Case History Taking:Need of Brilliant Approach
Dr. Dilip Kr. Goswami

*Corresponding Author: Dr. Dilip Kr. Goswami* MD (Ayurveda), Ph.D.  Associate Professor, Agada Tantra and Vidhi Ayurveda (Toxicology and Forensic Medicine) Govt. Ayurvedic College, Guwahati, Assam, India.

Received Date:  September 16, 2020.

Publication Date: October 01, 2020

Case history taking is a process of collection of information from the patient about his/her personal life, sufferings, course of the sufferings, etc. To diagnose the disease for the planning of appropriate treatment. A properly recorded case history leads the physician to the appropriate diagnosis. Appropriate diagnosis is the key to successful treatment. When a physician meets a patient he/she should always keep some facts in mind.

For example

1. A patient is an individual who feels inferior to the others in respect of health.

2. A feeling of negligence always remains in the minds of the patients.

3. Most of the patients feel shy and fear to speak to the physician about the sufferings.

4. A good number of patients have no capacity of expression appropriately about the sufferings.

5. Patients, in most of the situations, fail to narrate the sufferings, course, etc. of the disease in chronological order. 

6. Language is another problem of the patients why they become unable to express all about themselves to the physician.

7. Some facts are tried to keep hidden by the patient willingly from the physician due to fear of referral, investigation, etc.

The above facts, if present in single or combined form, then the physician faces problems in reaching the appropriate diagnosis. An inappropriate diagnosis always fails treatment.

Hence an effort should always be made by the physician to avoid even one of them. For this purpose, some measures can be taken.

For example

1. The physician should maintain an impressive appearance. For the purpose wearing of a clean, white dress, well-polished shoe,  clean shaving, maintenance of hair discipline are important. 

2.Regular bath to keep the body free from foul-smelling, use of good smelling sprays or applications like Sandal paste, etc. should be practiced.

3. At the time of welcoming the patient the physician should always maintain a smiling face.

4. The conversation should be made with a soft, impressive voice and language. In no condition,   a patient should be treated with harsh language.

5.When the time of asking questions will come the physician should choose an appropriate question with an expectation of a proper answer.

6. If the patient fails to answer appropriately then the question should be repeated with an effort to make the patient understand the motive and expectation in respect of the answer.

7.It should be kept in mind that, the patient has already lost patience. So, sometimes the response to the physician’s queries may be harsh. In such a situation, the patient should be cooled down with soft behavior and tolerance. Even sometimes there may be a need of giving relaxation to the patient by allowing to talk with others or to have some food/drink liked by him.

8.Bringing the patient to the appropriate track during history taking is a brilliant task that cannot be taught by others. Experience and heartfelt closeness with the patient is the only tool for the physician.

To make the new learner’s expert in the line of history taking the experienced teachers always give effort during the course in the institutions of medical and paramedical training. Many books are written, published, and made available in the market for the new learners. But it should always be kept in mind that, they are providing only the basic guidelines. Being trained with the basics technique should be developed to get success in case history taking which is the key to the appropriate diagnosis. A physician with the capacity of appropriate diagnosis never fails in treatment.

In this connection let us look back to the advice of the Ayurvedic scholars, the pioneers of Indian health science, to the physicians about the expected behavior and attitude towards the patients. The Ayurvedic classics written before about 5000 years of Christ consist of some important advice to the physicians like –

1. Always try to get the quality in education, speech, dress, and wealth to attract honor and respect from society. In respect of a physician, it has great importance.

2. Behave with all strangers like friends. Start a conversation first with them by asking for their good news. The behavior of the physician towards the patient also needs the same attitude.

3. A patient should always be treated as a son. Parents never become harsh towards the son/daughter as they are the beloved ones. All mistakes of them are excused and corrected by the parents. In the same way, the physician should never show anger towards a patient even they will not be able to co-operate in the process of diagnosis and treatment appropriately.

4. So the Ayurvedic scholars advise the physicians to be a “TATWAVIT” (knowing facts) and to talk with the patient with an effort to read the internal of him to get success in practice.

To conclude it can be said that, correct diagnosis always needs efficient case history taking, successful treatment is the result of correct diagnosis and case history taking is a brilliant task for which the physician should make continuous self-analysis and exercise.

Volume 1 Issue 4 October 2020

©All rights reserved by Dr. Dilip Kr. Goswami.