CASE TAKING
During case taking-
1. Follow general instructions given by our master
2. Give importance to the firsthand information given by the patient
3. Feel the essence of the case {totality}
4. The first and main task is to know the predominating symptoms relating to the present ailment (state of imbalance in the body) of the patient, because we must remember that we have to establish the reverse order of its coming.
5. Select the exact rubric avoiding general rubric, and for so know our rubrics thoroughly with their exact meaning and sense. E.g. We can avoid general rubric WEEPING (with its 328 remedies in synthesis) if we can differentiate between the particular sub rubrics i.e. WEEPING – causeless (52 remedies), WEEPING – causeless - without knowing why (12 remedies), WEEPING – involuntarily (47 remedies) and so on….
6. Select those rubrics which represents CAR, i.e. Concern, Adaptation, Reaction. Concern represents how patient considers to his chief complaints; Adaptation represents how he is adapting himself with chief complaints during sickness, while reaction represents reaction of patient towards chief complaints.
Observe
1. What he say? Pt. may say about his condition, relief, investigations, about recovery etc. E.g. pt. says, "I can’t bear this pain any more” in this case if tone = louder noisy, then rubrics may be impatient, anger pain from, abusive pain during etc. if tone = low, rough, jarring then rubrics may be, IRRITABILITY PAIN DURING, EMBARRASSMENT AILMENTS AFTER etc. and if tone = low, REVERENCE FOR THOSE AROUND HIM, CONTENTED, RECOGNIZE REALITY AND ACCEPTS IT etc. maybe think of….
2. Why he says? (The reason and purpose behind the saying) e.g. If patient says, “I can’t bear this pain anymore” IMPATIENT, FEAR EXTRAVAGANCE OF, ALERT, FEAR BETRAYED OF BEING, etc. may be considered…
3. How he say? I.e. Tone (speech), style (manner, gesture). E.g. Heavy tone = louder, noisy = IMPOLITE, RUDENESS, DICTATORIAL, ABUSIVE in general and ANGER, RAGE, BRUTALITY, THREATENING in particular can be think. Low tone = rough, jarring or unpleasant = ABRUPT, SHRIEKING, MOOD REPULSIVE, SADNESS, IRRITABILITY, LAMENTING etc. Fine tone = mild and pleasant tone = POLITE, SMILING, PLAYFUL, REVERENCE, YIELDING etc.
4. When he says? E.g. after sickness has started increasing = FEAR – extravagance of, FRIVOLOUS. And SUPERSTITIOUS, DISTURBED – averse to being, FEAR – dark of etc. when indicated
5. His speech, gestures he wants to convey. E.g. pt. says, “do something for my troubles” 1) manner - speech is fast OR hesitating, then rubrics may be SPEECH – HASTY, HESITATING, CARRIED – DESIRE TO BE FAST etc. may think of. 2) Tone – high = CALLING / SHRIEKING HELP/AID FOR etc. and if tone is low = PRAYING, BEGGING etc. and if tone is fine then DESPAIR, SADNESS, TIMIDITY etc. maybe think of.
6. What concerns him? E.g. pt. says, "during attack I just prefer to keep quite on bed” then the rubrics may be as, QUIET; wants to be - repose and tranquility; desires, DISTURBED; averse to being, BED - remain in bed; desire to etc….
7. How things affect him i.e. influence of external factors and here, WEEPING - looked at; when, DELUSION – pursued he is, ADMONITION - agg. DISTURBED – averse to being may be used accordingly.
8. What emotions & feelings attached to his expressions? Here giving importance to emotions and feelings one may think of rubrics like, HELPLESSNESS; feeling of, WEEPING - telling - sickness; when telling of her, EXCITEMENT - talking, while etc. may be used.
9. How is he adapting to this (dis-ease) situation because this affects center (vital force?) and rubrics which we should think are DELUSIONS - well, he is, CONTENT, INDIFFERENCE - complain; does not, DOUBTFUL - recovery, of etc.
10. And the most important thing of all is, you should give importance to those mental symptoms which pt. has developed recently during illness (present), as well as the symptoms which are accompanied most of the time of sickness (persistent) and also the symptoms which attract your attention (predominant)
11. No need to enquire the healthy and past life of patient, like how was he, during his school and college time? This rather will enhance confusion of patient and of physician also. No doubt we can’t ignore the importance of causative rubrics (ailments from) but with utter precaution, as one always not sure regarding the same….
During case taking-
1. Follow general instructions given by our master
2. Give importance to the firsthand information given by the patient
3. Feel the essence of the case {totality}
4. The first and main task is to know the predominating symptoms relating to the present ailment (state of imbalance in the body) of the patient, because we must remember that we have to establish the reverse order of its coming.
5. Select the exact rubric avoiding general rubric, and for so know our rubrics thoroughly with their exact meaning and sense. E.g. We can avoid general rubric WEEPING (with its 328 remedies in synthesis) if we can differentiate between the particular sub rubrics i.e. WEEPING – causeless (52 remedies), WEEPING – causeless - without knowing why (12 remedies), WEEPING – involuntarily (47 remedies) and so on….
6. Select those rubrics which represents CAR, i.e. Concern, Adaptation, Reaction. Concern represents how patient considers to his chief complaints; Adaptation represents how he is adapting himself with chief complaints during sickness, while reaction represents reaction of patient towards chief complaints.
Observe
1. What he say? Pt. may say about his condition, relief, investigations, about recovery etc. E.g. pt. says, "I can’t bear this pain any more” in this case if tone = louder noisy, then rubrics may be impatient, anger pain from, abusive pain during etc. if tone = low, rough, jarring then rubrics may be, IRRITABILITY PAIN DURING, EMBARRASSMENT AILMENTS AFTER etc. and if tone = low, REVERENCE FOR THOSE AROUND HIM, CONTENTED, RECOGNIZE REALITY AND ACCEPTS IT etc. maybe think of….
2. Why he says? (The reason and purpose behind the saying) e.g. If patient says, “I can’t bear this pain anymore” IMPATIENT, FEAR EXTRAVAGANCE OF, ALERT, FEAR BETRAYED OF BEING, etc. may be considered…
3. How he say? I.e. Tone (speech), style (manner, gesture). E.g. Heavy tone = louder, noisy = IMPOLITE, RUDENESS, DICTATORIAL, ABUSIVE in general and ANGER, RAGE, BRUTALITY, THREATENING in particular can be think. Low tone = rough, jarring or unpleasant = ABRUPT, SHRIEKING, MOOD REPULSIVE, SADNESS, IRRITABILITY, LAMENTING etc. Fine tone = mild and pleasant tone = POLITE, SMILING, PLAYFUL, REVERENCE, YIELDING etc.
4. When he says? E.g. after sickness has started increasing = FEAR – extravagance of, FRIVOLOUS. And SUPERSTITIOUS, DISTURBED – averse to being, FEAR – dark of etc. when indicated
5. His speech, gestures he wants to convey. E.g. pt. says, “do something for my troubles” 1) manner - speech is fast OR hesitating, then rubrics may be SPEECH – HASTY, HESITATING, CARRIED – DESIRE TO BE FAST etc. may think of. 2) Tone – high = CALLING / SHRIEKING HELP/AID FOR etc. and if tone is low = PRAYING, BEGGING etc. and if tone is fine then DESPAIR, SADNESS, TIMIDITY etc. maybe think of.
6. What concerns him? E.g. pt. says, "during attack I just prefer to keep quite on bed” then the rubrics may be as, QUIET; wants to be - repose and tranquility; desires, DISTURBED; averse to being, BED - remain in bed; desire to etc….
7. How things affect him i.e. influence of external factors and here, WEEPING - looked at; when, DELUSION – pursued he is, ADMONITION - agg. DISTURBED – averse to being may be used accordingly.
8. What emotions & feelings attached to his expressions? Here giving importance to emotions and feelings one may think of rubrics like, HELPLESSNESS; feeling of, WEEPING - telling - sickness; when telling of her, EXCITEMENT - talking, while etc. may be used.
9. How is he adapting to this (dis-ease) situation because this affects center (vital force?) and rubrics which we should think are DELUSIONS - well, he is, CONTENT, INDIFFERENCE - complain; does not, DOUBTFUL - recovery, of etc.
10. And the most important thing of all is, you should give importance to those mental symptoms which pt. has developed recently during illness (present), as well as the symptoms which are accompanied most of the time of sickness (persistent) and also the symptoms which attract your attention (predominant)
11. No need to enquire the healthy and past life of patient, like how was he, during his school and college time? This rather will enhance confusion of patient and of physician also. No doubt we can’t ignore the importance of causative rubrics (ailments from) but with utter precaution, as one always not sure regarding the same….
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