KENT’S REPERTORY
by James Tyler Kent

 

 

 

HISTORY AND EVOLUTION OF KENT’S REPERTORY

 

Kent's repertory belongs to logical utilitarian type. 

Towards the last quarter of 19th century, there was flooding of the field of repertories by a large number of regional or clinical repertories. The number of repertories increased up to 120. 

A need was felt for a new and a more complete and useful repertory. The first step in this direction was the Repertory to the more Characteristic Symptoms of our Materia Medica by Constantine Lippe. In this repertory modalities were given in detail. The concepts were broadened and put to maximum benefit In Kent's repertory. Initially, Kent used Therapeutic Pocket Book but was soon dissatisfied with its philosophy and he started to go through the repertories published up to that time. He liked the plan and arrangement of Lippe's repertory. Dr: Kent had a thorough knowledge of Materia Medica and he found that many medicines were lacking in Lippe's repertory. So he added notes to each symptom or rubric. This was interleaved many times. He got into contact with Lippe – he wanted Kent to work along with Lee who was preparing a 3rd edition of Lippe's repertory. By this time Dr. Kent had prepared a repertory of urinary organs, chill, fever, sweat, etc.

Taking help from Dr: Kent, Lee started working and compiled a repertory on Mind and Head. But the compilation was based on Boenninghausen’s idea of generals and modalities were given at the end. Dr: Kent was not satisfied with this work and when Lee became blind, Kent rearranged it according to his plan.

Kent then started working on the repertory. In his opinion all the repertories had a common source, which were drug proving reports, Materia Medica and clinical verifications. According to Kent, a verified symptom in any repertory has immense value. Therefore he asked his students to copy the symptom and remedies already collected in other repertories. He was helped in this endeavor by Milton Powell, Mary Ives, Arthur Allen end F. E. Gladwin.

 

·         Gathered and compiled all material that had appeared in existing repertories

·         Added into this compilation, the notes made over years

·         Obtained from Materia Medica more symptoms and remedies for adding into the compilation.

·         Added only those clinical symptoms that were found not contradictory with their proving but consistent with their nature.

·         Checked and rechecked everything. For this Kent had gone through all repertories. But soon he found out that there were a lot of mistakes in the existing repertories. He found many omissions, missing, or over emphasis of symptoms.


So Kent discarded all the compilations and worked out a new format of repertory. After the completion of the work, Kent started using it in his clinical practice. On demand from the profession it was taken up for publication. But the cost of publication was too high which was estimated to be $ 9000 and was refused by Boericke and Tafel due to the huge outlay involved. So it was decided to publish the book in sections and subscriptions were sought from the profession.

200 subscriptions were obtained at $30.

At last the first edition of repertory came out in loose sheet form in 1897.

By the time of publication of 2nd volume, 90 withdrew subscription. Repertory was issued in the book form for the fist time in 1899.

2nd edition was published by Dr. Kent white he was in Lancaster.

3rd edition - Kent at the time of his death left three handwritten and corrected copies for 3rd edition of his repertory. In the preface, he writes about this work as ‘’The 3rd edition completes my life work, I have brought up to date, I have rearranged and made numerous corrections In addition to adding of many new remedies. I have verified every symptom in the book." He corrected and perfected the 3rd edition mostly during 1906 - 1909. Of these 3 handwritten copies of the 3rd edition, one was with Dr. F. E. GIadwin, Dr. J. S. Pugh and other one was with his wife Dr. Clara Louis Kent. Dr. Ehrhart with the help of F. E .Gladwin and J. S. Pugh published the 3rd edition in 1924. It can be seen that the 3rd edition published after Kent's death has some glaring mistakes when compared to Kent's manuscripts for the 3rd edition and the mistakes were carried over to the present edition. Kent's corrected manuscript was with F. E. Gladwin and she noted the mistakes and published it in Homoeopathic Recorder volume Xlll February 1928.

4th edition - Published in Chicago in 1935 by Ehrhart and Karl with the help of Clara Louise Kent, F. E. Gladwin and J. S. Pugh.

5th edition -This edition of Kent's repertory was planned in 1939. But due to the outbreak of the war it was considered unwise to attempt such a large undertaking. Some how it was published In 1945 before the end of war by Dr. Clara Louise Kent

6th American edition was published in 1957

 

1st Indian edition came out in 1961.

 


Dr. Gladwin gave her copy of Kent's manuscript of 3rd edition to Dr. Austin who in turn passed it to Dr. Pierre Schmidt along with the golden diamond ring which Dr. Kent wore during his lifetime. Dr P. Schmidt assisted in revising 3rd, 4th and 5th editions.

Dr. Schmidt discovered many mistakes in the American and Indian editions. There were omissions, wrong insertions, mistakes in alphabetical order, spellings, incorrect placing of rubrics and sub rubrics, error in grading, etc. Unfortunately this corrected manuscript, which was ready for printing, was stolen by a selfish person. And he asked for help to publish the repertory, Dr. C. S. Sandhu got in contact with him and he was given a portion of the manuscript to be copied down. But in the beginning Dr. Sandhu was unaware that he was seeing Kent original manuscripts. It was decided to bring out the repertory in sections. Two volumes were published which contained Mind and Vertigo in the 1st volume and head, eye and vision in the 2nd volume.

At the same time on request from Dr. P. Schmidt, Dr. Diwan Harish Chand got in touch with the person who had stolen it and managed to obtain the manuscripts which were in a mutilated form. He got this after prolonged and continuous persuasion. At last it was published in 1974. This edition is supposed to be the 7th edition of Kent's repertory but the same repertory is now termed as Kent's final general repertory of Homoeopathic Materia Medica.

 

·         Dr. C. M. Boger added a lot of rubrics to Kent's repertory

·         Additions were made by Dr. Vithoulkas

·         Dr. R. P. Patel published a corrected and improved Kent's repertory

·         Expanded by Dr. Sivaraman

·         Jost Kunzli made additions/corrections and published Repertorium Generale

·         Synthetic repertory - Generals of Kent worked out into 3 volumes by Barthel and Klunker

 

 

Kent’s Repertory has formed the basis of the following repertories

·         Synthesis - Frederik Schroyens

·         Homoeopathic Medical Repertory - Robin Murphy

·         Complete Repertory - Roger Van Zandvoort

·         Kent's Comparative Repertory - Dockx & Kokelenberg

 

 

PHILOSOPHICAL BACKGROUND

 

Kent severely criticized the faulty method of giving importance to parts and overgeneralization of symptoms and favored the selection of symptom on the basis of generals. As a master of Materia Medica, he noticed that particulars do not fall in line with generals in all cases and he emphasized the importance of generals. He said that in order to understand a person, his expressions at the level of generals must be noted and relied upon.

Emphasis should be given to study the expression of sick person as a whole – the approach according to which the disease starts in the core. Mental symptoms are most important because disease primarily deranges the core or mental domain. After that it may cause some effect on the physical level producing physical symptoms touching the patient as a whole, at last disease gets localized and produces particular symptoms. The symptom noticeable at the level of parts should be considered only after mental generals and physical generals.

 

Kent says "man is prior to organs and the home in which he lives is his body. What is expressed in parts is always preceded by a deviation in the state of health of the person. Such a deviation can be known only through expressions at the general level.”

Kent's repertory is based on the philosophy of DEDUCTIVE LOGIC. Generals are dealt with in detail followed by particulars and minute peculiars.

By working out a case in the other direction i.e. from generals to particulars the general rubric will include all the remedies that are related to the symptom and if after having done this, the particulars are gone into and the remedy that runs through the general rubric is found to have the particular symptom. This will aid in the choice of the remedy to be prescribed.

Kent rejected numerous symptoms and drugs that were insufficiently confirmed. Thus his repertory contains only 648 drugs.

 

TYPOGRAPHY - Evaluation of remedies
He used three varieties of typography to indicate the gradation of remedies unlike the 5 gradations of Boenninghausen and Boger
Bold - 3 marks - 1st grade - felt strongly by all provers of majority of provers, frequently confirmed and verified.
Italics - 2 marks - 2nd grade symptoms brought out by few provers, have not been confirmed but occasionally verified.
Roman - 1 mark - 3rd grade, verified by curing patients so accepted as clinical symptom.

 

 

PLAN AND CONSTRUCTION

Repertory is divided into 37 chapters arranged in double columns. The repertory starts with Mind chapter, which has been given prime importance. Last chapter is on Generalities, which contains physical generals and physical general modalities.

 

Most of the chapters deal with anatomical locations. It also includes chapters on discharges like stool and urine, local pathology - cough and expectoration, physiological functions -respiration, vision, hearing and sleep.

Numbers of medicines – 648 – an index of medicines with their abbreviations are given in the beginning of repertory.

 

The plan followed through out is from generals to particulars - general rubrics containing all the remedies that have produced all the symptoms followed by particulars like side, time, modalities and lastly extensions.

Up to 6th edition, Kent's repertory contained 37 chapters. 7th edition or Kent's final general repertory by Pierre Schmidt contained 39 chapters, where he gave independent status to smell and voice which under the earlier editions were put under nose and larynx respectively. In Kunzli's Repertorium Generale, Kunzli reduced the total number of chapters into 27 by putting vision under eyes, external throat under throat, bladder, kidney, prostate, urethra and urine under urinary organs and chill, fever and perspiration under one section.

 

In every chapter, arrangement of rubrics is in alphabetical order. The plan followed through out is from generals to particulars.

 

Arrangement of sub-rubrics under every rubric is based on the principle of generals to particulars. General rubric includes all those medicines where the prover reported a symptom with several modifications. In such cases medicine will be seen under the general rubric and also under the particular rubric. It also includes symptoms without any modifications, symptoms of an undefined kind or nature and also some symptoms with undefined modalities.

 

Arrangement of sub rubrics is always in a fixed pattern, i.e. side, time, modalities and extensions.


1.      MIND

2.      VERTIGO

3.      HEAD

4.      EYE

5.      VISION

6.      EAR

7.      HEARING

8.      NOSE

9.      FACE

10.  MOUTH

11.  TEETH

12.  THROAT

13.  EXTERNAL THROAT

14.  STOMACH

15.  ABDOMEN

16.  RECTUM

17.  STOOL

18.  BLADDER

19.  KIDNEY

20.  PROSTATE

21.  URETHRA

22.  URINE

23.  GENITALIA

24.  GENITALIA - FEMALE

25.  LARYNX AND TRACHEA

26.  RESPIRATION

27.  COUGH

28.  EXPECTORATION

29.  CHEST

30.  BACK

31.  EXTREMITIES

32.  SLEEP

33.  CHILL

34.  FEVER

35.  PERSPIRATION

36.  SKIN

37.  GENERALITIES

 

 

 

Working out a case with Kent’s Repertory
Kent emphasises that after taking the case following the guide lines laid down by Dr. Hahnemann in his Organon of Medicine.

The working out of a case consists of the following steps.  

·         Case taking

 

·         Evaluation or grading of symptoms


The symptoms are broken into
a) Mental Generals. Among them the hierarchy followed is
1. Emotions
2. Intellect
3. Memory

b) Physical generals, here the importance is given in the following order
1. Related to blood, colour of discharge, Aversions and Cravings
2. Menstrual functions (general aggravations related to menses, the character of menses)

3. Environmental factors

c) Particular symptoms, here the hierarchy followed is
1. Peculiar or unusual symptoms

2. Discharges
3. Modalities

d) Common symptoms—they become important when they are absent or when intensified –

 

·         Conversion of symptoms to rubrics.

 

·         Erecting the reportorial totality.

 

·         Repertorisation proper. One can adopt repertorisation in two ways

·         Analysis and prescription.    

 

 

 

Criticism of the Repertory

 

·         In some parts, rubrics are generalized (mind) whereas in some parts the rubrics over particularized (Extremities).

·         Similar rubrics with different remedies and with different evaluation are given in many chapters. This poses difficulties in working out a case, because the chances of missing out a remedy is great. Example – “Liquids taken are forced into nose” (page 454) also under the chapter Nose “Liquids comes out through the nose on attempting to swallow”.

·         Kent has advocated use of bigger, general rubrics to avoid the error of omission while repertorizing, but at some places, general rubrics themselves do not represent the medicines that are mentioned in sub-rubrics.

·         Certain organs are given separate rubrics with out any modifying rubrics; this is in general against the philosophy and construction of the repertory. eg liver and region of, spleen etc.

·         In certain rubric drugs are not well represented, for example in the chapter generalities rubric Paralysis – one side, Drug opium is not mentioned, and a better rubric for the same condition is given in the chapter Extremities - paralysis.

·         Lot of printing errors is present through out the Repertory.

·         Some remedies, which are not given in the index, represent certain rubrics. Eg.  Nux-J in Talk indisposed to; Kali-ox in Insanity

·         Omission of drugs in certain rubrics.

·         Kent has given importance to thermal condition of patient, but unfortunately there is no single definite rubric that can guide the physician in this respect.

·         Some of the nosodes are not represented well.

 

 

 

DR. SUMIT GOEL M.D. (Hom)

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