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;
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.