Case Taking REPERTORIAL APPROACH

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Case Taking REPERTORIAL APPROACH

• Dr.K.R.Mansoor Ali
• Tutor.GHMC.Calicut
• Director Chief Editor.www.similima.com

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• Case taking is essentially a social interaction
  between a patient Physician under certain
  pre-determined condition
• Primary Object
• Collection of data for a prescription based
  on Homeopathic Philosophy

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Background Knowledge Required

• Principles of Homeopathy
• Basic Medical science
• Clinical subjects
• Communication Skills

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Basic Requirement best Result

• Case taking should be perfect
• If you neglect making a careful exam. The
  patient will be the 1st sufferer, but in the end
  you yourself will suffer from it .. and
  Homeopathy also

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Pre-Requisites

• Facility for recording the case
• Sitting arrangement Comfortable
• Reading materials
• Attractive painting
• Toys
• Quietness Privacy
• Drinking water, Toilet
• Advance Booking
• Aphorism 83

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• Homeopathic practitioner does not try to fit the
  patient to a particular remedy.
• But seeks first to clearly understand the patient
  and then to find appropriate remedy through
  repertorisation and materia medica.
• 
  
  
  - Dr.Rajan
  Sankaran

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Precautions

• Should not hurry a patient
• Record all the events without any omissions
• Avoid questions along the line of remedy
• Record intensity during case taking
• Separate the symptoms before after a treatment
  

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Precautions contd

• Record in a chronological order
• Symptoms expressed with spontaneity, clarity
  intensity of highest value
• Never accept what the patient says at face value
• Leave space between symptoms
• Avoid examining a lady in the absence of relative
  or female nurse

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Bed Ridden Patient ??

• Position in bed
• Manner of moving
• Mental state
• Skin
• Color, odor
• Ventilation
• Excretions
• Sensorium
• Temperature

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Hahnemannian Over view

• A Concise idea about case taking (5)
• General Direction (83-93)
• Patient coming directly ( 83-90)
• Patient coming from other physician (91-93)
• Chronic case taking ( 94-98)
• Acute Case taking (99-102)

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Case taking in acutes

• Require few questions only
• Aetiology
• Physical examination
• Lab findings
• Diagnosis
• Less time is required

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Chronic Disease

• Detailed and time consuming
• Require more than one sitting
• Family history- Paternal Maternal
• Cover the past as well as presenting
• Exciting maintaining cause
• Occupation ,mode of living, relations
• Analysis, evaluation Interpretations

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Chronic Disease with A/C Exacerbation

• Consider only the acute Totality
• Eg. R/C Tonsilitis
• Acute Disease with a C/C Back Ground
• Consider only the acute Totality
• Eg. R/C Asthma

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Chronic Disease without a/c exacerbation

• As natural chronic disease
• Eg. Vitiligo
• A/C Disease with a different Chronic Background
• Consider only acute totality
• Eg. Chicken Pox in a IHD Patient

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Case taking in

• Epidemic Sporadic
• One sided disease

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Intermittent Fever

• Sporadic /epidemic
• Acute then Chronic
• Epidemic in non marshy
• Acute Totality
• Pernicious in non marshy
• Acute, if recure Chronic
• Endemic in marshy
• Remove marinating cause
• Chronic case taking

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Mental Diseases

• Appearing with decline of corporeal symptoms -
  Past history
• Mental disease without corporeal disease -
  maintaining cause
• Mental disease appearing suddenly
• Due to Psychological factors constitutional

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HPC

• Aetiology
• Diagnosis
• Nature of Disease
• Onset Progress of disease
• Extn Alternation

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Past History

• Aetiology
• Diagnosis
• Development of disease
• Miasm

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Family History

• Diagnosis
• Miasm

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Individualizing features should be present
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Personal History

• DLM
• Occupation
• Habits
• Marriage
• Obstetric history

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• Age
• Sex
• Religion
• Treatment History

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Observation

• Human element / logic is important in Case taking

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Deceitful
Apprehensive
Aggressor
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Brave
Absentminded
Confident
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Positive (Hopeful)
Negative (Hopeless)
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Impatience
High-spirited
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Charming
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Elegance
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Proud
Thoughtful
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Dictatorial
Frightened
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Hilarious
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Pretend, Absence of guilt feeling
Pride
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Lier, Deceitful
Boredom
Doubtful
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Sincere
Sincerity
Insincerity
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Possesivness
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Aggressive
Lack of confidence
Insecurity
Lying, Frustration
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Confident, superior, positive
Superiority- confidence gesture
Negative, Secretive, Suspicious
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Nervous, Fearful, Negative emotion
Dominant
Humble
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• Never violate principles
• Understand our limitations
• Read, Read and Read

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Time

• Time is same to all
• But some make it as a good time, by using it in a
  right way
• Some neglect it by wasting
• More work you do, will fetch you more Good Time

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Your time

• 1st BHMS 1610 hours
• 2nd BHMS 1065 hours
• 3rd BHMS 950 hours
• 4th BHMS 1175 hours
• Total 4800 hours
• Utilised it effectively? Introspect

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INDIA Largest infrastructure

•    3,00000 qualified homeopaths    UG Colleges
  178 (12785 admissions)    PG Colleges 31 (1040
  admissions)    Government clinics 7500   
  Licensed pharmacies 659    Hospitals 307
• A Separate regulation for UG PG only in India
• After the introduction of external MD more than
  5000 BHMS seats are vacant

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KERARLA

• Homeopathy approved in 1928
• First Govt. Dispensary in 1958
• Homeopathic Education in 1960
• 5 Colleges, 525 GHD, 31 Hospitals, 12 ESI
• 2 Research Institute
• 1 Pharmacy in public sector
• But ??? 6 out of 3.18 crore

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So..

• You must have good vision, loyalty dedication
• Only you can do something about it
• There's is no short cut for success
• Take homeopathy into greater heights

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Thank You

• Best Wishes

and best wishes