1) Case taking is an art that involves conversation, observation, and collecting information from the patient and others to understand the patient and their disease. 2) Hahnemann provides detailed guidance on case taking for acute vs chronic diseases, diseases from other physicians, difficulties assessing chronic diseases, and recording information. 3) Key aspects of case taking include not leading the patient, understanding lifestyle factors, assessing specific symptoms, and accurately documenting the patient's description of their condition in their own words.

1. CASE TAKING - § 83 -104
Dr Aiswarya M.S
P.G PAEDIATRICS

2. Case taking
By
Master Samuel Hahnemann

3. Case taking is a unique art of
getting into conversation,
observation and collecting
information from patient, as well as
from bystanders to define the
patient as a person and the disease.

4. §83-90 : general instructions
§91-93 : patients coming from other physicians.
§94-98 : difficulties in chronic case taking.
§99: acute case taking.
§100- 102 : epidemic and sporadic diseases.
§103 : chronic miasmatic maladies.
§104 : record keeping.

5. § 81-why do we get
sick?
• congenital
• Acquired(aphorisms 74,75,76,77)
• Life itself(81 footnote)-climate, physical
character of the place, physical and
mental training of youth.
• Diet and regimen.
• passions, manners, habits and customs.

6. Genetic predisposition
Secondary symptoms of psora(acquired) due to
lifestyle or allopathic medicines.
Acute or Chronic diseases
Incurable allopathic treatment
chronic incurable and Genetic disease.

7. §82-Individualisation
• Strict personal care by careful casetaking
is must.
• Acute -chief symptoms, less time, fresh in
memory.
• Chronic –more time.

8. § 83- Demands of the
physician
• freedom from prejudice
• sound senses
• attention in observing
• fidelity in tracing the picture of the
disease.

9. § 84
• He writes down accurately all that
the patient and his friends have told
him in the very expressions used by
them.
• The physician sees, hears, and
remarks by his senses what there is
of an altered or unusual character
about patient.
Fn :Every interruption breaks the train of
thoughts.

10. § 85
He begins a fresh line with every
new circumstance mentioned by the
patient or his friends
§ 86
When the narrators have finished
what they would say of their own
accord, the physician then reverts
to each particular symptom and
elicits more precise information

11. § 87
✓Should not ask YES or NO question
✓Should not ask any leading question that
itself suggest an answer
Fn – tend to seduce patient to give a false
answer.

12. § 88
The physician asks- functions of the
body and the state of his disposition
or mind.
Fn 88, master advices to note the character
of stool, urine, sleep, state of his disposition,
his humour, memory, thirst, taste, food and
drinks, unusual taste, anything about head,
limbs or abdomen .

13. § 89
The physician asks- more precise,
more special questions.
Fn 6th edition of 89, master advices to note
the character of menstruation and other
discharges etc.

14. § 90
• Physician has to note down his own
observations about the individual
peculiarity of the patient in disease and
health.
Fn eg –behavior of patient, speech, colour of face and
eyes, skin, degree of liveliness, nature of tongue,
breathing, smell from mouth, hearing, character of
pulse, condition on abdomen, position of sleep.

15. Patient comes from other
physician
• 91-chronic cases……….what to do?
Stop medications to get uncontaminated
symptoms and furnish pure picture of the
disease. Give placebo.
• 92- acute cases……….. what to do?
Just form an apprehension of the
complete picture of disease and prescribe
as you cannot wait/delay.

16. • Treat and save life.
• Medicinal disease with severe side effects by
use of inappropriate drugs.
• Severe acute diseases.
• Conjoint malady

17. • 93-obvious cause……chronic/acute
…..what to do?
How to get private H/O from relatives/
friends.
•Psychiatric cases.
•Pediatric cases.
•Comatose/ICU cases
93 fn: Any causes of disgraceful character - by
skillful framing of questions or by private
information.

18. Fn 93
93 fn: major disappointing events, attempting suicide,
unnatural debauchery, family worry, grief, injured
pride, masturbation, infection with venereal diseases,
extra marital affairs, unfortunate love, jealousy, sexual
perversions, superstitious fear, hunger, imperfection in
private parts .

19. § 94
-maintaining causes
While inquiring into the state of
chronic diseases, the particular
circumstances of the patient with
regard to his occupations, his usual
mode of living and diet, his domestic
situation, and so forth, must be well
considered.

20. § 94 fn
Female case taking- 7 points
•Pregnancy
• sterility
• sexual desire
• miscarriages
• suckling
•state of menstrual discharge
• leucorrhoea

21. § 95
How to underline or give intensity to the
symptoms of patient?
•PREGNET WITH MEANING!!
•CREATE A TIMELINE IF A CLEAR TOTALITY
IS NOT AVAILABLE in chronic disease.
•Difficult to get PQRS or accessory symptom in
case of chronic disease, because of
•Patient has FORGOTTEN in suffering.
•MODIFIED due to treatment.
•Symptoms have become their part of life.

22. § 95
About lesser accessory symptoms.
Symptoms which are often pregnant with
meaning, very useful in determining the choice
of remedy and regard them as most necessary
part of their condition, the real feeling of
which they have well forgotten and can scarcely
believe that these greater or lesser deviations
from healthy state, can have any connection
with their principal malady.

23. § 96
hypochondriacs and other persons
of great sensitiveness and
impatient of suffering.
FN : physician gives placebo but we
must deduct something from their
exaggeration, the strong character of
their expressions to their excessive
sensibility.

24. § 97
• partly from indolence, partly from
false modesty, partly from a kind of
mildness of disposition or weakness
of mind, refrain from mentioning
their symptoms.
• Open patient
• Closed patient
• Intellectual patient.
• Ask Leading questions

25. § 98
QUALTIES OF HOMOEOPATH IN CHRONIC
CASE TAKING
• As certainly as we should listen particularly to
the patient's description of his sufferings and
sensations, and attach credence especially to
his own expressions wherewith he endeavors to
make us understand his ailments - because in
the mouths of his friends and attendants they
are usually altered and erroneously stated.

26. § 99
• Investigation of acute diseases is
much the easiest for the
physician.
• All phenomena and deviations are
fresh in the memory of patient.

27. § 100-102
• epidemic disease
• In investigating totality of symptoms
of epidemic and sporadic disease it is
quite immaterial whether or not some
thing similar has ever happened in the
world before under the same or other
names.
• Totality of its signs and symptoms
collected by close observation of
several cases.

28. § 103
•Whole array of symptoms belonging to such a
miasmatic , chronic disease and especially to
psora can only be ascertained from the
observation of very many single patients
affected with such a chronic disease and
without a complete survey and collective
picture of these symptoms the medicine
cannot be discovered.

29. § 104
• When the totality of the symptoms that
specially mark and distinguish the case of
disease or, in other words, when the
picture of the disease, whatever be its
kind, is once accurately sketched, the
most difficult part of the task is
accomplished. The physician has then the
picture of the disease