Chronic Cases
The Homoeopathic physician must possess a complete picture of the disease which he is to cure. He is to know everything about his patient before he can give his prescription. Tracing the picture of the disease is the most difficult part of his task. This art of symptom examination requires a good deal of skill and a strong common sense. The method of examination of a chronic disease is shown below:-
A. (statement made by patient)
1. First allow the patient to describe his symptoms. Let him say what he has got to say regarding himself and his disease. He should be given sufficient time to do it. Do not be in haste. You should be alone with the patient, ask all other persons to leave the room. At the very beginning ask him to open his whole heart to you, he should narrate all facts about him without any reservation. His statement should be committed to writing.
2. When the patient has finished his story he should be allowed to leave the room. Now ask the father and mother of the patient to appear before you. Let them narrate the symptoms of the patient without exaggeration. Exaggeration is an obstacle to cure. Their statement should be carefully noted. Encourage them to give a full history of the patient from his very infancy. The past history and the present history will make a complete picture.
3. Now let them go and ask other members of the family or his relatives to come and describe his symptoms as far as they know. If necessary the neighbours should be called to make a statement about the man, his disease and character.
4. Now you are to examine each particular symptom and ask the narrator such questions as will elicit more accurate information respecting it. Ask him to answer your questions in plain words and he should speak slowly so that you can take down his answer in writing.
(B. Physicians own observation)
1. Watch carefully whether the patient is quick or slow in his movements, speaks fast or slowly and mark well the colour of his tongue, lips, face and other orifices of the body. See the condition of his hairs, nails, skin and teeth. See as much as you can with naked eyes. The eye observation is important. Here you need not ask him any question. These symptoms should be noted with care. Mark well the expression of the face, see whether it is anxious or cheerful.
2. Then comes the observation by sense of touch. Touch his feet, soles of feet, tip of toes, hands, fingers, palms of hands, finger tips, lips, face, forehead, occiput, top of head, ears, tip of tongue, and know, whether these particular parts are cold to touch or hot, whether one part is cold and another part is hot, touch the skin and feel whether it is hot or cold, rough or smooth or oily; dry or moist. Here also you need not ask him any question. Your observation should be committed to writing.
3. Observation by sense of smell. As soon as you enter the room you will probably be unable to stay there long because of an offensive smell about the patient or in the room. Now you understand that he is an offensive patient and his discharges are fetid. This is a strong indication.
4. Then examine the condition of the room in which he lies, the surroundings of the house. The position of his dwelling will give you much valuable information. Take into account the climate condition of the locality.
5. Now you are to know what he usually eats. What food he ate or what did he do or where did he go before the first invasion of the disease.
6. It is very important to discover the fundamental cause of the disease. You success will largely depend on your ability to find out the exciting cause of the disease. If you can discover the cause and remove it, your task will be easy. If the disease is caused by living on damp ground or in moist climate, send him elsewhere where the ground is dry or the climate is not moist.
If sexual excesses be responsible for the growth of the disease, such excesses should be first stopped. If excesses is eating and drinking seem to create or perpetuate the disease care should be taken to use them in moderation. If grief or disappointment seems to have caused the disease the causes of such grief or disappointment should be studied and removed.
7. Family history or personal history of syphilis, gonorrhoea, tubercular diseases, asthma, eczema, cancer, ringworm, psora, etc. Should be carefully noted.
8. Find out whether the patient was vaccinated once or every year or very frequently. See whether the present ailment was preceded by Pneumonia, Whooping cough, Pleurisy, measles, Small- pox etc.
9. Information should be gathered about the previous treatment, to know what medicines were used before your examination.
10. Moral and intellectual character of the patient should be taken into account.
11. Occupation. Know whether he works in factory or field or in mines, whether he performs mental works or physical works. Study the nature of his work and the place where he works. Study his age, habits.
12. Study his social and domestic relations and see whether you can trace any symptom originating in such associations.
13. Try to collect the symptoms which first appeared before any medicine was given. Trace the symptoms which failed to yield to previous treatment or the symptoms which remained to be removed. Probably man of the original symptoms have been suppressed. When prescribing, the suppressed symptoms, if necessary, should be considered for an accurate prescription.
14. See which symptom appeared first and which one appeared afterwards.
15. Symptoms and ailments before the use of medicines or symptoms and ailments after the previous medicine has been discontinued for some days, are very important for your consideration.
16. Any exaggeration of ailments should be carefully guarded.
17. Some patients do not like to describe a number of their symptoms or express them in vague terms. Guard against any such statements.
18. Some patients are stupid, and they have no capacity to describe aright their symptoms. Here the physician must help the patients in order to enable them to describe their ailments.
19. Discover suppressions, if there be any, suppression of habitual discharges, of skin eruptions, and perspiration. Many diseases are caused by such suppressions. Restoration of suppressed discharges or re-establishment of suppressed eruptions, will help you to cure your patient. Suppressed emotions also cause many diseases.
20. The patients or their friends are not often willing to confess any causes of a disgraceful character. Here the physician must manage to know them by private information or by skilfully framing his question.
C. (PARTICULARS)
1. Head-pain – vertigo – heaviness – falling off of hair. Itching-eruptions-hairs dry, gray, thin.
2. Eyes-lachrymation, its time and character, hot or cold, bland or acrid – Discharges, colour, bland or acrid, time, sticky or stringy, smell-Burning, time, aggravation and amelioration- itching, time, aggravation and amelioration-falling off of eye lashes – swelling of eyelids or about eyes – Eruptions on or about eyes, aggravation and amelioration.
3. Nose – discharges, colour, quantity, smell, sticky, stringy, aggravation, amelioration. – Eruptions, other peculiarities. General appearance.
4. Ears – discharges – pain – itching, hot or cold, redness of ears etc.
5. Tongue – its colour – general appearance, cracked, smooth- rough, trembles and catches at teeth when produced, eruptions, ulcers etc.
6. Lips : Hot, cold, red, black, pale, brown, cracked, eruptions, etc.
7. Mouth-dry-moist-salivation (bloody fetid, at night, constant) offensive smell- hot, cold, etc.
8. Throat: painful, effect of heat or hot drinks, effects of cold water or hot water or hot application. Eruptions, growths etc.
9. Neck – Stiffness, eruptions etc.
10. Face: oily, dry, rough, anxious, eyes sunken, colour (blackish, red, pale) blackish discolouration about eyes and mouth. Skin cracked. Twitching. Wrinkled. Hot, cold. One side hot the other cold, one side pale the other red, changes colour.
11. Teeth – Colour (yellow, black) serrated caries – gums white, blue, wrinkled bleeding – painful – offensive etc.
12. Forehead, wrinkled, sweat, eruptions, cold – or hot etc.
13. Speech : hasty, stammering, slow, failing.
14. Back – pain, eruptions, stiffness, etc.
15. Hand – pain, eruptions, paralysis, rheumatism, sensations, sweat, cracks, hot, cold, numbness, trembling, discolouration, Burning.
Palms – sweat; hot; cold; cracks; desquamation; hardness of skin of; soft; burning; fingers – cold tips, cracks, numbness, things fall from hand, warts, desquamation. Nails, discoloured, cracked, brittle, hangnails, corrugated, white spots on.
16. Legs – Emaciation; eruptions; pain; paralysis; sweat; hot; cold; burning; sensations etc.
17. Chest – pain; eruptions, soreness, cannot lie on chest, sensitive to touch, painful on coughing or inspiration, etc.
18. Cough: Dry, moist, worse on lying, on lying on back or right side or left side, on eating or drinking, on laughing or use of voice, exertion etc. Amelioration by drinking water, cold or hot, lying on abdomen, on back, on left side, on right side, etc. Time of cough, in warm room or in open air.
Calcutta