Comparing the time modality chapter of the Therapeutic Pocket Book (TPB-German, TPB-Hempel and TPB-Allen) with Materia Medica Pura or chronic disease – An exploratory study

INTRODUCTION

Time, which is indicated using hours or phases, represents a quantifiable element in the cause-effect continuum. It is the most easily identified element by the patient while describing their ailments. Hence, the stalwarts of homoeopathy took note of this element in their literature and in drug proving. When it came to converting the philosophy of the stalwarts to the process of repertorisation, time in its various forms became a top-ranking symptom. Hence, time as a causative modality, aggravating or ameliorating modality, periodical return of complaints and as association became important when selecting the simillimum.^[1-5]

Boenninghausen’s Therapeutic Pocket Book (TPB) is the benchmark for all the philosophical repertories in homoeopathy. True to the philosophy of the book, time modalities are not provided under every chapter or rubric, but as general modalities. Hence, the question arises about the logic based on which he generalised the specific element of time modality. How can it be used for all specific complaints? Can one generalise modalities the way they are represented in the TPB? Does it match the representation in Materia Medica? All the above questions lead to the present study wherein we compared the representation of time modalities in Materia Medica and TPB. Dr. Allen made additions to rubrics as well as to remedies and their grades in his edit. Hence, the study is focused only on the representation and an attempt to justify the presence of remedies/grades assigned by the various stalwarts who have edited the TPB with that of Materia Medica.^[6-8]

MATERIAL AND METHODS

Three editions of TPB were chosen to compare the time modality sections: (1) TPB-German (TPB-G), published by Druck und Verlag der Coppenrath’ schen Buch- und Kunsthandlung, Munster in 1846, sourced from the internet, (2) TPB-Hempel (TPB-H) published by W. Radde, New York in 1847, sourced from the internet, and (3) TPB-Allen (TPB-A) published by B. Jain Publishers (P) Ltd. New Delhi in 2009. The TPB-G and TPB-H were sourced from the internet. Their authenticity was accepted as is.

The rubrics and grades allocated to remedies under time modality section across editions of TPB were identified.

Physical verification of representation of time modalities in Materia Medica Pura published by B. Jain Publishers (P) Ltd., New Delhi in 1999 or Chronic Disease published by B. Jain Publishers (P) Ltd., New Delhi in 1995 with grades assigned to remedies in TPB. This was chosen as Materia Medica Pura or chronic disease was only available at the time of Boenninghausen.

The remedies chosen for this study were poly crests such as Pulsatilla, Natrum Mur and Sepia.

Pulsatilla was studied from Materia Medica Pura, while Natrum mur and Sepia were studied from chronic disease. The remedy and its markings against it in every rubric of the time modality section were noted. For example, the marking of Natrum mur in TPB-G, TPB-H and TPB-A has been noted under each rubric to identify any changes in that.

Then under the heading of the anatomical schema in the Materia Medica by Dr. Hahnemann, the presence of time modality was studied by going through every symptom of the prover and ‘*’ was placed under the appropriate rubric on the availability of that time modality. For example, from the mind section of Natrum mur, we found aggravation in forenoon, afternoon and night in two symptoms each; therefore, ‘*’ was placed twice ‘**.’ Likewise, if aggravation in the evening was noted in five symptoms, ‘*****’ were added [Table 2].

Finally, we compared the presence of time modality in Materia Medica and the marking given in the time modality chapter of TPB.^[6-10]

RESULTS

Dr. Allen has added rubrics ‘during the day’ and ‘at noon’ in the time modality chapter of TPB. Whereas Dr. Hempel has kept the rubrics as it was in original German edition [Table 1] [Refer Table 3].

DISCUSSION

Dr. Allen added the ‘during the day’ rubric and the remedies under the same heading, but the exact source of additions is not known, as there is less representation in Materia Medica Pura and Chronic Disease. On accessing the same rubric in TPB-A, only 12 remedies are seen, which suggests that the work was in progress and more remedies can be added under it by critically analysing the morning, forenoon, and afternoon rubrics as well as Materia Medica. Therefore, it is wise to use it with caution.

From this study, we cannot comment on how and why Dr. Allen added the ‘at noon’ rubric. On accessing this rubric in TPB-A, only five remedies are found, which suggests this rubric was under progress and requires a critical study of Materia Medica. Therefore, it is wise to use it with caution.

Boenninghausen did not add rubrics like ‘during the day’ and ‘at noon’ as there is no direct representation in Materia Medica Pura or chronic disease.

Dr. Hempel has neither added nor changed any rubric or the markings of any remedy; he simply translated them from German to English. Boenninghausen’s markings match the representation in the Materia Medica Pura or chronic disease in the original edition. In some rubrics, he gave higher markings that could be attributed to his clinical experience.

Boenninghausen has generalised time modalities that can be used with any complaints because he included only those remedies under that time modality, which covers most of the systems in Materia Medica. Furthermore, it justifies the principle of grand generalisation and analogy.

Dr. Allen retained the markings of each remedy under each rubric as it is or raised the markings. At some places, the rise in markings is justifiable whereas at many places it’s questionable. Therefore, it is to be used with caution and requires further study.

Remedies under the rubric ‘periodicity’ do not have direct representation in Materia Medica. On studying symptoms with interpretation under the light of periodicity, it can be justified, but the markings do not match the representation. This requires further study of symptoms from Materia Medica and clinical verification.

CONCLUSION

Grading assigned by Boenninghusen in TPB-G is in accordance with Materia Medica most times except few instances where mismatch is there, which is assumed to be due to his clinical experience. Generalization of the rubrics and remedies under particular time modalities by Boenninghausen is done if it is present in most anatomical parts or systems in Materia Medica Pura or Chronic Disease, hence it is justifiable to use the analogy.

The time related modalities as represented in Allen’s edition of TPB need to be referred to as work in progress; for genuine referencing, it is better to refer Hemple’s translation of TPB. This conclusion may be tested by further study of more remedies using the methodology adopted.

All the above conclusions drawn are an attempt to justify the changes made by the various authors who edited the original TPB, as none of the original stalwarts is currently alive, we felt it would be prudent to derive reasonable justification for the modifications they made. We accept that this may be looked upon as subjective, but we have been fact driven when deriving our conclusions.