WHAT DOES CASE TAKING MEAN AND HOW IS IT ACCOMPLISHED?.
Case taking is really a misnomer. you have already taken the case when you have accepted the patient. Case taking, as commonly understood, is a thorough examining of the patient from every possible angle that will give a definite clue in the search for the indicated remedy. It is the greatest problem with which the physician must contend, and requires every atom of his ingenuity, skill and patience, for the case properly taken or canvassed is fully one-half cured. The physician must be a good listener, a very acute observer and a past master in the art of cross- questioning. He must know how to ask questions when necessary without any hint of suggestion of the correct answer. Watch the patients every movement.
Seat the patient, after he enters the consultation room. Before allowing the patient to give his or her history, impress upon him, or her, the grave importance of telling everything; o telling nothing but the truth; of confining remarks to the ailments, leaving all visiting until after the examination is ended; of hiding nothing whatever as it is all for his her own good; that that hiding important data might be serious and they would be the losers in so doing.
Now let them begin their history, watching their every movement and expression, and, if possible, following every symptom to its completion before another is started, e.g., if it is a headache, have its character defined, its location, direction, modalities, etc. The principal points to be secured are the family history, the personal history, the mental and physical symptoms, the temperaments, the habits, and lastly the morphology and pathology. These latter, if any, are more for a diagnosis.
Of course it is to be understood that the above method is neither dogmatic nor final, for every one, after more or less experience, will develop some satisfactory, short-cut method of his own. The above is merely given as reliable guide to the beginner.
After some practical experience one will be able to detect patients as follows: Mrs. A. will enter, sit down and heave a deep,grieved,troubled sigh: Mrs. B. will enter, sit down and begin tell her troubles, punctuated with copious tears; Mrs. C. will enter, and before she has time to sit down will, whether she knows you or not, lay her head on your shoulder, burst into a copious flood of tears, and, as soon as the storm is over, will say, “Doctor I do not know why I do this but I cannot help it”; Mrs. D. will enter, sit down, shut up like a calm, and be so cranky that every time you ask her a question she almost snaps your head off.
We made a mental prescription for all four of those cases, the first and third before they even said a word, the other two right after the first question. We did not have to change the remedy nor repeat it, but we do not advocate that kind of prescribing, we merely mention it to show how far observation will carry one.- A.P.
The I.H.A. went on record in 1924 as being opposed to compulsory vaccination. A survey of the present status of vaccination show that thirty-four states of the Union have no compulsory vaccination laws. Six states leave vaccination by scarification optional with the local authorities. Four states have gone to the limit in the freedom and prohibit by statute compulsory vaccination. Kentucky and Maryland are the only states in the Union making vaccination of infants compulsory. Eight states and the District of Columbia make vaccination the price of admission to the public schools.
In the state of Arkansas a test case is being fought by Dr.C.F. Ellis against compulsory vaccination by scarification. This has been carried through the lower courts and has been appealed to the Supreme Court, where it will be tried this month. Many of the I.H.A. men are assisting in this expense of this suit, and we trust Dr.Ellis will be successful. This question is within the province of each state to determine, as the question of the health of the citizens comes within the police power granted to each state by the Federal Government. It is interesting to note that Iowa and Michigan have tried such cases in their courts, and that decisions have been handed down in these states that the internal administration of Variolinum in potency was a legal vaccination.- H.A.R.