Abstract
Observation plays a major role in Homoeopathic case taking. The true significance of importance to observation comes in clinical practice. Unlike Allopathy, which focuses treatment on disease diagnosis, Homoeopathy requires detailed case analysis, incorporating the principles of Organon of Medicine, Homoeopathic Materia Medica, and Homoeopathic Repertory to identify the most suitable similimum for the patient.
This article highlights the importance of observation in Homoeopathy through practical examples highlighting Allopathic and Homoeopathic approaches. Cases below illustrate Homoeopathic practitioners who not only focus on chief symptoms but also considers sensations, behaviors and modalities required to individualize the patient which narrows down to the most similar remedy achieving deeper healing.
Content
Throughout our academic journey, from the first year to the final year, we often hear our teachers emphasize the importance of patient observation in Homoeopathy. However, as students, we tend to overlook these words, focusing instead on memorizing points for examinations. We learn the characteristic features of remedies merely for the sake of passing tests, without fully grasping their practical significance.
It is only when we begin to practice that we truly understand the value of these teachings. In a Homoeopathic setup, observing each minute detail and characteristic of a case is a fundamental part of prescribing the correct similimum.
But when we find ourselves in an Allopathic setting, working alongside Allopathic practitioners, we begin to realize the depth of observation required in Homoeopathic case taking.
During internship, we have the opportunity to interact with Allopathic practitioners in various cases. On one occasion, a medical intern, curious about our approach, asked how we take cases and apply medicines. This conversation highlighted the connection between Homoeopathic Materia Medica, Organon of Medicine, and Homoeopathic Repertory.
The Role of Observation in Case Taking
Consider a patient in an Allopathic outpatient department (OPD) who presents with the complaint:
“I have a severe headache, as if my head would burst!” (while grasping their head with both hands and appearing highly irritable).
An Allopathic doctor would focus only on the term headache and prescribe Paracetamol 650 mg (1-0-1). In contrast, a Homoeopathic doctor would take into account not just the headache but also:
The intensity (severe headache)
The sensation (as if the head would burst)
The accompanying action (grasping the head with both hands)
The emotional state (irritability)
By analyzing these details, the Homoeopath would correlate the case with Organon of Medicine for principles of case taking, refer to Homoeopathic Materia Medica for characteristic symptoms, and use Repertory to narrow down the list of potential remedies. Further evaluation would then lead to the most suitable similimum.
Examples Highlighting Homoeopathic Observation
- Abdominal Pain with a Strange Sensation
A patient complains, “I have abdominal pain, and it feels as if something is alive inside my abdomen.”
An Allopathic physician may ignore the sensation and prescribe medication for abdominal pain.
A Homoeopathic physician, however, would take note of both abdominal pain and the peculiar sensation of something alive, leading to a more individualized prescription.
- Cough with Time Modality
A patient experiences a persistent cough that worsens between 3 AM and 4 AM.
In Allopathy, treatment would focus on suppressing the cough.
In Homoeopathy, the time modality is crucial in remedy selection, guiding the doctor toward a more precise prescription.
- Behavioral Observation in a Case of Hypertension
A patient rushes into the OPD and demands a blood pressure check while simultaneously using a mobile phone, seemingly indifferent to their own condition.
A Homoeopathic physician would observe this indifferent or careless attitude, which could be an important symptom in remedy selection.
- Fever with Flushed Face
A patient presents with fever along with significant flushing of the face.
In Allopathy, the fever would be treated by antipyretics.
In Homoeopathy, the flushed face would be a key observation, helping to identify a remedy specific to the patient’s presentation.
We know that a particular disease has numerous remedies in Homoeopathy. However, when a Homoeopathic physician carefully observes the specific signs and symptoms in a patient, they can identify a more accurate remedy for the patient, leading to effective healing.
Some of the examples from ‘Keynotes by H.C Allen’ where a doctor can make a note of the patient to choose the right remedy.(1)
- Ammonium carbonicum – Women who must have the smelling bottle continually at hand; readily catch cold in winter.
- Aloe socotrina – Jelly-like lump from mucous membrane.
- Lachesis, Amylenum nitrosum – Collar seems too tight, must loosen it.
- Allium cepa – Patient grasps larynx on coughing.
- Anacardium orientale – Feels as though he had two wills, one commanding him to do what the other forbids.
- Antimonium crudum – Irrestible desire to talk in rhymes or repeat verses.
- Apis mellifica – Edema under eyes.
- Kalium carbonicum – Edema over eyes.
- Bismuth – Headache returns every winter, alternating with gastralgia.
- Antimonium tartaricum – When the patient coughs up there appears to be a large collection of mucus on bronchi, it seems as if much would be expectorated, but nothing comes up.
- Arum triphyllum – Constant picking at the nose until it bleeds; boring with finger into the side of the nose. Pick lips until they bleed, bite nails until fingers bleed.
- Cactus grandifloras – Whole body feels as if caged.
- Corallium rubrum – Eruption which are of coral red colour. Cough as gurgling sound as if water was being poured from a bottle.
- Bromium – Fan like motion of alae nasi.
- Gelsemium, Argentum nitricum – Diarrhea sets in when ready for church or opera.
- Sepia– Yellow nose
The following are the key areas where Dr Samuel Hahnemann provides guidance on a physician’s observation during case taking, as mentioned in 6th edition of Organon of Medicine(2)
Aphorism 6 – Unprejudiced Observer
Dr. Hahnemann emphasizes that a physician should always be an unprejudiced observer when taking a case. Each case should be approached as entirely new, without being influenced by past experiences which can either end up in mal observation or non observation. The physician should carefully note the deviations in the patient’s health, presented by the patient and observed by himself.
Aphorism 83 – Qualities of Physician
Dr. Hahnemann mentions that while examining a case or individualizing the person, the physician should be free from prejudice, possess sound senses, attention in observing and fidelity in tracing the picture of the disease.
Aphorism 90 – Physician’s Observation
Dr Hahnemann mentions that physicians should make a note of what he himself observed in the patient.
In the footnote Dr Hahnemann gives us examples such as behaviour of patient, overall state, facial complexion, eyes and skin colour, breathing pattern, pupils, pulse of the patient etc.
Next we will explore some rubrics in Kent Repertory which can be noted characteristic when observed in a patient
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- Mind, delusion, disease that he has every : Aur-m, stram
- Eye, styes, recurrent : Alum, carb-s, con, graph, psor, sil, sulph
- Mind, refuses to take the medicine: hyos
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- Ear, discharges, gluey, sticky: Graph, nat-m
- Face, twitching, lips, upper: Agar, ars, carb-v, graph, nicc, thuj, zinc
- Mind, weeping joy, from: Coff, lach, plat
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- Head, pain, shaking head, amel: Cina, gels, hyos
- Aversion, smell of: Ars, cocc, colch, ip, podo, sep
- Urethra, hemorrahage, stool during: Lyc, puls
- Cough, paroxysmal, consisting long coughs: Ambr, carb-v, cupr, ip, lob
- Back, injuries of the spine, lifting from: Calc, rhus-t
- Extremities, cramps, night: Merc
Conclusion
Observation is the cornerstone of Homoeopathic practice. While Allopathy often focuses on diagnosing diseases and prescribing medications accordingly, Homoeopathy looks into individual symptoms, sensations, and behavioral patterns. The integration of Organon of Medicine, Homoeopathic Materia Medica, and Homoeopathic Repertory allows a Homoeopathic physician to identify the most accurate similimum, leading to deeper healing. What we initially learn as theoretical knowledge in medical school becomes profoundly meaningful in real practice. The words of our teachers about patient observation hold immense value, shaping us into keen observers and skilled homoeopaths.
References
- Keynotes rearranged and classified with leading remedies of the materia medica added with other leading nosodes and bowel nosodes by H.C ALLEN
- 6th edition of Organon of Medicine by Samuel Hahnemann.
- Repertory of the Homoeopathic Materia Medica by J.T Kent.
Authors
Sahana Sapthashree J R
Intern – Yenepoya Homoeopathic Medical College and Hospital Yenepoya (Deemed to be University) Mangaluru
Guide: Dr Melita Alva
Additional Professor and Head of the Department, Department of Homoeopathic Materia Medica, Yenepoya Homoepathic Medical College and Hospital Yenepoya (Deemed to be University) Mangaluru
