Observe and select rubrics during case taking

Observe and select rubrics during case taking

Dr Muhammed Rafeeque

The methodology of case taking in homoeopathy is unique by many ways. Here, the sick individual is keenly observed right from his entry in to the consultation room. A homoeopath considers the patient’s walking style, personal appearance, sitting posture, expressions, behavior, response to questions etc. with due importance. It is a fact that the indications of the similimum are found in different ways in different individuals requiring the same remedy. Apart from the symptoms told by the patient, the features observed by the physician also help in distinguishing the similimum from a group of similar drugs.

Here, examples of some features we may observe during consultation are given along with suitable rubrics and drugs.

1. WHEN THE PATIENT ENTERS THE CONSULTATION ROOM:

Anxiety with perspiration of face: Synthesis- mind- anxiety- face- perspiration of face- with: Ars, cic, mur.ac, nat.c.

Fruitlessly busy: Synthesis- mind- busy- fruitlessly: Absin, apis, arg.n, ars, borx, calc, canth, kali.br, lil.t, mag.p, stann, sulph, tarent, ther.

Impulsive: Synthesis- mind- impulsive: Acon, alum, anac, ant.c, ARG.N, ars, aur, camph, cere-b, cham, choc, cic, coloc, croc, cupr, gins, hep, IGN, iod, ip, lach, marb.w, med, merc, nat.m, nux.v, PULS, rheum, rhust, sep, staph, tarent, thea.

Restless activity: Synthesis- mind- activity- restless: Coff, dig, ign, lycps-v, nux.v, verat.

Stoop shouldered: Synthesis- generals- stoop shouldered: Arg.n, calc, carb.v, cocc, coff, coloc, lyc, mang, med, nat.c, nux.v, op, PHOS, sil, SULPH, ter, tub, verat.

Walking rapidly from anxiety: Robin Murphy- mind- walking- rapidly from anxiety: Arg.n, fl.ac, sep.

Time anxiety [If appointment is given and comes late]: Synthesis- mind- anxiety- time is set, if a: Alum, arg.n, carc, gels, med.

2. CONSTITUTION:

Dwarfish: Synthesis- general- dwarfishness: Ambr, aster, bac, BAR.C, bar.m, borx, calc, CALC.P, carbn.s, carc, con, iod, lyc, mag.m, med, merc, merc.pr.a, nat.m, nep, nux.m, ol.j, op, ph.ac, sec, sil, sulfa, SULPH, SYPH, thyr, tub, zinc.

Mild: Robin Murphy- generals- constitutions- mild: Ambr, bell, calad, chim.m, cic, cocc, ign, ph.ac, PULS, sil, sulph.

Lax fibers: Robin Murphy- generals- constitution- fiber, lax: Agar, bor, calc, caps, cinnam, hep, KALI.C, MAG.C, op, sabad, sil, spong.

Rigid fibers: Robin Murphy- generals- constitution- fiber, rigid: ACON, coff.t, NIT.AC, NUX.V, SEP.

Nervous: Robin Murphy- generals- constitution- nervous: Acon, ANAC, ARS, bell, CALC, carb.v, CHAM, chin.s, con, hep, HYOS, IGN, lach, LYC, MAG.C, MAG.P, merc, nat.m, NUX.M, NUX.V, PHOS, ph.ac, plat, puls, rhust, sep, sil, stann, sulph, valer. [Refer book for third grade drugs]

Weakly: Robin Murphy- generals- constitution- weakly: Ars, calc, calc.p, carb.v, chin.s, chin, cocc, colch, ferr, fl.ac, hep, lach, merc, nat.m, nux.v, phos, PH.AC, sec, sep, SIL, spig, SULPH, verat.

3. DRESSING AND COLOUR PREFERANCE:

Indecent dressing: Synthesis- mind- dress- indecently, dresses: Hell, hyos, stram.

Tasteless in dressing: Synthesis- mind- tastless in dressing: Calc, caust, hell, hyos, lyc, nat.m, nux.v, sec, staph, stram, sulph.

Strange dressing: Synthesis- mind- strange- dressing in: Hell, sil, sulph.

Colors [Desire for color must be confirmed before considering]

Desire for black color: Synthesis- mind- colors- black- desire for: Ign.

Desire for black and white: Synthesis- mind- color- black- desire for; white and: Bung.

Desire for blue: Synthesis- mind- color- blue- desire for: Tarent.

Desire for dark blue: Synthesis- mind- color- blue- desire for- dark blue: Ign, lach, nux.v, staph.

Desire for light blue: Synthesis- mind- color- blue- desire for- light blue: Cocc, ign, kali.bi, nux.v, phos, sep, sil, staph, tub.

Desire for dark brown: Synthesis- mind- color- brown- desire for dark brown: Sil.

Desire for light brown: Synthesis- mind- color- brown- desire for- light brown: Nux.v, sep.

Desire for changeable colors: Synthesis- mind- color- changeable- desire for: Puls.

Desire for green: Synthesis- mind- color- green- desire for: Nux.v, sil, tarent.

Desire for light green: Synthesis- mind- color- green- desire for- light green: Ign, nux.v, sep, sil, tub.

Desire for light color: Synthesis- mind- color- light color- desire for: Ign, lach, mangi, nux.v, sep, tub.

Desire for no particular color: Synthesis- mind- color- no particular color- desire for: Nux.v.

Desire for pink: Synthesis- mind- color- pink- desire for: Ign, nat.m, nit.ac, nux.v, phos, puls, sep, sil, tub, zinc.

Desire for purple: Synthesis- mind- color- purple- desire for: Nux.v, sep.

Desire for red: Synthesis- mind- color- red- desire for: Aur, ign, phos, tarent.

Desire for violet: Synthesis- mind- color- violet- desire for: Nux.v, sep.

Desire for white: Synthesis- mind- color- white- desire for: Ars, ign, kali.bi, lach, mangi, med, nux.v, phos, sep, sil, staph, sulph, thuj, tub, zinc.

Desire for lemon yellow: Synthesis- mind- color- yellow- desire for- lemon yellow: Ars.i, ign, sep.

4. HYGIENE:

Apathy to personal appearance: Synthesis- mind- indifference, apathy- appearance- to his personal: Coca, SULPH.

Aversion to washing and bathing: Synthesis- mind- washing- aversion to wash, bathing: Am.c, ant.c, borx, calc, canth, clem, kali.n, marb.w, mez, nit.ac, psor, rhust. Sep, spig, stron.c, sulph.

Mania for cleanliness: Synthesis- mind- washing- cleanness, mania for: Ars, sil, sulph.

Offensive: Synthesis- generals- offensiveness, fetor: Arn, ars, bapt, bry, carb.ac, CARB.V, hep, kali.p, LACH, nit.ac, podo, PSOR, rhust, sec, sep, sil, sulph, tell, thuj.

5. FACIAL EXPRESSIONS:

Anxious: Synthesis- face- expression- anxious: ACON, AETH, AIL, ant.t, apis, ARS, aspar, bapt, bell, BORX, cact, calc,CAMPH, carb.v, chel, CHINN.S, coloc, crot.h, cupr, cur, dig, kalm, LAC.C, lat.m, lyc, nux.v, plb, spig, spong, stram, stry, sulph, VERAT. [Refer book for third grade drugs]

Besotted: Synthesis- face- expression- besotted: Ail, BAPT, bell, bry, bufo, cench, cocc, crot.c, crot.h, gels, lach, led, mur.ac, nux.m, op, sol.ni, stram.

Confused: Synthesis- face- expression- confused: Aesc, ars, bufo, cupr.act, hyos, LYC, nat.m, phos, plb.

Distressed: Synthesis- face- expression- distressed: Ail, am.c, ARS, aspar, CACT, crot.t, cupr, gels, iod, lach, nux.m, nux.v, phos, spong, stram, stry, zinc.p.

Foolish: Synthesis- face- expression- foolish: Absin, acon, arg.n, bar.c, BUFO, kali.br, lyc, nux.m, phos, stram.

Frightened: Synthesis- face- expression- frightened: ACON, apis, ars, atro, bapt, bell, cact, canth, cimic, cocc, cupr, kali.ar, lyss, sol.ni, STRAM, stry, tab, tarent, vip, zinc.

Idiotic: Synthesis- face- expression- idiotic: AGAR, bry, calc, cann.i, kali.br, lach, laur, lyc, plb, sec, stram, tarent, thuj.

Haggard: Synthesis- face- expression- haggard: Am.c, ARS, bell, camph, canth, caps, carb.v, colch, cupr, hydr, hyos, kali.ar, KALI.C, kali.p, lach, merc, morph, naja, nat.m, nit.ac, op, ox.ac, phos, plb, sang, sec, sil, staph, stram, sul.i, tab, varat.v, zinc.p.

Happy: Synthesis- face- expression- happy: Apis, Op.

Intoxicated: Synthesis- face expression- intoxicated: Bapt, bry, bufo, cann.i, cench, chlol, cocc, dor, eug, gels, hydr, hyos, kali.i, lach, led, merc, merl, mur.ac, nux.v, op, ruta, stram.

Pinched: Synthesis- face- expression- pinched: Acon, aeth, carb.an, carb.v, cina, cocc, cupr, ferr, iod, kali.ar, kali.n, merc, phos, sec, staph, tab, verat, verat.v, zinc.

Sleepy: Synthesis- face- expression- sleepy: CANN.I, laur, nux.m, OP, phos, phys.

Vacant: Synthesis- face- expression- vacant: Anac, anan, arn, bell, camph, cann.i, carb.n.s, cic, cocc, ferr, hell, hyos, kali.br, lach, mez, op, ph.ac, phos, psor, stram, sul.ac, zinc.

6. MANNERISMS AND GESTURES:

Awkward in gestures: Synthesis- mind- awkward- gestures in: Caps, nat.c, nat.m, nux.v, sil, sulph.

Biting nails: Synthesis- mind- biting- nails: Acon, am.br, am.m, ambr, ant.t, arn, ars, ARUM.T, BAR.C, brom, calc, calc.f, carc, caust, cina, cisplat, gaert, hura, hyos, lyc, lyss, mag.c, MED, nat.m, nit.ac, phos, plb, sanic, senec, sil, stram, sulph, VERAT.

Make gestures: Synthesis- mind- gestures: Ars, asc.t, bell, bufo, camph, cann.i, chinin.s, cic, cocc, hell, hyos, kreos, mosch, nux.m, nux.v, plat, plb, puls, sep, stram, tarent, verat.

Involuntary motion of hands: Synthesis- mind- gestures- hands, involuntary motion of the: Alumn, ars, bell, cann.i, caust, cic, coca, fl.ac, hell, hyos, kali.br, merc, mosch, nat.m, nux.m, phos, puls, sang, sil, stram, sulph, tab, verat.

Playing with hands: Synthesis- mind- gestures- hands- playing with hands: Calc.

Rubbing the face with hands: Synthesis- mind- gestures- hands- rubbing- face, the: Alum.

Rubbing the hands together: Synthesis- mind- gestures- hands- rubbing- together- rubbing hands: Bapt, cann.i.

Wringing the hands: Synthesis- mind- gestures- hands- wringing the hands: Ars, aur, bapt, bufo, kali.br, kali.p, phos, plat, psor, puls, stram, sulph, tarent, ther.

Stamping the feet: Synthesis- mind- gestures- stamping the feet: Acon, anac, ant.c, ant.t, cann.i, cham, cina, dulc, hyos, lyc, nitr.o, nux.v, op, plb, puls, stram, VERAT.

Grimaces: Synthesis- mind- grimaces: Agar, bell, carc, cina, cupr, gels, hell, hyos, ign, nux.m, olnd, pall, stram, verat.v.

Jesting: Synthesis- mind- jesting: Caps, cic, cocc, ign, kali.i, lach, nux.m, stann, stram, tarent. [refer book for first grade drugs]

Play antics: Synthesis- mind- antics- playing: Apis, bell, cic, croc, cupr, HYOS, ign, kali.bi, lact, merc, op, phos, plb, stram, verat.

7. ANSWERING AND TALKING:

Absent minded during conversation: Synthesis- mind- absentminded- conversing, when: Chin.b, psil.

Anger when obliged to answer: Synthesis- mind- anger- answer when obliged to: Arn, ars, coloc, nat.m, NUX.V, ph.ac, puls.

Answering abruptly: Synthesis- mind- answering- abruptly: Ars, ars.h, cham, cic, coff, gels, hyos, jatr.c, mur.ac, nux.v, ph.ac, phos, plb, rhust, sec, sin.n, stann, sulph, tarent.

Aversion to answer: Synthesis- mind- answering- aversion to: Agar, arn, aur, cocloc, GLON, HYOS, kali.p,MANC, NUX.V, PH.AC, phos, puls, sec, stann, stry, sul.ac, sulph. [Refer book for third grade drugs]

Uncivil answering: Synthesis- mind- answering- civil can’t be: CHAM.

Dictatorial answering: Synthesis- mind- answering- dictatorial: Lach, lyc, plat, sulph.

Answers disconnected: Synthesis- mind- answering- disconnected: Coff, crot.h, kali.br, phos, stram,stry.

Foolish answering: Synthesis- mind- answering- foolish: Ars, bell.

Answering with gestures: Synthesis- mind- answering- gestures with: Carbn.s.

Answering hastily: Synthesis- mind- answering- hastily: Ars, bell, bry, bufo, cimic, cocc, hep, lach, lyc, rhust, stry.

Answering incorrectly: Synthesis- mind- answering- incorrectly: Ail, bell, carb.v, cham, hyos, merc, nux.m, nux.v, op, ph.ac, phos, stram, verat.

Answering irrelevantly: Synthesis- mind- answering- irrelevantly: Atro, bell, carb.v, cimic, hyos, nux.m, ph.ac, phos, stram, sul.ac, sulph, valer.

Answer in monosyllables: Synthesis- mind- answering- monosyllables: Achy, agar.pa, bell, carbn.h, carb.s, carc, gels, kali.br, merc, mur.ac, PH.AC, plb, puls, sep, VERAT.

Answering by nodding: Synthesis- mind- answering- nodding- by: Puls.

Repeats the question while answering: Synthesis- mind- answering- repeats the question first: Ambr, caust, hell, kali.br, med, sulph.

Answering slowly: Synthesis- mind- answering- slowly: Anac, carb.v, cocc, con, GELS, HELL, kali.br, MERC, nux.m, PH.AC, PHOS, rhust. Sulph, thuj. [Refer book for third grade drugs]

Answering snappishly: Synthesis- mind- answering- snappishly: Ant.c, CHAM, sin.n.

Anxiety speaking when: Synthesis- mind- anxiety- speaking, when: Alum, ambr, aq.mar, hell, nat.c, plat, stram.

Communicative: Synthesis- mind- communicative: Acon, alum, bar.c, choc, hydr.c, lach, limest.b, marb.w.

Concentration difficult while talking: Synthesis- mind- concentration- difficult- talking while: Gink.b, limest.b, merc.c, nat.m.

Aversion to conversation: Synthesis- mind- conversation- aversion to: Ambr, ars, ars.s.f, asim, atro, bell, calc, carb.an, carc, chel, choc, ferr, gels, gink.b, granit.m, murx, ox.ac, plb, ptel, thea, ziz.

Desire for conversation: Synthesis- mind- conversion- desire for: Ars, chen.a, narcot.

Mistakes in speaking: Synthesis- mind- mistakes- speaking in: Agar, alum, am.c, arn, bell, calc, cham, chin, cocc, dulc, kali.c, lac.c, lyc, merc, NAT.M, puls, thuj. [refer book for third grade drugs]

Confused speech: Synthesis- mind- speech- confused: Alco, bell, ben.n, bry, calc, cann.s, carl, caust, choc, crot.c, crot.h, gels, hyos, lach, lyc, med, mosch, nat.m, nux.m, nux.v, op, sec, sep, stram, thuj.

Intoxicated as if when speaking: Synthesis- mind- speech- intoxicated as if: Amyg, andr.c, carb.an, gels, HYOS, lach, lyc, meph, nat.m, nux.v, vip.

Low soft voice: Synthesis- mind- speech- low, soft voice: Bell, carb.an, hydrog, nux.v, sec, staph, tab, viol.o.

Slow speech: Synthesis- mind- speech- slow: Aesc.g, arg.n, both, bov, cann.s, caust, HELL, ign, kali.br, LACH, op, ph.ac, phos, plb, sec, sep, thuj. [refer book for first grade drugs]

8. ATTITUDE AND BEHAVIOUR:

Abrupt: Synthesis- mind- abrupt: CALC, cham, hep, lyc, med, nat.m, nit.ac, nux.v, plat, PULS, rauw, sil, sulph, tarent.

Absentminded: Synthesis- mind- absentminded: AGN, APIS, CANN.I, CAUST, CHAM, HELL, LACH, MEZ, NAT.M, NUX.M, PLAT, PULS, SEP, VERAT. [Refer book for second and third grade drugs]

Alert: Synthesis- mind- alert: Choc, hydrog, op.

Admiration excessive: Synthesis- mind- admiration- excessive: Cic.

Asking for nothing: Synthesis- mind- asking -nothing for: Ant.c, ars, aur.m, bry, cocc, hell, hep, hyos, linu.c, mez, mill, nicc, op, puls, rheum, sep.

Childish behavior: Synthesis- mind- childish behavior: Agar, aloe, apis, arg.n, BAR.C, bar.m, calc, carb.s, CIC, croc, hell, ign, nat.c, nux.m, ph.ac, stram.[ refer book for third grade drugs]

Contemptuous: Synthesis- mind – contemptuous: Aloe, alum, androc, arn, ars, bry, canth, cham, chin, CIC, cina, com, cycl, granitm, guaj, hell, hyos, ign, ip, lac.ac, lach, lyc, merc, nat.m, nit.ac, nux.v, pall, par, PLAT, puls, sec, sil, spong, stram, verat.

Eccentricity: Synthesis- mind- eccentricity: Anh, asar, bell, cann.i, LACH, op, tarent. [Refer book for third grade drugs]

Fastidious: Synthesis – mind – fastidious: Anac, ARS, carc, graph, nat.m, nux.v.[Refer book for third grade drugs]

Immoderate laughing: Synthesis – mind- laughing – immoderately: Am.c, CANN.I, croc, ferr, hyos, ign, mosch, NAT.M, nux.m, nux.v, plat, stry, stryp.[ refer book for third grade drugs]

Loquacity, changing: Synthesis – mind- loquacity, changing quickly one subject to another: Agar, ambr, arg.met, arg.n, bry, choc, cimic, hyos, LACH, lyc, onos, par, phos, podo, rhus.t, sel, stram, teucr, tub, valer.

Mildness: Synthesis – mind- mildness: Acon, ARN, ARS, ars.i, BORX, cact, calad, calc, cann.i, cina, COCC, croc, cupr, ign, indg, lil.t, lyc, .marct, NAT.M, nit.ac, nux.v, phos, PULS, RHUS.T, sep, SIL, spong, stram, sulph, thuj, verat. [Refer book for third grade drugs]

Mischievous: Synthesis- mind- mischievous: Agar, aloe, ANAC, arn, ars, bar.c, bufo, calc, CANN.I, CHAM, CINA, calc.ar, cupr, hyos, lach, merc, NUX.V, puls, spong, STANN, stram, tarent, tub, verat.

Overactive: Synthesis – mind- overactive: Hyos, op, spig, spong, verat, verb.

Reserved: Synthesis – mind- reserved: Calc, hell, hyos, ign, mang, mur.ac,NAT.M, PHOS, plat, puls, stann, staph.

9. RESPONSE TO DOCTOR:

Anger when spoken to: Synthesis- mind- anger- spoken to when: Cham, elaps, hell.

Anger when touched: Synthesis- mind- anger- touched when: Ant.c, CHAM, iod, sanic, TARENT.

Anger from conversation: Synthesis- mind- anger- conversation from: Puls, tarent.

Anger from interruption: Synthesis- mind- anger- interruption from: Androc, cench, cham, cocc, granit.m, graph, hell, marb.w, nux.v.

Anxiety of being touched: Synthesis- mind- anxiety- touched; anxiety for being: Ant.c, arn, cina, hep.

Confusion when spoken: Synthesis- mind- confusion of mind- spoken to, when: ALUM, alumn, sep.

Consolation aggravates: Synthesis- mind- consolation- aggravates: Ars, bell, calc.p, carc, hell, IGN, kali.p, lil.t,NAT.M, nit.ac, plat, SEP, SIL, SYPH. [Refer book for first grade drugs]

Consolation ameliorates: Synthesis- mind- consolation- Amel: asaf, calc.p, camph, caust, gels, hell, kali.s, phos, PULS, sil, staph, syph.

Impatience when spoken to: Synthesis- mind- impatience- spoken to, when: Lil.t, nux.v.

Disobedience: Synthesis- mind- disobedience: Am.c, arg.n, CAUST, chin, dig, lyc, MERC, syph, TARENT, viol.o, viol.t. [Refer book for first grade drugs]

Starting when touched: Synthesis- mind- starting- touched when: Bell, cocc, coff, KALI.C, kali.p, kali.sil, mag.c, ruta, sil, stry.

Refuse to take the medicine: Synthesis- mind- refusing- medicine to take the: Arn, cimic, hyos, kali.p, LACH, stram, verat.v, visc.

Normally, patients don’t bargain or show their avariciousness in front of doctors, as they are more worried about cure rather than consultation charges. But the following rubrics have to be considered at least for some patients.

Bargaining: Synthesis- mind- bargaining: Bry, puls, sil, sulph.

Avarice: Synthesis- mind- avarice: ARS, lyc, MERC, ph.ac, PULS, sep, SIL. [Refer book for first grade drugs]

© Dr Muhammed Rafeeque,Kerala, India.

(Article published in Homoeopathic Heritage, published by B. Jain Publishers, New Delhi)