WHAT DO WE MEAN BY CASE TAKING: – To find out the most similimum drug after getting the totality (qualitative & quantitative data) of the given case. With a good case taking more than half the battle is won. Dr Hahnemann has clearly mentioned some instructions regarding case taking in the 5th edition of Organon’s Aphorism no.43-104, 139-141,150-152,147-171.
Also in the aphorism no he has cautioned us to be unprejudiced observer. That means; before case taking, the physician should be unconditioned with respect to his moods, unbiased with respect to his drugs, flexible like amoeba to take 100% impression. This and above all we should be a KEEN OBSERVER.
BODY LANGUAGE: – Unadulterated expressions of the body, which is constantly showing signs which the patient & even we fail to notice. We must pick up these unconscious’s signals. Even if the person lies his body language will not lie. E.g. Anxious persons will have mostly nail biting (like Arg.nit, Ars, Iod, Kalis etc) Sly deceitful persons will have movements like snake (Lachesis,Naja etc).Pricking lower lips (like in Lyco).Rounded face (globulous)persons love appreciation.
Different presentations for diff types of cases:-
1.For acute cases
2.For chronic cases
3.Acute exacerbation of chronic
To clarify this let us have an example of a tree in storm. When the intensity of the storm is less, there will not be any damage to the tree if it is strong. Only few leaves may fall. This we call as Indisposition. There is no need to prescribe for such conditions except Placebo. Now if the intensity of the storm is higher damaging the branches, trunk etc we need a prop to save this tree. This we call as Acute where some acute remedy is needed. And when the storm is settled the props applied are removed and the tree remains unchanged. Now if the intensity of the storm is very high shaking the roots of the tree then we need some constitutional remedy (miasmatic) remedy to strengthen the tree as a whole. This we call as Chronic. During the constitutional treatment if any acute problem occurs again and again, this we call as acute exacerbation of chronic then some acute drug in relation to that chronic drug may be needed e.g. Sulph -Aloes. Sulph-Podo etc. If no relief is there, constitutional is to be repeated.
Acute diseases are sharp, sudden, intense & short lived. Prescribe according to Dr Vijaykar’s chart. Here acute or chronic have nothing to do with the pace or speed of the illness, severity of disease or with respect to medicine or disease. If the complaints are recurring again and again, look for any maintaining factor e.g. scent causing headache or working in cotton factory or working in mines or living in marshy places etc etc. We have to remove this maintaining causes also and prescribe according to totality, considering the MAN who is sick not the vice versa. When the man in general feels better, keep your fingers off (may be any drug substance or counseling etc)
OBSERVATIONS:-(Caution-don’t prescribe according to observations only)
What the patient says is not much important but how he/she says is more important.
1.Record Keeping:-How does a patient keep his/her record (Meticulous-Ars,N.V,.Sil,Carc etc Distorted-Sulph,Psor,lach)
2.Postures- a) Sitting -Straight (Lyco, Sil, Aur etc), On the edge (all anxious remedies like Ars, Arg, Ign, Iod etc) Slouched back ( Calc,C.V. etc) Leaning forward (Puls,Asaf)
b) Prefer sitting (Rhus tox, Lach, Iod etc)
3.Gestures:- Opisthotonus(Strychnine) Finger pointing(Aur,Nux vom etc) gesticulating first then speaking (Thea)
4.Dressing- Weird (Conium, Sulph etc) Foppish (Lach, Vert alb, Calc iod etc) Colorful ( Lach, Tarent.) Meticulous (Ars, Carc, NV)
5.Physical make up:- Tall slender (Phos,C.P,Tub ) Short (Calc,Baryta,Bufo) Proportionate-(Long neck- N.M.,Short neck-Kalis,Large head-Abrot,Sil,Calc)
ESSENTIALS OF GENETIC CONSTITUTIONAL HISTORY TAKING.
Expressive Non Expressive
-Cheerful -Talk indisposed to
-Vivacious -Quiet disposition
-Loquacity -Anger suppressed
Strong willed Week willed
-Audacity -Will weakness of
-Pertinacity -Confidence want of
-Plans, makes many -Fearful
-High places <
-Touched, aversion to.
Conscientious Non Conscientious
Diligent Non Diligent
Benevolence Moral affections, Want of moral feelings
-Plans make many
-Learning desire for
d) NATURAL TRAITS (undiseased characters)
f) SENSITIVITY: –
-Social positions etc…
g) ATTACHMENTS: -clinging to mother
-Lover, Friend, Children, Dog or animals…
GENERAL MAKE UP
(i)Energy or Activity
(a)Speed of physical activity: -slow / fast / m. fast
(b)Speed of thinking process: –
e.g. – Vivaciousness
(ii) Speech: – natural to different & these are innate characteristics arising out of genetics
(Rule out any pathology)
e.g. -Jerky (Shatrughan Sinha, Devanand)
– Formal etc…
(iii) Tolerances or intolerances
(iv) Thermals: – Hot / Chilly / Ambithermal
(v)Appetite, Cravings, aversions
(vii) Sexual functions
(ix) Character peculiar to that person
(x) Agg / amel
(xi) Time / Season / Effect
ACTUAL CASE TAKING
Note down every observation & Statement.
Patient’s chief complaint is very important for him.
Show interest in the patient & his reports.
Do not interrupt the patient’s flow of telling complaints. See how he is narrating his complaints. ( e.g. Sep, Puls, N.v.-constantly talking of his complaints. Plat,Arg nit- will try to corner the doctor)
Write down all complaints in a chronological order w.r.t time to ascertain suppression or disease progress.
Look for general trends w.r.t diseases suffered.
Eg :- Cv, Cocc ind, Sep – H/o Hernia, Prolapse.
Puls, Thuja, Cf, KI. H/o warts, fibroids,
Look for H/o Accidents, # & side effected (Head injuries etc…)
Ask for any family history of cancer, tuberculosis,
Asthma, any degenerative diseases from maternal or paternal side.
Thirst, Appetite, Sleep (Including dreams), Stool, Urine, Desires & Cravings, Aversions, THERMALS.
MENTALS OR NATURE OF PATIENT
Learn to develop the ‘feel’ of the patient.
FEEL :- Perceive, Conscious experience, be affected by, emotional impression, sensation characterizing something, sensitivity or susceptibility to, CORE. Dr. Kanjilal says – Mental are those symp, with we observe.
To sum up :- Our Universe is made of Five essential elements
As we all know MAN is the part of this universe thus made of all these five constituents i.e. Panchtatavas (accepted by all )
Here 1.Fire -represents heat regulatory mechanism i.e. thermals
2.Water-Water contents of the body i.e. thirst.
3. Space- Cosmic energy which is all present & controls the activity of this universe vis a vis a MAN.
Thus activity -thirst -thermal covers three of the five essential constituents.
If we add 4 AIR-mind 5 EARTH-body it will cover the man as a whole.
TIPS FOR BEGINNERS
a) Impress upon the patient the absolute necessity of his opening out with you.
-For this – discuss some homoeopathy with him.
-Give him a background of where we are leading him & why.
b) It is very important to imbibe
-Finally faith in the patient
c) For this we must be
-Confident of ourselves & our science
-Complementary & Communicative, Friendly.
We must trust our science; only them will our patient trust us as a Doctor.
d) Finally, all this must reach the patient & be appreciated by him.
e) A genuine concern for the patient never fails to arouse a favorable response.
f) All this makes case taking much easier. If we are diffident, Unsure, Disinterested, patient does not get what he wants, so he dose not open out and may not visit you again.
g) All this positive first interview gives the patient’s vital force the much-needed stimulus – which hastens cure.
h) Guarantee for CARE not CURE.
Keep in mind A mismanaged first interface can seldom be repaired
Written by: –
Dr S S Vithal’s
Dr Vithal’s Homoeopathic Medicare Centre,
SCF-17, Samadhi Road, Narotam Nagar,
Phone No 01628-221093,226092