Circling back to the basics: The perennial importance of the genius of Boenninghausen

‘We shall not cease from exploration

And the end of all our exploring

Will be to arrive where we started

And know the place for the first time’.^[1]

It is refreshing to start an editorial remembering the timeless lines of the brilliantly original literature, T. S. Eliot. The analogy to our own genius, Carl von Boenninghausen, is close indeed!

Repertories have served as a reliable index to the Homoeopathic Materia Medica.^[2] They continue to do so with the ease of a click in their modern avatar in the numerous software and applications. This has aided their successful integration of contemporary homoeopathic practice, thereby ensuring easy accessibility and instant utility to the same. They have also been updated with the ever-growing repository of rubrics and newer remedies. Some do question the haste with which this expansion is occurring and if the care which the creators of the original repertories exercised is being adhered to. And more importantly, are the modern repertories still true to the philosophical backgrounds on which the primary repertories were created? It is worthwhile to pay a brief visit to these concepts.

The first repertory of Boenninghausen has formed the basis of all further repertories, including Kent’s Repertory. Boger adopted this pattern and brought about a synthesis of Boenninghausen’s early repertories, Therapeutic Pocket Book and to some extent Kent’s Repertory in Boenninghausen’s Characteristics and Repertory.^[2] What was the genius of Boenninghausen that compelled others to follow him?

Boenninghausen perceived that the whole of the man was ill. The illness is not of the parts, although the manifestations may be limited to parts. He observed this in patients and in the Homoeopathic Materia Medica. The manifestations in the different localities showed a tendency to resemble each other than otherwise. He interpreted what he observed and perceived on the grounds of analogy and postulated that whenever the observations were missing in a particular area, they could validly be inferred from the characteristic expressions in the other areas. This extended use of the principle of generalisation is often referred to as Grand Generalisation.

This concept, though criticised by Dr. Kent, has been found extremely useful in clinical work. Boenninghausen’s method of utilising an incomplete symptom from the Homoeopathic Materia Medica or the case record by incorporating it into totality is a technique effectively propounded by Dr. H. A. Roberts and Dr. M. L. Dhawale.

The genius of Boenninghausen is also seen in his introduction of the fourth element of ‘Concomitants’ to the three elements of Symptoms- Location, Sensation and Modalities. This laid the foundation of his repertorial system and the use of his Therapeutic Pocket Book in clinical practice. There is a lot of misunderstanding of this approach and a factual account of the process employed by him to arrive at this would be fascinating and beneficial to the profession. In this issue, we have an original article by Akbari et al that attempts to do just that.^[3] They unearth how Boenninghausen may have come up with the concept of concomitant and gave it a place of prominence in clinical practice.^[3] This well-researched paper will provide a sound understanding of our basic repertories, thereby helping us ‘to arrive where we started, And know the place for the first time’. Poetic expression for us may be helpful to develop newer insights.

Boenninghausen was a ‘Master Generalist’, and Kent differed by emphasising the Particulars. Hence, the detailed section on Particulars in Kent’s repertory is unrivalled. All modern repertories have drawn inspiration from it and have attempted to improve upon the original structure given by him. Interestingly, the utility of extensive chapters on particulars is less discussed vis-à-vis the Mind and the Generalities chapters. We have a refreshingly original research article demonstrating the practical applicability and utility of Kent’s repertory in the treatment of upper respiratory tract infections.^[4]

Since the first repertory, homoeopathic repertories and Materia Medica have grown exponentially. Some thoughts did strike my mind-that is more always better? What is the validity of the newer remedies that keep getting ‘updated’ in the software-based repertories every other day? Have all the newer remedies been subjected to the rigour of Hahnemannian Provings? Are all the newer rubrics of modern repertories true to the original patients’ symptoms during the provings? Are the newer schools of homoeopathy advocating the usage of only mind rubrics – truly interpreting them as per the original prover’s language? Or are they taking liberties to colour the rubrics with their interpretation, which may not be in sync with the original symptom? Are we using the repertories in the right way? Is not returning to the basic repertories the one reliable method of truly understanding Hahnemannian thought? Arriving where we started (studying the work of the triumvirate of Boenninghausen, Kent and Boger) is not a choice, but perhaps the only way to rediscover homoeopathic prescribing.

We continue to build a solid evidence base to demonstrate the effects of our ultrahigh dilutions on biochemistry. In a randomised control trial, Karthika et al. demonstrate the efficacy of Vanadium Metallicum 30C and A. Farinosa 30C in significantly improving the serum ferritin levels in women with iron-deficiency anaemia.^[5] This study provides preliminary clinical evidence for the effectiveness of these remedies and conforms with their traditional homoeopathic use.^[5]

In addition to these wonderful original articles, there are evidence-based case reports demonstrating the efficacy of homoeopathy in clinical conditions such as adolescent polycystic ovarian syndrome,^[6] verruca plana,^[7] and primary infertility.^[8]

Repertory has been our foundation. However, we have also been introduced to non-repertorial approaches to sort out the totality. Allen’s keynotes have been one such popular method widely used due to their simplicity and ease. Dr. M. L. Dhawale was an astonishing polymath who commanded several disciplines. He evolved ‘structuralisation’ as a technique to understand the evolution of the illness, the patient as a person and the remedy perceived beyond the symptoms of repertories and materia medica. It is a brilliant process to understand all aspects of the ‘homoeopathic clinical process’. Most have found this approach difficult to apply in their clinical practice. It was fitting that the Golden Jubilee Institute of Clinical Research (ICR) National Symposium was held on this topic. The 3-day symposium, through 12 diverse cases, aptly demonstrated the concept and technique of structuralisation. The conference report dwells on the proceedings of this eye-opening symposia which broke fresh ground for all of us who participated.

The true enigma of Boenninghausen can be understood from the testimony by none other than Dr Samuel Hahnemann. He writes. ‘Baron…, has studied and grasped my homoeopathic system of treatment so thoroughly that as a homoeopath he deserves to be fully trusted, and if I should be ill and unable to help myself, I would not entrust myself to any other physician’.^[9] Such was the faith and conviction that Dr Hahnemann had for Boenninghausen. No wonder he is described by many as one of the first master minds of homoeopathic science.^[10] It is time to bring back the Baron, his philosophy and his repertories. It is time we revisit Boenninghausen.