CASE TAKING IN

1
CASE TAKING IN COMMUNITY, CLINIC AND WARD WITH
DEMONSTRATION OF CASES
Prof. (Dr.) Niranjan Mohanty MD (Hom) Director
International Study Research Center on
Homoeopathy, 92, Dharmavihar, Khandagiri,
Bhubaneswar Honorary Project Advisor, RRI (H),
Puri Honorary President, F.P.A.I. BBSR Branch
2
SOLE/SOLITARY OBJECTIVE OF HOMOEOPATHIC PHYSICIAN
EXACT / CORRECT PRESCRIPTION
APHORISM ONE
ESTABLISH SIMILARITY BETWEEN THE PHENOMENON OF
CURATIVE PRESCRIPTION BASED ON TOTALITY OF
SYMPTOMS
ARTIFICIAL DRUG DISEASE
NATURAL DISEASE
3
NATURAL DISEASES
ARTIFICIAL DISEASES
CASE SELECTION
CASE TAKING
MATERIA MEDICA
CASE RECORDING
ANALYSIS OF SYMPTOMS
CONCEPTUAL IMAGE OF THE CASE
REPERTORY
SYNTHESIS OF THE CASE
EVALUATION /ERECTING A TOTALITY OF SYMPTOMS
MIASMATIC ASSESMENT
DISEASE DIAGNOSIS
GENERAL MANAGEMENT
PLAN OF TRETMENT
MEDICAL MANAGEMENT
4
ABSOLUTE SURGICAL CASES FRANKLY SURGICAL
CASES (HERNIA / CATARACT / INTESTINAL
OBSTRUCTION)
CASES OF ACUTE POISONING
CASE SELECTION

MOST URGENT CASES WHERE DANGER TO LIFE IMMINENT
DEATHALLOW NO TIME FOR THE ACTION OF HOMOEOPATHIC
REMEDY NOT HOURS SOMETIME NOT EVEN QUARTER HOURS
AND SCARCELY MINUTES.
IN SUDDEN ACCIDENTS OCCURING TO PREVIOUSLY
HEALTHY INDIVIDUALS . EX ?ASPHYXIA ?
LIGHTENING ? SUFFOCATION ? FREEZING ? DROWNING
APHORISM 67
ALL ABOVE CONDITIONS LIE OUTSIDE THE FIELD OF
APPLICATIONS OF THE LAW OF SIMILARS.
5
NOSOLOGICAL DIAGNOSIS
REMEDY SELECTION
MIASMATIC DIAGNOSIS
SHORTED OUT
ERECTING A TOTALITY OF SYMPTOMS
DATA FED BY PATIENT INTORRENT NEEDS TO BE
SHIFTED
EVALUATED
ANALYSED
?THEREFORE
PHYSICIAN SHOULD HAVE KNOWLEDGE REGARDING
?ALL BRANCHES OF MEDICAL SCIENCE. ? THROUGH
KNOWLEDGE REGARDING HOMOEOPATHIC
THERAPEUTICS. ? PATIENCE OF AN EMINENT DEGREE.
6
INFORMATS
CASE RECEIVING
PHYSICIAN
APHORISM 6
? ALERT ? ACTIVE ? I NTELLIGENT
PATIENT
(FEEDS DATA / LIFE HISTORY THROUGH VERBAL /
NON-VARBAL WAY)
DIAGNOSTIC PURPOSE
NOSOLOGICAL DIAGNOSIS
REMEDY DIAGNOSIS
MIASMATIC DIAGNOSIS
THERAPEUTIC PURPOSE (EMOTIONALLY CHARGED PATIENTS)
7
Aphorism 7th. Hahnemann delineated the focus for
case taking, the totality of symptoms alone form
the basis of prescription. Aphorism 83. The
qualities of the physician for case taking.
8
Aphorism 84. Details the manner in which the
consultation has to be taken place. This aphorism
has to read with the foot note which cautious
against the disruption of the patients train of
narration. Aphorism 85. Say that every new
expression made by the patient or attended has to
be entered in a fresh line. This may help to
complete the data's later and prevent confusion
about the discrimination of symptoms
9
Aphorism 86. Narrate the manner in which the
incomplete information can be made complete.
Aphorism 87. Cautious about the don'ts in the
case taking. This aphorism has to be read with
the foot note Aphorism 88. When the case
taking come to a dead end, the doctor can engage
the patient in a conversation, makes general
suggestions and try to get more information.
Details are given in foot note
10
Aphorism 89. Narrate the information that the
doctor required to seek, once the patient has
completed the narration. This narration has to be
read with the foot note . Aphorism 90. Narrate
the necessity to discriminate the symptoms from
the attributes of the patient. This aphorism has
to be read with the foot note ,which details the
observation the doctor can make of the patient
during consultation.
11
Aphorism 91. Suggest that to understand the
patients state of health before the illness, the
doctor has to discount those expression which
were noticed after the medication. This course of
action is advised for c/c disease. Aphorism 92.
Warns that if the disease is of an a/c and
fulminate nature no chance should be taken to
keep the patient under observation with out
medication, for eliciting the true nature of the
disease. The doctor must try to access the
expression previous to medication
12
Aphorism 93. Deals with the doctor to elicit the
probable cause for the suffering. The information
can be obtained either from the patient or
attendant. This aphorism has to be read with the
foot note ,which elaborate the probable cause for
a/c and c/c affections.
13
Aphorism 94. Asserts that in C/C sufferings,
inquiry should be directed towards eliciting the
patients mode of living, daily habits etc.This
aphorism has to be read with the aphorism 5 and
foot note ,which details about the information
one may seek from the female patients. Aphorism
95. Asserts that the details of the expression
of c/c cases have to be investigated thoroughly.
Aphorism 96. Cautious the doctor to be on the
guard against such patients who exaggerate their
symptoms. This aphorism has to be read with the
foot note .
14
Aphorism 97. Due to modesty or shame the patient
reluctant to speak out. A difficult situation in
case taking. Aphorism 98. Narrate the
attributes of the doctor in conducting the case
taking section, especially of a c/c disease. It
say that the doctor should have the qualities of
circumspection, tact, knowledge of human nature,
cautions on conducting inquiry and patience in an
eminent degree.
15
Aphorism 99. Details the projections available
in the acute conditions and the mode of case
taking in a/c cases. Aphorism 100. Case taking
in epidemic and sporadic cases. Aphorism
101_102. An appraisal of several cases in an
epidemic reveals a pattern in the disease
expression leads to the genus epidemicus.This
aphorism has to read with the foot note .
16
Aphorism 104. Responsibility of the doctor after
the case taking, include case analysis, selection
of similimum etc.This aphorism has to read with
foot note. Aphorism 153. States that the
selection of the similimum must always depend on
the data elicited from the patient, which is more
striking,singular,uncommon and peculiar.
17
KENT'S SPECIAL INSTRUCTIONS FOR CASE TAKING 1.
All the information obtained from the patient
should be recorded in the patients own words 2.
By standers if anxious do not give correct
information 3. The physician should frame the
collateral questions and not the leading
questions 4. He must be able to collect symptoms
with regards to pathology, diagnosis prognosis
and materia medica.Symptoms with respect to
materia medica are the key to the prescriptions
5. The physician should know that anything that
affect a change in these symptoms Eg. Drugs,
alcohol etc. He should get the original form of
the malady 6. The circumstances of the life and
habit must be studied with a view to going in to
the slightest particulars 7. Exaggerated and
indolent patients do not give a true picture 8.
Never consider acute and chronic together 9.
Sequel of acute diseases are psoric disorders and
must be treated as psora 10. Don't prejudice by
"similar cases" in the past
18
H.A.ROBERT'S SPECIAL INSTRUCTIONS FOR CASE
TAKING     He had given much importance to the
history of presenting complaints 1. The first
requisite is the case record 2. Absolute rest
and poise attitude of the physician with no pre
conceived Idea or prejudices 3. The physician
should not fail to obtain a detailed a family
history 4. Special care is to be taken while
recording the past history of a patient to
inquire about his recovery from each illiness.
5. The source of information must always be
scanned with a great deal of circumspection and
he must weigh the integrity of the source as
being worthy of consideration 6. While dealing
with an acute condition do not dip in to the
chronic state at the same time 7. A clear
picture of the chronic state is obtained at the
the end of an acute attack 8. The physician
should not interrupt a patient in his narration
9. Cross examination is required in many of the
cases
19
STUART CLOSE'S SPECIAL INSTRUCTIONS FOR CASE
TAKING 1. The selection of Homoeopathic remedy
is mainly based upon the subjective, conscious
experience perceived by the patient and stated by
him to the doctor, his friends or perceived by
the physician himself. 2. The physician should
gain the confidence of the patient and relive the
tension of the patient as far as possible 3. The
physicians attitude should be calm,dignified,quit
and sympathetic 4. The physician should not
hurry a patient in his narratives 5. Classify
the symptoms as general particular and common 6.
Laziness, selfishness and easy conscience are
responsible for many failures and sins 9. The
physicians senses must be on alert, mind
clear,logical faculties acute, sympathies and
prejudices held in abeyance 10. Bring out the
symptoms to permit comparison with the materia
medica.
20
ELIZABETH WRIGHT'S INSTRUCTIONS 1. The
homoeopath must know his patient spiritually
emotionally mentally physically and
sociologically . 2. The physician must be
receptive, must clear his mind of other pre
occupations and must be tranquil and cordial 3.
He must allow the patient to tell his own story
in his own way without any interruption 4. The
personality of the patient his state of mind
physical status traits of character should be
noted. 5. The beginner Should not down all the
symptoms and later sort it 6. The physician
should encourage the patient while narrating his
story 7. Beware of loquacious and reticent
patients 8. Case may be completed on subsequent
appointments if required 9. The physician must
make sure that he has questioned the patient on
every system and function 10. The mental
symptoms and characteristics of the patient
should usually be elicited last when the
patient's confidence has been more fully gained
11. The patient must get an impression that the
physician is interested in his case.
21
EXPRESSED
EMOTIONAL OVERTONE
CRYPTIC
CHRONOLOGICAL SEQUENCE
FACTUAL DATA
TRANSACTIONAL ANALYSIS RECORD
LINEAR TRANSACTION BETWEEN PATIENT PHYSICIAN
MODE OF INTERVIEW
INTERVIEW HAS TWO ASPECTS
CONTENTS OF INTERVIEW
CASE RECORDING PROFORMA
APHORISM 83 ONWARDS
NEOPHYTES (SIMPLE PASSIVE MECHANICAL
FILTER) EXPERIENCE (ACTIVE FILTER) REJECTS
?IRRELEVANT ?NON-ESSENTIAL ?LESS
VALUABLE ?UNIMPORTANT DATA
FREEDOM FROM PREJUDICES SOUND SENSES, ATTENTION
IN OBSERVING FIDELITY IN TRACING THE PICTURE OF
THE DISEASE.
22
DIFFERENCE IN CASE TRAKING IN BOTH THE SCHOOL
MODERN SCHOOL
HOMOEOPATHIC
NOSOLOGICAL DIAGNOSIS
NOSOLOGICAL DIAGNOSIS
MIASMATIC DIAGNOSIS
ERECTING A TOTALITY OF SYMPTOMS
REMEDY SELECTION
23
REPUTATION OF THE PHYSICIAN IS PRESERVED
CHOOSING THE SUITABLE POTENCY
REMOVAL OF OBSTRUCTION
PROGNOSIS
GENERAL MANAGEMENT (DIET/REGIMEN/AUXILLARY
MEASURES)
NOSOLOGICAL DIAGNOSIS
COMMON UNCOMMON DETERMINATION
FOR STATISTICS
PATIENT IS SICK OR NOT SICK
TO FIND OUT AETIOLOGY ?PHYSICAL ? CHEMICAL ?
MECHANICAL ? PSYCHIC ? IATROGENIC
COMMUNICABLE OR NON-COMMUNICABLE FOR ISOLATION
24
TO COORDINATE
TO QUESTION
TO WRITE
TO LISTEN
SUMMARY OF CASE TAKING
HISTORY
GEOGRAPHY
CHEMISTRY
25
HAHNEMANNIAN CASE TAKING (From Lesser Writings
Medicine of Experience) Symptoms Which Are
Constant, Frequent, Strongest And Most
Troublesome To The Patient Seat, Course And
Sensations Confirmation By Re-questioning
After The Completion Of Case Taking. Assumed
Aetiology Should Not Be Considered For Remedy
Selection
26
SCIENTIFIC PART OF CASE TAKING (SUPPLIED IN
STANDARDISED CASE RECORDING PROFORMA / FORMAT)
CASE TAKING
ARTISTIC PART OF CASE TAKING
? WRITING DOWN ACCURATELY. ? NO INTERRUPTION. ?
ARRANGE SYMPTOMS SEPARATELY. ? EXTRACTION OF
SYMPTOMS. L /S /M /C/ (AUSEVAOS) ? RECOED
MAGNITUDE.
?NO DIRECT QUESTION. ?YES / NO ? ALTERNATIVES ?
UNEARTH THERAPEUTIC DIAGNOSIS ? DETERMINE
DISEASE DIAGNOSIS ? NO JUMP FROM ONE SUBJECTS
TO ANOTHER.
27
TO FIND OUT MODE OF DEVELOPMENT OF SYMPTOMS.
TO FIND OUT CAUSATION OF DISEASE.
TO FIND OUT NATURE OF DISEASE. (CURABLE OR
INCURABLE)
TO ERECT TOTALITY OF SYMPTOMS.
TO PERCEIVE DYNAMIC STAGE OF PATIENTS.
PURPOSE OF CASE TAKING
KNOWLEDGE OF DISEASE.
ANLYSIS / SYNTHESIS / EVALUATION OF SYMPTOMS.
TO COLLECT IMPORTANT SYMPTOMS.
TO CURE THE CURABLE TO PALLIATE INCURABLE
SYMPTOMS.
TO KEEP SYMPTOMS FOR FUTURE REFERENCES.
TO GIVE PROGNOSIS OF THE CASE.
FOR NOSOLOGICAL DIAGNOSIS TO ASSES THE
CURABILITY, INCURABILITY OF THE CASE.
28

• The different headings in the recommended format
  for case taking under particulars of patient are
  not only needed for statistical analysis but also
  helps in searching the rubrics in repertory. How
  these headings are related to the rubrics
  mentioned in our repertory, are explained.

29
Particulars of the patient
30
IDENTIFICATION
NAME
FOR FUTURE REFERENCE
31
AGE
Reproductive age group Pelvic inflammatory
disease Uterine fibroid
Older age group Menopausal syndrome
Certain diseases are prevalent in certain age
group
32
Age- GENERALS-CYANOSIS- infants in (Synthesis-
page-1589)
33
ADDRESS
Malaria, Filaria, Black water fever in west
Bengal parts of Orissa
34
MARITAL STATUS
Date of marriage
MARRIED
Single
Widow
Details of sexual life
Infertility
35
HAEMOPHILIA A
Females X- linked recessive
NEPHROGENIC DIABETES INSPIDUS
36
MARRIAGE IN EXTREMES OF AGE
congenital cardiac defects, abortion
Elderly Mothers
Paternal
Downs syndrome
Marfans syndrome
37
RUBRICS RELATED TO MARRIAGE Mind. Marriage
idea of marriage seems un endurable Genit.F
Sexual desire increased in widows
38
OCCUPATION
symptoms due to fatigue or occupational hazards
39
NATURE OF OCCUPATION  Generalities - stone
cutters Respiration - Asthmatic miners
asthma from cold dust   Rectum -
Constipation sedentary habits from
40

• Sex- MIND-INSANITY-women in (Syn- page-137)
• MIND-JEALOUSY- men between (Syn- P-146)
• MIND-JEALOUSY- women between (Syn- P-146)
• Occupation- RESPIRATION - DIFFICULT - athletics,
  in (Syn-P-974)
• RESPIRATION - ASTHMATIC - miner's asthma,
  from coal dust (Syn-P-972)
• RESPIRATION - ASTHMATIC - sailors as soon
  as they go ashore (Syn-P-972)

41
SOCIO ECONOMIC STATUS
During family planning guidance
To give reasonable realistic antenatal advice.
Complications likely to be associated with low
social status such as anaemia, pre-eclampsia,
prematurity, etc
42
HABITAT
Urban
Slum
Rural
Habitat - RESPIRATION- DIFFICULT- mountain in
(Syn-P-977)
43
RUBRICS RELATED TO HABITS    Respiration -
Asthamatic drunkards    Head - Pain tobacco
smoking from    Generalities - Food alcohol lt
   Generalities - Tobacco lt    Generalities -
Narcotics lt
44
Hindu
Religion
Muslim
Others
Christian
Religion MIND-RELIGIOUS affections- bible
all day wants to read the (Syn-
P-180)
45
Medical history
Complaints and their duration
History of present illness
Menstrual history
Contraceptive history
Obstetrical history
Past history
Family history
Functional history
46
Complaints and their duration
Chronological order of appearance
Herings law of cure
47

• Interrogation
• Present complaints
• As narrated by the patient with its location,
  sensation, modality, and concomitant.
• Location- ABDOMEN - PAIN Hypogastrium
• HEAD - PAIN - Occiput and Forehead
• Sensation- ABDOMEN - Pain Stitching.

48

• Modalities- EXTREMITIES - PAIN - Lower limbs -
  hang down amel. letting limb
• EXTREMITIES - PAIN - Lower limbs - eructations
  amel.
• STOMACH - PAIN - bread, after
• EXTREMITIES - PAIN - Lower limbs - night
• Concomitant- EXTREMITIES - PAIN - Knee - cough,
  during

49

• Side-EXTREMITIES - PAIN - Knee - right
• EXTREMITIES - PAIN - Knee left
• Time- EXTREMITIES - PAIN - Lower limbs -
  afternoon
• EXTREMITIES - PAIN - Lower limbs - evening
• Extension-
• HEAD - PAIN - extending to - eyes - left eye
• HEAD - PAIN - extending to - neck
• HEAD - PAIN - extending to - upper malar bone

50

• Various types-
• FEVER - AUTUMNAL
• FEVER - HECTIC fever
• FEVER - GASTRIC fever
• GENERALS - PAIN - stitching
• HEAD - PAIN - pulsating
• HEAD - PAIN bursting
• Unexpected deviation-
• MOUTH - DRYNESS - Tongue - thirst, without
• SKIN - ITCHING - eruptions without
• Associated with- EXTREMITIES - PAIN - Lower
  limbs - sciatica - numbness, with

51
History of present illness
In order of their appearance Patients own
language.
52
History of present illness
Causation- ABDOMEN - PAIN - acids,
from ABDOMEN - PAIN - fright,
from Alternation- HEAD - PAIN - alternating with
- diarrhoea HEAD - PAIN - alternating with -
perspiration feet EXTREMITIES - PAIN -
Knee - right - alternating with pain in right
temple
53
Onset- HEAD - PAIN - sudden pains GENERALS -
PAIN - appear gradually GENERALS - PAIN -
appear suddenly
54
Menstrual history
Age of menarche Duration of menstrual
period Interval between menses in days
(cycle) Amount of loss average/heavy
/scanty Character of loss Average (darkish red
liquid)/ bright red with clots/ foul smelling
55
Female Genitalia - Menarche Delayed Female
Genitalia Menses - Delayed Female Genitalia
Menses Irregular Female Genitalia Menses-
lasting too long Female Genitalia Menses
late, too Female Genitalia Menses-
Protracted Sadness Menses - during
menarche
56
Dysmenorrhoea
Present
Absent
Primary
Secondary
Obstetrical history Fixed retroverted uterus
Pelvic inflammation
Endometriosis Unequal development of mullerian
duct Uterine hypoplasia
57
Menstrual history
Intermenstrual bleeding or discharge its
relation to the menses is seen in case of
metrorrhagia. Date of last menstrual period
its first and last dates are to be recorded. From
the L.M.P., the expected date of delivery has to
be calculated.
58
Contraceptive history
Use of oral contraceptive Intrauterine
contraceptive device, etc. is recorded.
59
Obstetrical history
60
The obstetrical history is to be summed up
as No. of living children _______ Boys
______ Girls ______ Health status of the baby
_________ Immunization ________ Last
issue________ The sex of children is needed when
permanent sterilization is to be considered.
61
PAST HISTORY
?PERSONALITY BEFORE ILLNESS. ? SOCIAL RELATION
WITH FAMILY. ? DISEASE OF ENCEPHALITIS. ? H / O
INJURY TO HEAD. ? H / O OPERATIONS. ? H / O PAST
MENTAL ILLNESS. ? TYPE (DEPRESSIVE / MANIC) ?
DURATION
62
Past history
Record of any previous illness or operation is
to be noted, viz., Tuberculosis Heart
disease Malaria Dysentery Syphilis Gonorrhea,
Any gynaecological treatment including
operation Any surgical operation Taking of drug
history prolonged corticosteroid
therapy Antibiotic allergy becomes very
important Giving of blood transfusion.
63

• Past History
• GENERALS - HISTORY personal
• ear infections recurrent
• gonorrhea, of
• Hydrocephalic children
• inflammation of frequent
• pneumoniaof
• tuberculosis, of
• whooping cough of

64
DATE OF BIRTH
DISEASE WITH MOTHER
PERSONAL HISTORY
FULL MATURITY / PREMATURITY

• MILESTONE OF DEVELOPMENT
• ?TEETHING
• (6 TO 8 MONTHS)
• WALKING
• (12 TO 14 MONTHS)
• ? SPEAKING (WITHIN 1 YR. MONOSYLLABLE)
• TOILET TRAINING
• (WITHIN 3 YR.)

FORCEPS DELIVERY
?MARITAL HISTORY ? SEXUAL HISTORY ? MENSTRUAL
HISTORY ? HABIT / ADDICTION (FORM / QUANTITY /
FREQUENCY)
65

• PERSONAL HISTORY
• Rubrics for symptoms related to habits and
  addictions
• COUGH - SMOKING
• GENERALS - TOBACCO - disgust for tobacco
  remedies to increase
• GENERALS - TOBACCO - desire for tobacco
• ABDOMEN - PAIN - brandy, after
• GENERALS - TREMBLING - externally - alcoholism
  from

66
FATHER / MOTHER
FAMILY HISTORY
? AGE OF THE PARENT DURING BIRTH / DEATH. ? F /
H OF MENTAL DISEASE ? OCCUPATION. ?
PERSONALITY. ? H / O SUICIDAL CASES. ?
SIBBLING ?DAUGHTER ? SON ? DEATH ?
INTERRELATIONSHIP
67
Family history
H/o T.B., HTN, Diabetes, Carcinoma, and
inherited disease in the family is to be
enquired.
68

• FAMILY HISTORY
• 1) Help in deciding the miasmatic background.
• 2) Helps in tracing consanguinity 3) H/O
  disease, cause of disease, cause of death. 4)
  Pre disposition and tendency to disease. 5)
  Individual peculiarities of all the relatives.
•   This will create a feeling in the patient that
  "doctor knows all about them" that he is not only
  interested in them and their families, personally
  and professionaly,but that he takes pains to
  learn and keep in touch with all their individual
  peculiarities.

69

• Family History
• GENERALS - FAMILY HISTORY of - Anemia
• Cancer
• Chickenpox
• Diabetes mellitus
• Malaria
• Measles
• Mumps
• Numerous bad diseases of
• Tuberculosis
• Typhoid fever
• Ulcers of stomach

70

• Gynecological history
• FEMALE GENITALIA/SEX - MENSES - delayed in girls,
  first menses
• FEMALE GENITALIA/SEX - MENSES - appear - proper
  age before the
• FEMALE GENITALIA/SEX - MENSES - late, too
• FEMALE GENITALIA/SEX - MENSES - frequent, too
• BLADDER - RETENTION of urine - confinement, after

71

• Obstetrics history
• FEMALE GENITALIA/SEX - ABORTION
• tendency to abortion
• threatening abortion
• FEMALE GENITALIA/SEX - DELIVERY
• - during complaints
• long and painful
• painless, almost
• premature
• rapid, too
• rigidity of muscles, with
• slow
• FEMALE GENITALIA/SEX - DELIVERY -
• after complaints -
• lesions of parts
• recovery, slow

72
Functional history
Functions of bowel, bladder, appetite, sleep
are to be noted. Any change of weight is to
be enquired.
73

• Treatment history
• GENERALS - MEDICINE -
• For Allopathic medicines
• -abuse of
• -addiction, to
• -oversensitive to -quick reaction to
• For Homoeopathic medicines
• GENERALS - REMEDIES
• -fail to act well selected remedies
• -violent reaction to homeopathic remedies
• -violent reaction to homeopathic remedies -
  high potencies, to

74

• PHYSICAL GENERALS
• Reaction with heat cold
• GENERALS - HEAT - lack of vital heat
• GENERALS - HEAT - sensation of
• General Tendency (For Suppuration/ Bleeding/
  Catching cold etc.)
• GENERALS - COLD - take cold tendency to
• GENERALS - WOUNDS - suppurating
• GENERALS - WOUNDS - heal tendency to - slowly
• GENERALS - WOUNDS - heal tendency to - quickly
• GENERALS - HEMORRHAGE - tendency to
• GENERALS - HEMORRHAGE - exudates, hemorrhagic

75

• Appetite-
• Thirst-
• Rubrics for these are found in the Stomach
  chapter in Synthesis repertory.
• Desire
• Aversion
• Intolerance
• Rubrics are found in the Generalities chapter
  under main rubric food and drinks

76

• Salivation quantity, character, time, taste etc.
  
• Rubrics for these are found in the Mouth
  chapter in Synthesis repertory.
• Bowel Habit
• Normal, constipation, diarrhoea, dysentery,
  hemorrhoids, character of stool, symptoms before,
  during and after defecation.
• Rubrics for these are found in the Rectum
  chapter in Synthesis repertory.

77

• Urination
• Character of Urine - Quantity, color,
  consistency, odor, frequency, symptoms before,
  during and after urination.
• Rubrics for these are found in the Bladder
  and Urine chapters in Synthesis repertory.
• Perspiration quantity, color, odor, stain,
  location, aggravation or amelioration during,
  complaints from suppression etc.
• Rubrics for these are found in the
  Perspiration as well as in other chapters also in
  Synthesis repertory.

78

• Sleep pattern, position in sleep, complaints
  before or after sleep etc.
• Rubrics for these are found in the Sleep chapter
  in Synthesis repertory.
• Dream anxious, absurd, fearful, death, business
  etc
• Rubrics for these are found in the Dream chapter
  in Synthesis repertory.

79

• Generalities
• Mental general
• Will
• Disturbances of emotion - Anger, irritability,
  laughing, weeping, sadness, depression,
  emotional, sensitive etc.
• Alteration in character - Obstinate, obsessive,
  capricious, whimsical, hysterical etc.

80

• Suicidal/ homicidal tendency, loathing of life,
  disturbances of affections such as love/ hate,
  jealousy, suspicion, fear, anxiety, nervousness
  etc.
• Understanding
• Delusion, delirium, hallucination, disorientation
  in time space, confusion, etc.
• Intellect
• Perception, thinking, consciousness, decision,
  judgment, performance, intelligence.

81

• Memory
• Faulty registration, retention and reproduction,
  mistakes in reading, writing and speaking, lack
  of concentration, forgetfulness,etc.
• Rubrics for all these mental general symptoms
  along with the subrubrics are vividly described
  in repertories like Synthesis, Synthetic and
  Murphys repertory.

82
MIND Absent minded menses during MIND anger
menses suppression of MIND Delirium menses
before MIND Delirium menses during MIND
irritability - menses intermission of
83
SPECIALLY IN CASE OF PSYCHOSIS
H /O FROM INFORMANT
H /O PRESENT ILLNESS
HISTORY OF PATIENTS OWN STATEMENT
DEPRESSIVE PSYCHOSIS PATIENT WILL TELL OF OWN
SELF MORE
84
TRAIN OF SPEECH
ACTUAL APPEARNCE AND BEHAVIOUR
TOUGH WITH SURROUNDING
GENERAL APPEARANCE / BEHAVIOUR
DRESS
EXPRESSION

• ? CLUMSY
• ? DIRTY
• ? FASTIDEOUS
• ? CARELESSNESS

? APATHETIC ? TENSE POSTURE ? EXTROVERTED ?
INTROVERTED ? INTERESTED TO SURROUNDING
85
Deceitful
Apprehensive
Aggressive
86
Brave
Absentminded
Confident
87
Positive (Hopeful)
Negative (Hopeless)
88
Impatience
High-spirited
89
Proud
Thoughtful
90
Dictatorial
Frightened
91
Gentleness
Hilarious
92
Pretend, Absence of guilt feeling
Pride
93
Lier, Deceitful
Boredom
Doubtful
94
Sincere
Sincerity
Insincerity
95
Aggressive
Lack of confidence
Insecurity
Lying, Frustration
96
Confident, superior, positive
Superiority- confidence gesture
Negative, Secretive, Suspicious
97
Nervous, Fearful, Negative emotion
Dominant
Humble
98
DRESS
EXPRESSION
? Fur, wraps up in summer

• APATHETIC
• Indifferences, apathy
• Listless

• FASTIDIOUS
• Fastidiousness
• Rest, cant, when things are not in proper place

• TENSE POSTURE
• Frown
• Exclamation
• Apprehension

CARELESSNESS ? Careless
99
EXPRESSION

• INTERESTED TO SURROUNDINGS
• Company desire for
• Gossiping
• Inquisitive
• Society
• Solitude

• INTROVERTED
• Hide, desire to
• Confinding
• Reserved

100
TONE ? LOW / INAUDIBLE ? VOLUMINOUS
ONLY TO QUESTION

• Answer abruptly, shortly, curtly
• Silent

SPEECH
SPONTANEOUS

• LOW
• Crocking
• Groaning
• Growling, like a dog
• Grunting
• Muttering

ARTICULATION ?STAMMERING ? SLURRING ?
INCOHERENT ? COHERENT

• ?Loquacity
• ?Question speaks continually in
• Talkative
• Talk, desire to, to some one
• Talk, to himself

• INCOHERENT
• Aphasia
• Speech
• Babbling

• VOLUMINOUS
• Barking
• Bellowing

101
MUTISM
TALKS
DISTRACTION
APHONIA
NEGATION
UNINTELLIGENT
FLIGHT OF IDEAS
AGRAPHIA
LAZY
IMPULSE
WRITING
BEHAVIOUR
102
BEHAVIOUR
LAZY ?Fine work ?Mesmerized, seem as
if ?Prostration of mind ? Reading aversion
to ?Study ?Stupidity ?Thinking aversion to ?Time
fritters away, his ?Torpor ?Undertakes, lacks
will power to under takes anything ?Work aversion
to mental
LAZY ?Business aversion to ?Escape ?Indolence,
aversion to work ?Manual work
103
BEHAVIOUR
IMPULSIVE ?Touch things impelled
to ?Rashness ?Quick to act ?Entertainment ?Abrupt
?Capriciousness ?Crazy ?Fanaticism ?Impulsive ?Imp
ulse to destroy himself ?Jumping ?Longing for
things, which are rejected when offered
104
MOOD
OBJECTIVE
SUBJECTIVE
? SAD ? FROWNING
?ANXIETY ? IRRITABILITY ? EMPATHISE
OTHER TYPE OF MOODS
? UNDUE HAPPINESS ? INFECTIOUS JOLLITY ? SWINGING
MOOD
105
SUBJECTIVE
IRRITABILITY ?Irascibility ?Irritability ?Petulant
?Rage, Fury ?Repulsive mood ?Striking ?Throws
things away ?Touched, aversion
to ?Vexation ?Violent, vehement, etc. ?Agitation

• EMPATHISE
• Reverence for those around him
• Sympathetic

106
OBJECTIVE
FROWNING
Grimaces
SAD
107
OTHER TYPE OF MOODS
UNDUE HAPPINESS

• Ecstasy
• Exaltation
• Exhilaration
• Gaity
• Good humour
• Happy
• Hilarity
• Kisses, every one
• Laughing
• Mirth
• Pleasure
• Vivacious
• Whistling

INFECTIOUS JOLLITY
? Humorous
SWINGING MOOD

• Mood agreeable
• Mood alternating
• Persist, in rolling

108
AUTISM
HIGHLY ORGANISED PSYCHOLOGICAL INTEGRATION OF
IDEAS , IMAGINATION, CONCEPTION AND REASONING.
THOUGHT PRODUCTION
THOUGHT PROCESS
THOUGHT PROGRESSION
THOUGHT CONTENTS

• ? FLIGHT OF IDEAS
• ? CLANG ASSOCIATION
• ? RETARDATION
• ? PERSEVARATION
• ? CIRCUMSTANCIALITY
• ? INCOHERENCY
• BLOCKING

? OBSESSION ? DELUSION ? PHOBIAS
IRRESSITIBLE BUT FOOLISH FEAR AND DOUBT
ACCOMPANIED BY ANXIETY / DEPRESSION.
109
THOUGHT PROGRESSION
FLIGHT OF IDEAS ? Comprehension difficult
RETARDATION ? Dullness
CIRCUMSTANTIALITY ? Circumspection lack of
110
THOUGHT CONTENTS

• OBSCESSION
• Roving naked about
• Reveries
• Obscene
• Nymphomania
• Naked, wants to
• Monomania
• Meditation
• Kneeling praying
• Absorbed

111
THOUGHT CONTENTS
DELUSION

• Air castles
• Wrong, everything seems
• Theorizing
• Stranger
• Magnetised, desire to be
• Looked at, cant bear to be
• Mental effort, inability to sustain
• Piety nocturnal
• Plans making many

• Deed, feels as if he could do great
• Fancies, absorbed in
• Hypochondriacal humor
• Injure, fears to be left alone, lest he should
  himself
• Religious affection
• Size, incorrect judge of
• Smaller, things appear
• Suspicious

112
THOUGHT CONTENTS
PHOBIAS

• ?Anthropophobia
• ?bed aversion to
• ?Blood cant look at
• ?aversion, approach to being
• ?Clinging to person or furniture
• Color aversion to, red, yellow etc.
• Dread
• Going out, aversion to

• Hydrophobia
• Light desire
• Marriage, the idea of seemed unendurable
• Men, dreads of
• Scream
• Shrieking
• Superstition
• Thought of death

113
PERCEPTUAL DISORDER
HALLUCINATION
DELUSION
ILLUSION
?Faces, sees

• Vision
• Sneers
• Unreal

?Hastiness ? Hurried
114
?Restlessness, Nervousness
?Impetuous ?Haughty ?Envy ?Arrogance ?Jealousy ?Pr
ide

• ?Attitude assumes strange
• Crawling, on floor
• Eccentricity
• Grouping as if in the dark
• Rolling in the floor

115
AGGRESSIVE
116
INDIVIDUAL MENTALLY LOCATES WITH ENVIRONMENT.
ORIENTATION
PERSON
PLACE

• ?Locality errors of
• Distance inaccurate judge of

TIME
IT IS A STATE OF MIND IN WHICH SENSORIUM WORKS TO
ITS FULL CAPACITY.
TWILIGHT STATE (EPILEPSY)
CONSCIOUSNESS
CLOUDING (CLEAR PERCEPTION)
DELIRIUM
STUPOR (LACK OF RESPONSIVENESS TO SURROUNDING)
CONFUSION ? BEWILDERMENT ? GRASPING ?
DISORIENTATION
117

• STUPOR
• Ask for nothing
• Benumbed
• Drunken
• Feces, passed on the floor
• Insensibility
• Stunted
• Stupefaction
• Succeeds
• Unconsciousness

• DELIRIUM
• ?Starting
• ?Searching on floor
• Runs about
• Mania
• Carphologia
• Battles talk about

118

• CONFUSION
• Confusion of mind
• Disconcerted
• Forgotten
• Intoxication
• Wild, feeling in head
• Will contradiction of
• Confounding, objects and ideas

• BEWILDERMENT
• Bewildered
• Cloudiness, confusion

119
? Abstraction of mind

• Ideas abundant
• Clearness of mind
• Acuteness (see memory)
• Memory active

HYPERMNESIA HIGHTEN MEMORY
PARAMNESIA ? CONFUBULATION (SENILE PSYCHOSIS) ?
RETROSPECTIVE FASCICULATION (ILLUSION OF
MEMORY) ? DEJAVU FAMILARITY WITH UNFAMILIAR
SCENES ? JAMAISVU OPPOSITE TO DEJAVU
AMNESIA (LOSS OF MEMORY) ? RETROGRATE ? ANTROGRADE
MEMORY
? Forgetful
JAMAIS VU OPPOSITE TO DÉJÀ VU ?New objects
seems ? Recognize, doesnt his relatives
120
ATTENTION
INATTENTIVE
ATTENTIVE
FLUCTUATING

• Unobserving humor
• Spoken to, averse to being
• Pre-occupied
• Absentminded
• Distraction
• Forgetful

• Gravity
• Attention
• Concentration active
• Earnestness

? Impatience
121
INTELLIGENCE
GENERAL
ARIRHMATIC

• Foolish behaviour
• Ludicrous, things seems
• Precocity
• Silly

? Mistakes in calculating
GRASP
STORY
ABSTRACTION
PROVERB
INSIGHT JUDGEMENT
AWARENESS TO OWN MENTAL CONDITION

• Clairvoyance ?Indiscretion ? Prophesying ?
  Unworthy object seem ? Introspection

CONCENTRATION
REVERSE COUNTING
122
PERSONAL
WITTY
JUDGEMENT ABILITY TO SOLVE REASONABLE
SITUATIONAL
SOCIAL
123
PERSONALITY DISORDER
TIMIDITY
SHYNESS
OBSTINANCY
SENSITIVENESS
EMOTIONAL DISTURBANCES
124

• PERSONALITY DISORDER
• Vindictive
• Squanders money
• Miserly
• Covetous
• Contradiction, intolerant of
• Contention
• Complaining
• Children aversion to
• Carried to be
• Affectation
• Bemoaning
• Wants something, he known no what
• Avarice

125

• TIMIDITY
• Timidity
• Mildness
• Low minded
• Frightened easily
• Embraced
• Cowardice
• Shy

• OBSTINANCY
• Stubborn Secretive
• Despises Dogmatic
• Egotism Fixed notion
• Headstrong Desires
• Heedless Obstinate
• Pertinacity Positiveness
• Suggestion, will not receive
• Well, says when he is sick

• SHYNESS
• Shameless
• Sulky

126

• SENSITIVENESS
• Sentimental
• Sensitive
• Horrible things, sad stories, affects her
• Music, aversion to
• Noise sensitive to
• Offended easily
• Oversensitive
• Senses acute
• Solemn
• Trifles, seems important

• EMOTIONAL DISTURBANCES
• Singing
• Irresolution
• Grumbling
• Frantic, frenzy
• Husband aversion to
• Reveals, secretes

127
BEHAVIOURAL DISORDER

• BEHAVIOURAL DISORDER
• Abusive
• Cruelty
• Selfishness
• Admonition agg.
• Begging, entreating
• Calumniate, desire to
• Chases imaginary objects
• Cosmopolitan
• Inciting others
• Praying
• Qurrelsome

TRUENCY
WANDERING
TEMPER TANTRUM
STEALING
CRUELITY
128

• TRUENCY
• Blindness, pretended
• Deafness, pretended
• Deceitful
• Distrustful
• Lie, never speaks the truth, doesnt know what
  she is saying
• Mischievous
• Untrustful

• WANDERING
• Emotional
• Travel desire to
• Wander desire to

• STEALING
• Hide, things
• Kleptomania

129

• ?Rudeness
• ?Scolding
• Scorn
• Scratches, with hand
• Spiteful
• Tear things
• Unsympathetic
• Hardhearted
• Imprudence
• Impertinence
• Inhumanity
• Insolent
• Kill desire to
• Malicious
• Mocking
• Moral, feeling want of

• CRUELTY
• Fire, wants to set things on
• Cursing
• Cut, others desire to
• Wicked disposition
• Unfriendly
• Unfeeling
• Threatening
• Murder desire to
• Mutilating his body
• Pull, desire to pull ones hair
• Resentment
• Revengeful

130
PICA
ENURESIS
HABIT DISORDER
TEETH GRINDING
NAIL BITING
THUMB SUCKING
131
NEUROSIS
ANXIETY
HYSTERIA
132
ECOPHRASIA (INITIATE MOVEMENT)
ECOLALIA (REPEAT PHRASES)
AUTOMATIC OBEDIENCE (AUTOMATICALLY OBEYS COMMANDS)
NEGATISM (PERFORMANCES OF OPPOSITE ACT)
MANNERISM (REPEATED GESTURE)
MOTOR ASPECT OF BEHAVIOUR
COMPULSION (IRRESISTIBLE URGE TO PERFORM USELESS
ACTS)
CATALEPSY
STEREO TYPE (REPETITIOUS ACTIVITY)
DECREASED ACTIVITY
INCREASED ACTIVITY
133
AUTOMATIC OBEDIENCE VENERATION TRANQUILITY SERENE
QUIET DISPOSITION GENTLENESS BENEVOLENCE
MANNERISM FACETIOUSNESS EMBRACES
COMPANIONS ANTICS PLAYS BUFONARY CHILDISH
BEHAVIOUR GESTURES JESTING MOTION PICKING STRANGE
DECREASED ACTIVITY IDIOCY IMBECILITY SITS, QUITE
STIFF SLOWNESS WEARINESS WEAKNESS WRITING
,AVERSION TO
134
COMPULSION CAUTIOUS CAREFULNESS BREAKING THINGS,
DSIRE TO CARES FULL OF
STEREO-TYPE AUTOMATIC COUNTING, CONTINUALLY
NEGATISM TORMENTS FAULT FINDING DUPLICITY CONTRARY
CONTRADICT, DISPOSITION TO ANTAGONISM WITH
HERSELF HIPOCRASY
INCREASED ACTIVITY ACTIVITY, DSIRES BUSY EXERCISE
INDUSTRIOUS OCCUPATION AMEL. PLAYFUL
135
DEPERSONALISATION (FEELING OF UNREALISE)
ELATION (FEELING OF WELL BEING)
DEPRESSION (FEELING OF DEJECTION)
APATHY (BLUNTING)
ANXIETY (EXCESSIVE TENSION)
FEELING LIFE AND PERSONALITY
AFFECTS
PERVERSION (LAUGH WITH SERIOUS THINGS)
AMBIVALENCE (LOVE HATE CO-EXIST)
SUSTAINED EMOTION OR EFFECTS
EMOTIONAL LABILITY (MOOD SWING)
TENSION (UNEASINESS, RESTLESSNESS,
DISSATISFACTION)
PANIC (PROLONGS TENSION)
136
ELATION LIVELY LIBERTINISM LEWDNESS
LASCIVIOUSNESS HIGH SPIRITED DANCING
VERSES SURPRISE, PLEASANT, AFFECTION
AFTER SMILING FOOLISH CHEERFUL
APATHY GODLESS WANT OF RELIGIOUS
FEEL PHLEGMATIC
EMOTIONAL LABILITY CHANGEABLE WHIMSICAL
FICKLE FITFUL INSTABILITY
PANIC - FORBODINGS
137
TENSION RESTLESSNESS ?SITTING AVERSION
TO ? FIDGETY DISSATISFACTION ? CONSCIENTIOUS ?
SCROPULOUS ? DISCONTENDED ? DISPLACED ?
DISSATISFIED
AMBIVALENCE ? AFFECTIONATE ? WOMEN,
AVERSION TO ? FORSAKEN HIS OWN CHILDREN ?
HATRED ? MISANTHROPY
ANXIETY ? FRETFUL ? EXERTION ? WALKING
RAPIDLY ? FROM ANXIETY
138
DEPRESSION
DESPAIR DIGECTION DEATH, DESIRE
TO AGITATION AMBITION LOSS OF CONSOLATION
AGG. SULLEN SUICIDAL DISPOSITION SLUGGISHNESS SIT,
INCLINATION TO SIGHING
WILDNESS WEARY OF LIFE UNATTENTIVE, THING
SEEM ISOLATION SENSATION OF KILLED, DESIRE TO
BE LOATHING LONELINESS LOVE, AILMENTS FROM
139
DEPRESSION
DISCOURAGED DISGUST ENNUI ESTRANGED FORSAKEN,
FEELING HELPLESSNESS HOME, DESIRE TO
GO HOMESICKNESS HONOUR EFFECTS OF
WOUNDED IRKSOME, EVERY THING IN
140

• Physical Examination
• General appearance
• Decubitus (Skin)
• Body built (Generalities)
• Height
• Anaemia (Generalities)
• - Jaundice (Skin)
• Enlarged glands
• (Generalities)

• Gait
• Edema
• Clubbing
• Cyanosis (Generalities)
• Respiration - rate, type
• Pulse - rate, rhythm, volume character
• (Generalities)
• Blood pressure (Murphys Repertory)
• Weight
• Pigmentation
• Temperature

141

• BODY BUILT-
• GENERALS - OBESITY
• GENERALS - EMACIATION, marasmus
• GENERALS - DWARFISHNESS

142
ANALYSIS OF SYMPTOMS-
143
CONCEPTUAL IMAGE- 1) Unexpected Deviations- 2)
Generalities - 3) Mentals Irritable, Desire
company, Weeping Memory weak. Complaints
aggravates when alone. 4) Physical- Hot patient,
144
CONCEPTUAL IMAGE- Desires milk and
sour. Aversion to sweet. Sweat from palm, soles,
chest. Sleep increased. Dreams of urination. 5)
Characteristic particular- Pain in right knee
joint agg when alone, 6) Common
particulars- Synovitis, Nocturnal enuresis
145
SYNTHESIS OF THE CASE- UNEXPECTED
DEVIATION- CAUSATIONS- GENERALITIES MENTAL- Ailme
nts from being alone. Weeping PHYSICAL- Hot
patient,
146
SYNTHESIS OF THE CASE- Desires salt, meat,
egg Aversion-sweet, sour, Dreams of
urination, CHARACTERISTIC PARTICULARS- Pain in
right knee joint agg when alone. COMMON
PARTICILAR- Synovitis, Nocturnal enuresis.
147
EVALUATION OF SYMPTOMS FIRST GRADE
SYMPTOMS- Complaints agg. when alone. Weeping
tendency. SECOND GRADE SYMPTOMS- Hot
patient, Desires milk and sour. Aversion-sweets. D
reams of urination, THIRD GRADE SYMPTOMS- Pain
in knee joint, agg when alone. Synovitis, Involunt
ary urination
148
TOTALITY Weeping tendency of. Complaints agg
when alone Hot patient Desire for milk and
sour. Aversion to sweets. Dreams of
urination. Pain and swelling in right knee
Nocturnal enuresis.
149
Thus in case of community acute cases are to be
treated. Hence location , sensation modality
and concomitants along with functional history
of appetite, thirst, sleep and elimination
history of stool, urine and sweat are to be
given credence.
150
In clinics acute and chronic cases are to be
treated . Acute case will be dealt as per the
mentioned guidelines by Hahnemann in aphorism
72 and aphorism 73
151
In ward acute and chronic cases are to be
treated.For treating such cases Steps of
Repetorisation are to be adherent strictly.
152
Model Case on Kents Repertory
A patient named X Hindu male aged 12 years
presented the following complaints
153
PRESENT COMPLAINTS
154
MENTAL GENERALS Absent minded Dullness Fear to
be alone, to dark Claustrophobia Weeps when
enraged Irritable
155
PHYSICAL GENERALS Desire for acids, cold
drinks, warm food. Intolerance to sweet. Mustard
coloured urine with pain at close of
urination. Sweat stains the cloth. Dreams of
being dead and carried.
156
General survey Built- Thin moderate built
slightly stooped shoulder Nutrition
poor Pallor-present Anaemia-() severe Facies-
Dull, vacant, moon face Pulse- 88min,
regular Respiration- 22/ min, regular Temp- 98
F Blood pressure- 112/80 mm of Hg Gait-
Normal Weight-34 kg Height- 44.
157
Systemic examination Inspection- Chest-
funnel shaped Movement of chest wall-
normal Engorged veins-On chest and
abdomen Abdomen- Bloated Bulging in
hypochondrium and in upper part of umbilical
region Umblicus is everted
158
Systemic examination Palpation- Chest- sternal
tenderness() Others-NAD Abdomen- Spleen-
palpable, extends up to left side of umbilicus
region Surface regular/smooth. Firm in
constiency Not clearly defined. Liver- Enlarged
, palpable Left lobe 2 enlarged from right
costal margin Surface smooth Soft in consistency
159
Systemic examination Urinary bladder-
distended, tender and palpable mass in supra
pubic region(?) Ascending colon-
tender Descending colon- Tender ,
palpable Caecum- tender Percussion- Abdomen-
Dullness over splenic enlargement Dullness
over enlarged liver. Auscultation- Chest, soft
systolic murmur in all the areas but more
prominent in pulmonary area.
160
Lab investigations
Blood- Serum protein- T.L.C- 7000/
cumm Total- 8.6 gm DC Albumin- 5.1gm N-
40 Globulin- 3.5 mg E- 12 M.C.V
86mm3 B-0 G.P.T-11 units/ml L-46 M.C.H
23pg R.B.C.-2.5 million/cumm. Hb
6.2gm E.S.R 32 mm/1st hour Anisocytosis P.C
.V 18 M.C.H.C 21
161
Lab investigations
Liver Function Tests Vanden Bergh test Direct
delayed (ve) Total Bilirubin 1.1
mg Conjugated Bilirubin 0.8 mg Alkaline
Phosphatase 26 K. A. Units Serum cholesterol
87mg
Straight X-ray of the abdomen Huge enlargement
of the spleen
162
Probable diagnosis is - CHRONIC HAEMOLYTIC
ANAEMIA (Thalassemia?)
163
Conceptual image
1. Unexpected deviation- 2. Causations- 3.
Generalities A. Mental Dullness, answers
with great difficulty. Comprehension
slow Irritable Weeps hen enraged Fear of
being alone, to dark Claustrophobia
164
Conceptual image
B. Physical- Desire acid, cold food, spicy
food, and sweet Intolerance sweet Urine
mustard coloured with pain at close Sweat
generalized stains the cloth Sleep profound
with stretching and yawning Dream being dead
and carried Agg At night, Empty stomach Amel
Food after
165
Conceptual image
4. Characteristic particulars a. Gum ,bleeding
while brushing at morning night (foeter
oris) 5.Common particulars Hardness/aching
pain in left hypochondrium lt empty stomach,
night gt after food. Hearing impaired. Vision
impaired. Weakness of right hand while writing.
166
Synthesis of the case
1. Unexpected deviation- 2. Causations- 3.
Generalities A. Mental Dullness, answers
with great difficulty. Irritable Weeps hen
enraged Fear of darkness Claustrophobia
167
Synthesis of the case
B. Physical- Desire acid, spicy
food Intolerance sweet Urine high coloured
with pain at close Sweat stains the
cloth Dream being dead and carried Agg At
night, Empty stomach C. Pathological- Anaemia
168
Synthesis of the case
4. Characteristic particulars a. Gum ,bleeding
while brushing at morning night (foeter
oris) 5.Common particulars Vision
impaired. Weakness of right hand while writing.
169
Evaluation Totality of the symptoms (Repertorial
totality)
First grade symptom- Irritability Weeping
enraged while Fear of darkness Claustrophobia D
ullness
170
Evaluation Totality of the symptoms (Repertorial
totality)
Second grade symptoms- Desire acids, spicy
food Intolerance sweets Urine High colored
with pain at close of urination Sweat
stains the cloth Night Aggravation Empty
stomach Aggravation
171
Evaluation Totality of the symptoms (Repertorial
totality)
Third grade symptoms- Gum ,bleeding while
brushing at morning night Hearing
impaired Vision impaired Weakness of right hand
while writing Anaemia
172
Miasmatic assessments
173
Miasmatic assessments
174
Miasmatic assessments
175
Miasmatic assessments
176
Miasmatic assessments
177
Miasmatic assessments
178
Selection of Rubrics in Kents Repertory

• Mind, irritability- 57
• mind, weeping, anger after-93
• Mind, fear, dark of-43
• Mind, dullness-37
• Mind, answers difficult-3
• Stomach, desire, sour- 48
• Stomach, desire, highly seasoned food- 48
• Generalities, food, sweet aggravation-1364

179
Selection of Rubrics in Kents Repertory
9. Urine colour dark-683 10. Urethra, burning,
cutting urination close at-1302 11. Perspiration,
staining the linen-1301 12. Generalities,
night-1342 13. Generalities, hunger from-1367 14.
Mouth, bleeding, gums, cleaning when-398 15.
Mouth, odour putrid- 409 16. Vision, blurred-
271 17. Weakness, hand, writing while-1277 18.
Generalities, anaemia-1344 19. Hearing ,
impaired-321
180
Repertorial Results

• Phos. 13 / 65
• Puls. 11 / 61
• Sulph. 13 / 59
• Sep. 10 / 47
• Lyco. 11 / 46
• Carb. Veg. 10 / 45
• Nat. mur. 10 / 43
• Rhus tox. 11 / 41

181
Model Case based on Boenninghausens Therapeutic
pocket book
A patient named X Hindu female aged 15 years
presented the following complaints
182
Present Complaints
183
History of Present Complaints
To start with there was itching of the eyes at
first, then profuse lachrymation, and later, a
sensation as if pins were sticking in the eyes
and then gradually all the symptoms appeared.
184
General survey Built- Thin moderate built
slightly stooped shoulder Nutrition
poor Pallor-present Anaemia-() Facies-
Dull Pulse- 72 / min, regular, Respiration- 18/
min, regular Temp- 98 F Blood pressure- 100/70
mm of Hg Gait- Normal Weight-40 kg Height- 47.
185
Systemic examination
Inspection- Chest- Bilaterally
symmetrical Movement of chest wall-
normal Abdomen- Bloated Nose examination- Turb
inates swollen
Palpation- Chest- sternal tenderness()
186
Lab investigations
D.C shows Neutrophil 60 Eosinophil
15 Basophil 0 Monocyte 5 Lymphocyte 20
187
Probable diagnosis is - Allergic Rhinitis
188
Conceptual image

• Unexpected deviation-
• Causations-
• 3. Generalities
• A. Mental
• B. Physical
• Chilly patient, takes cold easily
• Sleepless due to stopped of nose
• C. Pathological
• D. Modalitiesltnight, light, reading, dry
  weather .
• gtrainy days

189
Conceptual image
4. Characteristic particulars Itching of the
eyes with profuse Lachrymation lt
night Stoppage of noseltnight gt on first rising
in the morning Sneezing lt night Expectoration
of thick, yellow mucus lt night gtcough
190
Synthesis of the case

• Unexpected deviation-
• Causations-
• 3. Generalities
• A. Mental
• B. Physical
• Chilly patient, takes cold easily
• Sleepless due to stopped of nose
• C. Pathological
• D. Modalitiesltnight, light, reading, dry
  weather .
• gtrainy days

191
Synthesis of the case
4. Characteristic particulars Itching of the
eyes with profuse Lachrymation lt
night Stoppage of noseltnight gt on first rising
in the morning Sneezing lt night Expectoration
of thick, yellow mucus lt night gtcough
192
Miasmatic Assessment
193
Miasmatic Assessment
194
Selection of Rubrics in BTPB
195
Selection of Rubrics in BTPB
196
Selection of Rubrics in BTPB
197
Selection of Rubrics in BTPB
198
Repertorial Results
Silicea 27/113 Pulsatilla- 26/115 Phos
26/110 Sulphur 26/109 Nux vom 26/103 Bryonia
26/102 Arsenic 26/97 Causticum 26/78
199
Model Case of Boenninghausens
Characteristics and Repertory
200

• Presenting complaints
• Menorrhagia, bright red blood, flow more at
  night
• Too profuse dark in color lack of sexual
  desire.
• There is vertigo before menses.

201

• Presenting complaints
• She is dissatisfied because her mother-in-law
  criticizes her it is a continuous issue in her
  family.
• Patient complaint of hoarseness of voice.
• There is extreme burning of palms soles.

202
GENERAL SURVEY Built- Obese built slightly
stooped shoulder Nutrition Average Pallor-presen
t Anaemia-() Facies- Dull Pulse- 76 / min,
regular,
203
GENERAL SURVEY Respiration- 16/ min,
regular Temp- 98 F Blood pressure- 140/98 mm of
Hg Gait- Normal Weight-82kg Height- 51
204
MENSTRUAL HISTORY Cycle - Every 20 days Flow -
For 6 days Quantity- profuse flow Character of
flow- Bright red fluid Concomitant - vertigo
before menses.
205
PHYSICAL GENERALS Thermal state Hot
patient Appetite Increased Thirst For large
quantities of cold water Sleep Normal Dream
frightful Salivation Absent
206
PHYSICAL GENERALS Perspiration Foetid
perspiration Stool Bowels, regular, urging
early in morning Desire Salt, sweet Aversion
Fish Aggravation Milk
207
SYSTEMIC EXAMINATION ABDOMINAL Liver-Surface
smoothSoft in consistency not
palpable.Abdomen- BloatedSurface is
nodularFirm in consistencyDull on percussion.
208
Pelvic exam -Bimanual exam uterus irregularly
enlarged by the swelling felt. Investigations
-USG of abdomen pelvis- A fibroid mass of size
12 mm is found in uterus.   The probable
diagnosis is Uterine fibroid.
209
The hierarchical arrangement of symptoms  Using
Causative modalities -Censure aliments
from Modalities, aggravations -Night
aggravation Physical generals and pathological
generals - Menorrhagia Concomitant-Vertigo Sensat
ion locations Ute