Just as Columbus’ discovery of the New World heralded a new age of exploration, the introduction of this much anticipated repertory ushers in a new era for veterinary homeopaths. Distilled from many decades of clinical experience, cured cases and based on reliable sources, the New World Veterinary Repertory is a gift to homeopathic veterinarians and the animals they treat and will undoubtedly become an indispensable tool in your practice.
— Beth Niles, Kent Homeopathic Associates
Why Make This Repertory?
— Richard Pitcairn, DVM, PhD
When I began to study homeopathy with some seriousness, about 1978, I first learned to use the Kent repertory and that was my reference text for about ten years. This is an excellent repertory, one that I still use, often on a daily basis.
Yet if we ask “what is the best repertory for the veterinarian?” then we must refer to the types of patients that we encounter. Our homeopathic work, if to be successful, must be based on the information forthcoming from the patient. Immediately we see differences from dealing with the human patient.
The method of Kent is to emphasize the mental and the general symptoms, working from these into the modifying factors — the modalities — and when necessary using some particular symptoms with which to differentiate. There is understandably the inclusion of some details of the mental and emotional state as well as sensations. With animals these are just not available. We can recognize emotions in animals but they are much more broadly categorized than in a person. We can say “fear” but not the details of the fear. We can say “anger” but not type of anger or really understand, for sure, the accuracy of calling it anger instead of fear or irritability or rage. A common example is the dog that is afraid of thunder. There is a rubric that is specific for this fear and sometimes it seems to be accurate to apply it to the fearful dog. But in my experience more often than not the more accurate way to understand it is “fear of noise” of which thunder happens to be a big example.
Another difference in evaluating animal conditions is the difficulty in separating the general symptoms (affecting the whole individual) with the particular symptoms (affecting just a part). If it was a person they could tell us, but this must be inferred from observation of the animal.
So we see that the approach of Kent, though very good, does not really work so well in animal cases because we just do not have the same accuracy of information. If we couple this with, in our time, how often we homeopathic veterinarians are presented with cases of chronic disease, instead of acute injuries, toxicities and infectious diseases, we can appreciate the challenge we face in doing this work. These chronic cases are almost never presented to us in their nascent or unmodified form. Often, the homeopathic veterinarian is turned to only after other treatments, that have muddled the appearance of the patient’s condition, make seeing the similar remedy even more difficult. As Kent has told us, with non-curative treatment the first symptoms to go are the characteristic ones, the most useful information and what we need to be certain of our remedy selection. These animals have pathology, often advanced pathology, and we know that pathology is the least useful guide to finding the remedy that is needed.
The Newer Repertories
With time, other repertories came along as general interest in homeopathy developed, especially notable the Synthetic Repertory by Barthel and Kent’s General Repertory edited by Künzli. These were very helpful and I used them quite a bit. Then more expanded repertories began to appear, such as Synthesis by Frederik Shroyens and The Complete by Roger Van Zandvoort.
Somewhere along these development lines I began to feel a shift in my work. As the number of rubrics increased, along with much larger rubrics from added remedies, I could see my analyses were not as definitive as they had been and I had more trouble feeling satisfied with the outcome. Simply put there was too much information and it was confusing. I do find that these larger, more inclusive repertories are very useful in some cases especially where I am searching for a particular symptom or a detailed emotional state but in most of my cases they are not advantageous.
Philosophical Approaches To Repertory Construction
I pondered the situation and came to the realization that there were two possible philosophies in developing a repertory. One is to expand it as much as possible, adding in all possible information so that the repertory was almost as complete as the materia medica itself. The other possibility was the opposite. Rather than strive for completeness of the rubrics by putting in every possible remedy, the large available inventory of remedies is assessed, through clinical application, for usefulness and only the ones that are clinically confirmed as being most often needed, the polychrests mostly, are kept in the repertory and are used to construct the rubrics. After all, 200 years of clinical experience in which the most useful remedies are identified is an extraordinary resource.
As an example, consider that for a particular condition, such as the common cold, the materia medica medica contains hundreds remedies that would seem to have some similarity (the Complete Repertory 2009 has 577 for this condition). However, as they are used in clinical practice it becomes apparent that really only about 30 are usually needed, one of the others being occasionally applicable but rarely. In fact, it may be that only 8-10 remedies will handle 90% of what is commonly seen. So in constructing a rubric for this condition, we have the choice of a very large rubric of hundreds of remedies — that will be difficult to narrow down to a small group for materia medica study — or we can start with a limited rubric of just the 30-40 most often needed ones, realizing that this will likely cover 98% of the cases we see.
The Boenninghausen Repertory
Coming from this latter perspective I spent some time using a variety of other repertories and came to the conclusion that the one repertory that best demonstrated this “winnowing” approach was the Boenninghausen repertory as edited by Boger. Before this perspective I had assumed that the rubrics in the Boenninghausen repertory were smaller because there was not enough information known at that time, or perhaps too few remedies, or not enough experience, etc. but as I used it, and understood the philosophical basis for it, I found it to be extraordinarily useful and accurate for all my cases — animal or human. I came to the realization that it had been deliberately designed to be a compilation of the most likely remedies in each rubric.
It may be more clear to put it like this: if we match a symptom from the patient, one that is important in the case (based on the corresponding intensity, persistence, or recurrence of that symptom) to the corresponding rubric, there is a very high probability that the rubric will contain the remedy needed. That in itself, it is a focus that is very practical. The last 10 years or so the Boenninghausen repertory (edited by Boger) has been the reference I first turn to and which I use in the great majority of my cases.
Experience From Teaching
A parallel influence was that, from 1992, I had a post-graduate, year long, training program for veterinarians in the use of homeopathy. From this perspective I could appreciate the difficulty the students had in using the repertories arranged for working with human patients. There is much information that only a human being can report — sensations, types of pain, locations, detailed mental and emotional symptoms. One can, of course, learn to ignore this information (as I did) but I began to think how nice it would be to have a repertory re-edited towards veterinary use.
The Boenninghausen Method
So these two influences came together and why I found the strategy of Boenninghausen to holds us in good stead. The Boenninghausen “method” was developed early on, in the time of Hahnemann. He worked with both people and animals and as his experience grew he proposed a different way of using the symptoms of the patient, one closer to the way Hahnemann understood a case. He divided the symptoms like this, in order of importance:
- Location (the focus of the lesion or disturbance).
- General symptoms.
The introduction of the idea of concomitants also came from Boenninghausen and is an extremely useful tool, one he emphasized in his repertory. He recognized a pattern in both patients and in those doing provings, an association of symptoms, some that would arise right before or at the same time as the main complaint. That association, the two symptoms together, was able to very much narrow the choice of remedies as there were fewer remedies that would have that association. He called these associated symptoms concomitants.
Generalized Modalities and Concomitants
Another difference with Boenninghausen, one actually that Kent did not like, was his extending some of the symptoms, the modalities and concomitants, into the category of “generals” which could be applied to an entire section of the repertory. If you look at the Respiratory section as an example, at the top of that section you will see rubric headings “Aggravation”, “Amelioration”, and “Concomitants”. So the listings in these will apply to all the other symptoms in the Respiratory section of the repertory.
Why did Boenninghausen do this? He based this on the clinical observation that a modality that aggravated bronchitis would also aggravate other respiratory symptoms in the patient. He also observed the same in provings. He concluded this was a reliable rule — that modalities tended to be generalized in most patients, “general” not in that they would appear in the General Section of the repertory but that they could be generalized to other conditions affecting the same part or function of the patient, thus by analogy the same repertory section. Further investigation confirmed that same could be done with concomitant symptoms.
Here is an example of applying one of the modalities in the Respiratory section to the other listings that are there (the symptoms and conditions). In the “Aggravation” grouping there is the rubric:
Respiration; AGG.; Anger, vexation, etc.: Ign., ran-b., STAPH.
There are three remedies in this rubric and and each of them could apply to any of the following symptoms. For example, if a patient had difficult breathing (one of the rubrics) and it was observed that they were made worse by getting upset, getting angry, then one could turn to the modality listed above and consider these three remedies: Ignatia, Ranunculus, and Staphysagria as a possible fit for this patient. That this modality was seen in the patient, is a hint that one of these remedies could be the appropriate remedy. It does not always work out that it is one of these remedies, but is certainly worth consideration of the possibility.
However, and here is what is different, the patient could, instead of having difficult breathing, have rattling of mucus (another rubric) and was also worse when emotionally upset by becoming angry. Then, again, the same modality rubric of the three remedies would apply and be worth perusing.
The same approach is used with concomitant symptoms. In the Respiratory section, there is a rubric “Concomitants” without any subrubrics which is different than what we just discussed with the Aggravation modalities which did have an extensive listing. It is interpreted like this: The respiratory condition in our patient is attended with other symptoms occurring right before or at the same time as the respiratory symptom of interest. The details of that concomitant symptom are not specified by this Concomitant rubric, so the meaning is this: just having any concomitant symptom, regardless of what it is like, is enough to apply this rubric.
In some sections, the Concomitants list is quite extensive. In the Cough section, for example, there are many detailed concomitants. A specific example for that section would be a patient with a hacking cough made worse by anxiety or fear (8 remedies). So we see that Boenninghausen arranged the concomitant symptoms to be used in the same way as the modalities.
In summary, the way that Boenninghausen arranged these groupings is by moving the modalities and concomitants out of subheadings under specific conditions and put them into a more generalized grouping for that repertory section.
At first look one would think this cannot be accurate as it is an assumption beyond the information that has been gathered in provings, and of course there are obvious exceptions. His observations were indeed based on clinical experience and also on the study of provings but Boenninghausen extended it further and used it to find his remedies in other cases. One could have a patient with a respiratory condition affected by a modality, yet that relationship had never been described in a proving before. Nonetheless, the “generalized” modality rubric could still be applied to that patient with success in finding the suitable remedy.
I was not sure about this suggestion of Boenninghausen when I first starting using the Boger/Boenninghausen repertory but I found that my experience also confirmed this as a good approach, often solving cases for me that no other method did. Like any method it is not perfect nonetheless it is surprisingly useful and reliable.
This is quite different than the way Kent structured his repertory. There you will find in the various repertory sections that the modalities are assigned to individual symptoms and you will see these modalities listed as subrubrics under that symptom. For example, in the Respiratory section of Kent, there is the rubric for accelerated respiration and under that, as a subrubric, there is “while lying down”. So we understand, from the way it is arranged, that the modality of worse from lying down applies to just the symptom of accelerated respiration. There are many other places in the Respiratory section that this modality of worse lying is given, however always under specific headings, detailed symptoms like the accelerated respiration one. This is the way that Kent preferred it, thinking it more accurate, and it is indeed a very useful arrangement.
In working animal cases we find it a most useful method and the way that the Boenninghausen method is used in animals is similar to what is described above (the list of symptom types as to importance). We cannot include “sensations” though occasionally we can make a reasonable guess at one. An example that comes to mind is the dog that will suddenly turn and begin to chew frantically at a place on the skin. They act just like bitten by a flea and sometimes it is accurate to use a skin rubric such as “biting sensation” or “stinging sensation”. However, most of the time we have to work without this idea of semi-certainty. So our emphasis, by necessity, is on:
Mental symptoms can sometimes be used, as I described above, but most often after other symptoms have narrowed down to a remedy group and we are making our final differentiation by bringing in the mental/emotional behavior as a help in deciding our remedy choice.
The Editing Process
In using the Boger/Boenninghausen repertory as our foundation, Wendy Jensen and I went through an editing that retained the philosophical structure that Boenninghausen introduced (and developed further by Boger). We removed what was not useful to our work and also brought in information from Kent, Boger and Jahr as our primary sources, as well as useful information from other repertories such as Knerr, Boericke and Allen’s Encyclopedia that would add remedies to some of the most important rubrics for us as veterinarians.
So the first part of the editing process was “cleaning up” the Boger/Boenninghausen repertory by taking out information not useful to us in our veterinary work — the sensations, the details of pain, the symptoms that simply could not be recognized in animals. Then, that done, we were especially interested in adding rubrics from other sources, especially Kent, that we would often want to find for our animal work. An example that comes to mind is a greenish discharge from the nose. Another is a rubric that characterizes the very frequent condition of ear irritation with excessive oily wax production in dogs (these days often diagnosed as “yeast infection”). So we searched for these rubrics or created them newly from the search of materia medica. When more than one rubric was found in other sources for the symptom of interest, then we would combine them including the remedies from two or more rubrics and retaining the highest grading for the remedies that were duplicated.
In some instances a rubric of veterinary interest was already in Boenninghausen but the rubric could be enlarged from other sources to our advantage. There are a number of such rubrics frequently seen in practice for which we would love to have more information of possible remedies to consider, so based on our experience in practice we paid special attention to these.
The addition of remedies from other sources has increased the range of remedies to consider for cases. The Boger/Boenninghausen repertory has 342 remedies while Kent has 624. So we will see in this new veterinary repertory some remedies that are not in the original Boger/Boenninghausen.
A Case Example
Moses, a 5 year old male cat, has become recently ill. He is very lethargic and completely lost his appetite. If made to stand he cries out. He has not moved for 24 hours. There is a fever going from 103.5 F. (39.7 C) to 105 F. (40.6 C). Blood analysis shows a normal WBC count, normal neutrophil levels but very low lymphocyte and monocyte numbers—suggesting a marked migration of these cells to some extravascular site. These values are also elevated: SGOT, CPK (very high), direct bilirubin, & blood glucose. The SGPT is normal as are BUN and Creatinine.
The remedy which cured this cat was Bryonia 30c given as single pellets on a four hourly schedule for four doses (until response evident).
Let’s start with a workup of the case using the Kent repertory.
We see that Bryonia is definitely in the top group for consideration. There are seven remedies that are similar enough to be in all of the rubrics chosen for the analysis. So it would not be difficult with a quick perusal of the materia medica (if even necessary) to choose Bryonia out of this group.
Just for comparison we can see the greater challenge if we were to use the Complete Repertory instead of Kent’s.
Here we still have Bryonia in the second position but now the remedies for consideration has increased to 13. Doable, but more work.
Lastly, here is the analysis in the Boger/Boenninghausen repertory.
Bryonia clearly is at the top of the list and the only remedy that is in all rubrics. Note that this analysis started with the “inflammatory fever” but then drew on two modalities from the Fever section as well as one concomitant (shrieking, crying out). So you can see here how the method of generalized modalities and concomitants is used.
In closing, here is a suggested way to use the New World Veterinary Repertory.
- Identify the focus of the condition in your patient. Use that location as your base for starting your analysis. The “location” need not be an anatomical region, it could be a function such as fever in the example case above.
- Then bring in the modalities and the concomitants that you have available. Use them to narrow the grouping of remedies for consideration.
- If there is not a corresponding modality in the repertory section you are focusing on, then use modalities from the Generals section.
- Use few rubrics in your analysis. The more rubrics you use, the more likely the remedy needed will be lost in the listings.
- The important symptoms to use are those that are intense (especially in acute conditions), that are persistent or recurrent (in chronic conditions), or are unusual in some way — either by appearance or in association with the rest of the case.
- If you do not have the information needed — the modalities, concomitants, the generals — then pick the one rubric that most accurately characterizes the chief complaint. Assume it is highly likely that the remedy you need is in that list. Then work with the list by adding one other symptom, one that is affecting a different region or function. See if that more clearly defines the remedy choices. You may need to add a second rubric, delete it, add another — back and forth until you are satisfied.
- In some very difficult cases, there is no other option than considering carefully every remedy in the one rubric list. It does help, in the chronic cases, to limit remedy considerations to those suitable for chronic disease. This can bring the remedies under consideration to a reasonable number. In the “Pitcairn Package” for MacRepertory that analysis choice of limiting to Hahnemann’s and Boenninghausen’s list of remedies suitable for treatment of the chronic miasmatic conditions is already included in your setup, so it is easy to toggle back and forth between “all remedies” and “chronic remedies.”
So what we have is the first truly edited veterinary repertory, worked from the ground up, with the intention it would be of the most practical usefulness to those working with animals. It will serve you well to practice using it with some cases for which you already know the curative remedy. That way you can try various approaches in analysis, using different rubrics, and gain some familiarity with how cases are worked out with this approach.
Good luck with using this repertory. I think you will find it both interesting and very useful.
Steps in the Repertory’s Construction
— Wendy Jensen, DVM
This repertory was constructed on the backbone of Boenninghausen’s Characteristics Materia Medica & Repertory as created by C.M. Boger. This repertory emphasizes concomitants, aggravations, and ameliorations of symptoms, which we have found to be the most reliable guide to the curative remedy in veterinary patients. The first step was to remove all the rubrics from Boger’s repertory that were not applicable to veterinary patients. This included many mental rubrics such as types of dreams, mental constructs such as thinking that things look beautiful, and so forth, as well as physical symptoms impossible to elicit in the non-verbal patient, such as types of pain, sensations, headaches, the taste of expectorated material, and many many others.
The next step was to add in all the applicable rubrics from Kent’s Repertory of the Homoeopathic Materia Medica, Jahr’s New Manual of the Homoeopathic Materia Medica, and finally Boger’s Synoptic Key. This step often required updating rubrics with remedies found in these references but not present in Boenninghausen’s repertory, as well as adding rubrics not found in Boenninghausen. A few useful rubrics were also formulated and added with the help of ReferenceWorks. The materia medica used for these searches included Hering’s, Allen’s, Hughes’ Cyclopedia, Allen’s Nosodes, Anshutz’s New, Old, and Forgotten Remedies, and Hahnemann’s Materia Medica Pura and his Chronic Diseases. Useful rubrics from Schwartz’s Wound Repertory were also added.
During this work we discovered many inconsistencies in the order of rubrics in the original sources. These were corrected and standardized for ease of navigation through the repertory. Finally the language was changed from the human body part to the analogous non-human anatomical location, such as “ankle” to “hock,” “wrist” to “carpus,” and “arm” to “foreleg.” Menses was described as Estrous (reproductive cycle). Definitions were also added to clarify older terminology or technical terms. For the last step, extensive cross references were added, and existing ones were refined to quickly guide the user to potentially more similar rubric choices for their cases.
The result of this painstaking work over a period of three years is a precise and exacting tool for the busy veterinary practitioner. This repertory would also be applicable to human non-verbal patients, such as infants or adults unable to communicate due to a mental condition such as schizophrenia or coma.
Dr. Wendy Jensen is a licensed veterinarian who has been practicing 100% homeopathy since 1992. She received her veterinary degree from the New York State College of Veterinary Medicine in 1987, and completed Dr. Richard Pitcairn’s Professional Course in Veterinary Homeopathy before being certified by the Academy of Veterinary Homeopathy (AVH) in 1994. Dr. Jensen served on the initial expanded board for the AVH. She has published numerous articles in holistic health magazines for animals as well as in the JAVH, for which she was the Executive Editor for its first 12 years in publication. She has lectured for the AVH, the Homeopathic Medical Society for the State of Pennsylvania, various breed clubs, schools, homeopathic study groups, and health organizations. She has taught for the Professional Course, and has been a mentor on the Course’s email listserve for over three years.
You can buy this new repertory at Kent Homeopathic Associates.