Allan D Sutherland
THE SIMILIMUM CASE TAKING
EDITORS NOTE: This was previously published in the Bulletin of the Ohio.
State Homoeopathic Medical Society.
It is freely conceded by homoeopathic physicians that the only remedy for the given case is the similimum which, to be more explicit, is that remedy whose pathogenetic symptoms are most similar to the symptoms presented by the patient. However, in order to arrive at the similimum one needs to follow a definite procedure.
The orthodox pattern of history-taking runs from the “chief complaint” through the history of the present illness and includes the “family history” and the past history and habits of the patient. Then follows a record of the physical findings and whatever laboratory procedures are desirable or pertinent. The result is to systematize our knowledge of the patient with a view to forming a diagnosis. This method is ideal for the purpose, and, since diagnosis is the prerequisite to therapeutics, leads to the institution of a rational therapy.
But the homoeopathic prescription is not based upon diagnosis and we often find that the usual method of history- taking gives us insufficient knowledge of the facts which should point to the similimum. We are convinced that those who find homoeopathy but an uncertain aid in the relief of sickness lack knowledge of the proper manner of homoeopathic case-taking.
The first essential to successful case-taking is to be a good listener. Let the patient tell his symptoms in his own way and in his own words and in his own time. The information obtained spontaneously is frequently of supreme importance.
The second essential is the written word. Put down everything relevant which the patient relates. Unfortunately, many patients are extremely loquacious (a symptom in itself) and will stray away from the story of their illness. So one must keep out of the record anything not pertinent.
Intelligent questioning is the third important factor in homoeopathic case-taking. This procedure should be reserved for when the patient has “run down.” Questions should be worded so as to require a definite and specific answer. Furthermore, no question should suggest the answer. By the time the physician has reached this point in taking the case, he has already thought of a possible remedy, but let him be warned not to form questions so that the answers will confirm this remedy.
When further questioning will bring out no additional useful information, then go into the fourth part of the procedure. This can be dismissed without further discussion by saying that it is the intelligent use of the senses of sight, hearing, smell and feeling. The information thus obtained should be made a part of the record.
The physician has now ascertained every outward and visible sign which defines his patients illness and is ready to use these facts in an intelligent search for the similimum. This will be made easier if he will sort his information according to a definite schema, such as Von Boenninghausens:.
1.Sensations and complaints.
2. Location of sensations and complaints.
3. Aggravations and ameliorations.
a. According to time.
b. According to circumstances.
We would suggest this method of case-taking to all those who would improve their homoeopathic technique. It has stood the test of time, and clinical experience has demonstrated its value.- ALLAN D., SUTHERLAND, M.D.