REPORT ON CASE TAKING SEMINAR BY Dr. DHIRAJ NANDA

One day seminar on case-taking was organized at P. D. Jain Homeopathic College at Parbhani, Maharashtra on 03/10/2009. The seminar began with the short inaugural session where the chief guest, chairman of college, Shri Kakaji Jain, Dr. S. Narvadkar, Principal of P. D. Jain Homeopathic College, Dr. Dhiraj Nanda lighted the lamp and garlanded the photo of Dr. Hahnemann.

       The short inaugural session was immediately followed by Dr. Dhiraj Nanda who spoke on case taking in the entire day long seminar. He explained that case-taking is a very small term used to call the process of receiving information from the patient. Being classical homoeopaths it should rather be called as case-perceiving where we perceive the man in the disease. He even quoted the Aphorisms where Dr. Hahnemann had explained about these points. Dr. Nanda then explained what constitutes man and how to perceive man in disease. 

  Here he divided case-taking/case-perceiving into 3 parts: Pre-Interview, Interview and Post-Interview.

Explaining the pre-Interview, Dr. Nanda said case-taking starts even before the patient enters our consultation room or even before we have asked our first question to the patient. The points that we take notice of here are definite pointers to the state or disposition of mind of the patient. He explained these with certain examples and pointers and even explained the rubrics that depict each of these behaviors. Here, a case was shown which was treated and cured by Dr. Nanda in his experience based on pre-interview observations.

Talking about interview he said when a patient comes to you for the first time you should be like a blank paper as what do you know about the constitution that is in front of you? You should start from the beginning and understand the man in the disease who has come to you. A classical homoeopath should give an indirect message to the patient that he does not know anything about the patient before the interview, to get full details from him. For this we should allow the patient to talk and as a classical homoeopath one has to play at least three roles: listener, observer and recorder. What the patient says may not be as important as how he says. Never interfere when the patient is talking and remember to use minimum words which give you freedom. For this he even quoted some examples of his experience which clearly explain this aspect of case-taking. He then explained the importance of observations and pauses that occur during the interview part of case-taking with certain cases of his experience.

While explaining the importance of post-Interview he explained that post-interview comes after you have closed the interview session and is a part or extension of the main interview. It has two main objectives, first to probe in details of information that remained incomplete during interview; and second to confirm the important findings to the interview session. He even said that post-interview session may be longer than the interview. Here, we need to ask open-ended questions, inductive-deductive questions or confirmatory questions depending on the case.

The morning session was followed by lunch. All the delegates were very satisfied with the seminar as well as the food.

    Post-lunch session started with a case being given to all the delegates to analyze according to their understanding and were given half-an-hour time for it.

In Post-Lunch session, Dr. Dhiraj Nanda talked about four different methodologies of case taking. They were- silent listening; observation; deduction; and induction.

Silent listening: It is a state of attentively hearing what the patient is communicating to us. This attentive listening will provide us the vital information that can be converted into an appropriate rubric that will be applicable to the patient. He gave many examples with interpretation of rubrics which were very helpful in practice.

Observation: It is study of patient by surveillance, viewing, watching and monitoring him. He even quoted the aphorisms where Dr. Hahnemann had mentioned the importance of observation in case-taking. If observations are contradictory to what patient is telling, observations should be given more importance, as what we observe is definitely more reliable. He gave different situations and explained what rubrics apply to those behaviors observed. He even gave some observations of few remedies which he observed in his long years of practice.

Deductions: It is interpretation or assumption or presumption based logical or reasonable inference. One can deduce from observations, past history, and by method of inductive deduction. Dr. Nanda has explained how to deduce rubrics from each of the above aspects in detail and in a very understandable way with examples.

Induction: It is the method in which we initiate or stimulate the patient to generate the history. Here the doctor stimulates the patient to come out with some more details of some aspect of his personality or history. He even explained the different methods of induction-as hitting at the observed trait in opposite, hitting at the observed trait directly, inducing him to speak what he likes about himself and other, and inducing him to speak what he dislikes about himself and other etc.
Finally, he explained when case-taking is to be considered to be complete with two cases from his experience.
The entire session was very interactive with active participation of most of the delegates during the sessions and question-answer session at the end.