History, Comparative Systems, and the Role of the Complete Repertory

Remedy grading is a fundamental concept in homeopathic analysis, serving as a structured way to express the strength, reliability, and frequency of a remedy under a particular symptom. While often misunderstood as indicating the intensity of a symptom, grading instead reflects the quality and amount of evidence supporting the remedy’s relation to that symptom. This article explores the origins of repertory grading, contrasts the systems of Kent and Bönninghausen, and examines how the Complete Repertory evolved to accommodate and modernize this essential homeopathic tool.

Origins of Remedy Grading

The concept of grading in homeopathy dates back to the early 19th-century repertories. As clinical experience and provings accumulated, it became necessary to distinguish remedies that had been frequently and reliably observed under certain symptoms from those with only sparse or tentative evidence.

The earliest repertories—such as those by von Bönninghausen—began incorporating symbols or typographic emphasis to indicate confidence levels. Later, James Tyler Kent, whose repertory was published in 1897, formalized the idea into a structured system with three grades. This tri-level grading system was widely adopted due to its simplicity and clarity.

Kent’s Grading System: Clinical Emphasis and Simplicity

Kent used a three-tier grading system, typically marked by:

• Grade 1 (Roman): Remedy mentioned once or rarely, less confirmed.

• Grade 2 (Italics): Remedy more frequently confirmed or clearly observed.

• Grade 3 (Bold): Strongly confirmed, clinically reliable, often seen.

Kent’s approach emphasized clinical experience, particularly remedies observed in his own practice or those of trusted contemporaries. However, because Kent’s repertory drew heavily from The Chronic Diseases by Hahnemann, Hering’s Guiding Symptoms, and some provings, it often underrepresented less-known remedies or newer clinical observations.

Kent deliberately omitted source referencing in his repertory, aiming instead for a usable clinical tool. This practice has drawn criticism for reducing transparency in remedy selection and making it harder to assess the basis of a given grade.

Bönninghausen’s Grading System: Analytic and Proving-Based

In contrast, Clemens von Bönninghausen employed a four-grade system in his repertories, starting with his Systematisch-Alphabetisches Repertorium (1832). His grading focused on the origin of a remedy’s inclusion:

1. Grade 1 (lowest) – The remedy is mentioned in a single proving or clinical observation, or based on analogy.

2. Grade 2 – The remedy is confirmed in two independent sources or provers (either provings or clinical observations).

3. Grade 3 – The remedy has been confirmed in three or more sources or by repeated reliable experience.

4. Grade 4 (highest) – The remedy is universally confirmed, having been proven through multiple provings and extensive clinical use. It is seen as highly reliable under this rubric.

Bönninghausen’s system was more analytical and source-aware, often tracking symptoms across a matrix of modalities, locations, sensations, and concomitants. Importantly, he paid attention to the generality of symptoms and their logical distribution across remedies, emphasizing consistency and the methodical use of proving data.

The Complete Repertory: Integrating and Advancing Grading

The Complete Repertory, initiated by Roger van Zandvoort in the late 20th century, aimed to combine the strengths of both Kent’s and Bönninghausen’s systems. It evolved from a digitized analysis of Kent’s Repertory but expanded to include a broad range of classical and modern sources, including:

• Hahnemann’s original provings (through Allen's Encyclopedia mostly)

• Allen's Encyclopedia, Hering’s Guiding Symptoms

• Bönninghausen’s repertories

• Later provings and authors such as Lippe, Clarke, Boericke

• Contemporary provings and clinical cases

Grading System in the Complete Repertory

The Complete Repertory uses a 4-level grading system, which aligns closely with Bönninghausen’s in purpose but modernized in scope and supported by data:

• Grade 1:  a single proving or clinical case.

• Grade 2: The remedy is found in several provers or cases.

• Grade 3: The remedy has clinical confirmation for the symptom/rubric, i.e. found in proving and cases, or in multiple cases only.

• Grade 4: frequently repeated clinical confirmations.

Crucially, this grading is data-driven—the Complete Repertory tracks source, type of evidence (proving vs clinical), number of authors, and even flags likely duplicates (e.g., when multiple authors report the same case). Evidence isn’t merely accumulated, but qualified, ensuring that the highest grades truly represent trustworthy, independent observations.

Unlike Kent’s repertory, the Complete Repertory is fully source-transparent. Editors and users can trace each remedy inclusion to its origin, making it a more scholarly and accountable resource while remaining clinically practical. (ongoing project)

The Effect of Grading on the Analysis of a Homeopathic Case

In homeopathic case analysis, grading plays a pivotal role in guiding the practitioner toward the most reliable remedy choices. While repertorization primarily helps identify remedies that match the patient’s symptoms, the grades attached to those remedies can profoundly affect both the selection and the confidence level in prescribing.

What Does Grading Represent?

Contrary to a common misconception, a higher grade does not indicate that the symptom is more intense in the patient, but that the remedy has a stronger confirmation for that particular symptom. Grading reflects:

• Quantity of evidence

• Number of independent confirmations

• Balance between provings and clinical success

• Consistency across time and authors

How Grading Affects Case Analysis

1.

Prioritization in the Repertory Chart

Most repertorization software gives higher weight to higher-grade remedies in the scoring process. For instance:

• A remedy appearing in five rubrics as grade 1 may score lower than a remedy appearing in three rubrics but with grade 3 or 4.

• Remedies with consistent high grades across multiple rubrics climb to the top of the chart, often becoming leading candidates for prescription.

Thus, grading can alter the hierarchy of remedies, especially when the remedy sets across rubrics overlap.

2.

Confidence in Prescription

A remedy that consistently appears in multiple rubrics with high grades suggests a well-confirmed match, thereby increasing the practitioner’s confidence in the choice.

On the contrary, if a remedy shows up frequently but always in grade 1, it might:

• Be a newer or less-tested remedy

• Be derived from limited data or singular observations

• Require deeper scrutiny before relying on it

In such cases, knowledge of materia medica and clinical experience must supplement repertory results.

3.

Avoiding False Positives

Grading helps filter out noise in the repertorization process. Without grading:

• All remedies would appear equal

• The repertory would behave like an unweighted list of symptoms

• Remedies with one-off mentions (possibly errors or unverified entries) could distort the outcome

By using grading, the practitioner is alerted to the reliability differential among remedies.

4.

Confirming Polycrests vs. Rare Remedies

• A grade 4 remedy, such as Sulphur or Lycopodium, appearing in several major rubrics reinforces its status as a polycrest—often indicated when the symptom totality is wide and the pathology is deep.

• A lesser-known remedy appearing in grade 2 or lower across many rubrics might represent a narrow but specific simillimum, requiring careful materia medica comparison to rule it in or out.

Thus, grading gives context to whether a remedy’s presence is casual or crucial.

5.

Strategic Grading Use: “Number of Rubrics Strategy”

Some practitioners prioritize how often a remedy appears across rubrics (the breadth), while others emphasize the grade in each rubric (the depth).

• A remedy in 10 rubrics at grade 1 vs. a remedy in 4 rubrics at grade 3–4 may indicate:

   

  • The former fits many symptoms but less reliably.

  • The latter fits fewer symptoms but is strongly confirmed.

   

A careful balance of these two factors—coverage and grade strength—is essential for precise prescribing.

Grading in Practice: A Case Example

Suppose a case includes:

• Vertigo, rising from bed

• Anxiety before sleep

• Thirstlessness during fever

Repertorization shows:

• Gelsemium appears in all three rubrics, grades 3–4

• Pulsatilla appears in all three, but only grades 1–2

Even if both remedies match symptomatically, Gelsemium may be the better initial prescription based on depth and reliability of confirmation.

Final Thoughts

Grading is not a cosmetic feature of repertories—it is an epistemological tool, guiding practitioners toward what is known, verified, and clinically supported. Whether you are relying on Kent, Bönninghausen, or the modern Complete Repertory, understanding grading can elevate your analysis from mechanical to discerning, from speculative to strategic.

When grading is used wisely in analysis:

• Remedies rise not just by number, but by weight

• Cases are solved not by symptom-matching alone, but by evidence-informed insight

• Repertorization becomes a thinking process, not just a counting exercise

Roger van Zandvoort, author of The Complete Repertory