“A well taken case is an half done Cure.” part 3

1. Physical generals.

Till now when we are working with the particulars, patient is now well aware of the environment of your clinic thus he is comfortable to answer you more details. 

This is the stage where one can start with the personal history. This includes;

Digestive system

The way to the heart goes from stomach. Thus we can start with the appetite, time of meals, likings, cravings and aversions in meals. 

One can ask craving and aversions in categories like sweets; spicy; oily n fatty food; sour/ lemonades; salt quantity; veg/ non veg; indigestible food stuffs etc.

Inferences we can get:

Taste – acute senses or altered taste can be Pqrs or a syphilitic symptom.

Appetite and meal habits – want of / voracious eater.

Cravings and aversions; these can help one in individualize a person, along with strong desire or aversion as a symptom to confirm the similimum.

Bowel movements:

One can start here from heartburn, regurgitation, hiccough, eructation, flatulence to constipation, diarrhea, dysentery, type of stool. Also one can ask the history of hemorrhoids bleeding or non bleeding. (Bleeding piles, epitasis, ecchymosis, menses profuse, bleeding gums can suggest hemorrhagic tendency.)

Thirst:

Generally people are not aware of the water intake. In winter they will say low and in summer will say thirsty. So try to ask the quantity in glasses or bottles of mineral water. Dryness of throat yet no need to drink water suggest a highly thirst less person. Bleeding gums can be confirmed here. (Bleeding piles, epitasis, ecchymosis, menses profuse, bleeding gums can suggest hemorrhagic tendency.) Preference for cold, chilled or luke warm water. Time interval between drinks.

Urine:

Different urinary complaints like frequent micturation; nocturnal frequency; enuresis; infections in urine; pustular cast; red cells or hematuria (Bleeding piles, epitasis, ecchymosis, menses profuse, bleeding gums can suggest hemorrhagic tendency.) oozing of semen; drop by drop urination; stream bifid or other; etc can be asked for. Special conditions like calculi; cyst and tumor are also the part of it. Local complaints like itching and eruption on the genitals with there specific characteristics can make the part of it.

Perspiration: 

 Do you perspire? We can start it from this question to which body parts; how much; specific time; odor; staining; acridity etc.

Thermals:  

This is one of very important issue during case taking. This not easy to confirm whether a person is Hot or Chilly. But a strong Hot or Chilly person can lead you clearly to the thermal confirmation. There are few questions like –

How’s your tolerance for cold or hot, why?

Do you prefer covering your face while sleeping, why?

Do you prefer warm or cold water for bathing, why?

Who is the first person to wear sweater or shawl at your home? These can help one to get the specific thermals of a patient.

But most syphilitic cases have altered thermals. So unless its confirmed, don’t take it as an evaluator symptom.

Menses:

History here starts from menarche; its age to attend; progress since then; regularity; flow; color; clots or membranes; how long it goes. Associated complaints can be taken as leucorrhea; odor; acridness/ blandness; dysmenorrhea; diarrhea; nausea vomiting etc. Any emotional relation of menses; fears; dreams during menses are also of much importance.

Sexuals:

For Males : Difficulty in erection; Wanted erection; unwanted erection; Weak erection; Failing erection; any other trouble during coitus; any perversion or unusual sex; Gay; Masturbation; are the points to find.

For females : Difficulty in Coitus; Want of Desire; Dryness of vagina; Spasms; Guilty; Any other trouble during coitus; any perversion or unusual sex; lesbianism; Masturbation; are the points to find.

Sleep and dreams;

Sleep is one of the favorite issues to many. But some may have problems related with it. Thus asking what time do you sleep and arise at what time, will give you the time of sleep. Housewives have sleeping habit of noon and may compliant of night watching. Students are always in lack of sleep how much they sleep. So what patient is saying is not important unless it is verified and logical. Also try to get the position, habits like grinding teethes, somnambulism, talking, kicking, screaming, crying etc.

Dreams are the involuntary signals of brains. Some says its future and some says its unfulfilled desires. But to us this of miasmatic importance, these dreams defines the mind miasm. Thus any dream remembered by patient is important.

Habits: 

Different habits like tobacco, alcohol, cigarette, coffee, stimulants and drugs etc are to be taken. These help us for diet and regimen and removing the hurdles of cure.

Sensitivity of senses:

All 5 sense of human are to be asked. Any sense which got acute or diminished in action or perverted can lead to a specific PQRS symptom. Patient affected may say aggravations from least noise, photophobia, anosmia, metallic taste etc.

Also we can consider some more sensitivities which might be related with the change of weather, place, air, water, sun or moon effects etc.

“A well taken case is an half done Cure.” part 2

Case taking according to me:

Case taking is a process where a patient becomes totally true to his extends to the doctor. It is very much possible that patient may mislead with some weird data which is of no use to you. Thus the questioner should be specific not only in order to get the desired data but also in for confirming the symptoms again and again. 

Patients don’t know what a doctor needs and what is the importance of the question asked to him or her. It is the doctor who has to investigate in such a way that it should not look like interrogation and feels like a soothing friend. Then only we can get the inner symptoms which the patient has not even shared with his nearest one.

Thus I had divided case taking into three sets of data along with subjective and objective symptoms.

1. Chief Complaint / particulars etc.:

This is the first thing which the patient shares us. But most of the times he may start with the on going symptoms. This is a starting opportunity from where we can be really friendly and light with the patient. Because chief complaints and its six modifications are the data which all patients share easily.

What to ask in this category:

Chief complaint: the main complaint which compelled the patient to take medicine. This complaint should accompany with six modifications like onset; location; sensation; radiation; concomitance and modalities. Complaints can be many so try to get all the details.

Past history: this gives a data of the disease which has occurred previously. Try to get this data in a sequence because this will help you get Herring’s Movement Law. Also it will help you tress the progress of the miasm and the pathology. According to Dr P Vijayakar, cure should be from higher miasm to lower miasm, is also a very important criteria to Herring’s movement law.

Family History: this shows the dominant miasm running through the family. Also we can be aware of the diseases which patient is prone for. Many disease conditions runs genetically like sickle cell etc.

So directly you are gathering the particular data of the disease and its modifications to make it a complete symptom. These are all subjective symptoms. While indirectly you have an opportunity to get comfortable with the patient where the observation starts. Practically observation starts from the approach of the patient for appointment. His entry in your chamber, his walk, his sitting posture, his way of talking, his approach towards your questions and his body language can also tell you a lot. But these are mere observations at this moment, further we have to confirm it.

Few examples for these are;

Timidity/ Confidence

Mannishness of women/ Effeminate of male

Reverence/ smiling/ expression less/ anxious look/ sad

Introvert / extrovert

Communicative/ loquacity/ vivacious/ boaster/ anger when obliged to answer/ taciturn/ abrupt

      Hasty speech/ hurried walk/ restless/ mischievous etc are the few observations which we 

      can be confirmed further during CT.

Inferences we can extract:

1. Miasm of the disease;

2. Speed, site and spread of the disease;

3. If three or more complaints are having common side, sensation, modality then we can make it a general symptom.

For e.g.: right sides congestive headache; right sided breast lump; right sided ovarian cyst and right knee pain – indicates right side in general; with sycotic miasm of the disease conditions.

4. Origin development and progress of the disease will show HML, which will be reversed when given a similimum. This will guide you in the follow up whether the case is going in right direction. If you are able get a perfect data with similimum prescribed one can predict the coming symptoms to the patient which can amaze a patient and strengthen the faith in you and Homoeopathy.

“A well taken case is an half done Cure.” Part 1

If you want to be a result oriented Homoeopath then the utmost important thing is the best of CASE TAKING. It is said that “A well taken case is an half done Cure.”

So starting with few case taking points:

1. Case taking can be in minutes to years. It does not end till you find the perfect symptom which leads you to the SIMILIMUM.

2. There are various ways of case taking. Some are snapshot case taking where few PQRS type symptoms along with few generals can lead to a remedy. Other one is getting a constitutional way. Here different criteria are set and the case taking goes in the same direction to fulfill the required data. This data contains the Miasm, Dominant side, Thermals, Physical Generals, Speed of the disease, Causation, Sensitivity an its Reaction, Temperaments, Physical make up, Innate characters, Will, Understandings, Morals etc. Practically snap shot technique is bit hard as you have to be very detailed with your Materia Medica knowledge which at times is difficult. The latter one is step to step way and confirmations lead to a confident prescription.

3. The way of CT can be any one but the end out put is a remedy which has an ability to cure or annihilate the disease. (according to apho 2).

4. Now here comes the understanding about cure. CURE we need no discussion as Hahnemann himself has defined it perfectly. It should be in reverse order of the disease origin according to Dr Hering.

5. Thus Case Taking is the specific method of achieving a group of symptoms through specific questioners belonging to criteria defined by you.

6. Always ask for “why” this will surely help you to get to the depth of the symptom.

Hello Dear Fellas!

I am Dr. Rahul Kolamkar, an Homoeopath, trying to follow all the bits and tips of Great Dr. Samuel Hahnemann. I am hereto share my thoughts on different topics of Homoeopathy. People can have difference of opinion, but my aim is to motivate all the juniors to have sound knowledge of Homoeopathy and believe Dr Hahnemann's best gift to the future centuries.

I am not here to criticize or nullify the difference of opinion. Its a pure heart effort to work conjointly.

Thanks n Regards

Dr. Rahul Kolamkar

www.megahomoeopathy.com