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Difficulties in Chronic Case Taking

Chronic disease case taking presents several difficulties for physicians. It can be hard to ascertain the accurate onset of a chronic disease or recall initial symptoms as the progression is often slow and gradual. Patients may dismiss early trivial symptoms and only remember subsequent severe changes, presenting an incomplete picture. By the time chronic patients seek treatment, considerable time has been wasted and the disease altered as they tried alternative palliative options. Prior suppressive treatments further complicate obtaining the original unmodified symptom picture needed for case taking. Due to longstanding suffering, patients may not report all valuable symptoms or consider some atypical ones normal. Incomplete symptom reports can make constructing an accurate totality and understanding the full case difficult.

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Suhas Ingale
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2K views3 pages

Difficulties in Chronic Case Taking

Chronic disease case taking presents several difficulties for physicians. It can be hard to ascertain the accurate onset of a chronic disease or recall initial symptoms as the progression is often slow and gradual. Patients may dismiss early trivial symptoms and only remember subsequent severe changes, presenting an incomplete picture. By the time chronic patients seek treatment, considerable time has been wasted and the disease altered as they tried alternative palliative options. Prior suppressive treatments further complicate obtaining the original unmodified symptom picture needed for case taking. Due to longstanding suffering, patients may not report all valuable symptoms or consider some atypical ones normal. Incomplete symptom reports can make constructing an accurate totality and understanding the full case difficult.

Uploaded by

Suhas Ingale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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DIFFICULTIES IN CHRONIC CASE TAKING

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 a 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 nor more able to
function effectively he seeks the opinion of a physician.

When the physician interviews such a sick person , some difficulties


might come in the way of case taking. A few of the difficulties are discussed
below.

1. Since a chronic disease is gradual in onset it is difficult to ascertain the


accurate time of its beginning.

2. Since the progress is slow and sometimes un-noticeable and uneventful,


many a times, the patient can not recall the initial symptoms details. In
such 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.

3. Initially when a disease starts with a few trivial symptoms the patient
does not attach much importance to them and tries to think that they are
insignificant . The subsequent grave changes are only remembered.
therefore , there is a tendency to present only a partial picture of a disease
in a chronic case.
4. 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 the
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 persons. In the process of seeking relief of 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.

5. When chronic cases come to a homoeopathic physician after the patient


has taken a long, palliative and suppressive treatment the whole picture
and presentation of the disease is different. In such cases it is difficult to
obtain an original , unmodified picture , which is very important aspect of
case taking.

6. Due to long standing suffering many of the symptoms become a part and
parcel of the patients life. In such cases he use discretion to present a few
symptoms significant to him and does not give out many valuable
symptoms.

7. Due to lack of knowledge the patient may consider a few symptoms an


expression of health due to their long standing presence. In such cases
many concomittants and auxiliary symptoms are not narrated to the
physician.

8. in some chronic cases, the patient has alternating symptoms like joint
complaints in summer and respiratory complaints in winter. In such cases
they mention only the presenting complaints and forget to mention the
other components. Hence the physician doe not get complete picture.
9. In the case of chronic disease , 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 co-operate while case taking
and does not share his symptoms in relation to emotion and intellect. In
such cases, constructing a totality would be difficult. If a totality is not
arrived at, case taking remains unfruitful.

10. In case of children and in persons with communication problems, it


would be difficult to understand the exact sensation. In such cases,
obtaining the correct and whole picture would be difficult task.

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