and ART of CASE TAKING
taking is one of the most important aspect of
homoeopathy from the view point of patient and
doctor, because every thing which leads to the
selection of the remedy depends on the information
obtained there of. If the information is precise
and exact, definitely it will lead us to cure.
Hence, it is rightly said that a well-taken
case is half solved.
doctors prepare themselves to a premeditated style
of case taking; some give Performa to be filled in
by the patient, and some other do an exhaustive
inquiry so as to bring out the inner man out. At
times, the process becomes so lengthy and
exhaustive that the patient becomes bored.
first and foremost thing is that we have to be
very clear about what we are going to search in a
patient and how to reach there. Then the
cumbersome process of case taking can be cut short
and the meaningful information can be spotted
first understand what Dr. Hahnemann has instructed
the early year of his practice, when he tried to
find the similibus and the affinity for that
particular organ or disease, the Master faced
failure. Then after deep thinking about the matter
for a long time Hahnemann came to conclusion that
what is taken for prescription is a mere fragment
of the real sickness. It needs further and more
reliable information so as to choose the right
indicated medicine. What was that? - It is the man
which has to be taken into consideration, not the
organs or the diseases. After this experiment, it
really brought the revolution in the field of his
means, the whole journey of the case taking is to
understand the man who is in question at the
moment. Every case needs a full exploration to
understand to prescribe.
the question which is very pertinent here is,
'What MAN?' Many people misunderstand it and start
compiling the symptoms from head to foot,
aggravations / ameliorations, concomitants and all
is not a mechanical or mathematical sum of the
symptoms the master had spoken of, but it is that
scientific, logical information or the group of
symptoms which establishes the individuality of
the patient. it is the particular individual who
is to be treated, and nothing other than that. The
aim of case taking is to reach to this individual.
Once the set of symptoms found, which establishes
the individuality, it will give us the perfect
S.F.C. Hahnemann has given utmost importance to
that mental state of the patient, which he used us
a decisive phenomenon, so as to select a remedy.
No doubt, Master Hahnemann and his followers had
also used physical symptoms very well to
prescribe. But, Dr. J. T. Kent has written that
Homoeopathy treats the man and man is in the mind.
It is the mental state which establishes the
individuality very precisely. Prescribing on
mental state means directly touching the deepest
layer of the man which uproots the disorder from
that Dr. J. T. Kent also used physicals, but, it
was very clear in his mind that 'Homoeopathy
treats the man and man is in the mind'.
understand the mental state of the patient is not
an easy task. Even the most experienced man in the
profession can be misled. It was Dr. Kent who
stressed most on the mentals, but his literature
shows that he used physicals also to a great
extent. To bring out the mentals in each and every
case is again a very tedious task, not possible
for a new comer to the profession. So what
happened? The mental section remained unused to
would like to tell you that the most significant
and most important thing i.e. the state of mind,
which we need to prescribe on, patient gives us
very vividly. But if we are not vigilant enough,
it passes without our notice. We need not to do
any premeditation or pre-assignments to make some
exhaustive inquiry. What we need is to be alert
and receive information from all the sources, as
the early days of my practice, i use to wonder,
why some patients behave rudely with the
physician, sometime very nicely and some others
very impatiently, irritated, angrily, dictatorial
a patient touches your feed whereas others
quarrel. Many a time, patient quarrels with the
doctor, which is really an embarrassing situation
for any doctor. Why someone cries and other laugh
in your clinic. Mind it! All these are very
important. HOW and WHY, are two
things which take you to your destination, to work
out for the similibus.
a case is very pleasurable job. The most you can
do about it, is to vacate your mind before meeting
a patient. Accept the things as they are coming to
you, never color them. Don't paint them with your
knowledge. Don't try to make a judgement which is
very scientifically supportive. The only thing
required in the part of physician is to have a
pure OBSERVATION. Everything, every
experience of the past is true, but what is
happening before you at the moment of encounter
with patient, is the only fact and most valuable
in regard of that particular individual.
a patient approaches you, it is very important to
know that what made the patient feel like coming
to you and to seek your help. Many a times, very
decisive and eye opening aspects are explored very
tactfully, to bring out the inner feeling of the
two lines are very precious:
we are in doubt, we should go ahead with the help
of these above two lines, asking queries to the
patient in the perspective of clearing our doubts.
Please don't forget that during the whole
discussion with the patient, utmost care should be
given to the tone and intensity of language and
words used. Many times, patients use a particular
sentence time and again. What is the meaning of
that in the patient's point of view? It is the
most significant line in case taking and all the
emphasis should be given to the patient's view
DISCUSS A CASE:
case of persistent dry spasmodic cough came to me
few days back. The lady complained that every time
she lie down cough start and it does not stop. She
said, "Doctors told me that it is in allergic
problem, it can take sometime. If I take
anti-allergic, I find relief but it recurs as soon
as I stop it."
I cannot take those medicines because it causes
lot of other problems. i cannot sleep at proper
time because of this cough. I have other problems,
like BP, pain in joints etc. Now, it is for quiet
sometime, may be two years, My husband died three
year back, our family is the joint family, many
members of my family are taking medicines from
you, and so I thought I should consult you."
was the information given to me by the patient on
her own. Now, the problem is from where I should
start putting questions? is there my entry point?
Yes! When you start exploration, never go away
from the patient's context. The point of her
interest which has become the issue for her is to
be spotted out. What are those?
version is full of information which has to be
explored. If we give a superficial look to this
information, perhaps it is only cough which is the
matter of concern. But to disclose about
family status, members and death of husband was a
bit eccentric, which fascinated my attention.
I asked her a question 'How her husband died and
what rest of the family members does?
she told me, "Doctor, you know that he was
elder to everyone in the house. After his death,
it is 'Me' who has to look after the house and
every other thing. But this cough does not let me
sleep at appropriate time and to get up at the
asked her, "The medicines (allopathic), you
are taking, gives you relief then why don't you
continue those medicines?
replied, "If I take those medicines, I get
relief, but my sleep gets extended beyond morning
- "What else do you want?"
- "Actually, doctor, you know, if I would not
wake up after midnight, anybody can enter my house
and take away all the valuables? It is my
responsibility, since I am the eldest in the
house, to take care of everything and everybody.
The elders are always supposed to worry about all
reached t two things:
lady has her own mind-set that she is bounded by
principles of her socio culture traits to which
she confirms her action. It gives us two rubrics:
- taking responsibility too seriously
prescribed her a does of Kali-carb 30, which
settled all the problems. She had relief in sleep.
She could sleep and wake up accordingly to
herself. Then, a lot of phlegm coughed out and
ultimately she was settled in a very small time.
visited that place again after two months and met
her. She told me that she keeping fine. Moreover,
the responsibility that seemed to be so important
is not troubling her much. Now that feeling of
responsibility has gone because of which she had
to keep awake at night. She can sleep well at
what I mean to say that it is not always the say
of the patient which matters, but what is behind
it, is of great significance.