MEDICAL
HISTORY FOR HOMEOPATHIC TREATMENT
Directions
for a written Submission
INTRODUCTION
For finding out correct Homoeopathic Remedy, lot of information with regard to the (I) Complaints – (a) Main as well as (b) subsidiary and (II) the patient as the person is required.
Incomplete information will make correct choice difficult. You are therefore, requested to supply all information without keeping back anything as irrelevant or of little importance. The information you supply in the Note forms the basis of further enquiry designed to assist you in the further delineation of the problem. Full co-operation, therefore, is requested. All information supplied is, of course, strictly confidential.
Since the enquiry can be a time consuming process and a lot of information is being collected we require recording it systematically. Prior appointment would be necessary.
We are sure you shall be fully co-operating with us in rendering you the best possible service.
Please supply the following information as standard routine: Name in full Date of Birth, Sex, Status, Single / Married or Widow-ed since/Divorcee since, Religion/Community/Sect, vegetarian/non-vegetarian/Eggs, Addictions, Tobacco chewing / smoking, Tea Coffee, Beer, Whisky and Liquors (please state the quantity consumed daily).
Education and career qualifications, occupation, current and previous with full description of responsibilities and job satisfaction. Description of the current family set-up, full details pertaining to all the members, their ages, relation, work they are doing and your relationship with responsibilities for them. Include in your list those who have died, stating the age of deaths the year and the cause of the same.
Include daily routine from getting up in the morning till retiring at night. Include in this your dietary schedule furnishing full details in respect of the quantities consumed. Financial responsibilities and strains (present as well as past). Difficulties experienced, place of work family set-up/social, give a full account.
Describe fully what bothers you most. Each trouble should be detailed as under:
Give full description of the trouble right from the time of onset, its subsequent development and spread and response of treatment taken. This should give full idea of:
(i) Area Affected: Location, extension direction of spread, the march of events.
(ii) Sensation experienced in the area of trouble
(iii) Conditions that has brought on the trouble: examine the circumstances that obtained just before or at the time of onset paying attention to physical as well as emotional factors.
(iv) Conditions that increase the trouble or those that afford relief.
(v) Other trouble experienced at the same time long with the main trouble for example perspiration vomiting / gas with pain.
Describe
here all other troubles you might be having or had in the past experienced.
Each should be described fully as suggested above for the chief complaint.
PERSONAL DATA
Give
a full account of the following:
(i)
Physical description of
self.
(ii)
Emotional and
intellectual attainments and aspirations. Indicate to what extent you have been
able to realize them. Give a clear-cut picture of your relationships with the
family members, friends and associations. Give a full idea of your
responsibilities in life and what you feel about them.
(iii)
Reactions to
surroundings.
(a)
Food: desire and
aversions, foods that do not suit, etc.
(b)
General environment:
weather, temperature, bath recreations, addictions etc.
(c)
Sleep and Dreams
(d)
Sex (inclusive of
menstrual and obstetric history)
PREVIOUS
ILLNESS
Give
a resume of the various illnesses you had and to what extent these have any
bearing on present troubles.
FAMILY HISTORY
Data
concerning the Parents, Brothers and Sisters, State details concerning the
health of wife and children.
GENERAL COMMENTS
Include
here any items, which have not been included above.
ENCLOSURES
Submit
Photocopies of medical reports. (If any)
Consultant Homoeopath
Clinic -1 Clinic- 2
14, Manish-Vijay Commercial Complex, 13, Charisma Centre, 19th Road,
Vasinaka, Chembur, Mumbai- 400 074. Nr. General Education School,
Time: 10 am to 1 pm. Chembur, Mumbai – 400 071.
Tel. - 25544856 Time: 5pm to 8.30 pm
e-mail: drshankar_c@yahoo.com Tel.-25299101
Disclaimer : A direct one-to-one communication between a physician and a patient is the best form of a clinical interview and an online consultation has its limitations.The consultants offering the Treatment on-line will not be responsible for the course of events during the period of treatment, which may be due to a variety of factors. The homoeopathic treatment, per se, is essentially harmless and safe. This site does not provide medical or any other health care advice, diagnosis or treatment. The site and its services are for informational purposes only and are not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your homoeopath or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information on this site.