Difficulties During Chronic Cases

In my last post (Here) I  mentioned  about homeopathic case taking. It is easy to take acute cases because in acute cases symptoms are fresh in patient’s mind so you will get exact picture. But in chronic cases symptoms are old patient may not remember all symptoms. So there are many difficulties that a homoeopathic physician might faces while taking a chronic case. In these certain situation physician might use some other way to get clear picture of the patient.

Now what is chronic case? A chronic case is defined as a case which has a long history of its existence with a miasmatic background. In the course of progress and development of chronic disease, the individual passes through a slow and gradual change in his functioning and finally loses his capacity to function efficiently. Only when the individual realizes that he is no more able to function effectively, he seeks the opinion of a physician. When the physician takes chronic case, some difficulties might come in the way of case taking. Some of the difficulties are mentioned below:

In chronic cases the progress is slow and sometimes un-noticeable and uneventful, many a times; the patient cannot recall the initial symptoms in details. In these cases, only a few striking changes in the health are mentioned to the physician. Thus, acquiring all the components of the initial symptoms will be difficult for a physician.

Since a chronic disease is gradual in onset, it is difficult to ascertain the accurate time of its beginning. Physician cannot ascertain its origin of the disease.

Initially, when a disease starts with a few trivial symptoms the patient does not gives much importance to them and tries to think that they are insignificant. Only the subsequent grave changes are remembered. Therefore, there is a tendency to patient only a partial picture of the disease in a chronic case.

Generally in a chronic case, a patient does not come to a physician in the beginning. The realization that he is sick occurs late in a majority of cases. Even when some realize it, they try to take some kind of palliative treatment by themselves due to various reasons or might seek the help of some non-medical person. In the process of seeking relief from symptoms, a considerable time is wasted and the disease picture is greatly altered when he finally reports to a homoeopathic physician. Therefore, the physician may find it difficult to understand the whole phenomenon of such cases.

Chronic cases come to a homoeopathic physician, generally after patient has taken long, palliative and suppressive treatment. Thereafter the entire picture and presentation of disease is different. In such cases, it is difficult to obtain an original, unmodified picture, which is a very important aspect of case taking.

In chronic cases patient had suffered for long time, several symptoms become a part parcel of the patient’s life. In such cases, he uses his discretion to present a few symptoms significant to him and does not give out many valuable symptoms. So patient may not reveal these symptoms to physician.

Due to lack of knowledge, the patients may consider some symptoms as an expression of health due to their long standing presence. In such cases, many concomitants and auxiliary symptoms are not narrated to the physician.

In some chronic cases the patient has alternating symptoms like join complaints in winter. In such cases, they mention only the presenting complaints and forget to mention the other component. Hence, the physician does not get a complete picture.

In the case of chronic diseases, all the deviations on the physical and mental planes should be obtained from the patient in order to form a portrait of disease. Due to lack of understanding of the homoeopathic physician, sometimes the patient does not cooperate while taking the case and does not share his symptoms in relation to emotions and intellect. In such cases, constructing a totality would be difficult. If a totally is not arrived at, case taking remains unfruitful.

In cases of children and in persons with communication problem, it would be difficult to understand the exact sensations. These patients cannot express themselves. In these chronic cases, obtaining the correct and whole picture would be a difficult task. In such cases patient’s attendees are valuable source of symptoms.  

So these are some difficulties which is seen during chronic case taking, to avoid these difficulties one have to get familiar with them. Physician has to approach these situations with different way. Hope this is helpful to you.