Passive Case Witnessing Problem

It’s a case of a 6 year old girl who consulted me on 18/12/08.

The very first peculiar thing we observe about the child is …she enters the consulting room holding mothers hand tightly.

M: She has made a drawing for you.

(Child’s sibling is also our patient. Every time when this child used to accompany her sister, she would draw and now also she has got the following drawings. This itself shows us the child’s intense connection with her subconscious through this form of art.)

M: She does not have any health problem as such but I wanted to start treatment for her overall development.

PASSIVE CASE WITNESSING PROCESS

D:        Tell me what’s happening to you..? Can I send your mother out?

P: No.

OBSERVATION: Clings tightly to her mother.

D:        Okay, tell me what’s your name?

P: OBSERVATION: Sitting in mothers lap with her hands around mother’s neck. N……P……

D:        Tell me more about you?

P: PAUSE

OBSERVATION: Smiles and clings more to the mother.

D:        Tell me what are your interest and hobbies? What you like to do?

P: I like to swim, like to draw, I like running…playing.

D:        Wow! What else?

P: I like to play on the computer, like to watch TV.

OBSERVATION: Now she removes her hand from the mother’s neck and sits leaning on the table, yet she is in her mothers lap.

D:        What else you like to do?

P: Like to go to school.

D:        Very nice, very nice you are talking?

M: You sit on the chair and talk to the doctor.

P: OBSERVATION; child sits on a chair next to the mother but still holding her arm.

As the mother starts to leave the room, the child jumps off the chair, starts crying and goes and hugs the mother, and goes out with her.)

(The mother comes in with her after some time but now the child sits on the chair and mother on the sofa behind her.)

D:        OK, so tell me what else you like to do?

P: I’ll like to play – go on a slide. Like to read books.

D:        Very nice. You are speaking so well. What else you like to do?

P: Like to dance… then I like to play, then I do homework.

OBSERVATION: Looks behind towards the  mother.

ACTIVE CASE WITNESSING PROCESS

D:        And what are you scared of?

P: Scared of lions, tigers…

D:        What else?

P: Bhoot.

The mother had some work and she had to go out of the room. Immediately the child said no.

D:        You are speaking so well. Just talk with me and your mother will come in 2 minutes.

P: No…no…(OBSERVATION: She gets up and clings to mother and starts crying)

D:        OK you don’t talk, but can you draw till your mom comes back?

(She sits on the chair and starts drawing.)

(Since she was not ready to communicate even after so much of encouragement and the fact that at the beginning she had brought drawings, we ask her to draw.)

OBSERVATION: She covers the paper with the hand and also draws at one lower section of the page.)

D:        Wow! What is this?

P: This is my sister & me, & this is my father and my brother.

D:        And what is this?

P: A heart.

ACTIVE – ACTIVE CASE WITNESSING PROCESS…

D:        What is this heart doing here?

P: I love heart so I drew it.

D:        Earlier also you drew hearts. What about this heart you love?

P: I love heart like that only.

D:        Heart with arrows what does this mean?

P: Looking into the drawing. (PAUSE)

D:        What are you all doing?

P: We all are looking at the heart and thinking what is it.

D:        What does the heart mean?

P: I don’t know.

D:        You like drawing heart huh. When do you draw it?

P: In school. In my drawing class. I draw heart and stars and one day I drew heart and star in the Christmas tree.

D:        In this drawing who is having the flower? (We spotted a flower in the drawing she had made.)

P: My sister- she is just holding it.

D:        She is going to give it to someone or what?

P: Me.

D:        And heart will go to whom.

P: To my brother and father.

D:        Why?

P: Like that only.

D:        Like that only. OK… Would you like to draw something more for me?

D:        Wow! What is this?

P: A drawing.

D:        Of what?

P: Drawing of a garden. This is me and my brother.

D:        What are you both doing here?

P: We have come here to play.

D:        What are you playing?

P: Running and catching.

D:        What is this?

P: Flowers.

D:        Which flower are they?

P: This is flower, this rose and…this …this is pink flower.

D:        Draw one more thing for me?

P: OBSERVATION:  She draws human figures and then joins all of them together.

D:        Wow! What is this? I don’t know what it is.

P: My family.

D:        What’s your family doing here?

P: Ring-a-ring-a-roses.

D:        Ring-a-ring-a-roses. What’s that?

P: I don’t know.

D:        Whom you like the most in your family?

P: My mom.

D:        What about mom you like the most.

P: (PAUSE)

D:        You like or your sister likes?

P: I like more.

D:        What else?

P: (PAUSE)

ACTIVE – ACTIVE IN DIFFERENT AREA – FEAR

D:        What are you scared the most.

P: Lion and tiger.

D:        What about them scares you the most?

P: Because lion crawls and eat us.

D:        What else do they do.

P: Smiles.

D:        You said previously that you are also scared of ghost. What about them scares you?

P: (PAUSE) … I saw the movie called Road side Romeo. (This is a bollywood movie)

(Here when we ask her about fears, she herself goes to the area of movies, so we become active- active to explore this area.)

ACTIVE – ACTIVE IN DIFFERENT AREA -MOVIES

D:        What is there in that movie?

P: There’s a dog, many dogs but 1 dog’s name is Romeo.

D:        Go on?

P: There is a girl called Leila and she loved…. and that dog he loved Leila..

D:        I don’t know what they do? Love means what?

P: I don’t know.

D:        What about the movie do you like the most?

P: I like Leila.

D:        What about Leila you like?

P: (PAUSE)

OBSERVATION: leans on the table and hides mouth behind both palms.

D:        Which other movies you like?

P: Romeo & Jaane tu… (It’s a Bollywood romantic movie.)

D:        And what is there in that movie Jaane tu…?

P: I forget.

D:        Anything else about you.

P: Nods no.

D:        So you like all movies with love/

P: Nods Yes.

D:        What about it you like?

P: I don’t know… because nice things happen.

D:        What?

P: Like they don’t shout, they don’t hit and all.

D:        Anything else.

P: No.

Child goes out and comes back with another drawing along with the mother.

MOTHER’S OBSERVATION OF THE CHILD

She is very affectionate child.  She will go and give big hugs even to strangers. She is very fond of her younger brother and she will make him understand things by saying you can win this or that and she lets him win. Actually she is friendly with anybody and everybody.

END OF THE CASE

—————————————————

UNDERSTANDING OF THE CASE

OU OF PLACE/ OUT OF ORDER

Passive case witnessing process

Verbally the child didn’t speak anything peculiar but our observations regarding the child were very peculiar…

• Her clinging.
• Sitting in the mother’s lap.
• Holding mother tightly.
• Holding her hand while talking.
• Hugging the mother.

Active case witnessing process

• Clings to mother as she tries to go out of the room.
• Covering the paper with hand while drawing.
• A heart.

Active-Active case witnessing process

• I love heart .
• I drew heart and star in the Christmas tree.
• Drawing of a garden
• Flowers.
• Draws human figures and then joins all of them together.
• Too much family attachment.
• Ring-a-ring-a-roses.
• That dog he loved Laila Leila
• Like they don’t shout, they don’t hit and all.

WHAT IS THE FOCUS/CENTRE/ESSENCE OF THE CASE

• Love, attachment and togetherness.
• Love for heart.

This is very evident from her body language and all her drawings. Also this further gets confirmed from the mother’s observation of the child.

WHICH KINGDOM?

• Pure sensitivity seen.
• Drawings of garden, flowers.

This clearly points to the PLANT KINGDOM.

WHICH FAMILY?

This tremendous attachment to the mother, togetherness of the family, hugging and clinginess, love for hearts is very suggestive of the MALVALES family.

WHICH MIASM?

We observed that whenever she draws she covers the paper with her hand. This gives a hint of the SYCOTIC MIASM.

WHICH REMEDY?

The remedy from the Malvales family with Sycotic miasm running in the centre is TILIA EUROPA. BUT in the case we observed that along with the general theme of the Malvales family, the child’s focus was “Heart”. So when a further inquisitive search was made keeping focus on the “Heart” interestingly we found out a remedy TILIA CORDATA which also belongs to the same family where the leaves of the tree are heart shaped.
Thus the remedy given was TILIA CORDATA.

WHICH POTENCY?

At the end of Passive case witnessing process, verbally the child seemed to be at the ‘Name and Fact’ level but the peculiar body language which we didn’t understand initially and which got connected later on with the whole phenomenon, represented the child’s complete altered energy pattern. Thus the child (non-verbally) vibrated at the Delusion level. Therefore the potency given was 1M, single dose.

A follow up drawing

END OF THE CASE

Homeopathic Case Taking



Hpathy Ezine, March, 2009 | Print This Post |

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 ————- * An Overview of Case-Taking * Definition * Objectives * Dr. S. Hahnemann’s Guidelines (aph. 83 to 104) * A Broad Scheme of Case-Taking * Gist of Case-Taking * Homeopathic Case-Taking and Pathological Diagnosis –Views of Dr. Stuart Close * 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 […]

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
————-
*
An Overview of Case-Taking
*
Definition
*
Objectives
*
Dr. S. Hahnemann’s Guidelines (aph. 83 to 104)
*
A Broad Scheme of Case-Taking
*
Gist of Case-Taking
*
Homeopathic Case-Taking and Pathological Diagnosis
–Views of Dr. Stuart Close
*
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.

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

Comments

  1. dr,anil ratnakar

    March 3, 2011

    The best article! Helpful while taking the case.
    Thank you.

    • amruta

      June 20, 2012

      Agreed

  2. amruta

    June 20, 2012

    Nice article . it will surely helpful for me while taking case and getting exact totality of symptoms.

    thus i will able to achieve correct medicine.

    Thank you.

  3. FALGUNI PANCHOLI

    July 26, 2012

    hi i m a student of 4th b.h.m.s.(bachlor in homoeopathy medicine & surgery) in india. i want mha(master in health administration) degree in uk. Is that possible that i can mha in uk? After mha can i do job in uk related to health or medicine? is there any scope?

  4. dr.pramod bhalekar

    August 10, 2012

    great information about case taking

  5. armanul haque

    September 18, 2012

    very good

  6. joseph km

    September 19, 2012

    very good ..Thank you

  7. Rody

    September 22, 2012

    Concise and very systematic.thank you for sharing your knowlege

  8. R.C.TAMILSELVAN

    July 26, 2013

    Very informative sir,Thank you sir.

  9. MANOJ KUMAR SINGH

    March 15, 2015

    NICE ARTICLE & BANIFICIAL OF EACH AND EVERY STUDENT & PRACTIONAR

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