Illustrated by a Clinical Case.
As I have already explained in the first part of my discussion. the taking of the history, especially a homoeopathic history, involves great forethought and tact. I shall re emphasize the necessity of allowing the patient to tell all he or she can, and ask questions indirectly only as suggested by the patient. Do not allow the patient to sway you in any direction and interrupt his story only when he begins to ramble and gets off the subject.
In order to put your patient at ease, one should always begin by asking some general questions as to age; note the sex, occupation and address. Having elicited these, allow your patient to tell his story. If during the recitation of his case, he should cease, one may always ask some question as, what else? and thus keep up the trend of the patients story.
History.-Age, 55. Sex, male. Occupation, tailor. Date, December 16, 1922.
Patients Story.- I have been a diabetic for the past five years (Here the patient stopped and I was forced to ask, “Why did you come here?”) My entire body itches all over and I have pain in the left chest. My feet and hands also pain me and I find it impossible to sleep. I have itching of my eye, ear, back and sides. This comes on especially in the afternoon like the sting of a mosquito. Also when sitting, I get electrical shocks (Here I asked if he noticed whether anything made it better or worse?) This is better from pressure.
He usually gets up in the middle of the night and micturates two to three times.
I always feel better during the summer and worse during the winter and cold weather. Always catches cold easily, and is subject to wry neck. Always gets dizzy spells when excited. This dizziness appears before the eyes. He prefers the open air.
He also has itching about the eyes. Complains of coated tongue. Has burning sensation in the stomach and gets relief from the use of soda. Fruits do not agree, causing a burning sensation.
He also has right-sided pains worse from pressure. Also complains of piles.
Nervous and weak, though not easily excited and expressed himself as craving sympathy from those at home but does not get it. Has a great thirst (polydipsia), 6-8 glasses of water, drinks tea and coffee.
Also states that he had a sore on the penis either gonococcal or luetic in origin. Complaints of a suppressed spermatorrhea. Had orchitis.
When hands are pendent they begin to pain.
This patient was rather singular for he gave an excellent expression of most of the reactions he observed and so enabled us to more accurately prescribe for him. One not versed in homoeopathic history-taking would consider this a hodge-podge of symptomatology, but to the homoeopath it is an individualistic expression of this mans reactions. The old school would simply call it a case of diabetes and treat it per se. We treat the individual and not the diabetes.
We shall now proceed to the next step with out patient. As I have mentioned, a physical examinations should be conducted. I have examined this patient and can state that nothing abnormal was found except the aortic second sound was markedly accentuated. As in all chronic cases of such character, physical examination reveals very little and cannot help to any extent in the treatment of the patients. However, I must insist that it shall always be conducted, for occasionally we do find pathology. Secondly, a physical examination always, makes the patients feel that a great deal is being done for them. A proper frame of mind on the part of the patient is essential to every treatment.
We shall now consider laboratory data in the case.
Urine examination:
Color and appearance Light straw color.
Specific gravity I. 019.
Reaction Neutral.
Albumin Neg.
Glucose 0.59 percent.
W.B.C.s Rare.
Epithelium Occasional.
Blood sugar report Not returned.
Wasserman Neg.
Clinical diagnosis Diabetes Mellitus
So far, all our work has led to a history and a final clinical diagnosis. The homoeopathic diagnosis of the similar remedy is now the problem.
In this case the problem of choosing the individualistic symptoms, heretofore referred to, is very difficult. The difficulty arises from the fact that we know that our patient is diabetic and consequently we know that some of his symptoms are distinctly due to the disease as such, and therefore are the general symptoms which any diabetic patient may present and are not individualistic to our patient.
Symptoms such as polydipsia, polyphagia, nocturia and pruritus are common characteristics of any diabetic. We cannot utilize them unless properly modified. Here, we were greatly helped, for the patient accurately described his own reactions to such symptomatology, where he could, and in that event these general symptoms really become very individualistic. A careful perusal of our history and we note the abundance of individualistic symptoms the patient presents.
American Homeopathy Doctor.
Rabe graduated from the New York Homeopathic Medical College and trained under Timothy Field Allen and William Tod Helmuth.
Rabe was President of the International Hahnemannian Association, editor in chief of the Homeopathic Recorder, and he wrote Medical Therapeutics for daily reference. Rabe was Dean and Professor of Homeopathic Therapeutics at the New York Homeopathic Medical College.