BY DR SREELEKHA,BHMS,M.

O I/C SEEMAPURI
DISPENSARY &DR B.K.SAHOO BHMS M.D M.OI/C
AJMERIGATE DISPENSARY
1.Individulaztion the symptoms of patient.

2.Totality of the characteristics symptoms.

3.Indentify the Chronic miasm.

4.Choose the correct constitutional remedy.
1.He should build trust with patient by good
eye contact& showing active interest.

2.He should use appropriate language &give
chance to patient to express freely.

3.He should present himself
caring,comptent&confident.

4.He should be an Unprejudiced observer.
1.Clinical diagnosis. (Based on
signs,symptoms&laboratory finding)

2.Remedy diagnosis. (From analysis of
symptoms )

3.Prognosis of case.

4.Management .
1.PRELIMINARY DATA
2.PRESENT ILLNESS
3.PAST HISTORY
4.CURRENT HEALTH STATUS
5.FAMILY HISTORY
6.CLINICAL EXAM & DIAGNOSIS
7.ELICITATION OF MENTAL SYMPTOMS
8.VALUATION &TOTALITY OF SYMPTOMS




AGE

SEX

OCCUPATION

DATE& TIME
O-ONSET
P-PROVACATION(AGG,AMEL OR RELIEVING
FACTOR)
Q-QUALITY (COMMON TO UNCOMMON
SYMPTOMS)
R-REGION&RADIATION
S-SEVERITY&INTENSITY
T-TIME(DURATION OF COMPLAINTS)
ASSOCIATE SYMPTOMS
RECURRANCE OF SYMPTOM

CHILDHOOD DISEASE
ADULT DISEASE
ACCIDENT OR INJURY
SURGERY OR HOSPITALIZATION
IMMUNIZATION & ITS ADVERSE EFFECTS
MEDICATIONS
LIFE STYLE(Habits of
smooking,alcohol,tobacco,special craving or
aversion for food)
SLEEP PATTERN
DAILY LIFE& ACTIVITES
SPECIFIC ALLERGY
RECATION TO ENVIORMENTAL
CHANGES,(heat,cold,season)

1.PATIENT WITH MULTIPLE SYMPTOMS
2.INTOXICATED PATIENT
3.LANGUAGE BARRIER
4.PATIENT WITH DIFFCULT IN HEARING&
VISION.
5.PAEDIATRIC CASES
6.OLD OR GERIATRIC CASE
7.HYPOCHONDRIAC OR HYSTERICAL PT.
SADNESS-(Dropped mouth& eye lids,
tears)

DISGST(wrinkled nose, frowned
eyebrows, pressed lips & chin)
PSYCHOLOGIST VIEW
1.It has established that certain diseases have connection between
emotional experience &physical symptoms i.e. somatization,physical
symptoms without diagnosis.e.g INSOMANIA,HEADACHE ,OBESITY,GT
DISTRESS,IBS,PALPITATION,CHORNIC PAIN,FATIGUE.
2.Supressed or unresolved emotional pain affect our health e.g.
ACE(ADVERSE CHILDHOOD EXPERIENCE)A/F ANGER,GRIEF,DISAPPOINT
LOVE ETC.
3.So healing of past EMOTIONAL EXPERIENCE create positive physical
changes in the body. It require counselling & empathy of health care
providers
HOMOEOPATHIC VIEW__.
1. The collection of data that characteristics changes in
mental state in a patient with physical illness or vice
versa are true guide for selection of remedy.
2. The extreme &persistent emotional changes or reactions
in response to events in a patient are essential
component of case taking.
3. It associate with MOOD,TEMPARMENT ,PERSONALITY&
BIOLOGICAL RECATION of an individual.
SOME MENTAL STATE OBSERVATIONS
SPONTANEOUS SPEECH(EAGERNESS,ENTHUSIATIC)
GREET ON FIRST VISITPHOSPHOURS,CAUSTICUM.
VOLUMINOUS SPEECH--- (HYSTERICAL- IGNATIA),HASTY SPEECH(ARG.
NIT,MERC.)VISIBLE IRRITABLE SPEECH(CANT WAIT FOR LONG TIME IN WAITING
ROOMNUX),ANSWER ONLY TO QUESTION- NAT MUR.
NO FACIAL EXPRESSION,SIT UP RIGHT POSTURE(APATHETIC,INDIFFRENCE),

TENSE POSTURE(APPREHENSION,WORRIES,NERVOUS),
LEAN FORWARD(EXTROVERTED,EAGERNESS,ATTENTIVENESS)
MAKE NO EYE CONTACT(SHYNESS OR HIDING SOMETHINGS),
LAZY (AVERSION TO WORK,STUDY,BUSINESS),
IMPULSIVE(JUMPS FROM ONE IDEA TO ANOTHER,TOCH THINGS IMPELLED
TO,QUICK TO ACT),
SADNESS,GRIEF(WEEP,TEARFUL MOOD,FROWNING,),
CARING,KINDNESS,EMPATHY(AWARNESS SUFFERING OF OTHERS),
FEAR,PHOBIA(CROWDED PLACE,CLOSE ROOM,HEIGHTNESS,DARKNESS)
PARANOID(IRRATIONAL FEAR,SUSPECIOUSNESS,MISTRUST,HOSTILE)
MEMORY ERRORS IN SPEAKING,INABLITY TO RECALL THE NAME(LYCO)
APPEARANCE-
CLUMSY,DIRTY ,UNTIDNESS(SULPHUR),
TIDNESS,CLEANLINESS,METICULOUS,ANXIOUS ABOUT PETTY DETAILS(ARS ALB)

ASSESMENT OF MENTAL SYMPTOMS DURING CASE TAKING

1. HOW DO YOU REACT TO OBSTACLES IN LIFE CREATED EITHER BY NATURAL OR
OTHERS? WHAT ARE YOUR FEELING THE PEOPLE WHO OPPOSE?

2. WHAT ARE SITUATION OR CIRCUMSTANCES THAT CAUSE THE HIGHEST DEGREE OF
ANXIETY OR FEAR?

3. WHAT TYPE OF ACTIVITES GIVE YOU PLEASURE?

4. WHAT ARE THE FACTORS THAT ADD OR TAKE AWAY PLEASURE OF YOUR LIFE?

5. DO YOU HAVE ANY PROBLEM RELATED TO SEX?

6. HOW IS YOUR REALTIONSHIP WITH SOCIETY,FAMILY& ASSOCIATE?

7. IS THERE EFFECT ON GRIEF,SHOCK,DISAPPOINTMENT IN YOUR LIFE?

8. DO YOU HAVE DIFFCULTY IN UNDERSTANDING , THINKING?

9. DO YOU HAVE ANY FIXED IDEA OR STRONG FEELING?

10. DO YOU HAVE ANY COMPULSIVE HABITS OR OBESSIVE THOUGHTS?

CONCLUSION
1. In modern age of practice many
patients present in front of us with multitude of
symptoms related to socioeconomic, emotional
stress related or hygienic. They present themselves
with list of prescription &most of them are
undiagnosed.
2.It is a challenge before us to solve
their problems with appropriate medicine &
advice. So we should be familiarized with other
systems which are involving in health care
delivery system.
3.To practice successfully , we should
reach out to the patient with dedication & sincerity.





KEY STEP FOR MANAGEMENT

1.SELECTION OF REMEDY.

2.OBSERVATION ON REMEDIAL REPONSE.

3.FOLLOW UP THE CASE.

4.REFEERAL (If necessary).

5.DIET& LIFE STYLE MANAGEMENT.


THANKS