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Organon by Hahnemann, aphorisms 83 - 92
"Individualized examination of a case of disease"

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Organon aphorism §83

This individualizing EXAMINATION OF A CASE OF DISEASE, for which I shall only give in this place general directions, of which the practitioner will bear in mind only what is applicable for each individual case, demands of the physician NOTHING BUT FREEDOM FROM PREJUDICE AND SOUND SENSES, attention in observing and fidelity in tracing the picture of the disease.

Organon aphorism §84

The patient details the history of his sufferings; those about him tell what they heard him complain of, how he has behaved and what they have noticed in him; the physician sees, hears, and remarks by his other senses what there is of an altered or unusual character about him. He writes down accurately all that the patient and his friends have told him in the very expressions used by them. Keeping silence himself, he allows them to say all they have to say, and refrains from interrupting them(81) unless they wander off to other matters. The physician advises them at the beginning of the examination to speak slowly, in order that he may take down in writing the important parts of what the speakers say.

Organon aphorism §85

He begins a fresh line with every new circumstance mentioned by the patient or his friends, so that the symptoms shall be all ranged separately one below the other. He can thus add to any one, that may at first have been related in too vague a manner, but subsequently more explicitly explained.

Organon aphorism §86

When the narrators have finished what they would say of their own accord, the physician then reverts to each particular symptom and elicits more precise information respecting it in the following manner; he reads over the symptoms as they were related to him one by one, and about each of them he inquires for further particulars: E. G., at what period did this symptom occur? Was it previous to taking the medicine he had hitherto been using? Whilst taking the medicine? Or only some days after leaving off the medicine? What kind of pain, what sensation exactly, was it that occurred on this spot? Where was the precise spot? Did the pain occur in fits and by itself, at various times? Or was it con- tinued, without intermission? How long did it last? At what time of the day or night, and in what position of the body was it worst, or ceased entirely? What was the exact nature of this or that event or circumstance mentioned—described in plain words?

Organon aphorism §87

And thus the physician obtains more precise information respecting each particular detail, but without ever framing his questions so as to suggest the answer to the patient,(82) so that he shall only have to answer yes or no; else he will be misled to answer in the affirmative or negative something untrue, half true, or not strictly correct, either from indolence or in order to please his interrogator, from which a false picture of the disease and an unsuitable mode of treatment must result.

Organon aphorism §88

If in these voluntary details nothing has been mentioned respecting several facts or functions of the body or his mental state, the physician asks what more can he told in regard to these parts and these functions, or the state of his disposition or mind;(83) but in doing this he only makes use of general expressions, in order that his informants may be obliged to enter into special details concerning them.

Organon aphorism §89

When the patient (for it is on him we have chiefly to rely for a description of his sensations, except in the case of feigned diseases) has by these details, given of his own accord and in answer to inquiries, furnished the requisite information and traced a tolerably perfect picture of the disease, the physician is at liberty and obliged (if he feels he has not yet gained all the informaton he needs)! to ask more precise, more special questions.(84)

Organon aphorism §90

When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient,(85) and ascertains how much of that was peculiar to the patient in his healthy state.

Organon aphorism §91

The symptoms and feelings of the patient during a previous course of medicine do not furnish the pure picture of the disease; but, on the other hand, those symptoms and ailments which he suffered from BEFORE THE USE OF THE MEDICINES, OR AFTER THEY HAD BEEN DISCONTINUED FOR SEVERAL DAYS, give the true fundamental idea of the ORIGINAL form of the disease, and these especially the physician must take note of. When the disease is of a chronic character, and the patient has been taking medicine up to the time he is seen, the physician may with advantage leave him some days quite without medicine, or in the meantime administer something of an unmedicinal nature and defer to a subsequent period the more precise scrutiny of the morbid symptoms, in order to be able to grasp in their purity the permanent uncontaminated symptoms of the old affection and to form a faithful picture of the disease.

Organon aphorism §92

But if it be a disease of a rapid course, and if its serious character admit of no delay, the physician must content himself with observing the morbid condition, altered though it may be by medicines, if he cannot ascertain what symptoms were present before the employment of the medicines,—in order that he may at least form a just apprehension of the complete picture of the disease in its actual condition, that is to say, of the conjoint malady formed by the medicinal and original diseases, which from the use of inappropriate drugs is generally more serious and dangerous than was the original disease, and hence demands prompt and efficient aid; and by thus tracing out the complete picture of the disease he will be enabled to combat it with a suitable homeopathic remedy, so that the patient shall not fall a sacrifice to the injurious drugs he has swallowed.

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Organon notes and explanatory remarks

--- 84 Organon aphorism ---

[81] Every interruption breaks the train of thought of the narrators, and all they would have said at first does not again occur to them in precisely the same manner after that.

--- 87 Organon aphorism ---

[82] For instance, the physician should not ask, Was not this or that circumstance present? He should never be guilty of mak-ing such suggestions, which tend to seduce the patient into giving a false answer and a false account of his symptoms.

--- 88 Organon aphorism ---

[83] For example, what is the character of his stools ? How does he pass his water? How is it with his day and night sleep? What is the state of his disposition, his humor, his memory? How about the thirst? What sort of taste has he in his mouth? What kinds of food and drink are most relished? What are most repugnant to him? Has each its full natural taste, or some other unusual taste? How does he feel after eating or drinking? Has he anything to tell about the head, the limbs, or the abdomen?

--- 89 Organon aphorism ---

[84] For example, how often are his bowels moved ? What is the exact character of the stools? Did the whitish evacuation consist of mucus or faeces? Had he or had he not pains during the evacuation? What was their exact character, and where were they seated? What did the patient vomit? Is the bad taste in the mouth putrid, or bitter, or sour, or what? before or after eating, or during the repast? At what period of the day was it worst? What is the taste of what is eructated? Does the urine only become turbid on standing, or is it turbid when first discharged? What is its color when first emitted? Of what color is the sediment? How does he behave during sleep? Does he whine, moan, talk or cry out in his sleep? Does he start during sleep? Does he snore during inspiration, or during expiration? Does he lie only on his back, or on which side? Does he cover himself well up, or can he not bear the clothes on him? Does he easily awake, or does he sleep too soundly? How does he feel immediately after waking from sleep? How often does this or that symptom occur? what is the cause that produces it each time it occurs? does it come on whilst sitting, lying, standing, or when in motion? only when fasting, or in the morning, or only in the evening, or only after a meal, or when does it usually appear? When did the rigor come on? was it merely a chilly sensation, or was he actually cold at the same time? if so, in what parts? or while feeling chilly, was he actually warm to the touch? was it merely a sensation of cold, without shivering? was he hot without redness of the face? what parts of him were hot to the touch? or did he complain of heat without being hot to the touch? How long did the chilliness last? how long the hot stage? When did the thirst ome on—during the cold stage? during the heat? or previous to it? or subsequently to it? How great was the thirst, and what was the beverage desired ? When did the sweat come on— at the beginning or the end of the heat? or how many hours after the heat? when asleep or when awake? How great was the sweat ? was it warm or cold ? on what parts ? how did it smell ? What does he complain of before or during the cold stage? what during the hot stage? what after it? what during or after the sweating stage?

In women, note the character of menstruation and other discharges, etc.

--- 90 Organon aphorism ---

[85] For example, how the patient behaved during the visit—• whether he was morose, quarrelsome, hasty, lachrymose, anxious, despairing or sad, or hopeful, calm, etc. Whether he was in a drowsy state or in any way dull of comprehension; whether he spoke hoarsely, or in a low tone, or incoherently, or how otherwise did he talk? what was the color of his face and eyes, and of his skin generally? what degree of liveliness and power was there in his expression and eyes? what was the state of his tongue, his breathing, the smell from his mouth, and his hearing? were his pupils dilated or contracted? how rapidly and to what extent did they alter in the dark and in the light? what was the character of the pulse? what the condition of the abdomen? how moist or hot, how cold or dry to the touch, was the skin of this or that part, or generally? whether he lay with head thrown back, with mouth half or wholly open, with the arms placed above the head, on his back, or in what other position? what effort did he make to raise himself? and anything else in him that may strike the physician as being remarkable.


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