1. Case taking and analysis

2. What is a homeopathic consultation?
When does the consultation become
homeopathic ?
Ask the audiencewhat they think
What makes them think of a homoeopathic approach ?

3. Why choose to open up the possibility of a homeopathic treatment ?
You were recently on a course
Colleague referral
Patient request
Well established indication
Strange, rare or peculiar symptom
Importance of attending courses
“Fat” notes and “heart sink” patients
Colocynth and colic
Burning pains > heat

4. Two Goals of The Homeopathic Consultation
Understanding the patient’s illness
Finding the remedy
Chase the remedy, lose the patient
5 Failings of Physicians, The Yellow Emperor’s Classic of Medicine ( years BC)
1. failing in diagnosis
2. failing in treatment, when physician neglects the patient’s emotional experiences
3. failing in deductive reasoning, without careful observation and history
4. failing in counselling, lacking compassion and sincerity
5. failing when simply inept and careless when administering medical care,

5. Koelher p
“ The aims of case-taking are initially the same as in modern medicine generally A diagnosis is to be made where possible. The prognosis is determined and assessed. A treatment plan is drawn up.”
The Handbook of Homoeopathy Gerhard Koehler
Organon para 3
If the physician clearly perceives what has to be cured in disease (knowledge of the disease)
if he clearly perceives what it is in medicines which heals (knowledge of medicinal powers)
if he applies in accordance with well-defined principles what is curative in medicines to what he has clearly recognised to be pathological in the patient, so that cure follows i.e. if he knows in each particular case how to apply the remedy most appropriate by its character (selection of the remedy), prepare it exactly as required and give it in the right amount (the correct dose), and repeat the dose exactly when required,
and, lastly, if in each case he know the obstacles to cure and how to remove them, so that recovery is permanent,
then he knows how to treat thoroughly and efficaciously, and is a true physician

6. Koelher p
“A patient’s signs and symptoms provide the material for finding the appropriate homoeopathic drug
the next stage is the encounter with the patient.”

7. The “Encounter” Understanding the patient Ask the patient for examples
Try to put yourself in the patient’s shoes
The practitioner’s attitude

8. Koelher p
Preconditions for good history-taking
calmness, time, patience, unbiased attitude, careful attention
Organon 83
This individualizing examination of a case demands of the physician only impartiality, sound senses, attentive observation, and faithfulness in recording the disease picture.

9. Vithoulkas p
“the environment should be quiet, with harmonious, simple, esthetic decor.”
Vitoulkhas The Science of Homoeopathy

10. The Homeopathic History
Presenting complaint
Past Medical History, Family History, Drug History, Social History, Allergies
“Complete Symptoms”
? normal so far
What is a complete symptom ?

11. What is a “Complete Symptom” ?
Aetiology
Localisation
Sensation
Modality
What preceded it?
Where exactly is the symptom experienced?
What exactly is the sensation ? What kind of pain ?
What if anything modifies the sensation ?

12. The Homeopathic History Generals
Appetite
Food
Aversions
Desire
Aggravations
Thirst
Sleep and Dreams
Typical physiological questioning

13. The Homeopathic History Generals
Temperature
Perspiration
Weather
Time
Menses
Hot person or cold person?
What about in bed?
Are there any time patterns - either locally or generally

14. The Homeopathic History
Other systemic enquiry
Mental symptoms

15. The Homeopathic History Mentals
How would you describe yourself ?
How would others describe you ?
May want to actually ask others - eg. parents of child

16. The Homeopathic History Mentals
Anxieties
Fears
Depression, apathy
Lack of self-confidence
Irritability, anger
Sensitivity, tears
Do you worry about anything?
Are you afraid of anything - dark, animals, thunder?
Do you get down?
What makes you angry?
What things upset you?

17. The Homeopathic History Mentals Quality of relationships
company
consolation
confrontation
contradiction
jealousy
sexual function
Emotional responses revealed in human interactions
Can the audience name any remedies with clear features around these areas?

18. The Homeopathic History Mentals Cognitive function
Memory
Concentration
Mistakes
Delusions
Poor memory for what? - repertory - Memory and forgetful - esp. “words” - “word-hunting” - patient with Bothrops
Concentration difficult - studying - and cross-reference thoughts wandering, studying (ham, phys)
Mistakes for what?

19. Recording the History Where to record the history

20. Recording the History How to record the history
one symptom per line
underlining
clarity
intensity
spontaneity
Organon 84
He write everything down exactly, including the verbatim expressions of patient and relatives.
Whenever possible he remains silent to let them finish what they have to say without interrupting them, as long as they do not digress unduly.
Organon 85
The things the patient or his relative say should be written down on separate lines so that all the symptoms appear seperately, one above the other. In this way the physician can add to any one of them that is too vague, in the begining, information subsequently stated more clearly.
Vithoulkas p 182
No underlining. Symptoms which are hazy, not given spontaneously, not perceived as intense by the patient
1 underline. greater clarity and intensity but elicited only on questioning
2 underlines. great clarity, mod. intensity and volunteered spontaneously
3 underlines. highest clarity, great intensity, entirely spontaneously given

21. Recording the History How to record the history
margins for remedies
marking selected symptoms with an asterix
recording sheets

22. Making Sense of it all Diagnosis Prognosis www.facultyofhomeopathy.org
First understand what is going on
then
have some idea of where it might go - with and without treatment

23. Quality or “Precision” of symptoms
Characteristic, striking and unusual symptoms
Spontaneous symptoms - with emphasis
“Complete symptoms”
Long-standing or new symptoms which are deteriorating
Relationship to Vithoulkas’ underlining scheme

24. Making sense of it all What symptoms are important to the patient?
What symptoms are you trying to “treat” ?
“Complete symptoms”
“Strange, rare and peculiar symptoms”
Where is the level of disturbance ?
What is the centre of gravity of the case?

25. “Complete symptoms” Aetiology Localisation Sensation Modality

26. The level of the disturbance
Peripheral - “local”
Physiological - “central” or “general”
Mental
cognitive
emotions
? examples
injury
thyroid disease
grief
PNI - the connections

27. Ranking order of symptoms
SRPs - Strange, rare and peculiar
Aetiology
Mental and intellectual symptoms
General symptoms relating to the whole person
Local symptoms with modalities &/or concomitants