Open Minded Approach.
NATIONAL JOURNAL OF HOMOEOPATHY 1996 Nov / Dec Vol V No 6.
Whaganna V M.
General Topics / Cases.
` Lil-t

Some of our highly talented Homoeopaths have given us new approaches for a case. But if we study them very carefully, we will find they dont differ much. What is important is there can be no single specific approach for a case. Each case is a new one. One has to mould according to the case. Masters can give us the hints and guidelines, but we have to decide our own way to approach without any prejudice.

Whatever the approach the following points are important:

1. Let the patient talk in his own language. English words should be avoided if it is not his mother tongue. This is to avoid misunderstanding about the meanings of words.
2. Be a careful listener. Do not interrupt the patient when he is telling the symptoms. You may miss very important symptoms useful for prescription.
3. Keep up the conversation going. Do not allow patient to stop talking except in dyspnoea, weeping etc. take some pause and continue. Ask him "what more" "What more" Encourage him to talk more about himself.
4. Be clinically suspicious. Do not always believe what the patient is telling you. He may deceive you. Make careful enquiry about each and every symptom in detail. Take the help of a close relative or a friend.
5. Never put such questions which can be answered with "yes" or "No". Such direct questions should be avoided. Make the patient think for every answer.
6. Great importance should be given for "Will" and "Emotions" symptoms. See if the patient is.
   (1) irritable (ii) egoistic (iii) hurried (iv) malicious (v) quick or indolent (vi) apathetic or indifferent (vii) extremely anxious (viii) suicidal (ix) dirty, no personal care (x) dependent or independent i.e. able to take own decisions (xi) impulsive (xii) depressed (xiii) jealous (xiv) quarrelsome.
7. Think of his emotions (i) his reactions to various emotions - sensitivity (ii) weeping disposition (iii) does he express it or not i.e. extroverted or introverted (iv) consolation < or >
   (v) is he affected easily by an emotional affairs (vi) sympathetic (vii) mild and shy.
8. Ask about his sexual desires. Here the patient may deceive you, so be careful. Enquire about masturbation, impure coition, homosexuality, constant dwelling on sexual thoughts etc.
9. Desires and aversions regarding food. Be sure it should not be a mere desire. It must be either a strong craving or a strong aversion.
10. Ailments from - This is a very important section. If you get any symptom here, often you may not need to go further in detail.
    a. Ailments from grief and disappointed love b) Ailments from suppressed emotions and fright c) Ailments from loss of vital fluids d) Ailments from ego and insult e) Ailments from indignation f) Ailments from rash and itch g) Ailments from discharges h) Ailments from sweat i) Ailments from burns j) Ailments from tooth extraction k) Ailments from injury - head, bones, nerves, etc. l) Ailments from acute diseases m) Ailments from tobacco and alcohol p) Ailments from puberty and menopause q) Ailments from overlifting and sprain r) Ailments from removal of warts s) Ailments from venereal diseases.
11. PECULIAR SYMPTOMS:
    1. Climacteric diseases
    2. symptoms on hot days and cold nights
    3. dentitional diarrhoea, etc.
    4. itch in winter only, etc.
    5. asthma in rainy season
    6. < in spring or autumn, etc.

    Study of the above gives you a specific group of medicines and this saves a lot of time in searching for the correct medicine.

12. Look for important major < or >, which helps you to differentiate one medicine from another. Sometimes, it is very difficult to decide between two or three medicines. At this time < or > helps to select the most similar medicine.
13. Never consider the general symptoms of the disease. Look always for PHYSICAL GENERALS and those symptoms which cannot be explained e.g. red triangular tip of the tongue, one-sided complaints etc.

The study of all the above things will give you the "PERSONALITY" and help to match the essence of both patient and drug.

Case :

A lady aged 30 years, a computer graduate, self-employed, married since last 16 years. She weighed 95 kg, (15 kg increase in last eight months,) complained of obesity, amenorrhoea since five years. D & C reports normal, hormonal study also normal she says reports were lost by her. Hormonal treatment helped very little, breast heavy and painful, once terminated pregnancy before marriage {Its a lover marriage} Since last five years cannot tolerate heat; always wants, fan, dyspnoea on mild exertion, since one year oedema on both feet and pain in knee and ankle, with swelling and shifting to (r) or (l). Backache on and off. Coition painful due to dryness of vagina but she has strong desire for sex. Mentally very depressed, weeps on slightest contradiction, highly irritable but weeps more when angry. Gets nervous thinking that she cannot satisfy her husband sexually and emotionally. Thinks she is incurable and cannot have a child.

Before marriage she was very healthy and never visited any doctor. All troubles started gradually after marriage. First menses became irregular i.e. once in 2 or 3 months and gradually stopped. I asked anything wrong after marriage? In answer, she started weeping vigorously. It took 15 minutes to pacify her. She said before marriage she was taking care of the house, of father, her mother and very younger brothers. The whole house was under her control. All the decisions were taken by her in the house. She used to coach her younger brother, and take care of food and medicines and clothes etc. of her parents. She says the whole house was completely dependent on her but now after marriage (10 years) there is no one who can take care of her parents. Constantly she worries about her house, her father, mother and brother. She talked and wept for one hour. Her husband said that she is worrying unnecessarily for her family; her parents stay in the same city. They are in very good health and economically. Her brother holds a good job. Two servants are in the house. Apart from that to keep her happy he visits the parents in the mornings.

She visits them in evening. Inspite of that she worries about them.

Though a love marriage, nobody opposed them. She is good with us. Everybody is co-operative and careful about her. I asked if she works in the house the way she used to work at her parents? Does she fulfil all the expectations of a housewife? He said now she is not able to (her eyes were wet with tears?). But she wants to do. Initially she was very active and fast in work. Always she kept busy doing some work. If she works calmly she produces very good quality of work, her cooking more tasty, than what she cooks in great hurry. She works as if somebody is behind her. She eats fast, walks fast, talks fast, reads fast. Even while seeing the movies on VCR she often fastforwards and completes the movie. This way she watches 5-6 cassettes in a day. She writes very fast. She cannot go slow. Before marriage she was not like this. Now also physically she is slow but mentally she is still too fast.

The case was clear for me. After spending two hours with them two important symptoms which are the essence of the case - HURRY AND WORRY.

Lilium tig 10 M one dose induced her menses in the first week only, remained for 10 days, was profuse, dark and offensive. Got relieved of lumbago, breast pain. Became charming, active and fresh. In three months after that dose, her weight was reduced by 8 kgs. and six months she became 72 kg.

Her menses became normal, and now they have a baby. so in each case, the importance of the approach is to reach the crux of the case.

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