HIERARCHY OF SYMPTOMS  : This is the term used to describe the ranking of symptoms in a case in order of importance. We select from the case only the most important symptoms, which will be placed at the top of the list, in descending order of importance. (see below)

When listing the symptoms – quote the patients own words where possible


There are two main methods – numerical and eliminative. Computer software programs may use other methods but the student of homeopathy needs to be fully comfortable with both of these basic methods.

  1. Numerical – uses a point scoring system based on the different type faces found in the rubrics.

CAPITAL BOLD  - 4 points – found in Synthesis and Complete

Bold                            - 3 points

Italic                            - 2 points

lower case                   - 1 point

Using the printed grid sheet the rubrics are listed in order of their hierarchy and the remedies are scored down the side column. Whenever a remedy appears in a chosen rubric the numerical value of the remedy is entered. The total number of points for each remedy is then calculated at the side of the page.

There are TWO TOTALS – the first shows how many rubrics the remedy appeared in and the second total shows the sum of the points scored by that remedy overall.


  1. Eliminative – the chosen rubrics are placed into an order of hierarchy and written down on a blank sheet of paper.

The first two rubrics are then crossed – an X is written beside them. The X indicates elimination. Only those remedies which appear in both of those rubrics are then listed.

The third rubric is then prefixed with an X and the only remedies listed are those which appear in this rubric AND in the list above.

This procedure is continued in descending order, through the rubric hierarchy. By the end of the repertorization only a few remedies remain.

In the eliminative method, the intensity and frequency of the symptoms in the proving are less important than the fact that the symptom occurred in the proving, or was added from clinical experience.


Within each case that we analyze we must be able to identify types of symptoms.

  1. a) Modalities – a condition or situation or position which makes the person feel better or worse
  2. b) a sensation / subjective symptom – describes the feelings as they appear to him or her, their sensations.
  3. c) an objective symptom – quantifiable and generally observable. Eg. circumscribed redness of the cheeks
  4. d) a particular symptom – “My”. Referring to a part of the body or to the disease
  5. e) a general symptom ( emotional, mental or physical) encompass the whole person. “I” symptoms
  6. f) a peculiar symptom – unusual symptoms. Eg since this cough started my front teeth have hurt.
  7. g) complete symptom – a complete description of the symptoms, often the whole of the first sentence.
  8. h) a concomitant symptom – a symptom that has occurred elsewhere in the body and seems unrelated to the presenting complaint. Eg the peculiar symptom. or eg “ Small hot spots have been happening on the soles of my feet recently. Nothing to do with my eczema of course.”
  9. i) affinity – the area of the body affected
  10. j) causation – what brought the symptom on

The INTENSITY of a symptom is important, whether it is a mental, emotional or physical symptom – if it is felt very strongly then that will govern the position you place it in the hierarchy. What is the patient feeling most intensely? A few mild fears that don’t inhibit life should take a lesser position than an intense migraine which is completely debilitating.