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CONSULTATION:
CASE INVESTIGATION/ patient’s detail
    IT is a unique art of getting into conversation, observation, and collecting information from patient and attendants pertaining to the complaints of patient.
 PURPOSE OF CASE INVESTIGATION:
    TO carefully diagnose the disease.
    To perceive the true mental, emotional, physical and dynamic state of patient.
    Patient has to provide all the necessary details in the order listed below :

STEPS IN CASE INVESTIGATION:
I.    STAGE OF OBSERVATION – Here the things which are basically noted are :
    Facial appearance/ make up{photograph of the patient} p 
    Mood { depressed, worried, anxious, timid, irritable, indifferent ,fastidious, comatose , delirium etc} 
    Attitude 
II.    LISTENING TO THE COMPLAINTS:
    First from the patient and then from the attendants. He must involve in active listening.
    Here the symptoms are completed w.r.t their location, sensation, and modalities. PRESENT COMPLAINTS:
    Duration of the complaint
    Onset of complaint ( sudden or gradual)
    Exact sequence of appearance of symptoms
    Location w.r.t any extension of pain or radiation.
    Sensation 
    Modalities (causation , aggravation and amelioration factors.)
    Concomitants – ex: 
i.    Mental plane { restlessness with pain}
ii.    Physical plane { perspiration with pain}
iii.    Discharges { its nature , colour, odour, consistency}
HISTORY OF PRESENTING COMPLAINTS:
    Was there any major event in the patient’s life at about the appearance of symptoms?
    Any mental or emotional shock ?
    Any major illness which might have affected the overall health of the patient?

HISTORY OF PREVIOUS ILLNESS:
    Any previous illnesses from childhood are traced down to the present, chronologically, which ages at which attack appeared, with its nature, symtoms, duration, severity and sequence.
    h/o any surgical intervention, exposure to radiation,.
    DetaiLs of accidents, animal bites, mechanical injuries ,mental shock.
    h/o  any infections, tumours, skin eruptions.
FAMILY HISTORY:
    Helps in deciding the inheritance background.
     Helps in tracing consanguinity.
     Individual peculiarities , pre-dispositions, their habits , any deaths with cause age and its impact on the patient.
    Diseases of mother during pregnancy and delivery .
    Any miasmatic disease in the family inc parents , grandparents ,siblings with paternal and maternal relations.

PERSONAL HISTORY:
    WHERE is the patient born and brought up?
    Appearance of different milestones.
    Details of breast feeding.
    Socioeconomic status, level of education , any reason for termination of study, occupation ,any frequent change of jobs , job satisfaction, social and domestic relations in office and family.
    Marital status , age of marriage, number of children, any frequent deliveries , nature of deliveries whether normal , instrumental or caesarean ,any abortions, still births, puerperal infections.
    Habits – smoking, drinking, tobacco, tea, coffee , any other drugs.
    Any extra marital relations.
    Place of living.
    Interests and hobbies

TREATMENT HISTORY:
     Throughout the life of the patient , what medicines have been taken with the effects produced.
     Details of vaccinations and its effect on the patient.
     SLEEP: 
    Position of the body, head, and extremities during sleep.
    What is the patient is doing during sleep – laughs , starts, shrieks , weeps , is afraid, grind his teeth , keeps eyes/ mouth open ,snoring, somnambulism, dribbling of saliva.
    Quality of sleep – hours and causes of waking, sleepiness, sleeplessness –at what time, difficulty in falling asleep , sleepless walking after.
    Covering during sleep – of whole body , or parts.
    All about dreams – common dreams of the patient.
    General </> before, during, after sleep.
PATHOLOGY WHICH APPLIES TO THE PATIENT AS A WHOLE:  
     Tendency to tumors, cyst, warts. Individual and family tendencies to certain diseases.
    Ailments from – mental plane [ emotions, suppressions]
Physical plane- from exposure to cold, wet ,sun.
From mechanical conditions – injuries, over eating, etc.
Overall quality of energy available to function daily.
Sensorium.


    GENERAL MODALITIES:
1.    TIME – Ask for what time of the day in 24 hrs the patient is getting aggravated or  ameliorated such as morning, evening, etc.
2.    Meteorological
3.    Heat /cold
4.    Season – summer, winter and rainy.
5.    Weather – change of weather, cloudy weather, thunder storm, open air, clear weather. 
6.    Touch – hard or light, pressure, rubbing .
7.    Position – usual positions of aggravations and ameliorations , standing, sitting, lying head high/low.
8.    Rest or motion
9.    Discharges [gen.] aggn or amel from discharges if any.
10.    Mind – a. Will { love , hates, emotions, obstinacy, contradiction, loquacity]
b. understanding- delusion, delirium, hallucinations, time sense.
C. intellect- memory, concentration, mistakes { talking, writing, reading etc.}
d. symptoms relating to death, suicide etc.
e. ailments from grief, vexation, mortification, indignation, anger, bad news, disappointed love.
f. fear, anxiety, anguish.
g. irritability, anger, violence, impatience, hastiness.
h. sadness, weeping, despair, effect of consolation.
i. jealousy, absent mindedness, concentration , mania. 
j. hobbies and interests.
k. patient’s nature as a child , his/her childhood memories.
l. anger -  and his reactions 
his obstinacy 
emotional attitude or not 
patients speed – like in walking , eating , talking.
Patient’s life incident – like good and specially bad incident {which affect most}
Consolation – like or not 
Patients nature like introvert /extrovert , make friends easily or not. 
Like compney of others or want solitude {compney aversion }
His sexual life{desire high or aversin towards it}
His will- how he/she reacts towords unexpected conditions.
Decision – quick or confusion {want help} 
.

Consultation