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Importance of Observation in Case Taking


Homeopathic Journal :: Volume: 3, Issue: 2, Dec, 2009 (Editorial)   -   from Homeorizon.com
Author : Dr. P. Singh, M.D. (Hom) India
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Article Updated: Dec 31, 2009


" You can see a lot just by observing"
                                                                                                             - Yogi Berra

The word Observation means, an act or instance of viewing or noting a fact or occurrence for some scientific or other special purpose. It is either an activity of a living being consisting of receiving knowledge of the outside world through the senses, or the recording of data using scientific instruments.

Through careful and diligent attention we attain some information which is analyzed by our brain to come to certain conclusions. These lay the path for future hypothesis and later principles.

Observation is one of the most important phenomena in Homeopathy. As we know that in Homeopathy we select the remedy which produces exactly the same picture during proving as that of the patient in disease. So selecting the similimum requires careful observation firstly in patient and then for tallying it with medicinal portrait.

Observation is done at different levels.

  • Visual- by looking at patient.
  • Auditory- by listening to his speech.
  • Tactile- by touch.
  • Olfactory- by smelling.
  • Discharges- their character

These senses are used to attain large number of information about the patient. This information is used by the physician to understand the patient, his disease and the similimum. Some of the facts we attain through observing the patient are:

  • Built
  • Shape and facial feature
  • Gestures
  • Postures
  • Hair
  • Tongue
  • Speech

Why is Observation important?

Understanding Patient:

- To note Objective signs: Sometimes we observes some objective signs just by looking at them e.g. the redness or pallor.

- To confirm or contradict certain symptoms of patient: A patient wringing his hands or biting his nails can never be a confident person and if he claims so the observer (physician) knows better.

Understanding Disease: By careful observation alone can we arrive to definite disease diagnosis. In disease diagnosis we do it both ways classifying it according to modern practice and also under Dr. Hahnemann's Classification of Diseases. If a patient comes with excessive hair fall from all parts of the body leaving bald patches; he is diagnosed as Alopecia universalis in modern medicine while as homeopaths we know the disease to be "One-sided Disease". Our course of action/treatment depends on this diagnosis.

Diagnosing Underlying Miasm: By a careful observation alone can we confirm the miasmatic diagnosis of the patient. The state of his hair, tongue, skin all gives us a clear view of the underlying miasm of the case.

Choosing Simillimum: The most important part of our homeopathic case taking i.e. choosing the right remedy for the case is also done by a close observation of the case. Selecting the remedy which has exactly the same symptoms requires a lot of finesse. Some red line symptoms do help us in this selection e.g. Clean tongue with excessive nausea and vomiting stands for Ipecac.

Knowing Case Prognosis: Now this is one of the most important benefits of a keen and observant eye. Sometimes a patient may deny any relief from your medicine but on close observation you can see for yourself the improvement in his state.

Thus we find that a keen and diligent observation is very important for a physician especially a homeopath and helps him in restoring the sick to health, cure as it is termed.

Dr. Samuel Hahnemann in § 90 of his Organon of Medicine emphasizes the grandness of Observation.

"When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient 1, and ascertains how much of that was peculiar to the patient in his healthy state."

[A] For example, how the patient behaved during the visit - whether he was morose, quarrelsome, hasty, lachrymose, anxious, despairing or sad, or hopeful, calm etc. Whether he was in a drowsy state or in any way dull of comprehension; whether he spoke hoarsely, or in a low tone, or incoherently, or how other wise did he talk? what was the color of his face and eyes, and of his skin generally? what degree of liveliness and power was there in his expression and eyes? what was the state of his tongue, his breathing, the smell from his mouth, and his hearing? were his pupils dilated or contracted? how rapidly and to what extent did they alter in the dark and in the light? what was the character of the pulse? what was the condition of the abdomen? how moist or hot, how cold or dry to the touch, was the skin of this or that part or generally? whether he lay with head thrown back, with mouth half or wholly open, with the arms placed above the head, on his back, or in what other position? what effort did he make to raise himself? and anything else in him that may strike the physician as being remarkable."

Some of the most important yet overlooked objective signs in a patient frequently found in our clinical practice are:

Hair:

- Messy, unitidy - Sulphur, Borax.

- Brittle - Kali carb, Psorinum

Built:

- Short / Dwarfish: Baryta carb., Medorrhinum, Thyroidinum,

- Lean: Cal.phos, Secale cor, Natrum mur

- Obese: Cal.carb, Baryta carb, Capsicum, Gaph, Phytolacca.

- Tall: Phos, Tuberculinum, Cal. Phos.

Posture:

- Erect - Diligent Remedies

- Sitting erect with slight tilt backward of head - all the haughty remedies (Pride egoistic)

- Stoop shoulder - Sulphur, Phos, Cal.phos

- Sitting at the edge of chair: Anxiety prone remedies.

Tongue:

- Clean anteriorly, coated posteriorly - Nux v

- Mapped, with red, insular patches - Nat.m.

- Grayish - white base - Kali m.

- Greenish - Nat.s., Plumb.ac.

This is a short glimpse of the multitude of information we obtain just by close observation. One gets the information either by going through our rich literatures or from sharing the experiences of our fellow homeopaths. Keeping this in view we are devoting the December Issue of Homeopathic Horizon on

"HOMEOKINESICS: UTILIZING NON VERBAL COMMUNICATION IN HOMEOPATHY"

We have included the interview, method of working, case of Dr. Grant Bentley and Louise Barton of Homeopathic Facial Analysis fame along with Dr. Ajit Kulkarni's article on Understanding Eye and its importance in Homeopathy; and then there is work on "Tongue and its Clinical Utility". This is not all there is so much else in the issue that I am sure you all will love to go through it.

Do send us your feed backs and suggestions about the issue. With best wishes for A Happy and Prosperous New Year, I present to you all the December Issue of Homeopathic Horizon.

Happy Reading!

Dr. P. Singh
Editor, Homeopathic Horizon Ezine.


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The article is really awesome..can u pls provide me details of homoeokinesics...
  Comment by: anit, India.    on Feb 26, 2010 1 Agree  |  0 Disagree       Report Abuse

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