Organon & Philosophy

Homeopathic Case Taking

Summary:
Case taking is the process of collecting all the facts about the patient, using various tools like observation, perception, history-taking – given by the patient/attendant, clinical examination etc. in order to find a remedy for the patient – using our knowledge of Homeopathic Materia Medica, Organon of Medicine, and Repertory.
Index
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An Overview of Case-Taking
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Definition
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Objectives
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Dr. S. Hahnemann’s Guidelines (aph. 83 to 104)
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A Broad Scheme of Case-Taking
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Gist of Case-Taking
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Homeopathic Case-Taking and Pathological Diagnosis
–Views of Dr. Stuart Close
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A Note on Totality of Symptoms
–Views of Dr. Stuart Close
–Guidelines of Dr. Samuel Hahnemnn

An Overview of Case Taking

Definition: Case taking is the process of collecting all the facts about the patient, using various tools like observation, perception, history-taking – given by the patient/attendant, clinical examination etc. in order to find a remedy for the patient – using our knowledge of Homeopathic Materia Medica, Organon of Medicine, and Reparatory.

According to Dr. Stuart Close: “The purpose of homeopathic examination is to bring out the symptoms of the patient in such a way as to permit their comparison with the symptoms of the materia medica for the purpose of selecting the similar or Homeopathic remedy.

Objective of Case-Taking: Collection of all the facts pertaining to the patient, which may help in reaching to the totality of the patient and thereby help in finding the correct similimum. It is also said that a case well taken is a case half cured.

Dr. Samuel Hahnemenn’s guidelines regarding the art of case-taking

Dr. Hahnemann in his ‘Organon of Medicine’, aphorisms 83-104, has given the following instructions regarding the method of case-taking:

$83: This individualizing examination of a case of disease, for which I shall only give in this place general directions, of which the practitioner will bear in mind only what is applicable for each individualizing case, demands of the physician nothing but freedom from prejudice and sound senses, attention to observing and fidelity in tracing the picture of the disease.

$84: The patient details the history of his sufferings; those about him tell what heard him complain, of how he has behaved and what they have noticed in him, the physician sees, hears, and remarks by his other senses what there is of an altered or unusual character about him. He writes down accurately all that the patients and his friends have told him in the very expressions used by them. Keeping silence himself he allows them to say all they have to say, and refrains from interrupting them unless they wander off to other matters. The physician advises them at the beginning of the examination to speak slowly, in order that he may take down in writing the important parts of what the speakers say.

$85: He begins a fresh line with every new circumstance mentioned by the patient or his friends, so that the symptoms shall be all arranged separately one below the other. He can thus add to any one, that may at first have been related in too vague a manner, but subsequently more explicitly explained.

$86: When the narrators have finished what they would say of their own accord, the physician then reverts to each particular symptom and elicits more precise information respecting it in the following manner; he reads over the symptoms as they were related to him one by one, and about each of them he inquires for further particulars; e.g., at what period did his symptom occur? What is previous to taking the medicine he had hitherto been using? Whilst taking the medicine? Or only some days after leaving off the medicine? What kind of pain, what sensation exactly, was it that occurred on the spot? What was the precise spot? Did the pain occur in fits and by itself, at various times? How long did it last? At what time of the day or night, and in what position of the body was it worst, or ceased entirely? What was the exact nature of this or that event or circumstances mentioned-describing in plain words.

$87: And thus the physician obtains more precise information respecting each particular detail, but without ever framing his questions so as to suggest the answer to the patient, so that he will be misled to answer yes or no; else he will be misled to answer in the affirmative or negative something untrue, half true, or not strictly correct, either from indolence or in order to please his interrogator, from which a false picture of the disease and an unsuitable mode of treatment may result.

$88: If in these voluntary details nothing has been mentioned respecting several parts or functions of the body or his mental state, the physician asks what more can he be hold in regard to these parts and these functions, or the state of his disposition or mind; but in doing this he only makes use of general expression, in order that this informants may be obliged to enter into special details concerning them.

$89: When a patient has by these details given of his own accord and in answer to inquiries, furnished the requisite information and traced a tolerably perfect picture of the disease, the physician is at liberty and obliged to ask more precise, more special questions.

What sort of taste has he in his mouth? What kind of food and drink are most relished? What are most repugnant to him? Has each it’s full natural taste, or some other unusual taste? How does he feel after drinking or eating? Has he anything to tell about the head, the limbs, or the abdomen?

$90: When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient, and ascertains how much of that was peculiar to the patient in his healthy state.

Dr. Samuel Hahnemenn’s guidelines regarding the art of case-taking

$91: The symptoms and feelings of the patient during a previous course of medicine do not furnish the pure picture of the disease; but, on the other hand, those symptoms and ailments which he suffered from before the use of medicines or after they have been discontinued for several days, give the true fundamental idea of the original form of the disease, and these especially the physician must take note of. When the disease is of a chronic character, and the patient has been taking medicine up to the time he is seen, the physician may with advantage leave him some days quite without medicine, or in the meantime administer something of an unmedicinal nature and defer to a subsequent period the more precise scrutiny of the morbid symptoms, in order to be able to grasp in their purity the permanent uncontaminated symptoms of the old affection and to form a faithful picture of the disease.

$92: But if it be a disease of a rapid course, and if its serious character admit of no delay, the physician must content himself with observing the morbid conditions, altered though it may be by medicines, if he cannot ascertain what symptoms were present before the employment of medicine, – in order that he may at least form a just apprehension of the complete picture of the disease in its actual condition, that is to say, of the conjoint malady formed by the medicinal and original disease, which from the use of inappropriate drugs is generally more serious and dangerous than was the original disease, and hence demands prompt and efficient aid, and by thus tracing out the complete picture of the disease he will be enabled to combat it with a suitable homeopathic remedy, so that the patient shall not fall a sacrifice to the injurious drugs he has swallowed.

$93: If the disease has been brought on a short time, or, in the case of a chronic affection, a considerable time previously, by some obvious cause, then the patient-or his friends when questioned privately-will mention it either spontaneously or when carefully interrogated.

$94: When inquiring into the state of chronic diseases, the particular circumstances of the patient with regard to his ordinary occupation, his usual mode of living and diet, his domestic situation, and forth, must be well considered and scrutinized, to ascertain what there is in them that may tend to produce or to manifest disease, in order that by their removal the recovery may be promoted.

$95: In chronic diseases the investigation of the signs of disease above mentioned, and of all others, must be pursued as carefully and circumstantially, as possible, and the unique peculiarities may be attended to, partly because in these diseases these are the most characteristic and least resemble those of acute diseases, and if a cure is tom be affected they cannot be too accurately noted; partly because the patients become so used to their long sufferings that they pay little or no heed to the lesser accessory symptoms, which are often very pregnant with meaning-often very useful in determining the choice of the remedy-and regard them as almost a necessary part of their condition, almost as health, the real meaning of which they have well-nigh forgotten in their sometimes fifteen or twenty years of suffering, and they can scarcely bring themselves to believe that these accessory symptoms, these greater or lesser deviation from the healthy state, can have any connection with the principal malady.

About the author

Manish Bhatia

Manish Bhatia

- CEO, Hpathy Medical Pvt. Ltd. - Homeopathy physician. - Lecturer of Organon & Homeopathic Philosophy. - Founder Director of Hpathy.com - Editor, Homeopathy 4 Everyone - Member, Advisory Board, Homeopathic Links - Member, Center for Advanced Studies in Homeopathy - Co-author - Homeopathy and Mental Health Care: Integrative Practice, Principles and Research - Author - Lectures on Organon of Medicine

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