How to Apply Boenninghausen's Method in Practice: A Guide to Case Taking and Remedy Selection

What the Method Asks You to Record Before You Repertorise

Boenninghausen's approach begins with a decision about what kind of information matters. Rather than chasing the most vivid or unusual symptom in the case, you build a picture from complete symptoms — each one carrying a location, a sensation, a modality and any accompanying condition. A patient who says 'the headache is worse in the open air' has given you three usable pieces: a part, a modality, and the general circumstance of air. Record them separately, because each will be looked up under a different heading.

The practical consequence is that case taking becomes a structured inventory rather than a conversation you later try to mine for quotes. Many practitioners use a fixed sheet: complaints listed by body region down one side, and columns for sensation, modality, concomitants and general symptoms. Nothing is discarded for being unremarkable. A patient's persistent chilliness, their craving for sour things, their tendency to feel worse after sleep — these are exactly the entries that make the method work.

Write the patient's own words next to each entry, then translate. 'It feels like a band tightening' becomes a sensation of constriction; 'I can't bear anyone near me' becomes a mental general of aversion to company. The translation step is where most errors enter a case, so keep both versions visible until you have settled on the rubric.

Separating General Symptoms from Particular Ones

The distinguishing move in this method is the weight given to symptoms that affect the patient as a whole. A burning pain in the stomach is a particular symptom, located in one part. A patient who is always worse from heat, whatever the complaint and wherever it sits, is showing a general. Boenninghausen treated generals and concomitants as the backbone of prescribing because they hold across the whole organism and therefore narrow the field fastest.

This does not mean particulars are ignored. They confirm and refine. The working order is to gather particulars for completeness, then ask which of them recur across different complaints or appear in the constitution regardless of the current illness. A patient with three separate complaints that all worsen in damp weather has given you one general that outranks any single local symptom.

Concomitants deserve their own attention. These are symptoms that appear alongside the main complaint without being caused by it — a cough that arrives with a headache, a stomach upset that comes with backache. Because they are not obviously connected, patients rarely volunteer them, and you have to ask directly: what else happens at the same time? In practice, a good concomitant often decides between two otherwise similar remedies.

Turning the Case into Rubrics Without Losing the Patient

Once the inventory is complete, each entry is matched to repertory language. Boenninghausen's repertory is organised around parts of the body, sensations, modalities and concomitants, with a separate section for general conditions — the circumstances that modify the whole patient. The general section is where much of the prescribing value sits, so it is worth reading it in full rather than only searching the exact phrase you wrote down.

Matching is a translation exercise with a known failure mode: forcing the patient's words into the nearest available rubric. If the closest heading is only approximately right, mark it as uncertain and keep looking. A rubric that is 70 per cent accurate will pull the analysis toward the wrong remedy and there is no later stage that corrects for it.

It helps to keep a running note of which entries you consider reliable. Symptoms the patient describes spontaneously, with detail and emphasis, usually carry more weight than answers extracted by direct questioning. That distinction is not part of the repertory structure, but it is part of good case taking, and it should survive into your final reasoning.

Grading and Combining: Where Remedies Separate

With rubrics in hand, the next question is how much each one counts. The method's characteristic emphasis falls on generals, concomitants and complete symptoms, so a general modality that applies to the whole patient typically outranks a single local sensation. Some practitioners assign simple marks — three for a strong general, two for a clear concomitant, one for a supporting particular — and total them. Others work by elimination, discarding remedies that fail a decisive general rather than scoring everything.

The elimination approach suits small, well-observed cases. If the patient is unmistakably worse from warmth and better from open air, any remedy without that modality drops out, and the remaining candidates are compared on the particulars. Scoring suits cases where no single general is decisive and several moderate symptoms must be weighed together. Neither is more faithful to the method; they are different ways of applying the same priority.

What matters is that the priority is set before you look at the results. Choosing which symptoms to emphasise after seeing that a favourite remedy scores well is the most common way a repertorisation misleads. Decide the hierarchy from the case, write it down, and then run the analysis.

• Complete symptoms first: location, sensation, modality and concomitant together.
• Generals that apply to the whole patient outrank single local symptoms.
• Concomitants carry weight because they are independent of the main complaint.
• Set the hierarchy before running the analysis, not after seeing the result.
• Discard remedies that fail a decisive general rather than averaging everything.

Choosing Between Two Close Remedies

The final comparison is usually between two or three remedies that survived the generals. At this point the particulars do the work. Read the materia medica for each candidate against the specific local symptoms you recorded — the exact sensation, the side affected, the time of day, the position that relieves it. A remedy that matches the whole constitution but not the presenting complaint is a weaker choice than one that matches both.

Concomitants often break the tie. Two remedies may share a headache modality and a general chilliness, but only one may have the accompanying nausea or the peculiar irritability that the patient described. Because concomitants are recorded independently of the main complaint, they are less likely to have been shaped by your expectations during the interview.

Where the case remains genuinely balanced, the honest answer is that the case is not yet clear enough. Asking one more question about sleep, dreams, food preferences or the patient's reaction to consolation is more useful than choosing on a coin toss. The method rewards a complete record; an incomplete one produces a prescription that has to be revised.

Following the Case After the Prescription

The record you built during case taking becomes the baseline for follow-up. Because each symptom was written with its modality and concomitant, you can ask whether the same symptom has changed in the same terms. 'The headache is still there but the open air no longer helps' is a specific, usable observation; 'I feel a bit better' is not.

Boenninghausen's framework also gives you a way to read partial responses. If the general symptoms improve while the local complaint persists, the remedy is probably acting and the local symptom may follow. If the general symptoms are unchanged and only the local one shifts, the picture is less clear and the case may need re-taking rather than repeating.

Keep the original sheet and add dated notes beside each entry rather than starting a fresh page. Over several consultations this turns into a longitudinal record of which modalities have held steady and which have moved, and that pattern is often more informative than any single interview. Homeopathic prescribing is a clinical judgement made with a practitioner's training; this article describes method, not treatment, and any decision about remedies for a specific person belongs with a qualified practitioner.