An approach to case taking in homoeopathy by DR BIJAY KUMAR SAHOO CMO ,DELHI GOVT

AN APPROACH TO CASE TAKING IN HOMOEOPATHY

1.Individulaztion the symptoms of patient.

2.Totality of the characteristics symptoms.

3.Indentify the Chronic miasm.

4.Choose the correct constitutional remedy.

FOUR ESSENTIONALS TO PRESCRIBE IN HOMOEOPATHY

1.He should build trust with patient by good eye contact& showing active interest.

2.He should use appropriate language &give chance to patient to express freely.

3.He should present himself caring,comptent&confident.

4.He should be an Unprejudiced observer.

FOUR REQUSITIES FOR DOCTORS

1.Clinical diagnosis. (Based on signs,symptoms&laboratory finding)

2.Remedy diagnosis. (From analysis of symptoms )

3.Prognosis of case.

4.Management .

FOUR COMPONENTS OF CASE TAKING

1.PRELIMINARY DATA 2.PRESENT ILLNESS 3.PAST HISTORY 4.CURRENT HEALTH STATUS 5.FAMILY HISTORY 6.CLINICAL EXAM & DIAGNOSIS 7.ELICITATION OF MENTAL SYMPTOMS 8.VALUATION &TOTALITY OF SYMPTOMS

PARTS OF CASE TAKING

AGE

SEX

OCCUPATION

DATE& TIME

PREIMINARY DATA

O-ONSET(TIME,DURATION& RECURRENCE OF SYMPTOMS)

P-PROVACATION(FACTORS AGG,AMEL OF PRESENT COMPLAINTS )

Q-QUALITY ( VALUE OF SYMPTOMS, COMMON TO UNCOMMON SYMPTOMS)

R-REGION&RADIATION OF PAIN & SENSATIONS.

S-SEVERITY&INTENSITY OF SYMPTOMS ASSOCIATE SYMPTOMS

PRESENT ILLNESS

CHILDHOOD DISEASE ADULT DISEASE ACCIDENT OR INJURY SURGERY OR HOSPITALIZATION IMMUNIZATION & ITS ADVERSE EFFECTS

PAST HISTORY

H/O OF CHRONIC DISEASE &MEDICATIONS DIET(AVERSION/DESIRE FOR FOOD),LIFE STYLE

HABITS(smooking,drinking,exercise) DAILY LIFE&

ACTIVITES(App.,Thirst,BM,Sweating&its effect,bladder or urinary complaints,sleep&dream)

SPECIFIC ALLERGY RECATION TO STRESS& ENVIORMENTAL

CHANGES,(heat,cold,weather,season) EFFECT OF LIFE CHANGING

EVENT(puberty,marriage,change of job,promtion)

CURRENT HEALTH STATUS

CLINICAL EXAMINATION

1.PATIENT WITH MULTIPLE SYMPTOMS 2.INTOXICATED PATIENT 3.LANGUAGE BARRIER 4.PATIENT WITH DIFFCULT IN HEARING&

VISION. 5.PAEDIATRIC CASES 6.OLD OR GERIATRIC CASE 7.HYPOCHONDRIAC OR HYSTERICAL PT.

SPECIAL NEEDS

OBSERVATION OF MENTAL SYMPTOMS

SADNESS-(Dropped mouth& eye lids, tears)

DISGST(wrinkled nose, frowned eyebrows, pressed lips & chin)

PSYCHOLOGIST VIEW –1.It has established that certain diseases have connection between emotional experience &physical symptoms i.e. somatization,physical symptoms without diagnosis.e.g INSOMANIA,HEADACHE ,OBESITY,GT DISTRESS,IBS,PALPITATION,CHORNIC PAIN,FATIGUE.2.Supressed or unresolved emotional pain affect our health e.g. ACE(ADVERSE CHILDHOOD EXPERIENCE)A/F ANGER,GRIEF,DISAPPOINT LOVE ETC.3.So healing of past EMOTIONAL EXPERIENCE create positive physical changes in the body. It require counselling & empathy of health care providers

HOMOEOPATHIC VIEW__.

1. The collection of data that characteristics changes in mental state in a patient with physical illness or vice versa are true guide for selection of remedy.

2. The extreme &persistent emotional changes or reactions in response to events in a patient are essential component of case taking.

3. It associate with MOOD,TEMPARMENT ,PERSONALITY& BIOLOGICAL RECATION of an individual.

SOME MENTAL STATE OBSERVATIONS SPONTANEOUS SPEECH(EAGERNESS,ENTHUSIATIC) GREET ON FIRST VISIT—PHOSPHOURS,CAUSTICUM.VOLUMINOUS SPEECH--- (HYSTERICAL- IGNATIA),HASTY SPEECH(ARG. NIT,MERC.)VISIBLE IRRITABLE SPEECH(CAN’T WAIT FOR LONG TIME IN WAITING ROOM—NUX),ANSWER ONLY TO QUESTION- NAT MUR.NO FACIAL EXPRESSION,SIT UP RIGHT POSTURE(APATHETIC,INDIFFRENCE),

TENSE POSTURE(APPREHENSION,WORRIES,NERVOUS),LEAN FORWARD(EXTROVERTED,EAGERNESS,ATTENTIVENESS) MAKE NO EYE CONTACT(SHYNESS OR HIDING SOMETHINGS), LAZY (AVERSION TO WORK,STUDY,BUSINESS),IMPULSIVE(JUMPS FROM ONE IDEA TO ANOTHER,TOCH THINGS IMPELLED TO,QUICK TO ACT),SADNESS,GRIEF(WEEP,TEARFUL MOOD,FROWNING,), CARING,KINDNESS,EMPATHY(AWARNESS SUFFERING OF OTHERS),FEAR,PHOBIA(CROWDED PLACE,CLOSE ROOM,HEIGHTNESS,DARKNESS)PARANOID(IRRATIONAL FEAR,SUSPECIOUSNESS,MISTRUST,HOSTILE)MEMORY– ERRORS IN SPEAKING,INABLITY TO RECALL THE NAME(LYCO)APPEARANCE-CLUMSY,DIRTY ,UNTIDNESS(SULPHUR),TIDNESS,CLEANLINESS,METICULOUS,ANXIOUS ABOUT PETTY DETAILS(ARS ALB)

ASSESMENT OF MENTAL SYMPTOMS DURING CASE TAKING

1. HOW DO YOU RECAT TO OBSTACLES IN LIFE CREATED EITHER BY NATURAL OR OTHERS? WHAT ARE YOUR FEELING THE PEOPLE WHO OPPOSE?

2. WHAT ARE SITUATION OR CIRCUMSTANCES THAT CAUSE THE HIGHEST DEGREE OF ANXIETY OR FEAR?

3. WHAT TYPE OF ACTIVITES GIVE YOU PLEASURE?

4. WHAT ARE THE FACTORS THAT ADD OR TAKE AWAY PLEASURE OF YOUR LIFE?

5. DO YOU HAVE ANY PROBLEM RELATED TO SEX?

6. HOW IS YOUR REALTIONSHIP WITH SOCIETY,FAMILY& ASSOCIATE?

7. IS THERE EFFECT ON GRIEF,SHOCK,DISAPPOINTMENT IN YOUR LIFE?

8. DO YOU HAVE DIFFCULTY IN UNDERSTANDING , THINKING?

9. DO YOU HAVE ANY FIXED IDEA OR STRONG FEELING?

10. DO YOU HAVE ANY COMPULSIVE HABITS OR OBESSIVE THOUGHTS?

CONCLUSION – 1. In modern age of practice many patients present in front of us with multitude of symptoms related to socioeconomic, emotional stress related or hygienic. They present themselves with list of prescription &most of them are undiagnosed. 2.It is a challenge before us to solve their problems with appropriate medicine & advice. So we should be familiarized with other systems which are involving in health care delivery system. 3.To practice successfully , we should reach out to the patient with dedication & sincerity.

KEY STEP FOR MANAGEMENT

1.SELECTION OF REMEDY.

2.OBSERVATION ON REMEDIAL REPONSE.

3.FOLLOW UP THE CASE.

4.REFEERAL (If necessary).

5.DIET& LIFE STYLE MANAGEMENT.

THANKS