FOURTH BHMS 2023 HOMOEOPATHIC REPERTORY AND CASE TAKING [Solved paper]

 

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✅ Q.2 – Short Answer Questions (6 × 5 = 30 marks)

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a) Subjective and Objective Symptoms with Examples

Subjective Symptoms:

• Symptoms felt only by the patient; not externally verifiable

• Examples:

  1. Pain in the stomach

  2. Burning in the throat

Objective Symptoms:

• Observable/measurable by physician

• Examples:

  1. Skin eruptions

  2. Rapid pulse

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b) Compare Rubrics: Anxiety vs. Fear + 2 Remedies Each

Feature	Anxiety	Fear
Nature	Apprehension of unknown danger	Response to known object/situation
Mindset	Restless, overthinking	Avoidance, withdrawal
Rubric	Mind – Anxiety	Mind – Fear

Remedies:

• Anxiety: Arsenicum album, Argentum nitricum

• Fear: Aconitum napellus, Stramonium

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c) Compare Rubrics: Capriciousness vs. Irresolution + 2 Remedies Each

Feature	Capriciousness	Irresolution
Meaning	Changeable mood/desire	Indecisive; unable to make choices
Example	Child wants toys then throws them	Patient can't decide on food or clothes
Rubric	Mind – Capriciousness	Mind – Irresolute

Remedies:

• Capriciousness: Chamomilla, Cina

• Irresolution: Pulsatilla, Silicea

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d) Concept of Totality According to Boenninghausen

• Boenninghausen defined totality as the complete collection of symptoms, including:

  1. Location

  2. Sensation

  3. Modalities

  4. Concomitants

• Emphasized importance of general modalities and concomitant symptoms

• Used complete symptom structure in repertorization

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e) Case Taking Approach in Older Patients

1. Be patient and empathetic

2. Account for multiple chronic conditions

3. Focus on mental and emotional changes with aging

4. Consider medications, memory issues, hearing loss

5. Respect their values and establish rapport

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f) Need of a Repertory

• Helps analyze large number of symptoms

• Connects symptom language to remedies

• Assists in individualization and remedy selection

• Useful in both acute and chronic prescribing

• Acts as bridge between Materia Medica and patient

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✅ Q.3 – Short Answer Questions (6 × 5 = 30 marks)

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a) Homoeopathic Therapeutics of Diarrhea

Remedies:

• Arsenicum alb: Watery, offensive, after spoiled food, restlessness

• Aloe socotrina: Sudden urge, gurgling before stool

• Podophyllum: Painless, profuse, early morning

• China: After loss of fluids, weakness

• Veratrum alb: Rice water stools, cramps, collapse

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b) The Prescriber by Dr. J.H. Clarke

• Practical guide for selecting remedies

• Organized alphabetically by condition

• Offers indicated drugs, not full provings

• Emphasizes use of keynotes for common ailments

• Used by beginners for rapid therapeutic hints

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c) Methods of Repertorization

1. Manual Repertorization

   • Classic paper-based, labor-intensive

2. Card Repertorization

   • Symptoms represented by cards

3. Computational Repertorization

   • Software like RADAR, Hompath

4. Graphic/Logical

   • Charts, diagrams to link rubrics

5. Intuitive

   • Used by experienced physicians using keynote symptoms

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d) Thematic Repertory

• Organized around themes, not hierarchy

• Example: Synthetic Repertory, Synthesis

• Easier access to rubrics under emotional or physical themes

• Helpful in mental/emotional cases

• Modern and software-compatible

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e) Advantages and Disadvantages of Computer Repertory

Advantages:

• Speed and accuracy

• Storage of patient data

• Multiple repertories available

• Saves time for complex cases

Disadvantages:

• Risk of over-dependence

• Cost and tech limitations

• May overlook artistic side of prescribing

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f) Methods of Record Keeping

1. Narrative Format: Full symptom descriptions

2. Problem-Oriented Records (SOAP)

3. Chronological Format

4. Computerized Systems

5. Benefits: Legal proof, follow-up assessment, research

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✅ Q.4 – Long Answer Questions (Any 2 × 10 = 20 marks)

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a) Historical Evolution of Card Repertory

• Introduced by Dr. R. Gibson Miller (1890s)

• Used cards with rubrics and remedy codes

• Evolved into Punch card repertory by Boenninghausen Institute

• Systematized by Dr. P.C. Majumdar in India

Scope:

• Organizes repertory for quick selection

• Suited to academic and research purposes

Limitations:

• Labor intensive

• Limited access to detailed symptom nuances

• Replaced by software today

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b) Difficulties in Taking a Chronic Case

1. Long duration masks peculiar symptoms

2. Mixed miasms = confusing symptom picture

3. Suppression by drugs hides original disease

4. Patient may forget past symptoms

5. Emotional factors or ego resist sharing

6. Must separate symptoms from diagnosis

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c) Compare Knerr’s Repertory with Gentry’s Concordance

Feature	Knerr’s Repertory	Gentry’s Concordance
Author	Calvin B. Knerr	William Gentry
Basis	Hering’s Guiding Symptoms	Concordance of key clinical conditions
Construction	Anatomical and clinical arrangement	Alphabetical, thematic
Strength	Clinical rubrics with cross-references	Precise therapeutic hints
Usage	Useful for rare symptoms	Quick bedside reference

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d) Relationship of Repertory with HMM and Organon

• HMM (Materia Medica):

  • Source of symptoms → Repertory classifies them

  • Repertory = index to Materia Medica

• Organon of Medicine:

  • Repertory aligns with individualization (§153)

  • Emphasizes totality, modalities, general symptoms

  • Reflects Hahnemann’s instructions for case analysis

Repertory = practical tool to apply philosophy (Organon) and materia medica knowledge.

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✅ Q.5 – Classification of Repertory (20 Marks)

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I. Based on Plan/Construction

1. Alphabetical – e.g., Clarke’s Clinical Repertory

2. Regional/Anatomical – e.g., Boenninghausen’s Therapeutic Pocket Book

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II. Based on Purpose

1. General Repertory – Kent’s Repertory

2. Special Repertory – Boericke’s Repertory (for specific conditions)

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III. Based on Format

1. Book-form – Kent’s Repertory

2. Card Repertory – Gibson Miller

3. Computer Repertory – RADAR, Hompath

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✅ Q.6 – Kent’s Repertory (20 Marks)

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Structure:

• 37 chapters

• First chapter: Mind

• Last chapter: Generalities

• Rubrics arranged alphabetically under each chapter

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Philosophy:

• Based on Kent’s hierarchical method: Mind > Generals > Particulars

• Emphasized mental symptoms

• Follows Hahnemannian totality

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Strengths:

• Detailed mental rubrics

• Useful in constitutional prescribing

• Hierarchical grading (1 to 3 marks)

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Limitations:

• Lacks many pathological rubrics

• Difficult to use for acute/clinical cases

• Pure Kentian followers may overlook therapeutic scope

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✅ Q.7 – BTPB vs. Boger Synoptic Key (20 Marks)

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Philosophical Background:

• BTPB (Boenninghausen): Based on complete symptom – location, sensation, modality, concomitant

• BSK (Boger): Integrates pathology, causation, time, modalities

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Construction:

Feature	BTPB	Boger Synoptic Key
Author	C.M.F. Boenninghausen	C.M. Boger
Chapters	Regional + modalities	Regional + general + time modalities
Layout	Analytical	Synoptic (summary-focused)

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Concept of Repertorization:

• BTPB: Uses complete symptom and modalities

• BSK: Uses pathological generals, modalities, and time

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Adaptability:

• BTPB: Suited for chronic cases, modality-based cases

• BSK: More adaptable to clinical and acute cases

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