Identify the ESSENCE of each case
Mamgain S K.
If one knows the ultimate outcome of the job one is undertaking, the job will be done whole heartedly and with care. In the medical field the physicians ultimate aim is to restore the sick to health. That is why Hahnemann has commenced the Organon with the following words:.
The physicians high and only mission is to restore the sick to health, to cure as it is termed..
This restoration of health must be gentle, rapid and permanent on easily comprehensible principles.
To achieve this goal, one of the most important jobs of the physician is to take the case. What kind of knowledge must a Homoeopathic physician possess? Hahnemann has very clearly suggested in this regard in Aphorism 3 of the Organon. About the knowledge of disease he says If the physician clearly perceives what is to be cured in disease, that is to say in every individual case of disease. knowledge of disease, indications.
He used the word perceived which has a specific and deeper meaning. He did not use the word understands or knows. Does the name of the disease serve any purpose when a physician is going to prescribe a Homoeopathic remedy? No, the name of the disease has no significance for prescribing a Homoeopathic remedy. The essence, the core of the disease or the personality of the disease in each case is important. And the Homoeopathic physician must develop the art of identifying the personality or the essence of each individual case.
Let me clarify what I mean by the essence / core of personality of the disease in each individual case. Clinical pathology of a so called disease may be the same in all the persons suffering from it, but the essence/ core/ personality of each individual suffering from the so called same disease may vary greatly in each case. The conditions of the aggravation and amelioration may be conditions of the aggravation and amelioration may be very different in each case regarding time, temperature, weather, posture, restore motion, sleep, eating and / or drinking etc.
The sensations of pain which are very numerous, painless where there should apparently be pain. Aversions, cravings. Abnormalities of thirst, sweating, stool, urine. Variations in mental state, change in temperament. Unusual symptoms e.g. sour taste after sugar, after milk, etc. Temperature and pulse disproportionate, and similar other symptoms. Concomitant symptoms are also important. Any of these variations from the normal state of health form the personality under the influence of disease which is to be cured. On the basis of this a Homoeopathic physician has to diagnose a remedy which has produced similar personality in its pathogenesis during provings on healthy persons.
For this very purpose the physician must be well versed in the art of case taking. Hahnemann has given guidelines in Aphorisms 84 to 99 for eliciting symptoms of acute and chronic diseases and in 100 to 104 for sporadic and epidemic diseases in his Organon.
JT Kent has elaborate the guidelines for case taking in his booklet. "What the Doctor needs to know in order to make a successful prescription.".
In actual practice a practitioner may develop his own way to case taking on the basis of these guidelines. One has to formulated questions to elicit clear picture of the disease according to the circumstances.
In the Preface to The Guiding symptoms of Our Materia Medica Dr. C. Hering has quoted the following:.
Many years ago, for the benefit of the students at Allentown, the following little schema was written on the black board in the lecture of Materia Medica.
Sensations
Localities Conditions : worse.
or
Tissues better Modalities.
Concomitants.
Though this schema was meant for materia medica but it is equally true for the case taking. Out of the four conditions if any three in the case in hand a properly collected and are similar to the provings of any drug {materia medica} the result can be predicated. The cure will ensue.
Keeping all the aspects in mind stated previously proceed as follows:.
I try to elicit in detail,.
- all about the main complaint when presenting.
- description of allied symptoms, if any.
- sensations and feelings of the complaint.
- causation / or the circumstances if any in which the complaint started.
- conditions of aggravation and amelioration modalities.
- history of past illness, if any.
- family history.
- pathological/ radiological etc. examination reports, where necessary.
As a rule, I note down all the relevant information about the case in hand. I also enquire all about the patient from the companion of the patient.
In subsequent visits I enquire about the change point by point, adding whatever new symptom the patient tells.
In this way I can keep proper track on the direction of the case during treatment.
The proper and regular study of the Materia Medica increases the proficiency of the physician, and helps him to match the remedy with the personality, or essence of each individual patient.
DR. S.K.MAMGAIN
Mamgain Homoeo Clinic
281, D.L. Road,
Dehra Dun - 248 001.
Phone : 0135 656578.
