Dr Rumsheed N BHMS MD(Hom)
In taking the case, the homoeopathic physician has two objects in view
- DIAGANOSIS
- TOTALITY OF SYMPTOMS
The homoeopathic physician never uses his diagnosis for therapeutic purposes. In this he differs from the ordinary school of medicine, which uses the diagnosis as a guide to the desired therapy, certain group conditions determined by the diagnosis determining the therapy to be applied.
With the homoeopathic physician, the group is never treated as a unit; the individual patient, into whatever diagnostic group he may fall, is treated as an individual, and the therapeutic measures are directed according to the individual symptoms
Totality of symptoms is the second and greater object in taking the case is to select the true symptoms of the patient, and to clarify them so that we can make a definite picture of the ills of the patient
1. Case records.
In making the first prescription, this record is all-important; and in the making of subsequent prescriptions and in reviewing the case so that we may know the sequence of symptoms and the order of disappearance of the symptoms, we cannot move with any degree of assurance unless we have the record in accessible form.
2.Attitude of the physician
The attitude of the physician Should be one of absolute rest and poise, with no preconceived ideas nor prejudices. He should be in a quiet, listening attitude, and as the case is presented to him he should have no previous impressions as to what remedy the patient will require, because this of itself would bias his judgment.
3.FIRST thing to note is the patient’s name, age, sex, vocation and, if possible, avocation
Then we are often greatly helped by getting a record of the family; that is, the age of the parents, their general health, and cause of death if they are deceased. This applies to brothers and sisters also; and we must not neglect to get a picture of the types of ailments from which they have suffered. We often get a good picture of hereditary tendencies in this way .Find out, if possible, if there is or has been blood relationships between ancestors. Consanguinity plays an important part in hereditary tendencies as well as in making your prescription (Phos.)
4.Past illnesses- What illnesses has he had?
How about his recovery from each illness? Particularly note whether he reports himself as fully recovering from illnesses, or whether he says he “has not been well since” any particular illness.
5. Presenting Complaints
His own words how he became ill and exactly how he feels. Do not offer any interruption, lest you break his thread of thought. As you record the symptoms, leave space between them so that you can fill in later answers to questions as it may be necessary. If he comes to a point where he seems to hesitate, simply ask, “What else?” Continue this system of interested listening until he (seemingly) has exhausted his story.
- Questioning by the doctor
- Avoid all leading questions.
- Never ask direct questions, that may be answered with a direct affirmative or negative.
- Never ask alternating questions.
- Avoid questioning along the line of a remedy. Sometimes we may get a clue from the statement of a symptom that may suggest a certain remedy, and we must be very cautious not to allow this to prejudice us in favour of the remedy suggested by questioning the patient along this line, and thus perhaps bias the patient in his replies
- While you are dealing with one symptom, confine yourself to that symptom. Never skip from one symptom to another at random, as it confuses the patient and scatters the physician’s ideas.
We must complete, as far as possible, every symptom that has been presented
- time and place
- the sensations;
- the kind of distress- the type of pain; all of the modalities connected with it
- probable causation,.
- modalities-aggravations and ameliorations of each individual symptom
- emotional reaction of the patient.
- In acute illnesses, take the acute symptoms, carefully record each one, and find out all there is to know about them.In chronic picture, record all the symptoms as far back as you can dig out the symptoms, and the sequence of the symptom pictures, and prescribe for that state chronic work it is necessary to take into consideration the general symptoms
- General symptoms we mean those symptoms which pertain to the patient as a whole
- The aggravations, the periodicity
- Thermic reactions of the patient? Is he hot or cold ?
- aversions and cravings
- sleep and dreams
- sexual functions
In an acute explosion the chronic picture will retreat completely; therefore, in treating the complete picture that is present there will be no need to take the chronic picture into consideration. At the close of the acute attack we again see the chronic picture. Then will be the time to deal with it.
- Examination of the patient- examination of the patient from every possible angle should be carried through, not for the gross diagnostic symptoms, important as these may be from diagnostic and hygienic points of view
Treatment history
Go over the previous drug treatment and consider that. Remember that the nature and sensations of the symptoms, the time of day, the positions and circumstances under which symptoms appear, are the most important modifiers of any given case.
- MENTAL SYMPTOMS : Mental symptoms that must be observed from the attitude of the patient
The examination you have probably been able to get the confidence of your patients to a greater degree and they will give you more fully their confidence ,it wil help u to get mental symptoms
Find if they are subject to hallucinations or fixed ideas, especially any fears that are persistent. Take into consideration irritability, or a change in disposition; if you can unearth traits of jealousy, or absent-mindedness, these must be seriously considered. Sadness, ailments arising from grief, vexation, sudden joy, are important. Is the patient over-insistent upon the minor details of life as to scrupulous cleanliness, etc.
Before leaving the case,- Ask yourself if you have skipped anything. See that you have questioned every item, every function; question the modalities in particular
