DIRECTIONS FOR MEDICAL HISTORY FOR HOMOEOPATHIC
TREATMENT
Homoeopathy aims at holistic approach towards the
patient taking into account physical complaints as well
as personality and changes in the behaviour of the patient.
Without full description of the symptoms it is difficult
to find out the medicine. So your full co-operation
is necessary in order to achieve best results. All information
given is strictly confidential.
Preliminary Information
Please supply the following information as standard
routine – Name, Age, Sex, Status- Single/ Married /
Widow-er / divorcee; Present occupation Address, Tel
No., Fax No., E-mail.
Chief Complaints
Give a full description of your Main Complaints as regards
-
(a) The location or area of complaints and its extension
if any.
(b) The duration of onset of complaints and its development.
(c) The nature of pain or sensitivity.
(d) The factors or conditions which bring on or worsen
the complaints, both
Physical and Emotional factors.
(e) The factors or conditions which give relief to the
complaints.
(f) Any specific cause leading to present complaints.
Personal Data
Give a full account of
(1) Height, Weight, any congenital malformations; eyesight
etc.
(2) Mental make-up and behaviour.
(3) Food - Particular desires and aversions in food.
Any specific food items
causing or worsening trouble.
(4) Thirst - Normal/very thirsty/ thirstless and also
amount of water
consumption per day.
(5) Sweating tendancies.
(6) Nature of stool and urine.
(7) Habits - Smoking, alcoholism, tobacco chewing, eating
bettlenuts, snuff, tea,
coffee etc. and their amount
of consumption per day.
(8) Sleep and dreams.
(9) Genera! environment - effect of heat, cold, weather
changes, bath etc.
(10) Sexual life-
Married - marital satisfaction; depression and
effect of the same on your main complaints. Any history
of sexually transmitted diseases.
Unmarried - Habit of masturbation and any other
sexually transmitted diseases.
Females - Details regarding your menses- its
regularity, duration, amount of bleeding ( excessive/scanty),
white discharge etc.
Married Females - Number of children and any
complications
during pregnancy and childbirth; history of abortions
and stillbirths.
Past History
Describe in detail the illnesses which you have suffered
in the past since your birth stating your age at the
time of suffering. Describe all the major illnesses
or accidents / operations and also the minor complaints
which are often recurring, like recurrent cold or recurrent
diarrhoea, mucoid stools etc.
Family History
Describe the health status of your parents, brothers
and sisters. State details concerning the health of
husband/wife and children. Include those who died in
your family stating the age and cause of death.
Investigations
If you have undergone any investigations like blood
test, urine/stool examination, X-ray, E.C.G., Ultrasound
etc. PLEASE inform or send the report.
