From Story to Rubric: Using CLAMS to Simplify Case-Taking
Master the "Complete Symptom": Why CLAMS is the Student’s Best Friend for Boenninghausen Prescribing
As homeopathic students and practitioners, we are taught to look for the "totality of symptoms". But in the heat of a consultation, especially a fast-moving acute case, that totality can feel like a scattered puzzle.
If you are looking to sharpen your repertorization skills, you need a reliable way to translate a patient's story into high-quality rubrics. This is where the CLAMS framework becomes a powerful clinical tool for building a "complete symptom picture".
While many modern students are taught Kentian repertorization, the CLAMS approach aligns perfectly with the Boenninghausen (Therapeutic Pocketbook) method. CLAMS helps you dig into the specifics that actually matter. It’s these fine details that reveal the true character of the remedy the patient actually needs.
Boenninghausen vs. the Kentian Hierarchy
While many students are introduced to repertorisation through Kent’s model - which prioritises mental symptoms, then physical generals, and finally particulars - Boenninghausen approached case analysis differently. His structure allows for modalities, locations, and concomitants to be given equal weight across the case, even if mental symptoms are not prominent. This means that in cases where mentals are unclear or absent, such as in young children, acute illnesses, or animals, the Boenninghausen method still allows for precise prescribing. CLAMS fits seamlessly here, as it helps extract the core building blocks that Boenninghausen valued: what changes the complaint, where it is felt, what else is happening alongside, how it arose, and what it feels like. In this way, CLAMS provides a structured route to the complete symptom without needing to rely on a strongly mental-led hierarchy.
What is CLAMS? (The Prescriber’s Checklist)
It is helpful to view the client's complaint through the lens of these five categories:
C – Concomitants: The symptoms that accompany the main complaint.
L – Location: The exact place of the trouble. Is it the right side? Does it radiate? Is it a on the surface or much deeper?
A – Aetiology: The "Never Well Since" factor. Was it a cold wind? An emotional shock? A physical injury?
M – Modalities: What makes the client better or worse? These are the "modifiers" of the case. Time of day, temperature, movement, and position are so helpful here and can really make or break a prescription.
S – Sensations: The patient’s subjective experience (burning, stitching, throbbing).
The Boenninghausen Connection
Why does CLAMS work so well for those of us using Boenninghausen-style repertories?
Clemens von Boenninghausen’s great contribution was building a repertory based on grand generalizations. He realized that a modality or sensation found in one part of a proving often applied to the whole person, so a bigger more general rubric could cover the pattern.
By using CLAMS, you are essentially gathering the "building blocks" of a complete symptom picture.
Why This Makes You a Better Prescriber
CLAMS forces you to slow down and ask the questions that reveal the individual experience.
Take Your Skills Further
If you are looking for coaching on how to repertorize for acute cases using a CLAMS approach book a Case Companion session for 1:1 time with me here.
Let’s refine your case-taking, sharpen your rubric selection, and get you prescribing with confidence.
Leah
https://rubricwise.com
