APPROACH TO THE CASE – ACCORDING TO THE CASE

                                            LOOK BEHND PRESENTING SYMPTOMS

          There is no iron clad rule in approaching to the case in any medical system. As most of the people deal with approach towards taking the case, I would like to deal with the prescription part of approaching the case. As such it is a vast subject to discuss I would like to make it very brief with ease to understand along with my experience.
            After taking the case thoroughly as it includes present symptoms, past history, family history, the stage comes to the physician to prescribe. The physician should decide his path towards curing the case. To make it brief it all depends on the present expression of the disease.

 i)If the present symptoms are leading to particular remedy basing on peculiar / characteristic symptoms or physical and mental generals along with particulars you can give the remedy and you will definitely find the good results.
35 Years female C/o joint pains of 2 years duration worse during rest, evening; better by walking. She feels more worse after bathing, during rainy season and cold weather. Better by warmth covering. Basing on the above symptoms I prescribed RT 200 1d she relieved within 4 days. It looks like a cooked up case but we do get cases with this kind of description and this kind of cases are very easy to treat.

ii) During the course of study we do here a lot from our seniors ‘Struck at the cause – Root out the disease’. If you know the causative factor it is very easy to treat but the difficulty comes to find out the causative factor. It doesn’t mean that patient did not reveal he may ignore/neglect it. And at times there looks so many causative factors but it is the analyzing power of the physician to find out the cause.

Here, I would like to share my few experiences :

             A) A male around 40 years old came with multiple recurrent ulcers and one chronic big with 9 cm x 5cm x 3cm                  depth over his left foot since 20 years there is swelling and severe burning. Unable to walk. Slight sticky                  watery fluid oozes out. On further questioning he said the similar complaint to his father. According to him it                  started after an injury with a wood to his both legs, he says it is not the cause for it as right leg is absolutely                  fine. He works in a farm where he has to deal with chemicals.
                 But I decided to give considering the injury as the causative factor Arnica 1M 1d – within 15 days lot of pus                  with offensive discharge which was not there in his 20 years but a general well being. I gave Saclac for                  another 15 days but a general well being. I gave Saclac for another 15 days. There is no another ulcer                  formation. The ulcer which was so big came to 9 cm x 3 cm x 0.5cm. still I have to wait for the progress of the                 disease.
            B) A male aged 45 years c/o frequent throat infection, back pain and skin eruptions for the past 25 years. On                 routine enquiry, he told he had an accident to back 10 years back. Severe chicken-pox, Jaundice, Malaria in                 chronological order from his childhood. I gave him Variolinum 1M 1d attributing it as a causative factor – if you                 analyze the case and the prognosis of chicken-pox neuralgia, skin eruptions along with general malaise.

       So the physician should know which is to be considered as the causative factor.

iii) Grossly speaking causative factor comes under Past History but the way you consider them is different. Many Junior doctors do get the doubt including myself, as I passed through that Period, how the past history helps to your prescription. Here again the caliber of the physician comes out.
A lady, 35 c/o white discharge, ropy in nature no odour, no itching, no burning through out the month – pain in back and lower limbs since 3 years. She took Homoeopathy Rx for the 1.5 years which doesn’t relieve her. When I asked about her obstetric history, she said this problem started after the last delivery which is FTND. The first one was also FTND. On further asking she said during her last pregnancy she had an attack of mumps. There I decided to go on the basis of the past history which also effects the ovaries in it’s long run-gave her Parotidium 1M 1d. Within 15 days the discharge completely stopped. For the past 5 months she had no complains.

iv)        There are few cases on noting down each and every symptom we left ourselves in a confused state. At times there appears so many characteristic symptoms but each indicates to different medicine where we fail to choose the remedy. Some times there are so many symptoms but to prescribe there is not symptom. In such case we can base our first prescription on the Previous treatment just to antidote it which puzzled/spoiled/suppressed the actual disease picture.

v)Family history also includes to know the miasmatic tendency. Young Homoeopaths doubt that every disease comes under three miasms them how to diagnos the tendency of miasm. In very few occasions we can diagnose the miasm on the basis of the name of the disease but in most of the cases we can do it only on the consequences of the disease. At times the nosodes helps a lot in overcoming the obstacles to cure at times ending the case in cure. Even after miasmatic diagnosis to give the miasmatic remedy you should keep the present evolved symptoms as we have got many miasmatic remedies.

vi)Time factor is mostly neglected by many physicians. Even patient repeats again and again the very specific time of aggravation/amelioration they do not consider it. If they prescribe on the basis we can find astonishing results.
           A Lady 44 Years c/o Numbness and cramps of alternate hands during mind night. Every night her sleep is disturbed due to that. I gave her syphillinum 200 1d which we find in SR under night aggravation. For the past 3 months she had no attack of the numbness and cramps.

Thus we should decide the case according the symptoms availability. At the same time we should not be carried by the diagnosis. If the symptoms are indicating even though we never thought of that remedy in those cases, we should prescribe the remedy and we’ll get the deserving results. In a case of haemorrhoids, when the patient complains of pain by slightest movement and better by rest I have given Bryonia 200 1d which we rarely think in such type of cases but the results are good.

Though there is no specific rule to approach the every case BUT, there will be always specific indication to that particular case if you analyse the presenting symptom properly. If physicians do not fail to catch that indication, Homoeopathy can show ‘miracles’- in terms of non-homoeopathic people.


                         Published in APPROACH TO CASE issue of NJH in the Vol. No.6 November-December 1996

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