Baltimore Homeopathic Study Group

Acute problems are easier to treat because the symptoms are fresh in the patient's mind. You need to get the symptoms that have developed since the illness began. Symptoms that existed before the illness are not symptoms of the acute disease. When taking the case, it's important that you be seated at a comfortable table with pen and paper. You should number the pages of the case and put the patient's name and the date at the top of each page. Start by writing down the patient's chief complaint. Write down each symptom the patient tells you, leaving plenty of white space between symptoms so you can write more about each symptom later. Let the patient speak freely, without interruption. If the patient stops talking, you may need to prompt them to talk.

After the patient has finished, go back to each symptom the patient has mentioned. Ask where the location is exactly. Ask what the problem feels like (the sensation) and how severe it is. Ask if a pain radiates to another location and what makes the problem better or worse (the modalities). If a sensation is difficult for the patient to describe, you can give a laundry list of possibilities. Peculiar symptoms are important and must be matched by the remedy. Concomitant symptoms are also important. The further away the concomitant symptom is from the chief complaint, the more important it is. Mental concomitants are even more important. The remedy you give for the acute problem may be the patient's constitutional remedy. So you may affect the patient on a deeper level than you expect.

After you have gotten all the information ask about the causation (etiology). This may be weather, stress, or an accident. This information has to do with the patient's susceptibility. Then ask about the physical generals. These symptoms are only important if they have changed since the illness began. If they are part of the patient's normal condition, they should be ignored. Ask about the body temperature (warm or chilly) and the energy level. Ask which time of day the patient feels worst. Ask for new food cravings and aversions and changes in thirst. Ask what position the patient sleeps in. Then do a review of symptoms. Ask specifically about each body part from head to toe. The symptoms uncovered are only important if they have changed since the onset of the illness. Usually it is not necessary to ask about sexual problems when taking an acute case. Ask about mental and emotional problems. It's best to ask someone who knows the patient about emotional problems. Get the patient's medical history to determine if the problem is chronic. A physical exam is important for determining the objective symptoms.

Don't refer to books when taking the case, you may miss subtle symptoms. It is important to establish an emotional connection with the patient, but also you must be dispassionate. Make sure you are not making faces at the patient or indicating you disapprove of them or what they are saying. If the patient is currently under constitutional care, it is best not to treat the case homeopathically.

Amy Rothenberg
NCH Summer School