. Extending to
5. Location
6. Phenomena

The principal difference between the structure of Kent’s Repertory and those compiled by Boenninghausen is in Kent’s use of a defined hierarchy in the way he organises the indexing of the symptoms. All locations and modifications of symptoms (with the exception of some rubrics in the Generalities section) are dependent on a primary classification based on sensation. In other words, you can’t find any location or modification unless it’s describing a sensation, no matter how characteristic of a remedy that location or modification might be in its own right. Because of this, integration of Boenninghausen’s rubrics which are independent of sensation (Locations, Sides, Times, Concomitants, Aggravations, Ameliorations, Alternations) can’t be achieved in a Kentian-structured repertory, and it isn’t possible to use Boenninghausen’s technique with such a repertory.

In the Repertorium Universale nearly 1.5 million remedy additions have been made in over 180,000 rubrics with extensive cross-referencing. It includes all the features of the Complete Repertory . The grades of remedies — an indication of their reliability in the context of each symptom — have been re-classified and further clarified. The abbreviations of the remedy names have been corrected and synonyms reconciled. Most importantly, the re-structuring of the layout of rubrics makes it possible to use different repertorisation methods in a single search strategy. This makes the Repertorium Universale a much more flexible tool for evaluating how closely a patient’s symptoms match a given remedy’s therapeutic profile in the Materia medica.

By re-structuring the format of the rubrics in the Repertorium Universale , both Kent’s and Boenninghausen’s models are accommodated and presented as a single fully integrated repertory. The Kentian-structured repertory (i.e. the Complete Repertory ) has been nested within an expanded hierarchy which now includes Boenninghausen’s rubrics in the primary classification of symptoms. This result in a repertory which effectively offers the best of both worlds — the greater precision of the complete symptoms found within the Kentian structure, plus the greater flexibility of symptom combination provided by the Boenninghausen-style rubrics.

Generalised partial rubrics have attracted a lot of criticism over the years, from Bönninghausen’s day onwards, much of it resulting from an understanding which evidently misses the most important feature of these rubrics. All the remedies contained in these rubrics are there because that particular partial symptom has been found to be characteristic of the remedy in its own right, having been recorded as a feature of at least three separate and distinct symptoms produced or cured by the remedy. Using this criterion, all the Bönninghausen-style rubrics contained in the Repertorium Universale have been thoroughly and comprehensively updated with all the new remedies since his time.

SPECIAL FEATURES :

It is the largest Kentian style repertory. All remedies from sub rubrics represented in the main rubric and all remedies and rubric of the specific pains taken into the general pain rubric.

In the Repertorium Universale , the addition of all Boenninghausen’s repertories has been completed, the Boenninghausen-specific rubrics have been updated with most if not all post-Boenninghausen material and the Kentian foundation finally gives way to a structure allowing an even balance between flexibility and precision.

Some exceptions to the updating process need mentioning. The Mind section contains two Boenninghausen rubrics which are added for completeness, but not updated. The first is Concomitant — remedies which feature mental alterations as a concomitant of physical symptoms. The second is General — remedies with a general affinity for the mental/emotional sphere. Updating will take place when (or if) Boenninghausen’s criteria for inclusion are sourced. There is a similar Concomitant rubric in the Generalities section.

A further three sections have been introduced to the primary classification (Heart and Circulation, Blood, and Clinical) and the two Phenomena sections which were listed in their own right in editions of the Complete Repertory — Head Pain and Extremity Pain — have been reincorporated into the Head and Extremities sections. The separate section indexing Mirilli’s themes, introduced in the Millennium edition of the Complete Repertory , is retained, now with more extensive cross-referencing and more remedies.

The "modalities" are impressively clear (Boenninghausen) while the repertory also offers a meaningful connection to the classical Kentian "phenomena". It is, in fact, a flexible tool, which enables him to adapt his clinical investigation to the phenomenological characteristics of a patient. That’s why he consider Roger’s work an actualization of a long-awaited, expanded approach to the patient, compatible with concepts of anthropological phenomenology. Repertorium Universale also represents the "probabilistic" nature of any investigation of reality, as a consequence of the analogical relationship between the aspects we perceive of the universe. Every aspect investigated, has in fact, simultaneously, many different links and analogical connections to other parts and aspects. Every connected Modality, Alternating symptom, Side, Time, Extension to, and Location represents a virtual door to "Possible Worlds" (Patients/Remedies). Regardless of any common conceptual frames, limits and biases we may be bound by, Repertorium Universale offers an easy and clean structure to directly apply any repertorial search/approach."

Cross-references between rubrics have been thoroughly revised and increased, with the new repertory featuring more than double the number included in the last edition of the Complete Repertory .

Working with the Bönninghausen’s approach also encourages a different perspective on the literature — patterns and themes are emphasized, which works well with the latest trends in analytical technique.

The grading system changes have been made to give a more accurate impression of the characteristic nature of symptoms recorded in proving — a frequent source of frustration for today’s proving directors. Bönninghausen’s criteria provide a clearer delineation between proving information (including herbal and toxicological data) and clinical confirmation. It gives a finer and more precise differentiation between the degrees and paves the way for further revisions in future editions of the repertory which will grade remedies according to even more precise criteria, removing all inconsistencies and confusion.

To make use of Boenninghausen’s generalised rubrics, the symptoms of the case are constructed from the appropriate generalised partial symptom amongst the symptom modifications (Alternations, Sides, Times, Modalities, Extensions, Locations) plus Phenomena. These rubrics have been created for each section from Boenninghausen’s original rubrics, including later additions from his handwritten works, and updated with all the newer remedies and clinical confirmations which qualify. They form the first level of the hierarchy in each section. Remedies only qualify for addition to these rubrics if the symptom quality is clearly characteristic of the remedy. This essential component — indeed guiding principle — of Boenninghausen’s generalization process cannot be overemphasized, having been consistently overlooked by critics of the approach who rightly draw attention to instances where generalization is inappropriate. In the Repertorium Universale a symptom quality is regarded as characteristic if it appears in three or more separate symptoms, and has been added to the Boenninghausen-style rubrics on this basis, maintaining the highest degree found in any of its occurrences.

In the Repertorium Universale , it’s now possible to use all methods within the one repertory, even to intermingle them in the one case if appropriate, or to use the generalised Boenninghausen-style rubrics to approach cases from a thematic angle (families, groups, etc). This effectively frees you to individualize the method to the case as precisely as you’d expect to individualize the remedy, drawing on a fully updated database of remedies.