Case Taking - Acute Case - 5fb39a204c288

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Dr.Priyanka P S
Assistant Professor
Dept .of Repertory, SKHMC
ACUTE CASE TAKING
Dr.Priyanka P S
Assistant Professor
Dept .of Repertory, SKHMC
DEFINE CASE TAKING
CASE TAKING is a unique art of getting into
conversation ,observation and collecting
information from patient as well as from by
standers to define the patient as a person and
diagnose the disease.
HAHNEMANNIAN CLASSIFICATION OF DISEASE
BASED ON CAUSATION
ACUTE DISEASE CHRONIC DISEASE

WHAT IS ACUTE DISEASE?
The diseases to whish man is liable are either rapid
morbid processes of the abnormally deranged vital
force, which have a tendency to finish their course
more or less quickly, but always in a moderate time-
these are termed Acute Diseases
Aphorism: 72
Acute diseases are caused by an exciting or acute

miasms.
Nature of Acute Diseases
Acute Diseases are easy to treat: In acute diseases
symptoms evolve quickly and the patient remembers
all of them
Needs much attention of Physiscian: Disease may be
of serious character and demands attention hence the
physician must give. prompt and efficient aid.
Needs less time to treat: The chief complaint strike us
and become evident to the senses more quickly than in
chronic disease
CLASSIFICATION OF ACUTE DISEASE-
APHORISM 73
 Acute disease is again subdivided into
 1. individual acute disease
 2. sporadic acute disease
 3. epidemic acute diseas
---Disease produced by an exciting cause – ACUTE DISEASE
---Disease manifested as a result of fundamental

cause – CHRONIC DISEASE
These diseases differ in onset , progress , duration and in
outcome.
Therefore, the scheme of case taking should differ
in acute and chronic diseases.

Primary object of case taking is the collection of data, for a
prescription on the basis of Homoeopathic philosophy

 The case taking for Homoeopathic management requires a
background knowledge of various disciplines _
a ) The Principles Of Homoeopathy,
b) Basic Medical Sciences,
c) Clinical Subjects
And
d) The Communication Skills.

ACUTE DISEASES
APHORISM: 72
ACUTE DISEASES are defined as diseases , which begin
- suddenly, progress faster
- run a definite course and
- finally end with recovery or death

They are caused by an
----------EXCITING CAUSE OR ACUTE MIASM ( Aph 5)
Exciting cause: may be defined as the cause which excites a
disease condition –either acute disease or acute exacerbation
in chronic diseases.
The acute miasm comes on either with sufficient violence to
cause death of patient
or
With less violence, wherein there is a period of
progress and a tendency to recover.

CASE TAKING
APHORISM -------5, 6, 83 -104.

APHORISM 5- CAUSES OF DISEASES
Exciting cause may be defined as the cause which excites a
disease condition –either acute disease or acute exacerbation
in chronic diseases.
----------Helps in selecting the medicine

APHORISM 6
Symptoms are obtained from the patient, from
bystanders and observed the physician hmself.

CLASSIFICATION OF ACUTE DISEASE
APHORISM :73
Acute disease is again subdivided into
1. individual acute disease
2. sporadic acute disease
3. epidemic acute disease

INDIVIDUAL A/C DISEASE
Is that which attacks a single human being. The
disease is caused by
 Excess in food
 Insufficient food and
 Severe physical exposure , that is chill, over heating, over
eating,mental emotion, strain,excitement, dissipation
.
SPORADIC A/C DISEASE
Is that which attacks several persons at the
same time here and there, sporadically
It is caused by
 Meteoric or climatic influences and injurious agents
 Telluric agents such as soil and water

EPIDEMIC A/C DISEASE
Attacks many persons with very similar suffering for

the same cause.
It is excited by
 Calamities of war
 Inundation, famine
 Acute miasm
CASE TAKING IN ACUTE DISEASES
Aphorism 99
 It is very easy to take a case in acute disease, because all the
phenomena and the deviation from the health that has been
recently lost are still in the memory of the patient and relatives.
 Physician wants to know everything in such cases also, but
he has much less to inquire into.
In acute disease the presenting complaints are very prominent
and impress our sense quickly, so much less time is required
for tracing the full picture of the disease.
 Requires only few questionings almost
everything is self evident.

Evolution of symptoms are very quick in a/c diseases and the
patient remember all of them.
 Any known causative factor for the explosion of latent psora
is to be ascertained.
MANAGEMENT
 If you are dealing with an acute condition, limit yourself to
dealing with the acute state alone, and do not at the same time
attempt to dip in to what has been a chronic state.
 In an acute explosion the chronic picture
will retreat completely.

CASE TAKING -ORGANON
 A concise idea about case taking (Aphorism 5)
 General directions ( Aphorism 83 - 104)
 Patient coming directly (Aphorism 83 _ 90)
 Patient coming from other physicians (Aphorism 91_ 93)
 Chronic case taking ( Aphorism 94 _ 98 )
 Acute case taking ( Aphorism 99 _ 102)
 Appraising the case taken ( Aphorism 103 _ 104)

APHORISM 213
 In acute diseases along with acute physical symptoms
observe the mental symptoms also.
 In foot note- aconite will never effect or cure if the patient is
calm,quiet and equable disposition
 Nux vom--- mild and phlegmatic
 Pulsatilla--- happy, gay and obstinate

DIET AND REGIMEN IN ACUTE DISEASE
APHORISM 262,263
 1. Food and drink- gratify the patients desire with regard to
food and drink without offering and urging.
 The friends and attendants should be advised not to put any
obstacle in the fulfilment of desires exressed by patient
as these are aroused by the inner subtle voice of the life
preserving vital force

the patient desires those things that give palliative
relief, and merey supply a sort of want
 Eg-aconite desires for cold water, the slight hindrance
in removal of disease is overcome by refreshing effect of
gratified desire.
2. Temperature and clothings- the temperature of the room and
the quality of coverings must be arranged entirely
according to the desire of the patient.
3. Mind- patient must be kept free from all over exertion of
mind and exciting emotion.

CASE TAKING IN EPIDEMIC AND SPORADIC DISEASE
APHORISM 100 – 103
 Individual vary from each other and even the generic

picture of the epidemic disease may vary from year to
year.
In epidemic disease the disease cause might be same or a fixed
miasm, giving rise to a general picture of the disease to which
all the patient confirm to ,but each individual patient adds his
quota to this general symptom complex to make
each patient unique and different from others.

So investigate each sporadic and epidemic disease as a new and
unknown case and select medicine according to its symptom
similarity. No disease is fully manifest through symptoms in one
individual case.
 In epidemic disease a complete picture of the disease is
apparent to the physician only when he observe a number of
cases during the epidemic.

Every epidemic disease in many respect a phenomenon of a
unique character , differing vastly from all previous
epidemics.
 The complete picture of an epidemic disease is grasped
through observation of a good many person falling victims to
that epidemic disease.

CASE TAKING IN ACUTE DISEASE WITH A CHRONIC
BACKGROUND
 When an individual has an a/c disease the case taking is

limited to the symptoms of the case only. Not to take into
consideration that the patient had any chronic disease.
 Take the case regarding the a/c complaint only, and prescribe
on that with out considering the c/c disease.
We have to pay little attention to the chronic symptoms,
because a/c disease have sudden onset and decline and they
are so violent and they give no time for a detailed case taking.
KENT'S VIEW IN A/C CASETAKING
 Never consider acute and chronic together
 Sequel of acute diseases are psoric disorders and
must be treated as psora

COLLECT TWO MAIN ASPECTS OF CASE
1. Presenting complaints can be described in four
components , i.e., LOCATION, SENSATION, MODALITIES,
and CONCOMITANT.
2. The feature at a general level
 Changes on the physical plane like appetite , thirst ,
thermal reaction , respiration , bowel movements etc.,
 Changes on the mental plane like irritability ,
confusion ,fear ,restlessness etc .

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

ACUTE DISEASE CHRONIC DISEASE

Acute diseases are caused by an exciting or acute

---Disease manifested as a result of fundamental

Therefore, the scheme of case taking should differ

in acute and chronic diseases.

prescription on the basis of Homoeopathic philosophy

background knowledge of various disciplines _

a ) The Principles Of Homoeopathy,

b) Basic Medical Sciences,

d) The Communication Skills.

- suddenly, progress faster

- run a definite course and

- finally end with recovery or death

----------EXCITING CAUSE OR ACUTE MIASM ( Aph 5)

Exciting cause: may be defined as the cause which excites a

disease condition –either acute disease or acute exacerbation

cause death of patient

With less violence, wherein there is a period of

progress and a tendency to recover.

APHORISM -------5, 6, 83 -104.

Exciting cause may be defined as the cause which excites a

disease condition –either acute disease or acute exacerbation

----------Helps in selecting the medicine

Symptoms are obtained from the patient, from

bystanders and observed the physician hmself.

Acute disease is again subdivided into

1. individual acute disease

2. sporadic acute disease

3. epidemic acute disease

Is that which attacks a single human being. The

 Insufficient food and

 Severe physical exposure , that is chill, over heating, over

eating,mental emotion, strain,excitement, dissipation

Is that which attacks several persons at the

same time here and there, sporadically

 Meteoric or climatic influences and injurious agents

 Telluric agents such as soil and water

Attacks many persons with very similar suffering for

and impress our sense quickly, so much less time is required

for tracing the full picture of the disease.

 Requires only few questionings almost

everything is self evident.

patient remember all of them.

 Any known causative factor for the explosion of latent psora

 If you are dealing with an acute condition, limit yourself to

attempt to dip in to what has been a chronic state.

 In an acute explosion the chronic picture

will retreat completely.

 A concise idea about case taking (Aphorism 5)

 General directions ( Aphorism 83 - 104)

 Patient coming directly (Aphorism 83 _ 90)

 Patient coming from other physicians (Aphorism 91_ 93)

 Chronic case taking ( Aphorism 94 _ 98 )

 Acute case taking ( Aphorism 99 _ 102)

 Appraising the case taken ( Aphorism 103 _ 104)

 In acute diseases along with acute physical symptoms

observe the mental symptoms also.

 In foot note- aconite will never effect or cure if the patient is

calm,quiet and equable disposition

 Nux vom--- mild and phlegmatic

 Pulsatilla--- happy, gay and obstinate