Difficulties in Taking a Chronic Case (According to Organon of Medicine)

by

Chronic cases are difficult to manage because the disease has existed for a long time, the symptom picture may be altered, suppressed, or incomplete, and both patient and physician contribute to obstacles in proper case taking. Hahnemann has mentioned several practical difficulties in chronic case taking in various aphorisms (especially Aphorisms 74, 95, 96, 97).

The difficulties are mainly divided into:

  1. Due to Patient
  2. Due to Physician
  3. Due to Disease

I. Difficulties Due to Patient

1. Hypochondriac and Hypersensitive Patients (Aphorism 96)

  • Hypochondriacs imagine complaints.
  • Hypersensitive patients exaggerate complaints.
  • They are impatient and overstate suffering to obtain relief.
  • This leads to a distorted totality of symptoms.

2. Indolence, False Modesty, Mildness, Weakness of Mind (Aphorism 97)

  • Some patients do not describe symptoms clearly.
  • Due to laziness, false modesty, or timid nature.
  • They give vague descriptions.
  • They feel minor symptoms are not important.

3. Intellectual Patients

  • They interpret symptoms according to their knowledge.
  • They explain away valuable subjective symptoms.
  • This interferes with formation of correct totality.

4. Long Suffering Considered Incurable

  • Patient ignores old symptoms.
  • Thinks disease is incurable.
  • Mentions only recent complaints.
  • Past history becomes incomplete.

5. Accessory Symptoms Forgotten (Aphorism 95)

  • Long suffering makes patient accustomed to symptoms.
  • Minor or accessory symptoms are not narrated.
  • These may be important for remedy selection.

6. Periodic Symptoms Not Narrated

  • Periodicity is important in homoeopathy.
  • Patients may ignore symptoms occurring at fixed intervals.

7. Alternating Symptoms Not Narrated

  • Some symptoms alternate (e.g., diarrhoea ↔ headache).
  • Patient may not recognize or report alternation.

8. Self-Medication

  • Suppression of symptoms.
  • True symptom picture gets masked.
  • Leads to difficulty in remedy selection.

9. Influence of Modern Medicine

  • Patients expect investigations and quick relief.
  • They may not cooperate in detailed case taking.
  • They may give more importance to diagnosis than symptoms.

II. Difficulties Due to Physician

1. Nature of Physician

  • Preconceived ideas and prejudice.
  • Bias regarding diagnosis.
  • Overconfidence from past experience.
  • These distort case analysis.

2. Patients Coming from Other Physicians

  • Previous drug treatment alters symptom image.
  • Drug symptoms mix with natural disease.

3. Artificial Chronic Disease (Aphorism 74)

  • Long use of strong suppressive drugs.
  • Produces drug disease.
  • Natural + artificial disease combine.
  • Creates complex chronic condition.

III. Difficulties Due to Disease

1. Advanced Pathology

  • With progress of pathology, symptoms reduce.
  • Childhood history forgotten.
  • Few symptoms remain → difficulty in prescription.

2. Complex Disease

  • Allopathic drugs produce their own symptoms.
  • Drug disease mixes with natural disease.
  • Case becomes complicated and difficult to cure.

3. Mixed Miasmatic Disease

  • Combination of Psora, Sycosis, Syphilis.
  • Symptom picture becomes confusing.
  • Requires deep miasmatic understanding.

4. One-Sided Disease

  • Very few symptoms available.
  • Totality incomplete.
  • Difficult to find similimum.

5. Altered Description by Relatives

  • Friends and attendants may exaggerate or alter facts.
  • Physician must rely mainly on patient’s own description.

Leave a Comment