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Case Taking

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					Case Taking
Ann Haw, September 2008

There are two important and distinct parts of Homeopathy:
   1. Knowledge of the Materia Medica
   2. Knowledge of the patient

The art of Homeopathy is to match the picture which the patient presents with one of
the pictures from our extensive materia medica.

We often recognize parts of these pictures in patients, or ourselves, but it can be
extremely difficult to decide which part of the case needs to be treated, and which of
the symptoms best describe the central core disturbance, which runs throughout the
whole case.

Techniques of eliciting the information which we need, are absolutely essential to the
successful practice. Having said that, I have also realized that every practitioner needs
to develop their own style of practice. It is all about establishing a line of
communication between you and the patient, so that the patient can show you, or tell
you what needs to be treated. The patient can even name the substance which will
heal him, if you can access the deep unconscious material.

.
What do we need to understand from the patient:
     -   Diagnosis
     -   The complete symptom
     -   Accompanying changes
     -   Generals
     -   Mentals
     -   Particulars

”.

It is not really about which school of homeopathy you wish to study, but of the basic
philosophy, that you need to enter into a relationship with your patient, which will
allow you to understand their “dis-ease”, in a deep and holistic way.

I try to use techniques which allow the patient space to give us all the information we
need, keeping direct questioning to a minimum. The truth lies within each person.
You have to believe that the patient would not have consulted you, if there was no
chance that between you, you could work out, what needs to be healed, and how to
heal it. Our anxiety about finding the correct remedy, can blind us. Trying to fit
patients into remedies, stops us from listening and observing, and allowing the story
to flow.

I have had to discipline myself, not to start thinking of remedies, the moment I meet
the patient. If you think of a remedy, write it down, and then forget about it. You
might well come back to this later.
Passive Case Taking:
Receiving the case:
This means sitting back in your chair, and inviting the patient to tell you everything
about themselves, and what is troubling them. This might sound easy, but believe me
it is really hard to sit back and say nothing. During this time it is important to observe
everything about the patient. This might even start in the waiting room outside. How
is the patient behaving? What are they chatting to the secretary about? What are they
moaning about? How hurried or laid back are they? The secretary can be a big help
here.

Observations:
   - Clothing
   - Appropriate dress for the weather or otherwise
   - the seat they take
   - Posture
   - Handshake
   - Gestures

Speech
   - Loud/ soft
   - Clarity
   - Vocabulary
   - Hesitation
   - Repeating
   - Words or phrases which are used often, in different situations, or to describe
       different things.
   - Words which are accompanied by hand gestures, particularly when these
       gestures are repeated in different parts of the case.
   - Words or phrases which are out of context, out of proportion, or strange, rare
       and peculiar




Active Case Taking

Here you will use more direct questions, and perhaps explore deeper, into parts of the
case which you suspect might lead you to important clues of the central disturbance.
Some homeopaths use this kind of approach right from the start. I find with some
patients, you have to start like this, in order to get them talking. You can be flexible,
and experiment with what works for you and your patient.

Questionnaires
 Questionnaires given out before the first consultation may be helpful, but I find that
you get more information about what the patient is like, by how he approaches the
questionnaire, than the actual contents of his answers.
Direct questions
Answers to questions can only really be trusted, when these are given with enthusiasm
or energy behind them. “Do you like heat or cold?” “Oh doctor I simply cannot
survive the cold in winter, it goes right through me”, must be taken note of, but “I
think I prefer the summer” is of no use.

The Mumbai School:
The Indians describe what needs to be healed as “Two songs being sung; the one is
human, the other non-Human. It is this non human song which needs to be treated, so
that, that which is healthy in human life can flourish

The technique of accurately following peoples’ language is very interesting. When
you pick up phrases which are being repeated, or which are out of context, or strange;
particularly when accompanied by hand gestures, repeat the phrase exactly as the
patient has said it, and ask him to tell you more about that. It is quite extraordinary
how the person can open up like this. Never assume you know what he is describing.
Ask him to tell you exactly what he means, or what he is experiencing when he shows
you that. This can be like catching onto the tail of the tiger. Gradually as you follow
it in, the whole picture suddenly becomes clear. The patient may start talking
absolute nonsense, but you get a very accurate description of the sensation which they
experience. Be careful of being too caught up in the story of their lives. It can be
very time consuming, and it is easy to become drawn into emotional sympathies,
which are sometimes distracting, to our objective understanding of what needs to be
treated.




Recognizing Themes:

This can simplify your life greatly. It is a form of classification which helps to
narrow down your choice of remedy.

				
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