Utility of past history in prescription and its therapeutic approach

The utility of past history in prescription and its therapeutic approach 

Dr. Navin Prakash Ray , PGT (NIH)
Dr. Usha Uchat, M.D. (Hom) Reader, Homoeopathic Material Medica, NIH.

ABSTRACT –  Past history is the most important point in case taking in all formats of treatment either modern or homoeopathic. If we analyze a person today, we will find him actually to be a product of his past experiences- occurring consciously, sub-consciously. We collect the past illness of the patient from his/her gestational time to till the time of the development of the present illness. Which in turns help us to plan the course of treatment.  We should emphasis on this point in very precise manner so that we can collect and correlate more information about the man, about the miasm lurking behind, about the obstacle to recovery, about the manner of development of  the persisting disease. 

KEYWORDS – Past history, case taking, chronic diseases, miasm, remedy, nosode susceptibility, intercurrent remedy, totality of symptoms.

INTRODUCTION – 

“He who watches a thing grow has the best view of it.” – Heraclitus of Ephasus

Every experience has a bearing upon the person – some last longer and many even change a person’s thinking, feelings and functioning.

According to aphorism 5 in organon of medicine “Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm.

In these investigations, the ascertainable physical constitution of the patient (and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, ..etc., are to be taken into consideration” 

Past history is a very important part of case taking which should be investigated very carefully. Past history provide information about susceptibility of the patient, miasm in the background, causation of the disease. 

Quite often the well chosen remedy can cover outstanding episodes in past history of the patient. Sometimes it seems that it is necessary to directly antidote bad effects of some past event which greatly disturb the patient’s health.  For example, Natrum sulph. may be required when patient has had concussion. 

A case by Dr. S. P. Dey, showing  significance of past history – In a Case of bronchial asthma, all symptoms were pointing towards Silicea, which failed but pertussin subsequently selected on the basis of history of whooping cough in childhood cured the patient. 

A case by Foubister – A university student had been unable to concentrate and suffered from attack of vertigo when walking. This begans after attack of measles two years previously. The cause of vertigo was obscure. He had been checked in dept. of ENT without a definite diagnosis have made. Morbillinum 200 followed by short aggravation, a complete cure occurred. 

 All the relevant factors such as the history of any miasmatic disease in the past, suppression caused by external medication, the main and the first cause of onset of the disease, history of vaccination and its bad effect etc. are to be considered. 

The past history may lead to an appropriate remedy for that individual when there is no clear symptomatic indication for any one remedy right there from the beginning. 

In “Essay on Homoeopathy“ , Dr. B. K. Sarkar has mentioned  that there are 6 methods of prescription and  the 5th method of prescription is applicable when there is a case which  contain only common symptom and pathological symptoms. In this condition physician has to use every means of his command   

 1) Personal history and Past history  2) Aetiological factor   3) Temperaments.

Past history includes any serious illness, injury, operation, or experience  which may have a bearing on the present condition. According to Phyllis Speight, the recording of the past history falls into three main groups: 1. Place of residence 2. Illness suffered 3. Unpleasant experiences.            

A record of previous illness, operation- injuries, are next considered. What was the recovery from these? All these when noted in chronological order, the practitioner can visualize the progress of a disease.[

In order to understand this evolutionary history of a patient we need to study the chronological order of past illness with treatment taken and recovery.

WHAT IS TO BE INVESTIGATED IN PAST HISTORY OF A PATIENT:- 

1. ANY CHRONIC INFECTION :-  During case taking we should investigate carefully for any chronic infections like tuberculosis, gonorrhoea, syphilis, any itching eruption that has been suppressed and character of the eruption , COPD, urticaria etc. This may help to choose a remedy , but the prescription should must be  selected individually. Example :-

• Past history with Tuberculosis, medicine indicated – Tuberculinum, Drosera, Spongia, Sepia, Theridion.
• Past history with Gonorrhoea, medicine indicated – Agnus cast, Benzoic acid, Clematis, Cannabis sat, Medorrhinum, Nat. Sulph,  sarsaparilla, Thuja occ. etc
• Past history of suppressed itch, medicine indicated – Agaricus, Baryta carb, Calc carb, Graphitis, Kali carb, Mezereum , Merc. Sol,  Psorinum, Sulphur, Selenium,  Zincum met etc. 
• Moist herpes after suppressed scabies; intolerable itching when getting warm; aggravated before midnight and in open air – Psorinum.
• Suppression of scabies in their history- Hepar sulph., Sulphur
• Chronic diarrhoea : after suppression of scabies. – Hepar sulph.

2. ANY ACUTE INFECTION :-  Any acute infection in past history or complaints after any acute infection has its own significance in treating the patient or in getting to the clue to the indicated medicine according to different materia medica. Such as :-

• Past history of measles and medicine indicated may be – Morbillinum, Pulsatilla, Carbo veg etc.
• Past history of typhoid and medicine indicated may be – Typhoidinum, Carbo veg, Selenium, Rhus tox etc.
• Past history of septicaemia and medicine indicated may be – Pyrogenium                                                                                                                     
• Past history of chicken pox and medicine indicated may be – Variolinum 

Sometime deficient reaction or diminished susceptibility may exist in a case or    appears during the treatment. This is  where improvement ceases and well chosen remedy do not seems to act. Under such condition it may be necessary to give a due of what is called intercurrent remedy. 

Dr. Margaret Tyler of London, England, reports a series of cases cured with these nosodes in “Homoeopathy,” the publication of The British Homoeopathic Association. “Never been well since mumps, scarlet fever or measles.” By prescribing the specific nosode, the patient made rapid improvement. Many cases have been reported in this country illustrating the beneficial results from these remedies.

3. HISTORY OF VACCINATION:-  Past history of vaccination and its bad effect  or any complaints arise after vaccination has its own significance in prescription. Medicine indicated after vaccination and its bad effect – 

Antim tart, Crotalus- horr., Lyssin, Mezerium, Psorinum, Sarsaparilla, Thuja occ, Silicea, Variolinum etc. 

Vaccinosis may block the way of action of Tuberculin- until Thuja has been given and then acts brilliantly. –  J.C.Burnett

4. HISTORY OF INJURY :- For after effect of head injury there are a group of remedies – Arnica, Cicuta, Hypericum, Nat sulph., Nat mur, Helleborus. Everyone has been injured at some time or another, it is only when there has been an injury in relation to the onset of ill health or when there has a severe injury in the past that it should called for consideration in constitutional prescription.                              

5. HISTORY OF ANY PSYCHOLOGICAL UPSETS :-  Sometime there is any psychological influence in the history of the patient resulting in development of the morbid process or clear history of complaint starting after  grief, fear and other emotional upsets may help to select the appropriate remedy for the individual case. As example :- 

• Bad effect of the fear still remaining – Opium, Aconite, Hyoscyamus
• Bad effect of disappointed affection – Antim. crud, Cal. phos., Ignitia, Nat. Mur.      

6. MISAMATIC ANALYSIS :- According to Organon of medicine in aphorism 5 master Hahnemann had advised  to investigate carefully most significant point in the whole history of the chronic disease to enable  to discover its fundamental cause which is generally due to a chronic  miasm. By careful investigation of past history we can find miasm lurking behind the disease and can find a antimiasmatic remedy for the case. For example : In past history having infections like PID, Appendicitis, Gout, Herpes zoster, Haemorrhoids, Warts, are due to sycotic background(Miasm) of the patient . Fallopian tube affections is the basic characteristic of sycosis. 

A scabious exanthema reduces psora to silence just as an external chancre does for internal syphilis : when these manifestations are suppressed by unnatural techniques, changes are generated which become the internal affection.  Scabies, or chronic itch in the past history points towadrs the psoric miasm present in the background.

In past history having diseases like Rickets, growing pain, Stomatitis, Fistula, Dry gangrene are due to syphilitic taint.                                      

Diseases like Urticaria, Varicose vein & ulcer, Corn, Hernias, Diabetes, stricture, Sinuses, Epilepsy are due to Tubercular diathesis.

THERAPEUTIC HINTS, APPROACH OF PAST HISTORY:-   In materia medica there are many more symptoms mentioned having certain disease or some significant event in the past history which indicates the particular medicine.           

Past history having chronic infection may indicate following remedies :-    

• Bad effect of acute gonorrhoea – Agnus cast.  Cannabis ind.                            
• When scabies are suppressed by local application of Mercury and Sulphur – Causticum .                                                                                                           
• Convulsions follow the suppression of scabies scabies  – Cuprum met.                                                                                                                         
• Ailments from Suppressed itch or skin disease – Sulphur, Psorinum ,                                                                                     
• Suppression of skin disease causes diarrhoea – Apis , Graphites                 
• Suppression of skin disease causes epilepsy – Agaricus, Kali ph, Zinc met.                  
• A sequel of suppressed gonorrhoea – Medorrhinum, Daphne ind., Clematis                                                          
• Rheumatism and neuralgia after gonorrhoea – Phytolacca                      
• Rheumatism, bone pain after checked gonorhhoea – Sarsaparilla                          
• History of suppressing primary syphilitic chancre – Syphilinum                                
• A long history of Suppression of skin disease in any form – X ray                       
• History of allergy in any form in the patient in past – Thyroidinum                               
• In past patient suffered from repeated attacks of urticaria – Thyroidinum     

Very frequently indicated remedy is gold – Aurum, either the Aurum met., the Aurum muriaticum, or the Aurum muriaticum natronatum. And this remedy is all the more frequently called for on account of the past history of some of the worst cases of post-arthritic heart affections. 

Past history having acute infection may indicate as follow :- 

• Past history of repeated inflammatory disease in childhood is great indication of – Carcinosin

• Lower vital power and hair loss after fluid loss or Typhoid – Carbo veg                        
• Bad effect of acute exanthema  suppressed – Apis mellifica                                  
• Malaria in past history – Chininum sulph. , Cinchona, Malaria off.               
• Auricular flutter and fibrillation especially when subsequently to rheumatic fever – Digitalis                                                                                                                     
• Covers the symptoms developing as the result of an underlying suppressed malaria  – Quercus , Nat. Mur., China, Pulsatilla.                                                                                  
• Neuralgia after zona – Mezereum                                                                    
• Deafness after scarlet fever – Hepar sulph                                                         
• Mumps, metastasis to mammae or testicle – Pulsatilla                                                
• With a history of liver disease – Chelidonium , Lycopodium , Kali mur.                 
• Dropsy after suppressed intermittent – Ferrum met, China, Carbo veg.                    
• Past history of influenza , medicine  may be – Eupatorium, Natrum salicylicum, Lathyrus sat, Influenzinum.

A tubercular patient has failed to react to carefully selected drugs until Bacillinum has been given, after which marked improvement results for several weeks or months, and that then, the symptoms having changed slightly, the patient begins to backslide and Bacillinum is no longer helpful. Careful study of the present symptoms and past history now shows that Natrum mur. or some other drug covers the symptoms developing as the result of an underlying suppressed malaria.

Case having a significant history of injury or any complaints after injury :-

• Bad effects resulting from mechanical injuries – Arnica Montana                      
• External wound with or without loss of substance – Calendula                                   
• Injurious chronic effect from concussion of brain  and spine – Cicuta vir                   
• Glandular indurations or stony hardness after bruise or injury –  Conium                     
• Bad effect of fall,  Mechanical injuries of external parts – Euphrasia                      
• Mechanical injuries and their latter consequences – Glonoine                                     
• Injury to the parts rich in sentient nerves – convulsion – Hypericum                           
• Ailments from a fall , haemorrhage of mechanical origin – Millefolium               
• Mental traumatism : chronic brain effect of blows, falls – Nat. Sulph                   
• Mechanical injuries: blows thrust on globe of the eyes – Symphytum                         
• Ill effect of burn – Causticum                                                                                           
• Facial neuralgia after extraction of tooth – Hekla lava                                    
• Complicating or traumatic urethritis or stricture – Petroselinum

Past history having significant psychological upset influencing the case :-

• Bad effect o sudden emotion or pleasure surprises – Coffea ,  Causticum                              
• Bad effect of exciting or bad news – Gelsemium                                                         
• Bad effect of unfortunate love with jealousy – Hyoscyamus                                         
• Bad effect of disappointed of love, long concentrated grief– Ignatia , Lachesis 
• Suicidal insanity ,brood constantly over imaginary trouble-Naja , Aurum met 
• Bad effect of violent mental emotions- Sambucus nig                                    
• Ailments from pride envy or chagrin , reserve displeasure – Staphysagria        
• Traumatism of grief , remorse or sudden realizing of financial loss – Arnica 
• Groundless fear of financial ruin – Calc flour.                                                            
• Mental anxiety, worry, fear accompanies the most trivial ailments- Aconite   
• Chorea brought on by fright – Cuprum met                                        

Any history of never well since any incidence :-  

• Never had been well since  that burn – Causticum                                                      
• Change  of life, never had been well since that time –  Lachesis                           
• Great weakness and debility remaining after acute disease – Psorinum                       
• Pubertal age, had never been well since – Pulsatilla                                                
• Had never been well since her last miscarriage – Sulphur

Past history of suppressed any discharge :- 

• Dropsy after suppressed sweat – Dulcamara                                                     
• Dropsy with suppression of urine – Digitalis                                                            
• Bad effect of suppressed foot sweat – Cuprum met, Silicea, Calc. Carb, Zinc. Met, Graphites                                                                                                                 
• Bad effect of cheked perspiration – Aconite, Bryonia.                                      
• Congestion in brain from suppressed menses – Glonoine                         
• Precancerous condition of cervix with history of suppression of long lasting leucorrhoea , possible medicine is – X ray  

CONCLUSION – The homoeopathic case taking is an art which helps physician to form holistic image of disease since its inception to its present development. Past history of a patient can play a key to the whole locker of the disease to be cured. So being a homoeopathic physician one should proceed more carefully during the investigation of past history of a patient during case taking. During case taking he try to find out the effect of all types of inimical influences on the constitution, starting from the gestational time, in both psychological and physical plane in chronological order. Though the most similar medicine of any given case at any particular time will be indicated by the totality of symptoms of that case.

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