homeo Flashcards
what is easier; acute or chronic cases
Acute cases are easier, though, because the patient notices the recent strong symptoms and relates them more easily!
what’s needed for chronic cases
information about their previous health and medical history, plus the family history may be relevant as well.
Plan to give yourself a lot more time for chronic case interviews, to review organ systems, mental and emotional aspects of the case, etc, etc.
what to do in case taking
-write the symptoms on seperate lines
-always individualize the case
-be impartial, attentive, observant, and accurate in recording the disease picture
-collect infromation from the patient, the relatives/witnesses, your own observations, exam, and your tests. transcribe the patients own words. never interrupt
questions to ask
open ended- how are you
non leading; tell me more, what else can you say
deepening; how would you describe this? what do you mean? what else?
questions about problem
When did it start? Was it before, during, or after… (started medication, an event happened, another symptom started…)? Or was it after stopping… (medication, activity…)? At what time does it appear, or get worse?
What does the pain/symptom feel like? Where is it, exactly? Does it change, or is it
continuous, does it go away or is it persistent?
WHAT makes it better? worse? POSITION, MOVING/NO …) (CHANGIN G, HEAT/COLD, RAIN/SUN TOUCH, EATIN
what was happening at the time (grief, trauma, emotions, lifestyle change?)
questioning style
-no leading questions
-no yes/no questions
-review of systems
-check for concomitants
-add observations
-ask about your observations
In general terms, ask about: Head, eyes, throat, limbs, chest… Bowel function, urinary system Appetite, thirst, cravings/aversions Taste in mouth, of food, water, odors Sleep (quality, position, naps, dreams) Feelings, mood, triggers for upsets… Memory, concentration, fears/phobias
Observe their behaviour, their physical symptoms, their mood…
and ask about that, to confirm if you are correct, and when the issue first appeared
questions After the patient has finished offering the details of their symptoms, you now ask clarifying, deepening questions, such as:
- Stools: How frequent? Their nature (watery, formed…)? Color (of feces, mucus…)? Any pains, when, where? Odour? Flatus (and flatulence)?
- Vomiting: what does vomitus look like? What is the taste in the mouth (putrid, bitter, sour…)? Happens when (before/after eating, time of day)?
- Belching: taste of eructations? Sound? Timing?
- Urine: cloudy, sediment, color, pains before, start, end, after urination?
- Sleep: Any snore (in or out), whine, moan, talk, cry in sleep? Position (preferred, impossible, hands/limbs…)? Covers? Refreshed by sleep?
- Fever: When is the heat stage returning (time, timing)? When does the chill occur, is it only a sensation of coldness or is the body cold to the touch as well? Where? Or is it hot to the touch? Any shivering? Is the face flushed or pale? When does the perspiration appear, is it hot, cold, clammy…? Where on the body is the perspiration? Is there an odour?
- When is the thirst (fever, chill)? How much, what amounts at a time (sips, large amounts)? Thirsty for what (hot, cold, sweet, sour…)?
- In women: monthly cycle (amount of blood, timing, clots, colour, pains)?
complete a smile or Clems
what does it feel like? better? worse? when is it better or worse? intensity or pain? where is it? what cause it? what triggers it? what was happening at the time
concomitants
- Details can be characteristic of the case – investigate!
- Patients don’t mention what they get used to over the years
ancious/hypochondriac patients
- Make allowances for the exaggerations, but
- Do take into consideration this aspect of their personality
indolent/ mild, vague patient
- Be aware some patients downplay their (serious) symptoms
Because we pay attention to the details and to their exactitude…
Remain TACTFUL CONSIDERATE
BRING CARE TO YOUR QUESTIONING
USE YOUR KNOWLEDGE OF HUMAN NATURE AND
BE PATIENT
acute and epidemic cases
Acute cases: easier for patient to tell their new striking symptoms
100 – Each epidemic must be individualized, anew
101 – The individual epidemic remedy is revealed in 2- 3+ patients
102 – The details from each patient will add up and complete the full picture of the genus epidemicus
chronic disease
Similarly, patients suffering from chronic diseases will each take only a part of a chronic disease (miasm), but the totality of symptoms of all their cases with show the whole extent of the same chronic disease (miasm).
So, patients do not possess all the symptoms known for a broad-acting remedy, even if that remedy will be the remedy that they need to treat their illness.
role of case taking and follow ups
Once the totality of the symptoms that principally determine and distinguish a case - in other words, the image of any kind of disease - has been exactly recorded, the most difficult work is done.
During the treatment (especially of a chronic disease), the physician then has the total disease image always before them. They can behold it in all of its parts and lift out the characteristic signs. They can then select (from the lists of symptoms of all the medicines which have become known according to their pure actions) a well-aimed similar, artificial disease potency, in the form of a homeopathically chosen medicinal means, to oppose the total disease image. During treatment [at a follow-up examination of the patient], when the physician inquires as to the result of the medicine and the altered condition of the patient, all they need to do with the new disease findings is refer to the original list of symptoms and omit those that have improved, note what is still present, and add whatever has, perchance, come up in the way of new ailments.
