Steps of repertorization

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steps of repertorization in homeopathy detailed

Here is a thorough breakdown of the Steps of Repertorization in homeopathy:

Steps of Repertorization

Step 1 - Case Taking

The process begins with a complete and careful case taking. The physician records:

Chief complaint and its history
Characteristic symptoms - mental, emotional, general, and physical
Modalities - what makes symptoms better or worse (time, temperature, position, weather, etc.)
Concomitants - associated symptoms occurring alongside the chief complaint
Causation - predisposing or exciting causes (e.g., grief, exposure to cold, injury)
Past and family history, miasmatic background

The raw data collected here is the foundation for everything that follows. Poor case taking leads to poor repertorization.

Step 2 - Analysis and Evaluation of Symptoms

After recording, symptoms are analyzed and graded by their value and hierarchy:

Grade	Type of Symptom	Priority
1st	Mental/Emotional generals	Highest
2nd	Physical generals (sleep, appetite, thirst, thermals, desires/aversions, sweat)	High
3rd	Strange, Rare, and Peculiar (SRP) symptoms	High (very specific)
4th	Particular symptoms with strong modalities	Moderate
5th	Common/pathological symptoms	Lowest

This hierarchical grading follows Kent's dictum: generals before particulars. Boenninghausen emphasized complete symptoms - location, sensation, modality, and concomitant.

Step 3 - Constructing the Totality of Symptoms

The totality is not just a list of all symptoms - it is a selection of the most characteristic, individualized symptoms that form a coherent picture of the patient. Hahnemann called this the "characteristic totality."

Symptoms selected for the totality should:

Be peculiar to the individual (not common to the disease)
Reflect the patient's constitution and miasm
Include at least one eliminating (keynote) symptom

Step 4 - Converting Symptoms to Rubrics

Each symptom from the totality must be translated into the language and structure of the repertory. This is called "rubricizing" or "finding the rubric."

The symptom is located in the appropriate chapter (Mind, Generalities, Head, etc.)
Sub-rubrics and sub-sub-rubrics are explored for greater specificity
If an exact rubric is unavailable, the nearest equivalent is chosen
The grade of remedies under each rubric is noted (bold = grade 3, italic = grade 2, plain = grade 1 in Kent's Repertory)

Step 5 - Selecting the Repertory

The appropriate repertory is chosen based on the nature of the case:

Kent's Repertory - when generals (mental and physical) and particulars are available (most commonly used)
Boenninghausen's TTTT - when complete symptoms (location, sensation, modality, concomitant) are available
Boger-Boenninghausen's Repertory (BBCR) - when causation, modalities (generals and particulars), and concomitants are prominent
Boericke's Repertory - useful in pathological cases or when generals are lacking
Phatak's Repertory - concise, useful for busy practice

Step 6 - Repertorization (Tabulation of Rubrics and Remedies)

There are two main technical methods:

a) Aggregation (Total Addition) Method

All rubrics are taken simultaneously
All remedies appearing under each rubric are listed on a chart
Marks (grades 1, 2, 3) against each remedy are added up across all rubrics
Remedies with the highest total score across the most rubrics are shortlisted
Advantage: no remedy is missed; more inclusive
Disadvantage: time-consuming; common remedies may score high artificially

b) Elimination Method

One eliminating rubric is selected first (most characteristic, most certain symptom - usually a mental general or SRP symptom)
Only the remedies present in that first rubric are carried forward
Subsequent rubrics are used to narrow down further
Remedies absent from the eliminating rubric are dropped
Advantage: faster, more focused
Disadvantage: risk of eliminating the correct remedy if the first rubric is poorly chosen

Step 7 - Analysis of the Repertorial Result

After tabulation, a short list of 3-5 remedies emerges. These are ranked by:

Total score
Number of rubrics covered
Grade of coverage (bold vs. plain)

This gives a differential list of probable remedies.

Step 8 - Cross-Reference with Materia Medica

The shortlisted remedies are now studied in depth in the Materia Medica to:

Confirm that the remedy's full drug picture matches the patient
Identify subtle differentiating features not captured in the repertory
Check for miasmatic correspondence
Verify rare or keynote symptoms

The repertory points the way; the Materia Medica confirms the choice. Neither can be used in isolation.

Step 9 - Selection of the Similimum

Based on the combined repertorial analysis and Materia Medica study, the similimum (the most similar remedy) is selected. Factors considered:

Highest degree of similarity to the totality
Constitutional and miasmatic fit
Sensitivity and susceptibility of the patient

Step 10 - Prescription and Follow-Up

The remedy is prescribed in the appropriate potency and dose
The patient is monitored for response (Hering's Law of Cure)
If needed, the case is re-repertorized with updated symptoms

Summary Flow Chart

Case Taking
    ↓
Analysis & Evaluation of Symptoms (grading by hierarchy)
    ↓
Constructing Totality of Symptoms
    ↓
Converting Symptoms to Rubrics
    ↓
Selecting the Appropriate Repertory
    ↓
Repertorization (Aggregation or Elimination Method)
    ↓
Analysis of Repertorial Results (shortlist)
    ↓
Cross-Reference with Materia Medica
    ↓
Selection of Similimum
    ↓
Prescription + Follow-Up

Key Principles to Remember

Repertory points, Materia Medica confirms - the two always go together
The quality of symptom selection matters more than quantity
An eliminating rubric should be used with caution - a wrongly chosen one will eliminate the correct remedy
SRP (Strange, Rare, Peculiar) symptoms carry the most weight in repertorization (Aphorism 153, Organon)
Computer-aided repertorization (RADAR, MacRepertory) uses the same logical steps but speeds up tabulation

Case taking Recording and interpretation Classification and evaluation of Symptoms Definig the problem Erecting the totality Selection of proper repertory Repetorial result Analysis of repetorial result.prescription

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steps of repertorization case taking recording classification evaluation totality selection repertory result analysis prescription homeopathy

Here is a detailed explanation of all 8 Steps of Repertorization as per standard homeopathic curriculum:

Steps of Repertorization

Step 1 - Case Taking

This is the foundation of the entire repertorization process. A case is taken according to Hahnemann's instructions in Organon of Medicine (§83-104).

What is collected:

Chief complaint - onset, duration, character, location, extension
Modalities - < (aggravation) and > (amelioration) from time, temperature, weather, position, food, motion, sleep, etc.
Concomitants - symptoms occurring alongside the chief complaint that appear unrelated but are consistent
Mental and emotional symptoms - fears, grief, anger, anxiety, desires, aversions, dreams
Physical generals - thermals, thirst, appetite, bowels, sleep, sweat
Past history / Family history
Causation (Aetiology) - e.g., ailments after grief, fright, exposure to cold, suppression

Types of case taking:

Type	Used When
Hahnemann's method	Detailed chronic case; physician is silent and lets patient speak
Boenninghausen's method	Emphasis on complete symptoms (SLMC - Seat, Location, Modality, Concomitant)
Kent's method	Mental generals first; then physical generals; then particulars
Boger's method	Causation, modalities and pathological generals emphasized

Step 2 - Recording and Interpretation

After case taking, the raw information is written down systematically and then interpreted.

Recording includes:

Patient's own words (verbatim notes)
Physician's clinical observations (objective symptoms)
All information arranged under appropriate headings (mental, generals, particulars)

Interpretation means:

Understanding what the patient actually means when they describe symptoms in their own language
Converting vague descriptions into precise symptom language
For example: "I feel worse when the weather changes" → interpreted as aggravation from change of weather
Differentiating pathological symptoms (common to disease) from individual symptoms (peculiar to the patient)

Important distinction:

The patient says: "I feel a burning sensation in my stomach but I want cold drinks"
Physician interprets: Burning pains - desires cold though pains are burning → a striking concomitant/SRP

Step 3 - Classification and Evaluation of Symptoms

Symptoms are classified by type and then evaluated (graded) by their value for repertorization.

Classification (Types of Symptoms):

Class	Examples
Mental/Emotional	Anxiety, grief, fear, irritability, sadness
Physical Generals	Thermals, thirst, appetite, sleep, sweat, desire/aversion
Particular symptoms	Symptoms of individual organs/parts
Common symptoms	Symptoms common to all cases of a disease
SRP (Strange, Rare, Peculiar)	Symptoms that appear contradictory or uncommon
Complete symptoms	Having all 4 components: Location + Sensation + Modality + Concomitant

Evaluation (Grading by Value):

Kent's grading hierarchy:

Mental generals (will, intellect, emotions)
Physical generals (whole body reactions)
SRP / Peculiar symptoms
Particular symptoms with strong modalities
Common/pathological symptoms (lowest value)

Boenninghausen's evaluation:

Emphasizes complete symptoms (each symptom with all 4 elements)
Concomitants carry special importance
Modalities of generals ranked highest

Why evaluation matters: If a common symptom (e.g., headache) is given equal weight to a peculiar general (e.g., craving for salt), the repertorization will yield an inaccurate result.

Step 4 - Defining the Problem

This step answers Hahnemann's fundamental question from §3 Organon:

"What is to be cured in diseases?"

The physician must clearly identify:

What is the disease picture - the totality of the patient's suffering
What is peculiar to this patient vs. what is common to the disease
The miasmatic background (psora, sycosis, syphilis) underlying the case
Whether the case is acute or chronic (determines depth of case taking)
Obstacles to cure - maintaining causes, lifestyle factors, suppressions
Centre of gravity of the case - the one thing around which all symptoms revolve (the "essence")

This step requires clinical judgment and philosophical understanding. Without properly defining the problem, even a perfectly executed repertorization will point to the wrong remedy.

Example: In a case with 20 symptoms, the physician must decide:

Is this primarily a mental/emotional case (grief-based)?
Is this a one-sided case (very few symptoms)?
Is it an acute flare of a chronic miasm?

Step 5 - Erecting the Totality of Symptoms

The totality is not simply a list of all symptoms - it is the carefully constructed, characteristic symptom picture that represents the patient as a whole.

Hahnemann (§7): The totality of symptoms is the "outwardly reflected image of the inner nature of the disease."

What goes into the totality:

The most characteristic, individualizing symptoms
Symptoms that are peculiar, rare, or striking
Symptoms with strong modalities
The generals + the most important particulars
Miasmatic indicators

What is excluded from the totality:

Common pathological symptoms (e.g., fever in malaria)
Symptoms with no modalities or characteristics
Symptoms that belong only to the disease, not the patient

Constructing the totality - approaches:

Approach	Priority
Kent's totality	Mental generals → Physical generals → Particulars
Boenninghausen's totality	Complete symptoms (SLMC) + Concomitants
Boger's totality	Causation + Generals + Pathological generals
Hahnemann's characteristic totality	Most peculiar + striking + uncommon symptoms

Once the totality is built, each symptom in it must be converted into a rubric from the chosen repertory.

Step 6 - Selection of the Proper Repertory

The appropriate repertory is chosen based on the type of symptoms available in the totality.

Repertory	Best Used When
Kent's Repertory	Mental generals and physical generals are clear; most commonly used
Boenninghausen's TTTT (Therapeutic Pocketbook)	Complete symptoms available; strong modalities and concomitants; one-sided cases
Boger-Boenninghausen's Repertory (BBCR)	Causation, pathological generals, and modalities are prominent
Boericke's Repertory	Pathological/clinical cases; when generals are few
Phatak's Repertory	Quick reference; concise clinical practice
Synthesis / Complete Repertory	Modern, comprehensive; used in computer-aided repertorization

Factors guiding selection:

Nature of the case (acute vs. chronic)
Dominant symptom type (mental vs. pathological vs. generals)
Availability of complete vs. incomplete symptoms
Physician's familiarity with the repertory's structure

Step 7 - Repertorial Result

After selecting rubrics and tabulating, the repertorization gives a numerical result - a table showing remedies ranked by their total coverage of the rubrics.

Two main methods of tabulation:

a) Total Addition (Aggregation) Method

All rubrics are taken simultaneously
Marks (grades 1, 2, 3) for each remedy are added across all rubrics
Remedies with highest total marks and maximum rubric coverage are ranked first
Used in: Hahnemann's method, Boger's method, computer repertorization

Remedy	Rubric 1	Rubric 2	Rubric 3	Rubric 4	Total
Nat-m	3	2	3	2	10
Puls	2	3	1	3	9
Sepia	1	2	2	3	8

b) Elimination Method

The most characteristic symptom (usually a mental general or SRP) is chosen as the eliminating rubric
Only remedies present under that first rubric are considered further
Remaining rubrics are used to further narrow down
Much faster; used in Kent's method

Keynote Method (variant):

Prescribing based on one or two striking keynote symptoms rather than full repertorization
Useful in acute cases or when one symptom is overwhelmingly characteristic

The repertorial result gives a short list of 3-6 remedies - these are the candidates for the similimum.

Step 8 - Analysis of Repertorial Result and Prescription

The numerical result is only a guide - final selection is made through careful analysis.

Analysis involves:

Studying the top remedies in Materia Medica - does the full drug picture match the patient?
Checking rubric coverage - does the remedy cover the most important rubrics (generals, SRP) rather than just common ones?
Miasmatic analysis - does the remedy match the patient's miasmatic background?
Checking for keynotes/essence - does any remedy have a keynote that perfectly fits the patient?
Eliminating remedies that score high only on common symptoms
Using the Potential Differential Field (PDF) - symptoms not used in repertorization that help differentiate between two equally-scoring remedies

The Similimum is selected when:

It covers the maximum number of characteristic rubrics
Its grade under important rubrics is highest (bold = grade 3)
Its Materia Medica picture resonates with the patient's constitution

Prescription includes:

Selection of remedy (the similimum)
Potency selection - based on sensitivity, vitality, pathology depth (e.g., 30C, 200C, 1M)
Dose and repetition - based on the case (single dose vs. repeated doses; LM potency in sensitive cases)
Follow-up plan - assessment of response after 4-6 weeks in chronic cases; Hering's Law of Cure applied
Second prescription criteria - based on whether there is improvement, relapse, or a new symptom picture

Summary at a Glance

1. Case Taking
        ↓
2. Recording & Interpretation
        ↓
3. Classification & Evaluation of Symptoms
        ↓
4. Defining the Problem
        ↓
5. Erecting the Totality
        ↓
6. Selection of Proper Repertory
        ↓
7. Repertorial Result (Tabulation)
        ↓
8. Analysis of Repertorial Result → PRESCRIPTION

Key principle throughout: The repertory is merely an index - it shortlists remedies. The final prescription always rests on the physician's knowledge of Materia Medica, Organon philosophy, and clinical judgment.

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